Woes of the world

  • 14/06/1996
  • WHO

THE recently published 1996 The 1996 World Health Organization infectious (WHO) report urges all the epidemics countries to target health care facilities as a primary governmental and international concern, particularly in the light of an onslaught by various diseases plaguing our globe today. According to the WHO report, over the past 20 years, at least 30 new diseases have been scientifically recognised the world over.

The increase of infectious disease-related deaths are seen to have a "crippling" effect on the socioeconomic development of many nations. Although many governments seem to be blaming mother nature alone, the WHO report reveals that the spurt in these viruses are largely human-induced. The report cites international movements of peoples due to wars and internal political turmoil, global travel and changes in lifestyles as key contributors to the rise in these diseases.

The HIV virus, which was unknown a decade ago, today infects more than 20 million adults, and the figure may jump to 40 million within five years. Hepatitis B, c, and E are new strains which have been identified in recent years, all three having claimed 1.1 million lives last year. In 1992, a completely new strain of cholera called Vibrio cholerae 0139 surfaced in southeastern India, and has since spread to other parts of India and South East Asia.

The hantavirus infections, which were first recognised in the us in 1993 (Down To Earth, Vol 4, No 20) have since been detected in 20 American states, with cases also reported from Canada, Argentina, Brazil, and Paraguay. In 1995, the Ebola virus which was unknown 20 years ago, caused a severe outbreak in Zaire, in which 80 per cent of the cases were fatal.

Hiroshi Nakajima, director-general Of WHO remarked, "Infectious diseases are attacking us on multiple fronts. Together they represent the world's leading cause of premature deaths." The socioeconomic consequences of these diseases are devastating. Nakajima explained that many of the victims are school-age children and working-age adults, "the potential workforces of tomorrow, and the actual workforces of today".

The most disturbing realisation that dawns from the report is that, several of these 52 million deaths reported last year could have been prevented. Of the 17 million deaths caused by infectious diseases, nine million that perished were children; they died of such preventable maladies as diarrhoea and pneumonia due to inadequate health care facilities.

Jayesh Shah, trustee for the Bombay- based human rights magazine Human Scape, stated that the lack of proper health care implementation programme, was a big - if not a bigger - human rights problem than the much politicised Kashmir issue. Shah explained that of the 189 municipal dispensaries in Bombay which received about 81 million cases last year, approximately only Rs 3 was cases earmarked for each patient.

This is of chilling significance if one considers the WHO report's appeal to nations to address their health problems by using readily available and existing "cost-effective" methods. Among these methods are immunisation of children against diseases like measles, tuberculosis (TB), polio, and hepatitis B. the health care cost being us $14.50 (approximately Rs 536.50) per child. The report also urges for health education programmes and standard procedures for improved diagnosis of sexually transmitted diseases, the cost standing at us $11.50 (approximately Rs 425.50) per person.

Other recommendations are providing adequate and clean drinking water, basic sanitation, and waste disposal to prevent polio, hepatitis, and typhoid. In the case of India, the recent Water pollution crisis in Bichhri (DTE, Vol 4, No 23) is just the tip of an iceberg. Despite these disturbing statistics, Nakajima ruefully observes that the international community and many countries on their own, have reduced investment in controlling diseases that cause "heavy economic and human tolls."

The result could be an appalling global health crisis, as several of these 11 small" infectious viruses are making a comeback with vengeance. Cholera, malaria, and TB have together claimed about 8.3 milhofi lives in 1995. The recent outpour of literature like Lorry Garrett's The Coming Plague, The Viruses, and Our Stolen Future, highlight the incompetence of the governments due to their fatalistic attitude.

What is more alarming is that these preventable infections often lead to incurable fatal diseases. For instance, 550,000 of the new cases of stomach cancer this year are attributable to a bacterium, Helicobacter pylori, which is transmitted through food. The sexually transmitted infection of the cervix with human papilloma viruses have a very high risk of developing cervical cancer. Of the 529,000 cervical cancer cases reported last year, 436,000 were caused by this virus. Similarly, 82 per cent of the world's total liver cancer cases are attributable to hepatitis B and c viruses. Nakajima states, "This complacency is now costing millions of lives - lives that we have the knowledge and the means to save, yet we are allowing them to trickle away through our fingers."

Fatal infections
The 1996 WHO report specifically focusses on infectious diseases, many of which caused lethal epidemics during the year 1995
Disease Location Reported cases
Dengue fever Central and South America (14 countries) 600,000
Cholera South America, Africa and eastern Europe 384,000
Yellow fever The Americas (began in Peru in 1950) and western Africa (Liberia) thousands of cases
Ebola fever Zaire 316 (about 80% died)
Diphtheria Eastern Europe (began in the Russian Federation in 1990 and then spread to 15 countries) 100,000

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