There was a time when the prevention of epidemic diseases was a cause that people embraced. When President Franklin D. Roosevelt called on Americans to join the fight against polio, he reported truckloads of envelopes containing “10 cents and 25 cents and even dollar bills” arrived at the White House, “from children who wanted to help other children to heal.”The March of Dimes campaign went on to fund the development of polio vaccines. When one of them, the Salk vaccine, proved effective, in April 1955, church bells rang.
Similarly, in the mid-1960s, when the World Health Organization announced its plan to eradicate smallpox in just 10 years, people rose to the challenge. Up to 150,000 people worked on the campaign and, with a last natural case discovered in Somalia in October 1977, smallpox in the wild was eradicated.
It may seem unlikely that we can ever regain that resolve. Instead of presenting a unified front against covid-19, we fought bitterly, and three years later, our shared response seems to be an unwillingness to even think about epidemic diseases. Politicians have become particularly nervous about what should be common sense measures to protect basic public health. In the United States, the Pasteur Law would address the crisis of resistance to antibiotics that threatens our entire health care system, but has been stalled in Congress for years.
Funding for pandemic preparedness programs is due to be reauthorized in September, but its approval is in doubt. Given the catastrophic losses caused by the covid-19 pandemic, this kind of inaction is puzzling.
The way to return to preventing infectious diseases is by focusing on the pathogens we already know well and for which we have new tools. Thinking in particular of three diseases with a long history of maiming, crippling, and killing human beings: tuberculosis, malaria, and polio.
The dark star of the three is tuberculosis. As Covid deaths decline, tuberculosis (TB) has regained its place as the deadliest infectious disease, killing around 1.5 million people a year, mostly in the developing world.
The ability to reduce that number is within our grasp. The development of diagnostic technologies like GeneXpert has reduced tuberculosis testing times from weeks to hours, a crucial difference because today, 40 percent of tuberculosis victims go undiagnosed. This spreads the disease to those around them.
Treatment with an antibiotic regimen has also become easier, being shortened from two years to just six months for antibiotic-resistant cases. In normal cases, the treatment time is likely to decrease soon as well.. Promising vaccines are also in the works.
The United States and other donor countries could argue that they are already doing more than their fair share. But donors still fall short of more than half the funding the WHO says it needs to end the tuberculosis epidemic by 2030.
Currently, up to 13 million Americans are living with a latent TB infection, according to estimates from the Centers for Disease Control and Prevention. The realities of modern travel mean that none of us is protected until we have protected people everywhere.
In June, for the first time in 20 years, cases of local malaria appeared in Texas and Florida, raising the specter that it could once again be endemic in the United States.
That should serve as a reminder that in 2021 an estimated 247 million cases of malaria occurred worldwide and 619,000 people died. The vast majority of them were children from sub-Saharan Africa and South Asia.
Malaria prevention has stumbled due to rapidly evolving resistance to drugs and insecticides. But we are moving forward with new tools and a more agile response.
Sixteen countries, from El Salvador to China, with efforts coordinated by the WHO, have eliminated malaria since 2000, and another 10 intend to do so in the next two years. In addition, public health agencies have a malaria vaccine for the first time, and about 1.7 million children in three countries in Africa—Ghana, Kenya, and Malawi—have already received at least one dose.
The vaccine is only moderately effective, but by preventing around 40 percent of cases of the deadliest variety of malaria, it is expected to save tens of thousands of children every year. With adequate funding, WHO’s goal for this decade is to reduce the number of annual deaths to less than 100,000—on the road to eradication.
Finally, polio offers the most immediate opportunity for great success. In 1988, when international agencies, national governments, and non-profit organizations launched an eradication campaign, polio was still endemic in 125 countries, paralyzing about 350,000 people each year, mostly young children.
This year there have been only seven cases of wild poliovirus, all in a small mountainous area on the border between Pakistan and Afghanistan, the last two countries where it is still endemic.
What we need is a powerful sense of our shared humanity in the fight against some of our oldest killers, and the courage and determination to win this fight now.
Richard Conniff is the author of “Ending Epidemics: A History of Escape From Contagion.”
By: Richard Conniff
BBC-NEWS-SRC: http://www.nytsyn.com/subscribed/stories/6873480, IMPORTING DATE: 2023-08-31 22:20:07
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