The Global Health Council has produced a number of interesting papers in the past few months, detailing the worldwide fight against continuing global health problems. Polio, malaria and neglected tropical diseases all still play a major role in global health; each has its own successes, and each has areas that are cause for significant concern.
Polio, for instance, is nowhere near the threat it once was; since 1988, cases of polio have decreased 99% worldwide, according to the GHC’s fact sheet on polio vaccination and challenges to eradication. But as has been noted elsewhere, eliminating the final 1% has proven a difficult task.
The GHC’s fact sheet notes that cases are primarily limited to four countries: Afghanistan, Nigeria, India and Pakistan. But closing the book on polio has been hampered by viral mutations, uneven vaccine effectiveness and – in the case Afghanistan and Pakistan – regional conflicts hindering vaccine distribution.
Complicating efforts is the way in which polio spreads. Many who host the polio virus are never affected by symptoms; unaware they are infected, they can easily pass the virus to others. Moreover, people with compromised immune systems may shed the virus for years after receiving a vaccine which contains the weakened virus; those with healthy immune systems shed the weakened virus for only a few weeks.
Unlike the nearly-extinct polio, malaria continues to be a threat across the globe, putting half the global population at risk. GHC’s malaria position paper, released last month, finds that the disease disproportionately affects those living in poverty. In some high-burden countries, GHC writes, the cost of treating the disease can account for one-quarter of household incomes. Imagine, then, the average American spending more than $11,000 annually.
The fact sheet notes that research will play a critical role in the battle against malaria. The basis for the most common treatments, artemisinin, may be on the verge of becoming obsolete; thus, new treatments are desperately needed. And though no vaccine for malaria has yet emerged, there are a handful of promising candidates.
NTDs are perhaps a larger problem than malaria and polio combined. GHC’s fact sheet on NTDs, released in February, states that between 18 to 57 million years of life are estimated to have been lost because of premature death and disability.
If those numbers aren’t large enough, consider this: One billion people around the world are currently infected with an NTD; two billion others remain at risk. That’s just under half of the world’s population.
As with malaria, research can have considerable influcence. For some NTDs without adequate control – the fact sheet lists Chagas’ disease, leishmaniasis, sleeping sickness and Buruli ulcer among them – research is critical. Several others depend on a key ingredient in treatment; as with malaria, resistance develops? Here too research, in the form of drug development, plays an important role.
Even if global health is not an area of focus for you, the fact sheets are well worth reading.