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19 April, 2017 00:00 00 AM
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Vaccines and other live-saving health success

Medicine has made it possible to deal with many conditions. Our lives are longer. Still, we have to say in all honesty that our control over chronic diseases is somewhat mixed
Mohammed Abul Kalam, PhD
Vaccines and other live-saving health success

Vaccines have proven to be one of the greatest public health accomplishments of the 20th century. Safe and effective vaccination has had a significant impact on global health by saving lives and increasing life expectancy. They not only protect the person receiving the vaccine, but also help prevent the spread of potentially deadly diseases. 

Fortunately, the vast majority of Bangladeshi believes in the benefits of childhood vaccinations provided by the Extended Programme for Immunizations (EPIs). The public health benefits from vaccines hinge on very high levels of immunization in the population. This is why adhering to the EPI’s immunization schedule of recommended vaccines is the best way to protect those that are most vulnerable – such as infants and young children. Furthermore, the EPI’s results showed that the Bangladesh continues to be the leading example with high immunization rates, and most children are up-to-date and fully vaccinated.
Battling Infectious Diseases in the 20th Century, the impact of vaccines helps to easily visualize the impact of vaccines have had against infectious diseases. With several years of data from across the world, we examined seven infectious diseases: measles, hepatitis A, mumps, pertussis (whooping cough), polio, rubella, and smallpox. Upon vaccine introduction, it shows a decline of infection from these diseases. Thanks to live-saving vaccines, the battle against these infectious diseases in the 20th Century looks very different.
With a number of infectious diseases being a thing of the past, it should come as no surprise those vaccines at the top. Throughout history, communicable diseases have had a tremendous impact on human history. So too, then, has the development of one of the most effective ways to defend against rampant viral infection — vaccination.
Through decades of innovation, it’s easy to see why vaccines and their positive impact are first on this list. The development of vaccination has been one of the most effective ways to defend against infections. From a global health standpoint, vaccine discovery has saved endless lives and continues to change the world.In addition to their public health benefits, vaccines also provide tremendous social and economic value. 
Vaccines have proven their ability to save lives time and time again, and we should continue to celebrate their success.Whether it's the technology that allows us to peer deep into the body or medicines that extend the lives of those with chronic diseases, it's easy to see how advances in health and medicine have touched the lives of nearly every person on the planet. 
Yet considering the ubiquitous nature of these developments, it is easy to see how many people take for granted the technologies and practices that, at one point or another, almost certainly saved their own lives or the lives of people they've loved. 
Surgical Anesthetic and Antisepsis
Without a doubt, surgery used to be a much graver proposition than it is today. One of the chief reasons for this is that before the middle of the 19th century, anesthetic simply wasn't an option. 
That changed October 16, 1846, when William T.G. Morton demonstrated the mysterious wonder of ether -- a substance powerful enough to dull the pain and agony that had long been associated with surgery. 
But while anesthetic was a great advance in and of itself, another advance that occurred at roughly the same time may have been even more beneficial -- antisepsis, or the creation of a sterile surgical environment. Anesthetic made it possible to operate on a patient without painbut without antisepsis they'd die anyway.
Clean Water and Improved Sanitation
Put them beside surgical advances and other cutting-edge technologies, and public health measures don't look so sexy. But the fact is that clean water and sanitation have likely saved millions -- perhaps billions -- of lives since they were widely implemented in the 19th and 20th centuries. It's something that's so important around the world. It used to be that 15 percent of infants would die, and the biggest reason for this was diarrhea brought about by unclean water and milk.
Clean water and public health measures dramatically cut down the incidence of such deadly water-borne diseases as cholera and improved sanitation, drastically lowering the health impacts of parasitic infections and other health conditions related to the environment. 
Antibiotics and Antivirals
As with vaccination, the advent of antibiotics hailed a new era in the treatment of communicable disease. Interestingly, then, that the concept of antibiotics may have been uncovered accidentally. In 1928, Sir Alexander Fleming left a petri dish of Staphylococci bacteria uncovered and later noted that the bacteria had been killed by a mold. Upon further studying the mold, he discovered it was from a family called Penicillium notatum. Others soon saw the potential uses of what later came to be known as penicillin. 
Today, antibiotics are used to treat a plethora of bacterial illnesses. And today, researchers are developing antivirals -- most notably, the AIDS-fighting antiviral AZT -- to deal with a host of viral illnesses as well. 
The Birth Control Pill
Arguably, few developments have had as profound a social impact as the introduction of the birth control pill -- though its path to widespread use has been a rocky one. But because of the Pill, countless women have been given control over their own fertility -- a concept that created a social revolution. 
Thinking about how it has transformed women's lives, in terms of family planning and the entry of women into the work force, its impact has been significant indeed. It was the first-ever lifestyle drug. It's not treating a disease, but it was making life better for women. 
Improvements in Heart Surgery and Cardiac Care
Heart disease remains at the top of the list of the country's killers. Despite this, numerous important advances in its treatment have made a considerable impact, extending and improving the lives of its sufferers. Not the least of these advancements is surgeons' ability to operate on and repair the heart -- without putting the patient at an unreasonable amount of risk. 
Maybe the breakthrough moment was the rise of the heart-lung bypass, which made it possible to operate on the heart for more than just a few minutes at a time. This was followed by coronary artery bypass grafting, which is, we believe, a most important procedure. 
Randomized Controlled Trials
Another development largely unnoticed by the public at large, the advent of the randomized controlled trial -- what many refer to as the gold standard of medical research -- gave medical researchers an important tool in determining which treatments work, and which do not. 
Randomized trials are conducted by dividing patient populations into two groups, where one group receives the intervention to be studied while the other does not. Examining the differences between groups in these types of trials has ushered in an era of evidence-based medicine that continues to guide clinical practice on a daily basis. I think this is huge. This is really what's changed how we deal with cancer and lots of other disease, too. In the future we'll look back at this as a huge step forward. 
Radiologic Imaging
Before the development of radiologic imaging technologies, beginning with the use of the X-ray, doctors were usually relegated to looking only for external signs of injury or damage. Today, the ability to peer inside the body and determine the cause, extent, or presence of disease has revolutionized the very way medicine operates and has saved countless lives in the process. 
Much of the initial work surrounding the discovery of X-rays was done by Roentgen, a German physicist in the late 1800s. Initially, they were viewed as an invasion of privacy rather than a life-saving tool. Its utility was soon realized, however, and many additional imaging technologies eventually followed. 
CT scans didn't come into the picture until the 1970s, and  adding that this technology was brought to us by the company BMI -- the same BMI which had previously made a fortune off the British band known as the Beatles. 
Advancements in Childbirth
Up until the end of the 20th century in Bangladesh, childbirth was considered to be the most feared part of a woman's life. If we go into any old graveyard, we always see a number of women who died in their 20s. That was in a large part due to childbirth.  With the advent of techniques in anesthesia, cesarean section, and forceps delivery, the chances of a successful have pregnancy improved, at least in developed countries. Unfortunately, many resource-poor societies around the world still lag behind in this arena. 
Organ Transplantation
Few surgical interventions today carry as much complexity -- or as much ethical significance -- as organ transplantation. It's such a technically complex intervention that it's an amazing thing that it can even be done. It ties together both surgery and immunology. 
The first successful transplant operation, which took place in 1954, removed a kidney from one donor and installed it in the body of his identical twin. Other organ transplants followed, including the first liver transplant in 1967 and the first heart transplant in 1968. 
It represented an important turning point in the field of medical ethics. It really challenged physicians' ethic of 'first, do no harm.' 
What's Next?
Considering the progress that has been made in years past, it is tempting to view the state of health and medicine today as an endpoint. Medicine has made it possible to deal with many conditions. Our lives are longer. Still, we have to say in all honesty that our control over chronic diseases is somewhat mixed. 
Additional research into how best to stave off these conditions -- even by delving into the secrets of the human genome -- could represent the next hopeful steps toward healthier, longer lives. 
In the future, we think we will begin to see more and more applications from genomic medicine, which will help us identify individuals at risk for chronic diseases and allow us to intervene earlier. 

The writer is former Head, Department of Medical Sociology Institute of Epidemiology, Disease Control & Research (IEDCR) Dhaka, Bangladesh, E-mail: [email protected]

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Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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