High-Tech Health vs. Essential Care: A Zero Sum Game
In an era of unprecedented global connectivity, where the farthest corners of the world are but a click or a flight away, the stark contrasts of human existence have never been more tangible. Visuals of extreme poverty and suffering have increasingly become juxtaposed against the opulence of the “developed” world, yet our collective response often seems muted.
A child in Hana, Ethiopia. September 2022
Lost on many of us is the simple truth that the world's resources, especially money (a construct that we willingly embrace), operate in what often seems like a zero-sum game akin to a giant casino. A place in which we are all players at various tables, and where the gains of a few come at the expense of a multitude of others.
Children in Hana, Ethiopia. September 2022
Lost as well is the fact that history is replete with examples of civilizations that faced decline or collapse, often due in part to the internal strife caused by economic disparities and greed - the Roman Empire, the Mayan Civilization, and the fall of Athens. As we contemplate these interconnected global dynamics, one can't help but ponder our global responsibilities to each other, particularly in the context of healthcare.
My cousin (right) in Soddo, Ethiopia. September 2022
In a world where each of us is just a flight away, we have become, more than ever, next-door neighbors on this blue dot. Yet, despite our newfound closeness, vast chasms of disparity persist. As the green line on the chart below continues its upward trajectory, measuring the persistent and troubling rise in global economic inequality, we must be compelled to confront the ethical implications of this reality: we do not love our neighbors.
Regardless, we do live in an age of remarkable technological advancement, and one striking innovation is the state-of-the-art MRI diagnostic technology developed by Prenuvo offering whole-body scans. According to the New York Times, Kim Kardashian and television host Maria Menounos have publicly endorsed Prenuvo on social media, and Kardashian credited Prenuvo with saving some of her friends' lives.
While high-tech medical advancements undoubtedly represent the pinnacle of medical technology in developed nations, it's crucial to view them within the broader context of global healthcare. There are underlying concerns that warrant our attention. When we examine this landscape, the disparities become glaringly evident. The majority of these cutting-edge solutions are primarily accessible to the highest income countries, leaving vast populations in regions of Africa largely untouched by their benefits. Consider this:
The United States has approximately one MRI system for every 26,230 people per MRI machine
Germany has approximately one MRI system for every 32,750 people.
West Africa has approximately one MRI system for every 4,428,571 people.
If an American has access to MRI systems at a rate that's 16,844% higher than someone from West Africa, does it imply that their life is 16,844% more valuable? The glaring disparities in healthcare access suggest that, as a global society, we have much work to do in ensuring that every individual's life is treated with the same reverence and importance
We can frame it another way: the cost of a full-body MRI scan like Prenuvo's, priced at around $2,500, could cover the direct medical costs for approximately 1,366 outpatients in Ethiopia (based on the median cost of 1.83 USD). Or, it could cover the annual healthcare expenditure for about 11 Ethiopian households (based on the mean annual expenditure of $227.37).
Surgical Team in Soddo, Ethiopia. September 2022
It isn’t just about access to equitable essential care, it's the purported life-saving benefits touted by medical imaging companies such as Prenuvo that need scrutiny. While MRI technologies undoubtedly have their merits, their primary use cases often don't address the leading causes of death. For instance, Ischaemic heart disease claims 1 in 5 Americans each year. The risk factors of which are tobacco, diabetes, high blood cholesterol levels, high blood triglyceride level, obesity, waist circumference, and lack of physical activity. All risk factors which are well within our own control. Beyond asking if we love our neighbors, perhaps we should be asking if we even love ourselves?
Essential is to understand that while the allure of high-tech solutions is tempting, they are not always superior or more effective than traditional methods. Dr. Larry Norton, a breast oncologist and the medical director of the Evelyn H. Lauder Breast Center at Memorial Sloan Kettering Cancer Center, was quoted in the New York Times saying, “there’s just no evidence to support” healthy people undergoing full-body M.R.I. screening, even for those with a family history of cancer. Simpler and more cost-effective diagnostic tools, such as blood work or targeted screenings, can provide equally valuable information about one's health.
And we should ask ourselves not if the costs of the diagnostics are worth it for our own lives, but what are the broader implications of our spending choices in this zero-sum game. As we invest more in attempts to exert control over our health, we must question: are we inadvertently perpetuating disparities by hoarding resources and opportunities? Every dollar spent on superfluous health luxuries is a dollar not spent on addressing fundamental health inequities.
In the global neighborhood we all share, some have built gated communities where the affluent chase after the latest medical marvels, while many of our neighbors are left outside, still seeking the most basic care. If money is a human construct, then we are the ones that have drawn these dividing lines, dictating who gets a chance at life and who doesn't. As our global community gets smaller, and the muffled knocks on the door grow louder, it seems we may never be bothered to answer.
Children in Hana, Ethiopia. September 2022
The photographs accompanying this article capture moments from my visit to Ethiopia in September 2022. They were taken during my time with my cousin, a dedicated teaching surgeon at Soddo Christian Hospital. If this piece has moved you and you feel the urge to 'answer the door,' consider making a direct donation to the Soddo Christian Hospital. Every gesture, no matter how small, can make a world of difference.