|
IRIN World Health Day Web Special: Taking Africa's Pulse
INFECTIOUS AND EMERGING DISEASES
|
Most infectious diseases are easily preventable or curable but access to vaccines or drugs in many African countries remains elusive
|
Infectious diseases are the world's leading killer of children and young adults, accounting for more than 13 million deaths a year. One in two of those deaths is in a developing country. Most infectious diseases are easily preventable or curable but access to vaccines or drugs in many African countries remains elusive.
"This suffering - and its social consequences - should not be happening," said Dr David L. Heymann, executive director for communicable diseases for the World Health Organisation. "We are the first generation ever to have the means of protecting the world from the most deadly and common infectious diseases. Today, we possess the knowledge and the drugs, vaccines and commodities to prevent or cure tuberculosis, malaria, HIV, diarrhoeal diseases, pneumonia and measles practically anywhere on our planet."
Those six diseases are responsible for 90 percent of infectious disease deaths, jeopardising economic growth, globalisation and international security as they wear down workforces, governments and their resources, according to recent studies. Poverty and conflict have contributed to the breakdown in health infrastructure in some countries, as well as the deterioration of roads and the environment, resulting in obscure diseases such as yellow fever emerging again. Other deadly diseases, such as ebola, are appearing as well.
"We are wise not to delay in controlling infectious diseases," said Heymann, speaking before the Committee on International Relations, US House of Representatives, in June last year. "Over thirty new diseases have emerged within just the past twenty years, and no one knows what other unforeseen microbial threats await us in the future."
Heymann warned that the window of opportunity to use medicines that weren't available a generation ago was closing. This is due to overuse of life-saving drugs, as well as misuse.
"Antimicrobial resistance develops when medicines are not widely accessible for the poorest segments of society, and when they are not wisely prescribed throughout the world," he said. "The under-use of medicines is particularly a problem in developing countires. For example, where patients are unable to afford the full course of medication, or where some medicines are sporadically unavailable, patients often take insufficient dosages that kill off the weakest microbes in the body, but provide the more resistant microbes an opportunity to survive and multiply."
Only one infectious disease - smallpox - has ever been eradicated. But there are other positive signs. Efforts are being stepped up to ensure that worldwide polio eradication is completed and certified by 2005. The number of reported cases fell from 35,000 to about 5,000 over the past decade. Cases of Guinea-worm disease have been reduced by 90 percent in the past decade. Almost ten million people have been cured of leprosy over the past 15 years in an effort to eliminate the disease. Onchocerciasis (river blindness) has been virtually wiped out in 11 countries in West Africa through a 20-year programme.
Health officials say that political commitment from governments at the highest level, a healthcare system or coordinated use of NGOs and private practitioners are needed to deliver services to the entire population to help battle infectious diseases. If carried out, and accompanied by the use of preventative measures and inexpensive and simple cures, millions of lives can be saved, they say. More widespread use of low-cost vaccines alone could prevent 1.6 million deaths a year among children under the age of five.
Millions of TB deaths could be averted through the use of DOTS, or Directly Observed Treatment, Short-course, an inexpensive strategy for the detection and treatment of TB. In Guinea, within four years of launching its TB control program through use of DOTS, the case detection rate had doubled and almost 80 percent of patients were being cured.
There could be up to a 30 percent reduction in HIV transmission in high risk countries with US $1billion for antibiotics to treat sexually transmitted infections, which amplify the risk of susequent infection with HIV. In Senegal, a rapid broad-based response to the HIV/AIDS epidemic succeeded in holding the spread of HIV at much lower levels than in many other African countries. The government acted swiftly, making sex education available in primary and secondary schools, providing treatment for sexually transmitted infections and actively promoting the use of condoms.
For more details and related information, please see:
www.who.int
www.who.int
www.who.int
http://filestore.who.int/
|
The toll:
- Disease has claimed 150 million lives since 1945 - six times more than war. The estimated global spending for prevention and control of AIDS, TB and malaria as of 1995 was US $15 billion. About US $864 billion was spent globally on the military.
- Over the next hour, 1,500 people will die from an infectious disease. Over half of them are children under five. Of the rest, most will be working-age adults, many of whom are breadwinners and parents. In some countries, one in five children dies before turning five.
- Africa's GDP would have been up to US $100 billion greater in 1999 if malaria had been eliminated years ago. The extra US $100 billion would be, by comparison, nearly five times greater than all development aid provided to Africa in 1999. In Nigeria, it has been estimated that subsistence farmers spend as much as 13 percent of total household expenditure on malaria treatment. Every day 3,000 people die from malaria - three out of four of them children. The illness kills more than one million people a year.
- Every year 1.5 million people die from tuberculosis and another eight million are newly infected. About one-third of all AIDS deaths today are caused by TB.
- Acute respiratory infections are responsible for 3.5 million deaths each year. Pneumonia kills more children than any other infectious disease.
- At the end of 1999, an estimated 33.6 million people were living with HIV worldwide. In some countries in sub-Saharan Africa, up to one in four of the adult population is now living with HIV/AIDS. There are an estimated 15,000 new HIV infections every day. Ninety-five percent of them are in developing countries. Sixty percent of those infected are under 24 years of age. The epidemic has left more than 11 million children orphaned.
- Diarrhoeal diseases claim nearly two million lives a year among children under five.
- Measles is the most contagious disease known to man. It accounts for about 900,000 deaths a year in developing countries. In Africa, fewer than two in three children today are immunised against measles.
- One in five children are still not fully immunized with the whole package of six basic childhood vaccines: diphtheria, whooping cough, tetanus, polio, measles and BCG.
|
Source: World Health Organisation
Cholera: An endemic problem in Somalia
Every year, a deadly visitor makes the rounds of the Somali capital, Mogadishu. It likes to arrive in the hot, dry season, sometime between November and May, and prefers young children, the weak and the elderly. Most of all, it likes to visit the poorest of the poor. Cholera, said one aid worker, "kills very fast".
In the absence of good security and basic infrastructure, cholera has taken root in the Somali capital, and peaks every year on a seasonal basis. Although it is a deadly disease, treatment and prevention can be simple. But in Mogadishu, treating cholera "has been pushed onto the front line", said one humanitarian source.
In January 2001, new cholera treatment centres were opened in north and south Mogadishu to cope with yet another seasonal outbreak. But humanitarian agencies have now been forced to rethink strategies in the face of the latest security incident, as the result of which operations by Medecins Sans Frontieres-Spain (MSF) in north Mogadishu were suspended - just as cholera in the city was being brought under control.
"For the moment, we see no change - but we are ready to try and absorb extra patients," Starlene Barthelot, head of the cholera programme for Action contre la faim (ACF), in south Mogadishu, told IRIN. According to ACF figures, there have been 629 cases since 1 January, with 60 deaths. The 39 new cases reported in the week that MSF pulled out its expatriate staff after a shoot-out in the aid compound, was part of a downward trend. Somalia demonstrates the direct relationship between controlling the disease and the need for effective administration and security.
Full report
First ever Africa Malaria Day
Malaria continues to be one of Africa's biggest killers, responsible for the deaths of nearly one million people on the continent every year. An estimated 700,000 of these deaths are among children under five, amounting to one death every 40 seconds. Drug resistance, deteriorating sanitation and the failure of health systems all contribute to the spread of a very preventable disease.
The impact of malaria on development and economic growth is crippling. Researchers estimate that a malaria-stricken family spends roughly one quarter of its income on treatment. According to the World Health Organisation (WHO), Africa would now be more than US $100 billion richer if it were not suffering the scourge of malaria. This figure is nearly five times greater than all the development aid provided to Africa in 1999.
As part of the fight against malaria, African leaders have declared 25 April 2001 the first Africa Malaria Day. Throughout the continent, activities will take place to raise awareness of malaria prevention and treatment. In Mozambique, President Joaqim Alberto Chissano will talk about the need for more widespread preventive action, and in Togo public demonstrations are planned on the use and re-treatment of bed-nets.
Roll Back Malaria (RBM), a joint project between WHO, UNICEF, UNDP and the World Bank dedicated to "halving the burden" of malaria by 2010, is launching a new report on progress made by African governments in tackling the potentially fatal disease. The report looks at measures applied in some countries, such as reduction or abolition of taxes and tariffs on insecticide-treated mosquito nets. WHO estimates that with wider use of insecticide-treated bed-nets, malaria among children could be halved. Presently, only two percent of African children are protected at night by a treated bed-net.
Africa Malaria Day marks the anniversary of the first African malaria summit. At the summit, on 25 April 2000 in the Nigerian capital, Abuja, representatives of 38 African states committed themselves to reducing the socioeconomic costs of malaria. They vowed to take action to ensure that by 2005, at least 60 percent of those struck by the disease would be able to obtain prompt, effective and affordable treatment within 24 hours, and that at least 60 percent of all pregnant women at risk of malaria would have access to effective treatment. Speaking at the summit, Nigerian President Olusegun Obansanjo said, "It does not have to be like this; malaria is preventable, treatable and curable."
For more details and related information, please see:
www.rbm.who.int
www.unicef.org
Meningitis belt in West Africa waits for rain
In the past two decades, meningitis epidemics have become more frequent and irregular even though health officials have become better able to predict when and how the disease will strike. Meningitis kills about 135,000 people worldwide each year. This year, it has already claimed the lives of more than 1,500 of the 9,500 people infected in Africa's meningitis belt, which stretches from Senegal to Ethiopia across 15 semi-arid countries.
The reasons for the escalating epidemics are varied. The five million doses of the vaccine, chloramphenical, produced worldwide for each season have proven insufficient, especially during major outbreaks, Dr Samuel Bugri, an epidemiologist with the World Health Organisation (WHO) in Abidjan, told IRIN. Burkina Faso alone needed four million doses for its current epidemic. Manufacturers produce a minimum of vaccines because countries are generally unable to predict outbreaks and the doses they would need, he said. Another drawback is that the vaccine is not always delivered on time. Ghana ordered one million doses to be delivered by the end of October 2000 in preparation for the meningitis season, but they only arrived at the start of 2001.
But the main reason for the high death tolls is the failure of most people to report the disease or to do so too late, Bugri said. Although the vaccine is intended to grant immunity for up to three years it often does not last that long, especially among children, whom it usually protects for about one year. Moreover, it has been ineffective against a more potent strain known as pneumococcal meningitis which kills patients much faster that the usual meningicoccal meningitis.
Full report
Funding appeal for synchronised polio immunisation
|
Polio is a crippling and sometimes fatal disease that attacks the central nervous system, usually in children under three years of age
|
New polio infections have fallen 99 percent since 1988 because of door-to-door vaccinations during synchronised National Immunisation Days (NIDs) in rural areas of Africa and other parts of the world, according to the Global Polio Eradication Initiative.
Health officials plan more synchronised vaccinations in Angola, the Republic of Congo and the Democratic Republic of Congo (DRC) for July, August and September aimed at reaching 15 million children in conflict-affected and cross-border regions. Some of the most intense polio transmission is in DRC and Angola.
It will be the first synchronisation effort focused on conflict-affected countries. To be successful, coordinated ceasefires are necessary.
"It's essential that warring parties and international mediators give priority to ceasefires that allow us to get polio vaccine to these children," UNICEF Executive Director Carol Bellamy said.
Recorded polio cases worldwide dropped to just 3,500 in 2000, compared with 350,000 cases recorded in 1988. Last year alone a record 550 million children under five years of age were immunised in 82 countries. This included a synchronised effort across West and Central Africa where 76 million children were immunised in 17 countries. In India, 152 million children were vaccinated in three days.
The partners behind the initiative hailed the progress made, which keeps the campaign on track for a world certified polio-free by 2005. But they warned that the biggest challenges of the programme lie ahead: accessing all children, closing a US $400 million funding gap and maintaining political commitment in the face of a disappearing disease.
"Victory over the poliovirus is within sight," said Dr Gro Harlem Brundtland, director-general of the World Health Organisation (WHO). "We must now close in on the remaining strongholds of the disease and use all possible resources to extinguish polio."
But until there is global eradication no child is safe from polio. In August 2000 an imported poliovirus from Angola caused a major outbreak on the West African island nation of Cape Verde, which had been polio-free for years. This outbreak paralysed 44 people and killed 17.
"Until all children everywhere are protected, every child is at risk," said Dr Jeffrey Koplan, director of the US Centers for Disease Control and Prevention (CDC). "This experience highlights the need to maintain recommended levels of routine immunisations, and ensure certification-standard surveillance for polio cases in every country."
Polio is a crippling and sometimes fatal disease that attacks the central nervous system, usually in children under three years of age. The virus is now found in only 20 countries, mainly in South Asia and sub-Saharan Africa, compared to 125 countries in 1988.
These are: Afghanistan, Angola, Bangladesh, Benin, the Central African Republic, Chad, Congo, Cote d'Ivoire, the Democratic Republic of Congo, Egypt, Ethiopia, Ghana, India, Nepal, Niger, Nigeria, Pakistan, Sierra Leone, Somalia and Sudan.
The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the CDC and UNICEF.
For more details and related information, please see:
www.who.int
www.polioeradication.org
www.unicef.org
|
Polio hits conflict areas hard
Angola - At war for more than a generation, only about 40 percent of Angola's infants receive routine immunisations. The migration of non-immunised children, displaced by conflict, fuelled the largest ever polio outbreak in Africa between March and May 1999, causing 1,103 cases and 89 deaths.
Congo-Brazzaville - Ongoing civil conflicts have destroyed the healthcare infrastructure in Congo-Brazzaville such that only 27 percent of paralysis cases are even adequately investigated to establish whether polio is the cause. Even so, the country accounts for 10 percent of virus-confirmed polio cases reported to date in 2000 in Africa.
Democratic Republic of Congo (DRC) - Both a country in conflict and a global polio reservoir, cross-border movement from DRC has repeatedly reintroduced poliovirus into neighbouring countries, threatening progress in east and southern Africa. Full nation-wide National Immunisation Days began in 1999, and in 2000, health workers and volunteers immunised children in 303 of 307 health districts.
|
Source: World Health Organisation, UN Children's Fund and Rotary International
Rabies: Not only a threat to animals
Rabies is endemic in Kenya and most other African countries. The Kenya Society for the Protection and Care of Animals (KSPCA) has had to deal with many cases of rabid domestic animals, mostly dogs and sometimes donkeys. The epidemics seem to come in cycles, usually in the dry season, according to animal care specialists. Despite the threat of the infectious disease, most people are unaware of its dangers.
"We have come across situations where well-educated people have had their dog come down with rabies," said Jean Gilchrist, KSPCA director of animal welfare. "The dog may have licked or bitten them, but they do not feel any sense of urgency about seeking medical advice, in spite of the fact they are aware that rabies is a fatal disease."
If a dog bites a person, the wound should be washed immediately and spirit or disinfectant put on it, she said. This measure has a good chance of killing the virus, but to ensure full protection a course of rabies vaccinations is necessary. The cost of a course of rabies vaccine, however, is beyond the reach of most Kenyans and other Africans. Studies by the World Health Organisation (WHO) have shown that if 60 percent of the dog population is vaccinated regularly, the disease will die out. The majority of animals in Kenya are never vaccinated, even those in cities whose owners can afford the vaccine.
Full report
|
|
|
In this section:
Quick Links:
|
|
Feedback:
IRIN welcomes constructive comments and will post a representative selection of readers views, but reserves the right to destroy material which is abusive and inflammatory. Please restrict the length of your reply to one page.
|
|
