Tropical Diseases
Neglected tropical diseases are transmitted diseases caused by parasites, and are usually found in tropical and subtropical regions. They mostly affect people in poverty who live in unsanitary conditions. Most of these neglected tropical diseases can be easily prevented with treatments and vaccinations that are affordable.

Lymphatic Filariasis

More than 1.3 billion people across 72 countries might be at risk for this disease, and more than 120 million people are infected by it. Lymphatic filariasis is caused by infections from parasites called filarial worms and leads to abnormal enlargements of body parts, which causes great pain. The disease is better known as elephantiasis. There has been some success in stopping the spread of the disease by using preventive chemotherapy. The disease can also be treated with a care package that alleviates pain and prevents any more disfigurement.

Onchocerciasis (River Blindness)

The River Blindness disease gets its name from the black flies that are found in fast-flowing streams and rivers. Infections cause blindness and skin disease. Ninety percent of cases occur in Africa, with a lot of cases in Latin America and Yemen as well. Long-term skin damage and blindness can be prevented with a medicine called ivermectin.

Schistosomiasis (Snail Fever)

Schistosomiasis gets the nickname “snail fever” from freshwater snails carrying the disease. Children can be highly susceptible to the disease when they swim and fish in infested waters. Snail fever has spread in a lot of poor areas in Africa because of migrations and population movements, but the World Health Organization has worked to spread awareness and treat infections. The WHO even implemented campaigns to distribute praziquantel, which can be a large-scale treatment of schistosomiasis.

Ascariasis (Roundworm Infection)

Ascariasis is one of the most common neglected tropical diseases, infecting more than one billion people per year and causing 60,000 deaths each year. The disease is caused by a parasitic roundworm called Ascaris lumbricoides. More than one hundred worms can infect a human at a time. The earthworm eggs can be accidentally ingested through contaminated food, water and soil. Some symptoms can be minor, such as coughing, loss of appetite and a fever. In severe cases, it can cause malnutrition, intestinal blockage and pneumonia. There have been companies donating to help fight the disease, such as Johnson and Johnson, pledging to donate 200 million tablets of mebendazole by 2020, and GlaxoSmithKline, donating one billion tablets of albendazole a year.

Trachoma

Trachoma is another eye disease that is much more severe than River Blindness. It is one of the most infectious causes of blindness and affects about 1.9 million people. Trachoma is either spread through physical contact with the eye or nose discharge from other people. Fleets of flies have been known to carry the disease as well. This neglected tropical disease mostly affects women and young children in poor rural areas in Africa and Asia. The World Health Assembly has adopted Resolution WHA51.11 which is geared towards eliminating the disease by 2020.

With continued intervention from governments, NGOs and corporations, these neglected tropical diseases can be effectively targeted and eliminated, ensuring lives of enhanced productivity and prosperity for millions of people around the world.

Emma Majewski

Photo: Flickr


Decades of war, along with the refugee crisis created conditions where some of the top diseases in Iraq have become prevalent. They include the infectious diseases of cholera, tuberculosis and leishmaniasis. Sanctions in the 1990s devastated the economy, and Iraq has been unable to improve conditions as a result. The pronounced lack of public infrastructure, medical resources and an inability to continue research exacerbate infection rates. While the destruction of war dismantled these, the poverty of Iraq has clear, yet unexpected, connections with these three issues.

1. Lack of Funding Makes Building Basic Infrastructure Challenging in Iraq

People contract cholera by drinking water or eating food contaminated by the bacterium Vibrio cholera. The disease can cause severe diarrhea, which may lead to death. Without clean drinking water and sewage removal, Iraqis can infect their communities, causing an outbreak of the disease. Additionally, the housing in refugee camps is often crowded and does not have proper water and sanitation facilities.

A parasitic disease called leishmaniasis transmits to humans through certain insects and animals typically found in poor living conditions. Humans can also spread the disease. Poor waste management attracts flies and rats. As a result, the infected animals are lured within close proximity to Iraqis, causing many to become infected. Inadequate housing and sanitation in Iraq provide the bacteria ample opportunities to increase infections through human-to-human contact.

Adequate housing, access to clean water and proper sewage disposal systems all cost money. Building and maintaining such infrastructure is challenging in lower-middle-income countries such as Iraq. The World Health Organization (WHO) states that a long-term investment in infrastructure is ultimately needed to fight cholera. Improved waste management and sanitation systems would also reduce the spread of leishmaniasis.

Progress is being made toward restoring infrastructure. The World Bank funded the rebuilding of water lines and training of water facility workers. Six hundred thousand Iraqis received improved drinking water daily, while 400 km of water lines, 90 km of sewage lines and house connections improved. Sixty thousand cubits of water are also being treated daily.

2. An Inability to Fund Medical Surveillance is Detrimental to Disease Control

The World Health Organization reports the financial crisis in Iraq is crippling the country’s disease surveillance. As a result, reports of the actual number of infected people may not be accurate.

Disease surveillance involves finding infected people, diagnosing them and keeping records of their disease and treatment course. It’s important to reducing transmission of leishmaniasis, cholera and tuberculosis. By diagnosing patients quickly, they are less likely to spread the disease. It also ensures patients are receiving proper treatment.

Tuberculosis is a lung infection that spreads through the air. Disease surveillance is most important in containing tuberculosis outbreaks. Treatment for the infection can require up to six months of antibiotics and careful monitoring. Improper use of antibiotics causes the bacteria to resist medications, resulting in a more difficult treatment plan. Resistant forms of tuberculosis require more expensive antibiotics, which can cost 10 times more than simpler antibiotics. More expensive drugs are a clear burden on any healthcare system.

The WHO has funded the training of several healthcare professionals to treat and monitor cholera outbreaks. Meanwhile, there may not be enough surveillance of cholera, and the disease rate is likely greater than reported. Iraq also does not have enough medical centers to diagnose leishmaniasis. A large grant, governed by the United Nations Development Programme greatly improved Iraq’s tuberculosis crisis, however, these improvements are threatened by Iraq’s financial crisis.

As of 2013, Iraq spent 3.3 percent of its gross domestic product (GDP) on healthcare. While this is slightly more than others in the Arab world, it is lower than the six percent world average spent on healthcare. As the conflict and humanitarian crises persist, the healthcare budget decreases, requiring continued funding from non-Iraqi government sources. If foreign aid does not continue funding health surveillance, current disease outbreaks may become worse.

In 2013, the WHO started the EWARNS system. This program monitors disease throughout Iraq, trains health professions in diagnosing conditions and improves laboratory capabilities. Initially, there were only five disease reporting centers, now there are over 180.

3. Research is an Important Piece in Healthcare but Low in Financial Priority

Treating disease outbreaks requires an evaluation of current practices and research into new treatments. Furthermore, some of the top diseases in Iraq, such as leishmaniasis, need further research to discover vaccines and better diagnostic methods. The majority of Iraq’s healthcare budget goes to daily medical expenses, like salaries, not research.

Outside funding helps research continue and reduces disease outbreaks. A portion of WHO’s tactic to treat cholera outbreaks at the worldwide level is research prevention and control of the infection. WHO is also researching treatment and control of leishmaniasis. After seven years of funding, the United Nations Development Programme brought the tuberculosis outbreak under control. This grant paid for many aspects of treating the disease, including research on its epidemiology and determining successful standard operating procedures.

The connection between poverty and healthcare in a country has many dimensions, especially in Iraq. War, social instability, education and the economy all impact disease progression and access to treatment. These do not negate the power of poverty’s impact on top diseases in Iraq.

Developed nations suffer many of the same diseases as impoverished nations. Poverty-related diseases are often treatable, and yet kill millions of people every year. This fact alone demands the need for further poverty-reducing measures.

Mary Katherine Crowley

Photo: Flickr


History is full of unsung female heroes, and the story of the fight against disease is no exception. March 8 is celebrated as International Women’s Day, and global health organizations worldwide took the opportunity this year to recognize amazing women who have made, and continue to make, important contributions. Here are five awesome women who fought disease:

 1. Lady Mary Wortley Montagu, 1689-1762

Lady Montagu was almost singlehandedly responsible for introducing inoculation to Western medicine. An accomplished poet and letter writer, Montagu became an advocate for global health after she witnessed a smallpox vaccine being administered during a visit to the Ottoman Empire. She used her writing skills to defend the practice at home in England, where she defied European doctors by having her son Edward vaccinated.

 2. Dr. Isabel Morgan, 1911-1996

Instrumental in the fight against polio, Morgan broke new ground in the medical understanding of vaccines with her work during the 1940s. She and her team proved that “killed-virus” vaccines were effective in the creation of antibodies in the immune systems of monkeys, preventing the virus from passing the blood-brain barrier. Thanks to her research, a safe and effective vaccine for humans was created and continues to save lives today.

3. Dr. Rebecca Lee Crumpler, 1831-1895

Crumpler challenged the status quo by becoming the first African-American woman to earn an M.D. She devoted her practice to caring for freed slaves and the poor after the end of the Civil War in 1865. Her written work published in 1883 Book of Medical Discourses, which contains a brief autobiography of her career, is one of the first medical references in the U.S. authored by an African-American individual.

4, Henrietta Lacks, 1920-1951

Lacks fought disease in a most surprising fashion: with her own cellular tissue. After being diagnosed with cervical cancer at age 30, Lacks provided a sample from a tumor that contained what medical research refers to as “immortal” cells. Her cells were code-named ‘HeLa cells’ by doctors and researchers. These particular cells are able to survive indefinitely in a laboratory environment, for reasons still partially unknown to science. They have been used to learn more about everything from developing vaccines to cellular behavior in zero gravity environments.

5. Nontokozo Zakwe, 1993-current

Zakwe is living proof that even without medical degrees, girls can grow up to become awesome women who fought disease. Zakwe is a volunteer and ambassador for the DREAMS partnership across 10 African countries, led by the U.S. President’s Emergency Plan for Aids Relief (PEPFAR). After being inspired by her mother’s battle with HIV, Zakwe continues to raise awareness and provide education for preventing the spread of the virus throughout the world.

On International Women’s Day 2017, the Joint United Nations Programme on HIV/AIDS (UNAIDS) released a report outlining its impressive goals to reduce the number of girls and women infected by the virus by providing access to reproductive health options to 90 percent of the population by 2020. Among the ranks of those working to achieve that reality, there will surely be more pioneering women in the global fight against the disease.

Dan Krajewski

Photo: Flickr

Diseases in Ireland
Like many developed countries, Ireland, with its green mountainsides and frequent rainfall, is home to many preventable, lifestyle-driven, diseases. Increasingly sedentary lifestyles and high rates of smoking mean the Irish people are susceptible to deadly but often avoidable diseases. Discussed below are the top three deadliest diseases in Ireland and their causes.

Deadliest Diseases in Ireland

 

1. Coronary Heart Disease

Ireland’s deadliest disease is coronary heart disease, which accounts for eight percent of deaths. While treatment options have improved, preventative measures are even more crucial, as 80 percent of coronary heart disease is preventable. Deaths from the disease have actually halved since the mid-1980s. This is due mostly to lifestyle changes such as eating healthier and exercising.

2. Lung Cancer

Cancer causes 30 percent of deaths in Ireland, six percent of which are due to lung cancer. While lung cancer is only the third most common type of cancer in Ireland, more people die from it than any other type. This makes it one of the deadliest diseases in Ireland. Smoking plays a large role, as it is the number one cause of lung cancer in Ireland, as well as the leading cause of preventable deaths. However, there is good news. Smoking rates have dropped more than seven percent since 2004, due in part to a ban on workplace smoking.

3. Chronic Obstructive Pulmonary Disease (COPD)

COPD, which includes chronic bronchitis and emphysema, makes up five percent of deaths in Ireland each year. Smoking is also largely to blame for COPD. Though working or living in areas with large amounts of smoke or dust can also cause it. COPD mostly affects people over the age of 35. There are treatments for COPD that can help improve breathing. However, most doctors recommend lifestyle changes that would prevent further exposure to pollutants.

While Ireland has made significant progress in decreasing the rate of these preventable diseases, they still harm thousands of people each year. Continuing to push for healthy lifestyle changes will help combat the deadliest diseases in Ireland.

Alexi Worley

Photo: Flickr

 


Vaccination has long been recognized as one of the most effective and cost-efficient methods available in preventing disease, yet a number of barriers exist that prevent its worldwide implementation. To meet these challenges, multiple organizations and individuals are brainstorming cutting-edge technologies to provide innovation in vaccine delivery.

Worldwide Collaboration

At the end of February, the Global Alliance for Vaccines and Immunisation, more commonly known as Gavi, announced the continuation of its INFUSE initiative from 2016. The program, the name of which is an acronym for Innovation for Uptake, Scale and Equity in immunization, serves as an invitational challenge to ambitious entrepreneurs, inventors and businesses worldwide to envision and develop brand new ways to provide life-saving vaccines to people living in poverty across the globe.

“This platform brings together global problem solvers who can find new ways to accelerate immunization coverage and reduce inequities in access to vaccination for the world’s poorest children,” said Marie-Ange Saraka-Yao, Gavi’s Managing Director of resource mobilization and private sector partnerships.

Currently, global immunization rates hover at around 80 percent, and approximately 19 million children do not have access to a full course of vaccines to prevent death from preventable afflictions such as pneumonia and diarrhea.

INFUSE has already made a difference in its first year of existence by generating a partnership between Nexleaf Analytics and Google, now actively working toward solving the problem of safely packaging and storing vaccines at cool temperatures in order to keep them functional. The CEO and Co-Founder of Nexleaf Dr. Martin Lukac stated in Gavi’s press release: “Becoming an INFUSE pacesetter helped us improve vaccine cold chains in low-income countries, and to significantly increase our impact.”

Rethinking Traditional Delivery Methods

One Seattle organization, PATH (Plan for Appropriate Technology in Health), has proposed a multitude of new concepts and products to improve on vaccine delivery worldwide. Its innovations include chemical formulas that can be mixed with existing vaccines to keep them stable, even in extreme temperatures, as well as alternative methods of administering vaccines without the need for needles and syringes.

As a group leader for vaccine technologies at PATH, Debra Kristensen outlines on the group’s website, “Called a sublingual gel, [the vaccine dose] begins as a liquid solution, but when it’s dropped under the tongue, it turns into a gel. The vaccine is easily absorbed by the thin tissue under the tongue. Another important area of research is intradermal delivery…technologies we’re investigating range from jet injectors to microneedles, which could potentially allow for self-administration of a vaccine.”

These exceptional ideas and many more, likely to come from initiatives like INFUSE, are ongoing examples of how innovation in vaccine delivery saves lives worldwide.

Dan Krajewski

Photo: Flickr


With highly-publicized diseases like the Zika virus present in Cameroon, it is easy to overlook risks posed by more common diseases. However, with the country lacking resources and proper healthcare, preventable or treatable diseases are common in Cameroon. Listed below are the top three deadliest diseases in Cameroon.

1. HIV/AIDS

HIV/AIDS is the leading cause of death in Cameroon, accounting for 13.4 percent of deaths. Cameroon has one of the highest rates of HIV infections in sub-Saharan Africa. Six new HIV infections occur every hour. While the number of infections in Cameroon has rapidly increased since the 1990s, recent efforts to combat the disease could help decrease the rate of infection. Subsequently, the government has launched initiatives to increase testing, encourage condom use, and bring better healthcare to regions with the highest rates of infection.

2. Lower Respiratory Infections

As one of the top diseases in Cameroon, lower respiratory infections kill about 29,000 people annually. That equates to 12.2 percent of deaths each year. These infections cause illnesses such as pneumonia and bronchitis. Lower respiratory infections are very common around the world and easily treated and prevented in most developing countries. However, a lack of adequate healthcare and awareness about prevention in Cameroon can make these infections deadly.

3. Diarrheal Diseases

Despite being easily prevented, diarrheal diseases still account for 14.4 percent of deaths in Cameroon. Diarrheal diseases disproportionately affect people living in poverty and in developing countries, where poor environmental sanitation and inadequate water supplies are more common. Although easily treatable, diarrheal diseases remain a top killer in the country. Simple interventions such as vaccines, oral rehydration tablets, and education initiatives about sanitation, could make a huge difference in preventing diarrheal diseases.

Despite the deadliest diseases in Cameroon being preventable and treatable, they remain widespread. Putting more resources toward basic healthcare and raising awareness about these diseases could help save thousands of lives each year.

Alexi Worley

Photo: Flickr


Tobacco use is still a huge problem in the world, killing around six million people a year. It can cause cancer, lung problems, heart diseases, gum problems, coronary heart diseases, and increased blood pressure. Low-income countries have the most users, but because of other major poverty issues, tobacco use control is not a huge priority.

Nearly 80 percent of the billion smokers in the world live in low and middle-income countries, and the number is predicted to rise. Studies show that the number of deaths per year related to tobacco use could kill more than eight million a year by 2030 with 80 percent of them being in lower-income countries.

Even if someone in poverty needed food, shelter, and education, there are studies that suggest that they are willing to spend money on tobacco because of its addictive qualities. Even though 80 percent of the population of Uganda live on less than $1 a day, 50 percent of men smoke while the poorest households in Bangladesh spend 10 times as much on tobacco as on education.

Marketing is a major cause of why users in poor countries smoke. The use of tobacco is actually declining in developed countries, but rising in developing ones. Prosperous first-world countries have constrained the advertising of smoking, but tobacco companies continue to target low-income areas. For example, before heavy advertising came about in the Soviet Union, very few women smoked. Then within ten years of the tobacco industry advertising in the Russian market, the smoking rates among women had doubled.

Because of a lack of education, people are not aware of the health risks of smoking. Only 38 percent of smokers in China are aware that smoking can cause coronary heart disease. Young people are more prone to advertising, and the tobacco companies use that advantage to target them. Children in impoverished nations are also exploited to work in tobacco farms to care for their families. The children’s health can be at risk, working long hours and being exposed to toxic pesticides.

How are organizations fighting this? The World Health Organization put up the WHO Framework Convention on Tobacco Control to call for scientific research to fight against tobacco use and improve global knowledge of its harm. The International Pediatric Association also works hard to combat tobacco use with children. The Bloomberg and Gates Foundation also devote a lot for their funding to tobacco control efforts. There have also been efforts from governments to increase the tax on tobacco, so people can avoid using it.

Developed countries are recovering from decades of tobacco addiction, and only government intervention in healthcare and industry regulations can allow the same to developing countries.

Emma Majewski

Photo: Flickr


Preventable diseases continue to claim thousands of lives each year in Africa, but leaders of state have taken a bold stand against this reality. An official pledge in January affirmed their commitment to realizing the goal of universal access to immunization by the year 2020.

African Union Commission Chairperson Nkosazana Dlamini-Zuma stated in a press release following the Addis Declaration on Immunization (ADI) summit: “With political support at the highest levels, we are closer than ever to ensuring that all children in Africa have an equal shot at a healthy and productive life.”

This announcement marks the continuation of ongoing efforts to provide immunizations to citizens of 40 separate countries by Gavi, the Vaccine Alliance. To date, Gavi has saved more than 4.5 million lives by providing vaccines.

“African leaders are making a sound economic investment in future generations,” Dr. Seth Berkley, the CEO of Gavi, said in response to the announcement.

Berkley’s comment is not figurative. According to a 2016 study by Johns Hopkins University, when factoring in quality of life and reduction in economic disease burdens, every one dollar invested by the U.S. in vaccination among the 94 poorest countries on Earth yields a staggering 44 dollars in returns. In those countries directly supported by Gavi, the figure rises even higher, to 48 dollars.

The extensive list of diseases prevented by such immunizations includes polio, whooping cough, tetanus, yellow fever, diarrhea, cervical cancers and the most deadly of all, measles. Due to its highly contagious nature, measles alone was the cause of nearly 40,000 deaths in Africa in 2013, based on a survey by the World Health Organization.

The African government is not alone in supporting immunization efforts for children. Africa United, a platform for raising awareness of global health issues, has enlisted star football athletes to provide public service adverts during this year’s Total Africa Cup of Nations tournament. “Football unites people from all across Africa and beyond,” stated Issa Hayatou, the President of the Confederation of African Football, the governing body of professional football for Africa. “Together we can help ensure millions of African children are immunized by 2020.”

Though great strides have been made during the past 15 years, approximately one in five young people in Africa still do not have access to vaccines that prevent these life-threatening diseases. This pledge may mark the first step in reducing that number to zero by providing universal access to immunization.

Dan Krajewski

Photo: Flickr

Vaccine StabilizersImmunizations are lauded as one of the greatest achievements in public health; the eradication of polio standing as a tremendous accomplishment and testament to this. According to one study, pre-vaccination incidence rates were used to predict polio occurrence and cost between 1970-2050. The program would have saved more than $128 billion in medical costs and more than 800,000 lives. By preventing millions of cases of paralysis, the polio vaccine has also significantly impacted the number of disability-adjusted life years. Unfortunately, success with other preventable diseases has been limited. One of the major barriers to immunization for other diseases has been storage requirements, and that is where vaccine stabilizers come in.

Several major childhood vaccines require strictly regulated storage conditions. One such vaccine is the rotavirus vaccine. Rotaviruses are the most common cause of diarrheal disease in children worldwide. According to the World Health Organization, more than 200,000 children under five die each year from rotavirus infections. One in 70 infected children requires hospitalization. Two vaccines are available and equally recommended for the prevention of rotavirus infection. Though one comes as a lyophilized powder, both must be stored at between two and eight degrees celsius. For resource-limited countries, where most rotavirus-related deaths occur, sustained temperature control is often unfeasible.

Researchers at the Ecole Polytechnique Fédérale de Lausanne are working to break down this barrier to immunization. They experimented with three additives that eliminate the refrigeration requirement. These vaccine stabilizers could prove to be the next breakthrough in public health. The researchers discovered that nanoparticles, polymers and sucrose each have the potential to prolong the stability of viral vector vaccines, by limiting the heat-induced fluctuations that destabilize vaccines.

If these vaccine stabilizers could be successfully applied to more vaccines, the public health benefits would be tremendous. The polio program has already demonstrated the efficiency and effectiveness of vaccination efforts. The returns are well worth the investment. If the onerous refrigeration requirements could be eliminated, several other preventable diseases could potentially be eliminated, or at least be drastically reduced, and the global health benefits would be immense.

Rebecca Yu

Photo: Flickr

Preparedness InnovationsWhen the Ebola virus broke out in 2014, the world was ill-prepared to respond. In all, there were more than 15,000 confirmed cases and 11,000 deaths. Although the outbreak was concentrated in West Africa, a handful of cases reached the United States and Europe. With the rise of globalization and intercontinental travel, the next epidemic could easily become a pandemic.

To combat this danger, a multinational coalition is needed. The formation of such a group — the Coalition for Epidemic Preparedness Innovations (CEPI) — was announced at the World Economic Forum in Davos earlier this year.

The Coalition for Epidemic Preparedness Innovations is backed by the governments of Norway, India, Japan and Germany. These countries are partnering with the Bill and Melinda Gates Foundation and the Wellcome Trust to invest in vaccines to prevent diseases that have the potential to cause the next great epidemic.

Given the cost-efficiency of immunization programs, the development of vaccines is an effective component of epidemic preparation. With an initial fund of $460 million, CEPI will be well worth the investment. Guinea, Liberia and Sierra Lione lost approximately $1.6 billion in GDP in 2015 alone. A worldwide pandemic would be drastically more costly; the World Bank estimates a flu pandemic would cost $3 trillion globally.

The Coalition for Epidemic Preparedness Innovations will initially focus on three viruses: MERS-CoV, Lassa and Nipah. These viruses are among the diseases identified by the World Health Organization that warrant prioritization. For each virus, CEPI hopes to develop at least two vaccines. This head start is critical, as vaccine development is a long, arduous process. On average, a vaccine takes about 10 years to reach the market, and epidemics take far less time to spread.

Although CEPI is a major step in the right direction, a more comprehensive strategy is necessary to control a potential pandemic. As shown by the Ebola outbreak, a global surveillance system is needed. In addition, vaccines cannot prevent all cases of disease; treatment development is also needed. The current members of CEPI have demonstrated admirable initiative in showing the world that everyone is a stakeholder concerning global health.

Rebecca Yu

Photo: Flickr