July 1996
GENEVA — In the age-old battle of man vs. disease, it looks like the diseases are winning, according to The World Health Report 1996.
In its annual report, the World Health Organization (WHO) noted that of the 52 million people who died during 1995, 17 million died as a result of infectious diseases.
A few infectious diseases are close to eradication, such as poliomyelitis, dracunculiasis and leprosy. Yet, this achievement is offset by the debut of previously unknown diseases — such as Ebola hemorrhagic fever, AIDS and hantavirus — and the re-emergence of diseases that were thought to be controlled, such as malaria and tuberculosis.
Such diseases have not simply returned; they are often drug-resistant and thus are virtually untreatable. Other "old" diseases, such as cholera and yellow fever, are emerging in regions where they had not existed before, the report said.
"Today's crisis is likely to get worse before it gets better," said WHO Director-General Hiroshi Nakajima, MD, PhD. "Internal and international movement of populations, including refugees and migrants; haphazard and uncontrolled urbanization; economic development; and changes in patterns of land use as well as in ecology and climate are creating new opportunities for the spread of infections."
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Describing the situation as a "serious crisis requiring immediate action," WHO offered solutions. The first priority is "to complete unfinished business," the report stated. That is, finish the eradication of polio, dracunculiasis, leprosy and Chagas disease.
"This does not require a huge expenditure, and if the resources are not found, these diseases will return with a vengeance, and previous efforts will be wasted," the report said.
Childhood immunizations, clean drinking water and sanitary facilities, school health programs to treat worm infections and micronutrient deficiencies, and appropriately diagnosing and treating conventional sexually transmitted diseases are cost-effective interventions that can be implemented.
The second priority is to regain control of old diseases that re-emerged as new problems, such as tuberculosis, dengue and malaria. WHO proposed eliminating the source of infection from communities, strengthening surveillance and boosting research into treatment and diagnosis. Also included in this category is improving vaccines for measles, neonatal tetanus, bacterial meningitis and tuberculosis.
Tackling newly emerging diseases is the third priority. The strategy includes a quick response to outbreaks while researching the natural course, treatment and prevention of new diseases.
Obstacles remain, however, the foremost of which is poverty, according to the WHO report. More than 1 billion people live in extreme poverty, according to the report, and half of the world's population has no regular access to essential drugs.
Population growth, urbanization, overcrowding and migration — including fleeing refugees — also contribute to the spread of infectious diseases, with the situation made worse by unclean water and poor sanitation. International travel, trade and tourism open the world to infectious agents.
"The only answer to a global threat is a global response — a response of the kind that saw smallpox vanquished forever," Nakajima said. "What is needed now is global solidarity that goes beyond selfish interests and national boundaries; it must provide a truly unprecedented response to make this world a safer and healthier one for all."
For more information, see:
- WHO. Executive Summary: The World Health Report 1996 — Fighting Disease, Fostering Development Geneva: WHO; 1996.
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