Like many, we were relieved to hear from the Government of Madagascar and WHO in November last year that the pulmonary plague outbreak in Madagascar had been contained. Plague is a disease caused by bacteria called Yersinia pestis that are typically transmitted by rodents through their fleas but can also be transmitted from human to human. Since the onset of the outbreak in early August 2017, there had been 2,300 human cases of plague reported, leading to 207 deaths (WHO update). WHO called for continued vigilance until the end of the plague season at the end of April, as more cases of bubonic plague should be expected and could lead to a resurgence of pulmonary plague. The President of Madagascar also committed to establishing a permanent “plague unit” at the level of the Prime Minister’s office to work on the eradication of plague―rightly so, as experience tells us that addressing risks at the interface of human, animal and environmental health is challenging.
The 2014–2015 Ebola epidemic was the longest and deadliest Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths and reversing a decade of mortality and economic gains in Guinea, Liberia, and Sierra Leone. The statistics would probably have been very different, however, had an Ebola vaccine been available or even further along on the clinical development path.
Turkey is a transcontinental country, with territory contiguously spanning two continents. It is bordered by eight countries and is circled by sea on three sides. The international airport in Istanbul is the 10th busiest airport in the world, and last year, in 2016, more than 60 million passengers went through it. Of these, two-thirds were international passengers. Yes, Turkey is very vulnerable to disease outbreaks. Indeed, all countries are.
In my blog in February I described the rationale behind the creation of the International Working Group on Financing Preparedness (“IWG”), which is focused on how to ensure sustainable funding for the first line of defence against pandemics – prevention, identification and containment of infectious disease outbreaks at a national level. The IWG had its second face-to –face meeting earlier this month in London at Wellcome Trust. The goal of this meeting was to review the analytical work that had taken place over the last couple of months and debate a draft set of recommendations. Since that meeting we have been refining these recommendations with a view to presenting them in draft form to the UN Secretary General’s Global Health Crisis taskforce on May 1 and launching the full report at the World Health Assembly on May 25.
The case for investing in pandemic preparedness is –or at least, should be - completely compelling. Few things could kill as many people as an influenza pandemic. Few threats can cause as much economic disruption as the contagion of fear triggered by a rapidly escalating epidemic. Reinforcing capabilities such as disease surveillance, diagnostic laboratories and infection control would be more effective and cost far less than spending money to contain outbreaks when they occur. Yet, so far, the global community has demonstrably not invested enough in preparedness. As a result, too many lives have been lost and too many livelihoods damaged, and the world remains scarily vulnerable.
Disease Outbreaks: A Constant Threat
The World Health Organization called for “heightened vigilance and strengthened surveillance efforts” last week to prevent and detect human transmission of a highly pathogenic strain of avian influenza or ‘bird flu’. And while no human cases have been reported and WHO itself called the risk “relatively low,” we know the potential devastating impacts of diseases spread from animals to humans.
Today the world is celebrating “One Health Day.” Sometimes great ideas appear simple, even intuitive: the One Health concept was created to demonstrate that the health of people and animals are interconnected, and that these are in turn, inextricably bound to the health of the environment on which all life depends.
In March 2014, Liberia announced that there were two suspected cases of Ebola in Lofa and Nimba counties. Six months later, Ebola had spread to 14 of the 15 counties of the country and a state of emergency had been declared. By the time the World Health Organization (WHO) announced that Liberia was officially ‘Ebola free’ in May 2015, more than 10,000 Liberians had contracted the virus and the economic fortunes of the post conflict nation had faced a significant downturn.
These are some of the views and reports relevant to our readers that caught our attention this week.
More people in less space: rapid urbanisation threatens global health
The global population looks set to rise to 9.7 billion people by 2050, when it is expected that more than two-thirds of humanity will be living in urban areas. The global health community is bracing itself. Compared to a more traditional rural existence, the shift in lifestyle and inevitable increase in exposure to pollution will lead to significant long-term rises in non-communicable diseases such as cancer and cardiovascular disease. Worrying as this prospect may be, current population trends are already altering the global health landscape even faster than we realise, and that could pose far bigger and more immediate problems. When population growth is combined with other pressures, such as climate change and human migration, some parts of the world are likely to experience unprecedented levels of urban density.
How Being Stateless Makes You Poor
For the first 24 years of his life, third-generation Palestinian refugee Waseem Khrtabeel rarely noticed any difference between himself and his Syrian neighbors. Like his parents, Khrtabeel was born and raised in Damascus. He speaks with a distinct Syrian accent, just like that of his many Syrian friends. But Khrtabeel is not like other Syrians. He’s stateless.The first time Khrtabeel, 30, grasped the magnitude of that word was in early 2010, after graduating from Damascus University with a mechanical engineering degree. Khrtabeel was elated when he secured an interview with the Saudi Binladin Group, one of Saudi Arabia’s most prominent construction companies. On an unseasonably warm day in January, he arrived at the company’s recruiting office in southwestern Damascus promptly at 2 p.m., energized and confident. He was shown the door less than seven minutes later.
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The recent, devastating Ebola crisis reminded the world of a hard truth: Pandemics are not just a threat to human health, they are a threat to societies and economies. That there will be another pandemic is not a question of “if,” but a question of “when.” A catastrophe on the scale of the 1918 flu epidemic could conceivably wipe out all development gains of the last century. We recognize this, but, still we are unprepared.