Diseases—Ignored Global Killers

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  • by Anup Shah
  • This Page Last Updated Saturday, October 02, 2010

Many people, most of them in tropical countries of the Third World, die of preventable, curable diseases.… Malaria, tuberculosis, acute lower-respiratory infections—in 1998, these claimed 6.1 million lives. People died because the drugs to treat those illnesses are nonexistent or are no longer effective. They died because it doesn’t pay to keep them alive.

Ken Silverstein, Millions for Viagra. Pennies for Diseases of the Poor1, The Nation, July 19, 1999

On this page:

  1. A larger killer than conflicts, worldwide
  2. An unimportant and ignored issue
  3. Not a profitable market for drug companies
  4. For more information

A larger killer than conflicts, worldwide

Consider the following:

  • One billion people lack access to health care systems2
  • Over 8 million children under the age of 5 die from malnutrition and mostly preventable diseases, each year3
  • In 2002, almost 11 million people died of infectious diseases4 alone … far more than the number killed in the natural or man-made catastrophes that make headlines. (These are the latest figures presented by the World Health Organization.)
  • AIDS/HIV has spread rapidly. UNAIDS estimates5 for 2008 that there were roughly:
    • 33.4 million living with HIV
    • 2.7 million new infections of HIV
    • 2 million deaths from AIDS
  • Tuberculosis kills 1.3 million people each year6, with 9.4 million new cases a year, as the World Health Organization (WHO) points out. In addition,
    • Someone in the world is newly infected with TB bacilli every second.
    • Overall, one-third of the world’s population is currently infected with the TB bacillus.
    • 5-10% of people who are infected with TB bacilli (but who are not infected with HIV) become sick or infectious at some time during their life.

    … TB is a leading cause of death among people who are HIV-positive. It accounts for about 13% of AIDS deaths worldwide. In Africa, HIV is the single most important factor determining the increased incidence of TB in the past 10 years.

    Tuberculosis7, World Health Organization, Fact Sheet No 104, March 2010
  • Image: Malaria testing © Robert Semeniuk, Personalizing the World Health Crisis8
    Consider the impacts of malaria:
    • Malaria causes some 243 million acute illnesses and 863,000 deaths, annually9.
    • 2000 children per day in Africa die from malaria10, almost one every 45 seconds.
    • Malaria is both a disease of poverty and a cause of poverty11, as the WHO also notes.
  • 164,000 people, mostly children under 5, died from measles in 200812 (the latest years for which figures are available, at time of writing) even though effective immunization, which includes vaccine and safe injection equipment, costs less than 1 US dollars and has been available for more than 40 years.
  • An estimated 600,000 people die from typhoid each year13

The World Health Organization’s explanation of the indirect costs of malaria are also applicable to most of the other diseases:

Malaria has significant measurable direct and indirect costs, and has recently been shown to be a major constraint to economic development.

… Annual economic growth in countries with high malaria transmission has historically been lower than in countries without malaria. Economists believe that malaria is responsible for a growth penalty of up to 1.3% per year in some African countries.

… The indirect costs of malaria include lost productivity or income associated with illness or death.

… Malaria has a greater impact on Africa’s human resources than simple lost earnings. Although difficult to express in dollar terms, another indirect cost of malaria is the human pain and suffering caused by the disease. Malaria also hampers children’s schooling and social development through both absenteeism and permanent neurological and other damage associated with severe episodes of the disease.

The simple presence of malaria in a community or country also hampers individual and national prosperity due to its influence on social and economic decisions. The risk of contracting malaria in endemic areas can deter investment, both internal and external and affect individual and household decision making in many ways that have a negative impact on economic productivity and growth.

Economic costs of malaria14, World Health Organization, accessed October 2, 2010

The following video details how malaria affects so many in Ethiopia, in turn highlighting numerous related issues such as the impact of poverty. The topics discussed in this video also apply to numerous regions around the world face—Africa in particular:

Malaria : Killer Number One15, Integrated Regional Information Network (IRIN), 2006)
Trachoma: the leading cause of preventable blindness, affects over 35 million people, yet is often easily preventable if not for poverty. © Robert Semeniuk, Personalizing the World Health Crisis16

This is just a small example. There are many more17 diseases and deteriorating health systems which cost many, many lives each year.

Poverty and social conditions, brought upon by human decisions and global institutions to shape the world economy in a way that favors a few western countries to the detriment of the rest of the world, continue. Increased poverty and debt is resulting in forced cut-backs in health and education18, the very things that would help form a foundation in ensuring such impacts are minimized.

While a lot of news reports and coverage tend to be of stock markets, booming (or now receding) economies, international war on terrorism, a few other selected conflicts and local news, etc. one issue that is often missed by the mainstream media is the sheer number of people affected and dying from tropical and infectious diseases—and that is largely preventable and curable.

Let me tell you a story about life, death and profit. It involves some of the poorest countries in the world and some of the richest companies. It goes to the heart of how the modern world is to be run and whether the institutions set up to police the global economy are up to the job.

Eleven million people in poor countries will die from infectious diseases this year. Put a different way, it means that by the time you finish reading this column 100 people will have died. Half of them will be children aged under five.

Larry Elliott, Evil triumphs in a sick society19, Guardian, February 12, 2001

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An unimportant and ignored issue

Of diseases in the Third World, AIDS is getting the most attention and focus. Not coincidentally, it is also one of the few diseases that remain a threat to First World countries.

Pharmaceutical companies put profits before needs, Project Censored (Seven Stories, 2000), P. 32

Until recently, AIDS had not killed as many as some of the other major diseases, yet it still received more attention than the other big killers in the world, which hardly seem to get covered, in comparison.

Largely impacting developing countries where health facilities and systems are weaker, poverty is also resulting in largely curable and preventable diseases from killing millions each year.

There are also other issues such as the various cultural and traditional barriers, and social issues and taboos that need to be overcome in some parts of the developing world, for treatments to be made readily accessible. However, a look, for example, at the causes of poverty20, as described on this web site, would help indicate why these issues are important for developed and wealthy nations alike and what roles and responsibilities they have as well:

  • Western nations through their imperial and colonial pasts now own most of the world’s wealth and ability to access and make goods from resources acquired from developing nations.
  • Most of the world’s patents21 on natural food and medicinal ingredients are in industrialized countries, even though the ingredients themselves are mostly from the developing countries.
  • International trade and economic policies22 are guided (or dictated) by the West. The poverty and debt that many poor nations are facing, are in part due to these policies.
  • The effects of such conditions are many. One of which is deteriorating health and provision of health systems for the majority of people.

Africa Action, an organization looking into political, economic and social justice for Africa has an article on the impacts of IMF and World Bank structural adjustments and its impacts on health in Africa, and is worth quoting at length:

Health status is influenced by socioeconomic factors as well as by the state of health care delivery systems. The policies prescribed by the World Bank and IMF have increased poverty in African countries and mandated cutbacks in the health sector. Combined, this has caused a massive deterioration in the continent’s health status.

The health care systems inherited by most African states after the colonial era were unevenly weighted toward privileged elites and urban centers. In the 1960s and 1970s, substantial progress was made in improving the reach of health care services in many African countries. Most African governments increased spending on the health sector during this period. They endeavored to extend primary health care and to emphasize the development of a public health system to redress the inequalities of the colonial era. The World Health Organization (WHO) emphasized the importance of primary healthcare at the historic Alma Ata Conference in 1978. The Declaration of Alma Ata focused on a community-based approach to health care and resolved that comprehensive health care was a basic right and a responsibility of government.

These efforts undertaken by African governments after independence were quite successful….

While the progress across the African continent was uneven, it was significant, not only because of its positive effects on the health of African populations. It also illustrated a commitment by African leaders to the principle of building and developing their health care systems.

With the economic crisis of the 1980s, much of Africa’s economic and social progress over the previous two decades began to come undone. As African governments became clients of the World Bank and IMF, they forfeited control over their domestic spending priorities. The loan conditions of these institutions forced contraction in government spending on health and other social services….

The relationship between poverty and ill-health is well established. The economic austerity policies attached to World Bank and IMF loans led to intensified poverty in many African countries in the 1980s and 1990s. This increased the vulnerability of African populations to the spread of diseases and to other health problems….

The deepening poverty across the continent has created fertile ground for the spread of infectious diseases. Declining living conditions and reduced access to basic services have led to decreased health status. In Africa today, almost half of the population lacks access to safe water and adequate sanitation services. As immune systems have become weakened, the susceptibility of Africa’s people to infectious diseases has greatly increased….

Even as government spending on health was cut back, the amounts being paid by African governments to foreign creditors continued to increase. By the 1990s, most African countries were spending more repaying foreign debts than on health or education for their people. Health care services in African countries disintegrated, while desperately needed resources were siphoned off by foreign creditors. It was estimated in 1997 that sub-Saharan African governments were transferring to Northern creditors four times what they were spending on the health of their people. In 1998, Senegal spent five times as much repaying foreign debts as on health. Across Africa, debt repayments compete directly with spending on Africa’s health care services.

The erosion of Africa’s health care infrastructure has left many countries unable to cope with the impact of HIV/AIDS and other diseases. Efforts to address the health crisis have been undermined by the lack of available resources and the breakdown in health care delivery systems. The privatization of basic health care has further impeded the response to the health crisis….

The World Bank has recommended several forms of privatization in the health sector…. Throughout Africa, the privatization of health care has reduced access to necessary services. The introduction of market principles into health care delivery has transformed health care from a public service to a private commodity. The outcome has been