The GÃ¶delian Argument: Turn over the Page

Philosophy

Etica & Politica / Ethics & Politics, 2003, 1 http://www.units.it/~dipfilo/etica_e_politica/2003_1/13_monographica.htm The Gödelian Argument: Turn Over the Page (*) J.R. Lucas Fellow of Merton College, Oxford Fellow of the British Academy I want to start by quarrelling with Sir Roger Penrose. In 1990 the Journal of Behavioral and Brain Sciences published a large number of peer reviews of his book, The Emperor's New Mind. At the end he said in his response: All my adverse critics on this topic have jumped to conclusions and, in one way or another, have missed the point of what I am trying to say. None seem to have grasped the full import of the Gödelian argument. The fault is mine: I should have explained things more clearly. (1) I have no quarrel with the first two sentences: but the third, though charitable and courteous, is quite untrue. Although there are criticisms which can be levelled against the Gödelian argument, most of the critics have not read either of my, or either of Penrose's, expositions carefully, and seek to refute arguments we never put forward, or else propose as a fatal objection one that had already been considered and countered in our expositions of the argument. Hence my title. The Gödelian Argument uses Gödel's theorem to show that minds cannot be explained in purely mechanist terms. It has been put forward, in different forms, by Gödel himself, by Penrose, and by me. Gödel gave the Gibbs lecture on Boxing Day, 1951, twenty years after he had discovered his theorem, to an audience in the United States, but the lecture was not published or much known about, until after his death. It appeared in the third volume of his Collected Works, which was published in 1995. I read a paper, "Minds, Machines and Gödel" to the Oxford Philosophical Society on October, 30th, 1959, which was subsequently published in Philosophy, 36, 1961, pp.112127, and reprinted in Kenneth M. Sayre and Frederick J.Crosson, eds., The Modeling of Mind, Notre Dame, 1963, pp. 255-271; and in A. R. Anderson, Minds and Machines, Prentice-Hall, 1964, pp. 43-59. In 1970 I published a fuller version in my The Freedom of the Will, in which I went in greater detail into objections to the Gödelian argument and how they should be answered. Roger Penrose had been thinking about the problem for many years before he published his The Emperor's New Clothes in 1989, which attracted much attention. In 1994 he published Shadows of the Mind in which he countered some of the criticisms that had been levelled against the earlier version of the argument. There have been a large number of discussions, mostly critical, of both his and my versions of the argument. Gödel argues for a disjunction: an Either/Or, with the strong suggestion that the second disjunct is untenable, and hence by Modus Tollendo Ponens that the first disjunct must be true. So the following disjunctive conclusion is inevitable: Either mathematics is incompletable in this sense, that its evident axioms can never be comprised in a finite rule, that is to say, the human mind (even within the realm of pure mathematics) infinitely surpasses the powers of any finite machine, or else there exist absolutely unsolvable diophantine problems of the type specified . . . (2) It is clear that Gödel thought the second disjunct false, so that by Modus Tollendo Ponens he was implicitly denying that any Turing machine could emulate the powers of the human mind. (3) Roger Penrose uses not Gödel's theorem itself but one of its corollaries, Turing's theorem, which he applies to the whole world-wide activity of all mathematicians put together, and claims that their creative activity cannot be completely accounted for by any algorithm, any set of rigid rules that a Turing machine could be programmed to follow. I used Gödel's theorem itself, and considered only individuals, reasonably numerate (able to follow and understand Gödel's theorem) but not professional mathematicians. I did not give a direct argument, but rather a schema, a schema of disproof, whereby any claim that a particular individual could be adequately represented by a Turing machine could be refuted. My version was, designedly, much less formal than the others, partly because I was addressing a not-verynumerate audience, but chiefly because I was not giving a direct disproof, but rather a schema which needed to be adapted to refute the particular case being propounded by the other side. I was trying to convey the spirit of disproof, not to dot every i and cross every t, which might have worked against one claim but would have failed against others. I also chose, in arguing against the thesis that the mind can be represented by a Turing machine, to use Gödel's theorem, not Turing's. This was in part because, once again, Gödel's theorem is easier to get the flavour of than Turing's theorem, but also because it involves the concept of truth, itself a peculiarly mental concept. Other differences need to be noted. Gödel was a convinced dualist. He thought it obvious that minds were essentially different from, and irreducible to, matter; one reason, perhaps, why he did not make more of his argument was that he did not feel the need to refute materialism: why waste effort flogging a dead horse? Penrose is a materialist, but thinks that physics needs to be radically revised in order to accommodate mental phenomena. Quite apart from this, he reckons physics must be developed to account for the phenomenon of the collapse of the psi function in quantum mechanics. He hopes to produce a unified theory which will be both a non-algorithmic theory of quantum collapse and accommodate the phenomenon of mind. I acknowledge the importance of both these problems, but think they are separate. Instead of trying to expand physics in order to have a physical theory of mind, I distinguish sharply two different types of explanation, the regularity explanations we use to explain natural phenomena and the rational explanations we use to justify and explain the actions of rational agents. In that sense I am a dualist. I have difficulty with the full-blooded Cartesian dualism of different sorts of substance, which was, I think, Gödel's position, and am, as regards substance only a oneand-a-halfist at most. But, as regards explanation, I am at least a dualist, indeed, a manytimesmore-than-dualist. Many objections have been raised against the Gödelian argument. Many AI enthusiasts protest that they do not work with Turing machines, and have much more complicated and subtle connexionist systems. I do not dispute that, and specifically allowed in my original article that we might one day be able to create something of silicon with a mind of its own, just as we are able now to procreate carbon based bodies with minds of their own. (4) To those who say I am therefore flogging a dead horse, I reply by citing Breuel, who explains the reason AI researchers, for practical purposes, adhere to the idea that brains are no more than computational devices is not philosophical stubbornness but the fact that no physical process is known to exist that can be used to build a device computationally more powerful than a Turing machine, and no concrete theories of psychological and cognitive phenomena have so far required any recourse to physical mechanisms that were more powerful than a Turing machine. (5) We are dealing not only with practical attempts to build machines that can insert a collar stud or tie a bow tie, but with attempts to understand the workings of the human mind; and then to show that one very widely accepted schema of explanation is unavailable is well worth doing. A much more serious objection is based on the assumption of consistency that I make. Hilary Putnam, when I first put the argument to him in a bar in Princeton, objected that in order to be in a position to know that the Gödelian formula was true, one needed to know that the system was consistent; he maintained that Gödel's second theorem showed that this was impossible. (6) Many other critics have maintained the same: Thus the premise that the Gödel sentence is true (and unprovable) cannot be known unless it is known that arithmetic is consistent, and no Turing machine can know the latter. So who says that humans can know it either: (7) Well, Gentzen for a start. He gave a convincing proof of the consistency of Peano Arithmetic (the simple arithmetic of the natural numbers), using transfinite induction. What Gödel's Second theorem showed was that a system could not be proved to be consistent within itself: we cannot prove Peano Arithmetic consistent from the axioms and by means of just the rules of Peano Arithmetic, but we can give a consistency proof---a very convincing one---applying principles from outside Peano Arithmetic. Such proofs, of course, depend on the wider set of principles being consistent, and that assumption can be called into question, the more particularly since Russell's pointing out that Frege's set theory was inconsistent. (8) These are proper objections, but not insuperable ones. Although by Gödel's second theorem we cannot prove the consistency of a formal system within that formal system, we can argue for the consistency of a formal system by means of wider considerations. And so when Putnam raised his objection, I countered that although a Turing machine could not, without inconsistency, prove its own consistency, we could affirm that any plausible representation of a mind must be consistent, since minds were selective and were unwilling to assert anything whatsoever, which an inconsistent machine will do. I discussed the matter both then and in my article and book, (9) but Putnam in his review of Shadows of the Mind in the New York Times Book Review (***, p.7) ignores the argument, and says simply: Mr Lucas's mistake was to confuse two very different statements that could be called "the statement that S is consistent." In particular Mr Lucas confused the colloquial statement that the methods of mathematicians use cannot lead to inconsistent results with the very complex mathematical statement that would arise if we were to apply Gödel's theorem to a hypothetical formalization of these methods. But I did not confuse them. I argued in some detail, considering and countering various objections that might be put forward, that the two were connected (why else would the word "consistent" be applied in each case?), and that if a Turing machine was inconsistent it could not be a plausible representation of the mind. Since many critics are unaware of the argument, (10) and are unlikely to look back at papers published some time ago, it is worth articulating the argument afresh. Here in Oxford in the fifth week of Trinity Term it is useful to borrow the terminology of First and Second Public Examinations. The Mechanist claims to have a model of the mind. We ask him whether it is consistent: if he cannot vouch for its consistency, it fails at the first examination; it just does not qualify as a plausible representation, since it does not distinguish those propositions it should affirm from those that it should deny, but is prepared to affirm both undiscriminatingly. We take the Mechanist seriously only if he will warrant that his purported model of the mind is consistent. In that case it passes the First Public Examination, but comes down at the Second, because knowing that it is consistent, we know that its Gödelian formula is true, which it cannot itself produce as true. More succinctly, we can, if a Mechanist presents us with a system that he claims is a model of the mind, ask him simply whether or not it can prove its Gödelian formula (according to some system of Gödel numbering). If he says it can, we know that it is inconsistent, and would be equally able to prove that 2 and 2 make 5, or that 0=1, and we waste little time on examining it. If, however, he acknowledges that the system cannot prove its Gödelian formula, then we know it is consistent, since it cannot prove every well-formed formula, and knowing that it is consistent, know also that its Gödelian formula is true. In this formulation we have, essentially, a dialogue between the Mechanist and the Mentalist, as we may call him, with the Mechanist claiming to be able to produce a mechanist model of the Mentalist's mind, and the Mentalist being able to refute each particular instance offered. Many critics have failed to note the dialectical character of the argument, and have rushed in to show that the Mentalist is not in all respects superior to all minds, but has his own limitations, and can often be beaten by a mind. But if only they had turned over the page, they would have seen that I acknowledged as much, and was not making a general claim of superiority, but only a particular one of some difference in each particular case. Other critics try to avoid the dangerous dialogue by having the mechanist not show his hand. (11) He does not tell us which precise model of Turing machine represents a particular mind, nor whether or not the purported mechanist model is consistent; and raises the question whether I, or any human mind, could really fathom the immense complexity of a representation of a human brain. But then why should I? It is for the Mechanist to make good his case. I cannot be just an abstract idea of a turing machine, a generalised Turing machine, I know not what. I must be a particular definite machine. Although Benacerraf may plead ignorance, it must in principle be knowable which machine it is that purports to represent me, and whether it is consistent. And then the argument proceeds. But still, it may be objected, the Turing machine will be fiendishly complicated. Presented with an enormous printout of gobbledygok, how could I make out what it meant, or what its Gödelian formula was? But it does not have to me just me. As Michael Dummett pointed out when I read the original paper to the Oxford Philosophical Society, I could be helped, indeed helped by all the mathematicians in the world, who might be keen to see a mind, even mine, defeat mechanism. (In this point there is a similarity with Penrose's argument, which is concerned with the output of the entire community of working mathematicians.) Also, now, of course, I could be helped by computers. Not everything has to be in machine code: we can have programs to translate into higher-level, more transparent languages. It would, admittedly, still be difficult to identify all the transformation rules, all the inferences that the machine could make, all its initial assumptions, but not impossibly so, if the mind really were a machine, and really did proceed according to some algorithmic rules. And once we had done this, and chosen some suitable scheme of Gödel numbering, we could set about calculating what the Gödelian formula for that system under that scheme of Gödel numbering must be. But, it is sometimes further objected, in order to be confident that I can always calculate the Gödelian formula, I must have an algorithm to do it by, in which case a machine could be programmed to do it too. (12) But this is not so. It is easiest seen if we pursue a criticism of I.J. Good, who pressed home an objection I had countered, that the Mechanist might incorporate a Gödelizing operator, which indeed he could, but at the cost of making the machine a different machine and hence with a different Gödel formula. But the move could be iterated, and though at each stage the machine would be different, we should be engaged in a game of catch-ascatch-can in the transfinite ordinals. (13) And there is no algorithm for naming the transfinite ordinals. (14) Every now and again we run out of existing names, and have to devise something new. I claim that this is something we can be confident of doing. My critics claim that I am being over-confident, and that only if there were an algorithm would I be justified in maintaining that I always could go on, and there is no such algorithm. But, say I, we do not have to have an algorithm; when we run out of standard names of transfinite ordinals, we invent new ones, not according to some rule but by the exercise of ingenuity. And, more generally, once we have got the hang of the Gödelian argument, we can adapt it as necessary to the needs of the particular case, and can go on producing appropriate Gödelian formulae, improvising as necessary when the going is not entirely straightforward. At this stage the importance of originality and creativity begins to emerge. What I have offered is not one knock-down argument but a schema of refutation, which can be seen to work in some cases, but needs adaptation to the particular case. When we consider not a particular case, but all possible cases, I cannot offer a single, all-sweeping argument, but only an approach, relying on the mind's ability to improvise as needed in new circumstance. It is a difficult schema of argumentation, and critics often try to reconstrue it as if it were a single allencompassing argument, and then find their reconstruction faulty. In spite of my specific disclaimer, (15) they suppose that I am trying to prove that the mind is better than all computers taken together. And then it is easy to point out that anything I do can be simulated by a computer suitably programmed. (16) All I can do is to repeat my original argument, that I do not claim to be better than all computers, but can show for each particular one that I am different from it. It is the Mechanist's claim that is being evaluated, and can be outwitted in each particular case and shown by the mind it claims to represent, to be an inadequate representation of that very mind. (17) The argument bifurcates. The Mechanists refuse to acknowledge any originality of the mind. And I cannot make them. If the only thing that will budge the Mechanists is a rule-governed inference which cannot be resisted on pain of inconsistency, then they cannot be made to see the general applicability of Gödelian arguments. All that can be done is to refute each and every particular claim they put forward. But their obduracy is unappealing. Once we get the hang of the Gödelian argument, we see that it will be applicable in all cases, though its mode of application will have to be altered to fit each case individually. There is a way of arguing that commends itself to those possessed of minds, who get the hang of the Gödelian argument, and twig that they can apply it, suitably adapted, in each and every case that crops up. Mechanists may refuse to see the general case, and, acknowledging only knock-down arguments, will have to be knocked down each time they put forward a detailed case: minds can generalise, and will realise that defeat for the Mechanists is always inevitable. The originality required of the mind is not very great, and it may still be objected that the Gödelian argument has not done much to vindicate real creativity in the face of sceptical doubt. So far as the argument thus far adduced, it is a fair complaint. All that has been achieved so far is to ``defeat the defeaters''; a line of argument, supposedly supported by the success of science, which would lead to a reductionist view of the mind, and the elimination of all originality, has been defeated. We no longer have to think of the mind as an essentially dull automaton, but may still observe that many minds are nonetheless somewhat dull, not to say boring. The Gödelian argument may refute mechanism, but leaves the woodenness of ordinary, uninspired human life untouched. (18) But, although Gödel cannot make us scintillate, he does show that scintillation is conceptually possible. He shows us that to be reasonable is not necessarily to be rule-governed, and that actions not governed by rules are not necessarily random. Many thinkers have thought otherwise, because they supposed that rational actions and decisions were so because they were in conformity with some explicit or implicit rule. Even great creative artists have a style peculiarly their own, and it is natural to think that their style is characterized by some finite description, with some parameters left undetermined, and that random choices of these parameters is what produces different masterpiece of the artist's oeuvre. But this need not be so: the disjunction between the random variation and the finished specification is not exhaustive. For in the case of First-order Peano Arithmetic there are Gödelian formulae (many, in fact infinitely many, one for each system of coding) which are not assigned truth-values by the rules of the system, and which could therefore be assigned either TRUE or FALSE, each such assignment yielding a logically possible, consistent system. These systems are random vaunts, all satisfying the core description of Peano Arithmetic. But among them there is one, the one that assigns TRUE to all the Gödelian formulae which is reasonable, characterizing standard arithmetic, although not more in accordance with the specification of Peano Arithmetic than any of the others. So there is some sort of reasonableness, pocking out this one instantiation of the specification in preference to all the others which is reasonable and right, though not any more in accordance with the antecedently formulated rules than any other instantiation. The critic may still complain that doing arithmetic in non-non-standard models is still a pretty boring activity; but that is not the point. Gödel's theorem shows that there is conceptual room for creativity, by allowing that to be reasonable is not necessarily to be in accordance with a rule. We can see how it works out with the style of great creative artists. Titian, or Bach, or Shakespeare, develop a style which is peculiarly their own, and which we can learn to recognise. But it is not static. Up to a point they can produce works that are variations on a theme, but beyond that point we begin to criticize, and say that they are painting, composing, or writing, according to a formula; it is the mark of second-rate artists to be content to go on doing just that, but the genius is not content to rest on his laurels, but seeks to go further, and innovate, breaking out of the mould that his previous style was coming to constitute for him. Instead of there just being a formula to which all his work conformed, he produces work which differs in some significant respect from what he had been doing, and this difference is not just a random one, but one which ex post facto we recognise as essentially right, even though it was not required by the previous specification of his style. (19) Thus, though the Gödelian formula is not a very interesting formula to enunciate, the Gödelian argument argues strongly for creativity, first in ruling out any reductionist account of the mind that would show us to be, au fond, necessarily unoriginal automata, and secondly by proving that the conceptual space exists in which it intelligible to speak of someone's being creative, without having to hold that he must be either acting at random or else in accordance with an antecedently specifiable rule. Notes (*) A talk given on 25/5/96 at a BSPS conference in Oxford. For the copyright of the papers of J.R. Lucas see http://users.ox.ac.uk/~jrlucas/ back (1) Journal of Behavioral and Brain Sciences, 13:4, 1990, p.693. back (2) Kurt Gödel: Collected Works, III, ed. Feferman, Oxford, 1995, p. 310. back (3) It is necessary to stress this point, as many critics try to distance Gödel's thought from that of Lucas and Penrose. Although there are significant differences between the three approaches, their conclusions are substantially similar. See H.Wang, From Mathematics to Philosophy, London, 1974, pp.324-326; and Reflections on Kurt Gödel, MIT Press, Cambridge, Mass., USA, 1987, p.48, pp.117-118. back (4) Minds, Machines, and Gödel, Philosophy, 36, 1961, p.126; The Modeling of Mind, Kenneth M.Sayre and Frederick J.Crosson, eds., Notre Dame Press, 1963, pp.269-270; Minds and Machines, ed Alan Ross Anderson, Prentice-Hall, 1954, pp.58-59. back (5) Thomas M.Breuer, Journal of Behavioral and Brain Sciences, 13:4, 1990, p.657; he continues: Penrose's argument may be cautious first steps towards changing both of these facts, but I feel they are still much too tentative and informal to require serious reconsideration of the marriage of AI and the Turing model of computation. back (6) See Hilary Putnam "Minds and Machines", in Sidney Hook, ed., Dimensions of Mind. A Symposium, New York, 1960; reprinted in A. R. Anderson, Minds and Machines, PrenticeHall, 1964, pp. 72-97. back (7) Chris Mortensen, Journal of Behavioral and Brain Sciences, 13:4, 1990, p.678. back (8) George Boolos, Journal of Behavioral and Brain Sciences, 13:4, 1990, p.655: I suggest that we do not know that we are not in the same situation vis-a-vis ZF that Frege was in with respect to naive set theory (or, more accurately, the system of his Basic Lavs of Arithmetic) before receiving, in June 1902, the famous letter from Russell, showing the derivability in his system of Russell's paradox. Martin Davis, Journal of Behavioral and Brain Sciences, 13:4, 1990, p.660: . . . convincing oneself that the given axioms are indeed consistent, since otherwise we will have no reason to believe that the Gödel sentence is true. But here things are quite murky: Great Iogicians (Frege, Curry, Church, Quine, Rosser) have managed to propose quite serious systems of logic which later have turned out to be inconsistent. back (9) pp.120-124/263-268/52-56. back (10) In addition to those noted in fn.8 above, it is worth citing: 1. S.Guccione, Journal of Behavioral and Brain Sciences, 16:3, 1993, p.612: The most conclusive and immediate objection against this argument is Putnam's (1960) observation that (following Gödel's theorem) the human mind can only demonstrate the implication: "If S is consistent, then Gs is true."; 2. Alexis Manaster-Ramer, Walter J. Savitch and Wlodek Zadrozny: But all this and more depends on granting Penrose's argument, and this we should not do. The error is a small but lethal flaw in his presentation, and application, of Gödel's theorem. For Gödel does not say that a certain proposition P is true but unprovable in a formal system F, but merely that P is true but unprovable if F is consistent. Penrose notes that if F is inconsistent then P is provable but false, but then makes the inexplicable mistake of assuming that, "Our formal system should not be so badly constructed that it actually allows false propositions to be proved!" (pp. 107108). Without this, only the conditional can be proved (and this can be done algorithmically!). 3. G.Boolos, in Kurt Gödel: Collected Works, III, ed. Feferman, Oxford, 1995, pp.296, 295: The classic reply to these views <of Ernest Nagel and James R. Newman (1958), J.R. Lucas (1961), and Roger Penrose (1989)> was given by Hilary Putnam (1960): Merely to find from a given machine M a statement S for which it can be proved that M, if consistent, cannot prove S is not to prove S---even if M is consistent. It is fair to say that the arguments of these writers have as yet obtained little credence. 4. David J.Chalmers, Review of Shadows of the Mind, in PSYCHE: an interdisciplinary journal of research on consciousness, 2(9), June, 1995. Filename: psyche-95-209-shadows-7chalmers, (an elaboration of his review in Scientific American, June 1995, pp. 117-18. back (11) Paul Benacerraf, God, the Devil and Gödel, The Monist, 1967, pp. 9-32. back (12) Judson C. Webb, Mechanism, Mentalism and Metamathematics; An Essay on Finitism, Dordrecht, 1980, p.230. back (13) I.J. Good, Human and Machine Logic, British Journal for the Philosophy of Science, 18, 1967, pp. 144-147; and "Gödel's Theorem is a Red Herring", British Journal for the Philosophy of Science, 19, 1968, pp. 357-8. back (14) This point is conceded by Douglas R.Hofstadter, Gödel, Escher, Bach, New York, 1979, p.475, and R.W.Kentridge, Journal of Behavioral and Brain Sciences, 13:4, 1990, p.671, who seem to think it is a criticism, not a support, of my argument. back (15) pp.117-118/262-262/49-50. back (16) See R.W.Kentridge, Journal of Behavioral and Brain Sciences, 13:4, 1990, p.671: What it <this demonstration> actually shows is that we can do better than one particular algorithm H. It is easy to see how to construct a new algorithm H', a modification of H in which H'(k;k)=O, which does just as well as we do. Therefore, the example does not show that we think nonalgorithmically; all it shows is that we can prove something that one particular algorithm cannot. Adina Roskies, Journal of Behavioral and Brain Sciences, 13:4, 1990, p.682: Briefly, Penrose conflates the ability to solve an instance of a noncomputable problem with the ability to solve all instances of that problem. Only the latter would entail solving it nonalgorithmically. (my emphasis) back (17) Thus J.Higginbotham, Journal of Behavioral and Brain Sciences, 13:4, 1990, p.668: Lucas's original argument to this effect is notoriously suggestive but vague, and critical literature on it has often taken the form of making the argument more precise, and then showing that in the precise form envisaged it fails to prove the case. (Penrose notes some of this literature, but does not discuss it directly in the text.) back (18) See Crispin Wright, Realism, Meaning and Truth, 2nd ed., Blackwell, Oxford, 1993, p.351. back (19) For further elucidation of the difference between there being a specification to which all cases belong and there being some case that differs from an antecedent specification, but is right to do so, see J.R.Lucas, ``The Lesbian Rule'', Philosophy, 1955, pp.195-213. back


Philosophical considerations in health: conceptualizing to educateâa perspective on neglected tropical diseases in Brazil

Philosophy

Creative Education, 2019, 10, 1125-1139 http://www.scirp.org/journal/ce ISSN Online: 2151-4771 ISSN Print: 2151-4755 DOI: 10.4236/ce.2019.106085 Jun. 18, 2019 1125 Creative Education Philosophical Considerations in Health: Conceptualizing to Educate-A Perspective on Neglected Tropical Diseases in Brazil Dilvani Oliveira Santos1,2,3* , Ludmila Veiga Faria1,2, Anna Fernandes S. C. Nascimento1,3 1Department of Molecular and Cell Biology (Institute of Biology), Laboratory of Bio-Pathogens and Cell Activation & Educational Process-Labiopac & ProEduc, University Federal Fluminense (UFF), Niterói, Rio de Janeiro, Brazil 2Graduate Program in Sciences and Biotechnology of the University Federal Fluminense (UFF), Niterói, Rio de Janeiro, Brazil 3Graduate Program in Applied Microbiology and Parasitology of the University Federal Fluminense (UFF), Niterói, Rio de Janeiro, Brazil Abstract This paper aims to recover the history of health concept evolution from its birth in Ancient Greece to the contemporary days, drawing an overview of the firsts philosophical thoughts about health in distinctive historical periods, analyzing how this concept has been impacted by knowledge improvement and both research and technological discoveries over time. In order to understand the persistence of Neglected Tropical Diseases which causes physical disabilities and social discrimination, this paper will focus on Leprosy and Cutaneous Leishmaniasis and its relation to social inequality mainly in developing countries. These approaches on the understanding of the health-disease binomial are necessary to reflect on health in the course of human history and, from there, to promote joint actions both in the area of scientific research and health education. Keywords Philosophy, Health, Education, Leprosy, Cutaneous Leishmaniasis 1. A Philosophical Vision of the Health Concept Evolution It was in Ancient Greece, that health was conceptualized under the influence of both philosophy and medicine. It is widely known that Greece, is considered the cradle of these two sciences already in the fifth century before Christ (bC). Philosophy, for example, reaches its apogee with Socrates, Plato and Aristotle, How to cite this paper: Santos, D. O., Faria, L. V., & Nascimento, A. F. S. C. (2019). Philosophical Considerations in Health: Conceptualizing to Educate-A Perspective on Neglected Tropical Diseases in Brazil. Creative Education, 10, 1125-1139. https://doi.org/10.4236/ce.2019.106085 Received: May 5, 2019 Accepted: June 15, 2019 Published: June 18, 2019 Copyright © 2019 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1126 Creative Education where they have consolidated the rationale on which Western knowledge is based on. The philosophical thought of Socrates, Plato and Aristotle, greatly influenced Hippocrates, another Greek philosopher, who later became a physician. Hippocrates' father was also a scientist who practiced health care (Salis & Silva, 2003). It is possible that all those external influences have contributed to mobilizing Hipocrates towards many medical discoveries at his historical period. Nowadays, this great philosopher is considered the symbol of medicine and his words became known as "You are what you eat" as well as the Hippocratic Oath3 which is read in all medical graduation ceremonies, at all Universities throughout the world, whether in an integral or summarized form. Curiously, the Hippocratic Oath1, mentions other Greek philosophers such as Apollo, Aclepius, Hygeia and Panakeia, who have their story told in Greek mythology2 as below mentioned. 2The legendary birth of Asclepius It is known that Asclepius was the son of the god Apollo with a mortal woman named Coronis. While Coronis was pregnant, she fell in love with Ischys, another mortal man. When Apollo learned of this relationship, he ordered Artemis to kill Coronis. In fact, Apollo witnessed the murder scene and felt guilty for killing his son. He then saved the baby, opening the womb of Coronis. It is believed that this was the first case of cesarean section in the history of humanity. Asclepius grew up healthy and became a qualified medical doctor (https://www.greeka.com/greece-myths/asclepius.htm). Afterward, Asclepius married and had two daughters: Hygeia and Panakeia which followed the skills of their father Asclepius in the health researches (https://www.greeka.com/greece-myths/asclepius.htm) (Figure 1). Panakeia, her sister (Hygeia), his father (Asclepius) and his grandfather (Apollo) appear in the oath of Hippocrates1, which is cited by the newly formed physicians at the time of their graduation ceremony, as previously mentioned: 1"I swear by Apollo medical doctor and Asclepius and Gednaea and Panacea and all the gods and goddesses, making them my witnesses that I will follow this oath and covenant according to my ability and oath" (Salis & Silva, 2003) Figure 1. Relevant issues to consider the emergence of the concept of preventive medicine and curative medicine. D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1127 Creative Education Philosophy has been spread throughout the world and right after Christ (aC); thus, in the Roman empire, another philosopher named Galen (131-201 aC), believed that the body was only a vehicle for the soul and that God defined body functions as the thought of Aristotle (Rhodes, 1985). These ideas were accepted by both Islam and Christianity, since this still accompanied the thoughts of Hippocrates in relation to the four moods: the four elements of nature (earth, water, air and fire) exist in proportions not only in the world but, also, in the human body, and correspond to specific functions: The earth is dry and cold, and corresponds to black bile; The water is wet and cold, and represents the phlegm; The air is wet and warm, and corresponds to the blood; The fire is dry and warm, and corresponds to the yellow bile (Salis & Silva, 2003). Hippocrates' thoughts about the four moods have influenced the Italian philosopher-Galen. And, interestingly, even today, one of Galen's knowledge is used, such as for example: an expert measure, of a medical-legal nature; called "Hydrostatic Docimasia of Galen". The word "docimasia" comes from the Greek dokimasia (experience, proof). It is an expert measure, of medical-legal nature, applied with the purpose of verifying if a child is born alive or dead and, therefore, whether arrives to breathe. In legal terms, docimasia is quite relevant because it contributes to the determination of the moment of death. If the person comes to the living or dead light, the legal consequences will be different in each case (Rhodes, 1985). In another part of the world, in Egypt, Hypatia, a philosopher born in 355 aC, was the first woman to study Law and defended, among other things, the right to Health Promotion, following the binomial "Healthy mind, healthy body". Even with the lack of written work, Hyphatia is widely recognized by scholars and her fame has survived up to the present moment. Many of the works commonly attributed to her are believed to have been collaborative work with her father, Téon de Alexandria. This type of authorship uncertainty is typical of female philosophers in Antiquity (Dzielska & Lyra, 1996). In the Persian Empire, Avicenna (980-1037 aC), another great physician who followed the line of Aristotle can be cited for having had made an influence on the concept of health. Thus, people of Arab origin, made huge progress in the area of Medicine, mainly using the technique of mummification of bodies. The most famous works of Avicenna is the "Book of Healing" and the "Canon of Medicine" which was the text used in medieval universities such as the University of Montpellier and the Catholic University of Leuven. Avicenna presents a complete system of medicine according to the principles of Galen and Hippocrates (Souza, 2002). At the time of the Cultural Renaissance, around the fifteenth century, medicine became prosperous. André Vésale, born in Brussels, Belgium, on 1514, was an anatomist and physician, considered by many historians of science as the greatest anatomist of the Renaissance, or even the greatest in history of medicine. He is the author of De humani corporis fabrica (On the Functioning of the D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1128 Creative Education Human Body), one of the most innovative books on human anatomy. He was also a great humanist of his time. His works, in addition to bringing anatomy into modernity, was contrary to the one of the dogmas of galenism that blocked scientific evolution for more than a thousand years both in Europe and in the Islamic world. Vesalius was not entirely against Galen's work, for which he had great admiration. However, he criticized some ideas from Galeno, to point out some of his mistakes. Back in Italy, Leonardo da Vinci was one of the most important figures of the Renaissance era, which stood out as a scientist, mathematician, engineer, inventor, anatomist, painter, sculptor, architect, botanist, poet and musician. Leonardo was often described as the archetype of the Renaissance man, someone whose insatiable curiosity was matched only by his inventiveness. He was more knowledgeable than the doctors themselves, and impressed everyone with his masterful mastery of bones, muscles, nerves, and vessels (Kickhöfel, 2011). In England, in the seventeenth century, William Havery discovered the circulatory system of blood, giving a better understanding of physiology and anatomy. In the 19th century, Louis Pasteur discovered that the disease was originated from bacteria (Salis & Silva, 2003). At the same time, the "sanitary police" was adopted as a health policy, where healthy people were coerced by the police to take appropriate health behaviors. In addition, there was isolation of the sick individuals, what happened to the lepers who were completely segregated from the social coexistence with relatives and friends. With these drastic measures, medicine directed its actions towards the disease and the body in order to reach a normal biological state, according to the beliefs of that time. In the nineteenth century, with the development of medicine, modernization, technological advancement and the expansion of information through the media provided the population with access to the social determinants of health (Salis & Silva, 2003). 2. Evolution on the Concept of Health in the 20th Century The 20th century was marked by progress characterized by models of confrontation with social inequalities and injustices that affected the world population (Heidmann et al., 2006). And it was in the post-war period, 1946, that the World Health Organization (WHO) was created and exposed a concept that compared the human body to a machine. According to the WHO, the health was responsible by the good functioning of machine, that is, the human body. Actually, in this period, health began to be collective obligation and not individual anymore. In fact, WHO was created by the United Nations (UN) and its headquarters is in Geneva, Switzerland. The World Health Organization (WHO) has fostered several discussions and argued that "The right to health is the responsibility of the state" (Canguilhem, 1990). In addition, WHO conceptualized Health as "the state of most complete physical, mental and social well-being, and, not only the absence of disease". This new concept, became more expressive on April 7, 1948, date that came to D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1129 Creative Education be celebrated World Health Day. Moreover to WHO's activities for health promotion, we should also mention the Ottawa Letter, a product of the International Conference on Health Promotion, in Ottawa, Canada, in 1986, which brought the "idea of health related to the quality of life relativized by different factors: food, shelter, education, stable ecosystem, equity, social justice, income, economic resources, sustainable resources and peace (World Health Organization (2007). II. Title: Making a Difference-30 Years of Research and Capacity Building in Tropical Diseases. doi:10.2471/TDR.07.978-924-1595575). And, this new concept of health established by WHO is closely linked to the thoughts of all philosophers mentioned above: Hippocrates correlated good nutrition to health as well as the existence of an interconnected system between environment and body systems on humans; Asclepius and his daughters (Hygeia and Panakea) intuited preventive and curative medicine; Galen demonstrated the importance of air (of breathing) for survival; Hypatia intuited that a healthy mind leads to a healthy body. Meanwhile, Avicena, Vesalius, da Vinci, Havery and Pasteur were the precursors on observations and trials related to the disease and, thus, compared them to the state of health. The VIII National Health Conference, which took place in Brazil in 1986, mentioned that "The right to health means the guarantee by the State of dignified living conditions and universal and equal access to the actions and services of promotion, protection and recovery of health, at all levels, to all inhabitants of the national territory, leading to the full development of the human being in his/her individuality (World Health Organization (2007). II. Title: Making a Difference-30 Years of Research and Capacity Building in Tropical Diseases. doi:10.2471/TDR.07.978-924-1595575). In addition, it is worth considering that Brazil has had a fundamental role in the history of the WHO and have been contributing to the WHO to raise global health standards. WHO's creation proposal was written by delegates and some of them, were representing Brazil, who proposed the establishment of an international public health organization with a global reach. Since then, Brazil and WHO have developed extensive collaboration. The Prof. Dr. Marcolino Candau, from University Fluminense Federal (UFF), Niterói, Rio de Janeiro, Brazil, was the second WHO general director for 20 years (1953 to 1973) (http://munksroll.rcplondon.ac.uk/Biography/Details/740). Furthermore, Dr. Dilvani Santos from the University Federal Fluminense, RJ, Brazil, was the lead researcher for a WHO funded project (Cytokines profile in Leprosy ID 931100) in collaboration with Innogenetics, Ghent, Belgium (1994-1998) and Leprosy Unit (Fiocruz, RJ, Brazil), having formed two important products in the field of Leprosy-the pioneer discovery of the reversal of immunological anergy often observed in Leprosy, through "in vitro" experiments demonstrating that dendritic cells from lepromatous Leprosy patients stimulated autologous lymphocytes, which in turn, responded successfully to Mycobacterium leprae infection. This work suggests the use of dendritic cells as D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1130 Creative Education a form of immunotherapy in Leprosy (Santos et al., 2001). Secondly, still within the collaboration with WHO, they discovered a biomarker (B7) for the early diagnosis of reactional episodes in Leprosy. This work was very important, since the lack of early diagnosis of reactional episodes in Leprosy could lead the patient to death (Santos et al., 2007). And, at the Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil, Dr. Carlos Morel was director of the WHO Special Program for Research and Training in Tropical Diseases (TDR) from 1998 to 2004 (https://www.who.int/tdr/publications/documents/anniversary_book_phase3.pd f?ua=1). However, despite the invaluable efforts of the WHO, progress in the area of Health was facing some difficulties for the feasibility of some research projects, especially in developing countries. Thus, even today, we perceive the social inequalities that prevent access to both health services and health information services, we understand the need for health in various ways, and how far away are the effective actions of health promotion and protection, especially in developing countries. When we think about health, we must understand that health is a result of the circumstances that involve: food, education, employment, housing, income, transportation, work, leisure, employment, freedom, access to land and access to health services, forms of social organization and production. However, these circumstances can create social inequalities in living standards. Health Promotion letters include the reference documents resulting from the process of discussion and collective elaboration of the essential concepts on the subject. Health Promotion proposition comprises health as a social production and, in this way, involves a space of action that goes beyond the health sector. The perception of health seen only through the biological relation cannot be considered, since its historical relation is fundamentally in face of social influence and culture in which it is introduced. At present, with the economic changes resulting from the process of globalization and the consequences of capitalism, there is the appreciation of competitiveness and individualism. These characteristics also influenced the evolution of the concept of health, which had a significant impact on the transformations that occurred with the evolution of humanity. It is worth mentioning that disciplines designed to investigate and understand health of populations (the social and behavioral sciences) are not the same as the basis for understanding the disease and its treatment (the biological sciences). The fundamental sciences that help to identify, prevent and treat diseases are mainly based on the biological functions of the human being. They analyze each of their components in a scientific way to understand the biological mechanisms of life and pathology (Canguilhem, 1978). In relation to the human sciences, they aim at understanding man in society. The analysis is done through individuals in their groups and on the relationships between social groups (family, community, society, humanity). However, it is due to the individual, as a social and biological being, that these D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1131 Creative Education two areas of expertise can match. At present, it is widely recognized that both biological and psychosocial being are related-neurology, psychology, and immunology-report the biological communication systems that exist between the central nervous system and the immune system, strengthening the work of psychologists and psychoanalysts about the mutual effects of the mind on the body according to the convictions of Hypatia, a philosopher born in 355 bC in Egypt, as previously cited. But regrettably, general society has not yet been educated to fully assimilate the importance of social context, and its broadest sense and complexity, to promote actions on individuals' health care. Health promotion had already been conceptualized traditionally, having been defined (Leavell & Clarck, 1976) as fundamental in the primary level of attention in preventive medicine. Over time, this concept has gained more prominence, especially in Canada, USA and Western European countries. Even in this circumstance, the proper understanding of what prevention and promotion differ from each other is precisely the awareness about the uncertainty of scientific knowledge which is not simply a technical limitation that can be successively overcome (Czeresnia, 1999). The longing for health is an issue not only of survival but of qualification of existence (Santos, 1987). It is something that leads us to the social, existential and ethical dimension, to a specific trajectory exposed to concrete situations, to the active engagement and commitment of the subjects, who dedicate their particularity to putting knowledge at the service of what is not understood in the search for truth which emerges from the lived experience (Badiou, 1995). To analyze, therefore, the terms of health promotion is to understand that behavioral changes are driven simultaneously by what is known about determinisms and by the clarity that it is not known, knowing that it will not even come to be known, all of them (Badiou, 1995). The understanding of "health-disease" binomial is necessary for the proposal of a common qualification that can clarify the concept of health in the course of human history. From the beginning, human being asked about the origin of life and the concept of health and disease. The sphere of Health Promotion calls us to reflect on the obligation of the concept of preservation of health, of all humanity equally, in the essence of going further from the exercise of preventive and curative medicine. In this context, the most current concept of Health Promotion according to WHO is defined by the following statement: Health promotion is the process of empowering people to increase health control and improve it (9th Global Conference on Health Promotion Shanghai, 2016). The priority is health and respect for equal rights, based on the central responsibility of the governments of their peoples, affirming the urgent and urgent need for a coherent, effective health and well-being policy and recognizing that this will require policy, courage and strategic vision (Atlan, 1991). Currently, the life expectancy of the population has increased and people has more access to technological advances almost in every sphere of the world. D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1132 Creative Education Unfortunately, social inequalities persist, especially in developing countries (http://www.who.int/healthpromotion/conferences/9gchp/en; Barreto, 2017). Specially in Brazil, between 2001-06, luckily, it has been estimated that falling labour income inequality accounted for half the inequality fall, driven by strong employment and income growth and falling returns to secondary and tertiary education (Simson, 2018). Back to the origin of Medicine that was undoubtedly through the Philosophy, as mentioned at the beginning of this article, we clearly see that by distancing itself from its philosophical origin, the Medicine has undergone a process of "dehumanization". In view of it, the technological advances have not been accompanied by advances on the social scale. According to Lee, 2004, p. 1 apud in (Lopez-Calva et al., 2013), the challenges of protecting and promoting health is inherently a political one-questioning "whose health needs should be addressed and how should available resources be allocated" (Lopez-Calva et al., 2013). According to the many lasted scientific research, revised by Sidsel Roalkvam & Desmond McNeill (2016) the Ebola crisis brought to the fore an ongoing controversy in global and international health about vertical versus horizontal approaches to health improvement. Vertical approaches are generally disease specific and promote targeted clinical interventions delivered by a specialized service. Horizontal approaches, by contrast, tackle several interrelated health issues by strengthening health systems and developing integrated delivery systems (Roalkvam & McNeill, 2016). This debate has focused especially on early vaccine initiatives and the more recent impact of global health initiatives such as GAVI and the Global Fund to fight AIDS, TB and Malaria (Behague & Storeng, 2008), but this is only two manifestations of a serious and more wide-ranging problem affecting health systems as a whole, in many countries of the world. To put it briefly, the progress is not linear, which raises the need to think about the quality and sustainability of human development. And, this scenario contributes to the prevalence of several pathologies spread throughout the world, including Neglected Tropical Diseases as a whole, and in this work, we will focus on Leprosy and cutaneous Leishmaniasis, especially in Brazil, since they are pathologies that, if not treated, can lead to physical disabilities and social discrimination. 3. How Can Health Education Be Used as a Strategy for the Control of Neglected Tropical Diseases? Leprosy and Cutaneous Leishmaniasis as a Model Neglected Tropical Diseases (NTDs) are endemic in countries characterized by problems of basic sanitation, socio-economic deficit and little investment of the large pharmaceutical industries to treat these diseases (Hanefeld, Spicer, Brugha, & Walt, 2007). In addition, ineffectiveness or lack of investment in health education measures should be taken into account. Thus, developing continents such as Africa and South America, ranging from rural areas to urban slums, are routinely scenarios of neglected tropical diseases in endemic form (Morel, 2006; D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1133 Creative Education Camargo, 2008). Note, in Figure 2, it is shown the ranking list of some Neglected Tropical Diseases and their incidence in the world, according to data available on WHO's official website. In 2012, diseases such as AIDS, Tuberculosis and Malaria are at the top of the list of priorities. And Leishmaniasis was on the list, followed by Leprosy as well. Interestingly, in the WHO reports, three years later, AIDS, tuberculosis and malaria did not appear in the ranking list anymore, while Leishmaniasis and Leprosy are still in their priorities, such as Chagas disease, dengue and schistosomiasis (Annual Reports WHO, 2015). Such public health problems generate negative impacts in several areas, since they are usually chronic and debilitating diseases that make it impossible for individuals to work and perform their daily activities. They generate stigmas that only fuel the continuing cycle of poverty. Although this scenario begins to change with stimuli and programs of government and non-governmental organizations (NGOs) with work in the area of Health Education, with a focus on prevention and control of Neglected Tropical Diseases (NTDs), the overall picture is far to be reversed in the short-term "eradication of these diseases" (Morel, 2006; WHO, 2012). Among NTDs, Leprosy and Leishmaniasis account for almost 2 million new cases per year worldwide (WHO, 2015). Although, they are caused by different pathogens, some cutaneous symptoms are very similar. Leprosy has two etiological agents: Mycobacterium leprae (Bechler, 2012) and the bacillus M. lepromatosis (Han et al., 2008). In the case of Cutaneous Leishmaniasis, the etiological agent is Leishmania sp. (several different species), together with the vectors that are transmitting insects, affects humans and other animals such as dogs (Camargo, 2008). Both diseases Figure 2. Ranking list of some Neglected Tropical Diseases spread in the world, according to incidence rates reported by WHO (2015).♦ AIDS, Tuberculosis and Malaria are not in the ranking list of priorities in 2015, anymore, while Chagas Disease and Dengue migrated to the top of this list in 2015. Leishmaniasis and Leprosy (diseases which cause physical disabilities) also remained included in those lists (2012 and 2015). D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1134 Creative Education have the skin as one of the main targets for the manifestation of symptoms, however, Leprosy also causes lesions in the peripheral nervous system, in addition to the typical skin lesions (Scollard et al., 2006). Regarding Health Education issues in Leprosy, Lennon, J.L. (1988) mentioned that in the Post-Congress Workshop on Health Education in 1984, the Gandhi Memorial Leprosy Foundation, the following policy statement was reached on Health Education in Leprosy. They stated: [...] Health education refers to the process of assimilation of knowledge, attitudes and scientific behavior in health in the culture of people. Health education in the objectives of Leprosy, ensures community participation in Leprosy control programs. Healthy education, therefore, addresses the patients, their families, the community and all components of health services" [...]. (Adiga, R.G. 1984 APUD Lennon, J. L. 1988) [...] Health education should produce behavioral changes in overcoming the sociocultural aspects of Leprosy stigma, identification and recognition of the disease, continuation of antileproic therapy and promotion of rehabilitation (both social and physical) [...] (Giri, S.K. 1976 APUD Lennon, J.L. 1988) In other words, health education refers to the process of acquisition of information concerning to the health conceptualizing to educate people about a health issue. Annual statistics for Leprosy in 2017 were officially received from 159 countries from all regions of the World Health Organization (WHO), with a prevalence register of 0.25 per 10,000 population with 192,173 cases of Leprosy in treatment by the end of 2017. During the year, 210,671 new cases (2.8 per 100,000 inhabitants) were reported globally. Of these, 12,189 (6%) of the cases had visible deformities or grade 2 of physical disability, including 238 children, which is very worrying. (www.searo.who.int/entity/global_Leprosy_programme/epidemiology/en). Currently, all Latin American countries have Leprosy, with the exception of Chile, and Brazil is the country with the highest prevalence, being the second country in the world in the greatest number of cases of the disease, losing only to India presenting the greatest number of cases of Leprosy in the world (WHO, 2015). However, Leprosy, is one of the oldest disease and the most marginalized illness in human history, its transmission mechanism is unknown until today. However, its pathogenesis is well studied and known and can be controlled as long as its endemic areas are treated with measures preventive and appropriate measures of public health. Since the introduction of free multi-drug therapy (MDT), cases of Leprosy have reduced from more than 5 million cases in the mid-1980s to less than 200,000 in the present. Nevertheless, some people still erroneously believe that Leprosy is incurable, which leads to fear of the disease (https://www.paho.org). However, Brazil is one of the three countries with the highest number of reported cases worldwide, recorded 26,875 new cases in 2017 (contributing more D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1135 Creative Education than 90% of the burden of diseases in the Americas) (https://www.paho.org). These data justify the maintenance of the level of attention and care for Leprosy in Brazil and the dissemination of this disease using information as a prophylactic measure. One of the major problems of Leprosy is the prejudice that prevents the search for notification, diagnosis and treatment, which fuels a vicious cycle of contagion and a propensity for physical disabilities. In addition, the treatment for Leprosy may lead to the appearance of reactional episodes (manifestations of acute inflammatory responses) that, if not specifically treated, can lead to death. In relation to cutaneous Leishmaniasis, in most cases, they are zoonoses caused by the protozoan of the genus Leishmania, transmitted by the dipteran vector of the Phlebotominae subfamily, of the genus Phlebotomus in the Old World and by the genus Lutzomyia, in the New World (Camargo, 2008; Santos et al., 2008). Leishmaniasis is a chronic and debilitating sickness and still has a significant impact on the health and economy of developing countries, and similar to Leprosy, can also lead to physical disabilities. In addition, Leishmaniasis is a continuing concern even in developed countries, due to the possibility that it may affect tourists from countries where the parasite is endemic (Santos et al., 2008). It is worth mentioning that in addition to Africa and Latin America, Leishmaniasis occurs in many regions of the Iberian Peninsula, in addition to Italy, Turkey and Greece (Camargo, 2008). It is worth noting that the incidence of Leprosy, as well as other neglected diseases, is also directly related to the low "Human Development Index" (HDI), which is used by the United Nations to analyze the quality of life of population. In Brazil, the total number of new Leprosy cases shows a total of 26,875 cases per year (Sinan/SVS, 2018). According to WHO 2015, (https://www.who.int/Leishmaniasis/burden/Status_of_endemicity_of_CL_worl dwide_2015_with_imported_cases.pdf?ua=1&ua=1) Leishmaniasis is considered endemic in 88 countries, with more than 12 million people presenting with this disease complex and a portion of the population of approximately 350 million at risk of infection. Therefore, in spite of all the efforts of the world research on scientific advances in these two areas, searching for new forms of treatment for Leprosy and Leishmaniasis, as well as the accumulated knowledge about these pathologies during all these years, these two diseases still remain as a challenge. It is of fundamental importance to reflect that, in addition to research aimed at more specific treatments (less toxic, more effective and low cost treatments), these diseases require urgent investments in the area of Health Education, such as scientific dissemination through educational campaigns: How is the form of your acquisition? How are the treatment regimens? How can they be prevented? These issues should be addressed primarily to people of low income and low education, who are, in fact, the largest public affected by these pathologies. Certainly, health education will become a priority need in programs against these D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1136 Creative Education Neglected Tropical Diseases or others, where the affected individuals will not become persons with physical disabilities and will not suffer social prejudices, as in the specific case of these two serious diseases: cutaneous Leishmaniasis and Leprosy. 4. Conclusion This article briefly mentioned the history of the evolution on health concept since the source of philosophy till the 20th century with the creation of the World Health Organization. And in this context, some Neglected Tropical Diseases were illustrated. One of the oldest diseases in the history of mankind-Leprosy, which has been confused with cutaneous Leishmaniasis and other skin diseases long time ago, because of the similarity with cutaneous lesions of other origins, was briefly mentioned. Leprosy has a cure and the intense knowledge about this millenary pathology needs to be widely diffused in the world for all people, regardless of age and degree of study. Especially up-to-date knowledge about the diagnosis and treatment of this disease can also contribute to the demystification of the stigma associated with it, especially in Brazil. Concerning to cutaneous Leishmaniasis, the treatment uses topical creams (mainly for children) and is currently available in clinical trials (Hotez et al., 2016). According to the natural cycle of Leishmaniasis, its control can also be done through the control of vectors and the disease's natural reservoirs. The continuous evaluation of control measures in endemic environments, together with population education programs are essential as measures to control and prevent Leishmaniasis. It is worth mentioning that, both diseases can lead to psychological disturbs associated with the deformities. Furthermore, women and children living in unhealthy environments represent the most vulnerable population to these NTDs. We hope this article will encourage scientists and educators to create scientific and academic products that address scientific dissemination about these and other pathologies, in the context of Health Education. This will be achieved through the implementation of awareness campaigns that will be responsible for improving the capacity to intensify and maintain Leprosy and Leishmaniasis control activities through the establishment or strengthening of institutions that carry out regular courses on diagnosis and treatment of these sicknesses. The organization of training workshops as well as organization of annual meetings of national programs that, in addition to informing knowledge, produce material in the educational area with easy access to the population such as booklets, websites, manuals and textbooks (specially addressed to children through short stories) can contribute to the elimination of stigma and discrimination against persons affected by Leprosy and Leishmaniasis and their families. And finally, special care should be done to the occurrence of Leprosy and Leishmaniasis on less developed areas and vulnerable populations mainly children. Finally, through the simultaneous work of Education and Scientific Research, D. O. Santos et al. DOI: 10.4236/ce.2019.106085 1137 Creative Education we believe that the two main pillars to elimination the NTDs, proposed by the World Health Organization could be reached. The great challenge for educators and/or researchers is to ensure that both experimental research and health education can effectively contribute to the eradication of some NTDs in the world. And to achieve this, Education is the way-this practically depends on the re-education of educators and/or researchers together with education of the population affected or not by these pathologies. Acknowledgements We would like to thank the Universidade Federal Fluminense (UFF), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Programa de Pós-Graduação em Microbiologia e Parasitologia Aplicada (UFF), Programa de Pós-Graduação em Ciências e Biotecnologia (UFF) for the constant stimulus to work in the educational area. Thanks also to Clara Maria Santos de Lacerda (CAE-Certificate in Advanced English-University of Cambridge-UK 2019) for the careful review of this article. Conflicts of Interest The authors declare no conflicts of interest regarding the publication of this paper. 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