Weighing Our Woes: Just as We Marshal Resources against Terrorism, We Must Increase Our Efforts to Control an Even More Prolific Killer-Infectious Disease. (Editor's Journal)
Finneran, Kevin, Issues in Science and Technology
The horror of September 11 is difficult to absorb. We all looked in disbelief as the tape of the buildings collapsing was played over and over and over again. We watched thinking that if we saw it often enough perhaps we could feel the magnitude of the loss. For more than three months the New York Times ran biographical sketches of the people who were killed that day in an effort to help us slowly come to understand the magnitude of this mind-numbing tragedy.
On November 2, the Department of State in cooperation with the National Academies sponsored an all-day meeting on a human disaster of even greater magnitude--the spread of infectious disease in the developing world. The day that 3,000 people died at the Trade Towers and the Pentagon, more than 8,000 people died of AIDS, 5,000 people died of tuberculosis, and several thousand more died of malaria. Of course, these deaths are different, because disease is not murder. Nobody wanted these deaths to occur, no one made them happen.
Yet these deaths are not exactly the same as deaths from disease in the developed world. With the exception of AIDS, infectious diseases are not taking the lives of young people in the rich countries, because most diseases can be prevented or treated relatively inexpensively, and even AIDS is being contained by prevention efforts. In Africa infectious diseases are the cause of almost 70 percent of all deaths. What makes the enormous toll of death in the developing world not just the way of all flesh is that we know very well what has to be done to prevent most of these deaths. But we don't act. And by not acting, we know that we are signing an early death warrant for tens of millions of people.
The nation's leaders are not insensitive to the seriousness of this neglect. Even as the nation reeled in shock from the events of September 11, Sen. Bill First (R-Tenn.) and State Department science advisor Norman Neureiter told participants at the meeting how important it is to address global health problems. Secretary of State Colin Powell was scheduled to speak but was called away to meet with congressional leaders. His prepared remarks, which were read at the meeting, indicate that he understands the severity of the problem and is looking for ways to take effective action.
The most comprehensive description of the problem and what will be needed to fix it came from Barry Bloom, dean of Harvard University's School of Public Health. Using data from the World Health Organization, he painted a devastating picture of human suffering and economic disaster.
Tuberculosis infects 8.4 million people per year and results in 2 million deaths, virtually all in the developing world. About one-third of deaths of AIDS patients in Africa are attributed to tuberculosis. It results in $1 billion in lost income from people too sick to work, $11 billion in future lost income from those who die, and $4 billion in diagnosis and treatment costs. Malaria infects 400 million-900 million people a year and results in 0.7-2.7 million deaths. More than 36 million people are living with AIDS, and 25 million of them are in sub-Saharan Africa. Of the roughly 3 million AIDS-related deaths that occurred last year, about 2.4 million were in sub-Saharan Africa. Of the 5.3 million new infections in 2000, about 3.8 million were in sub-Saharan Africa.
The pain and suffering caused by infectious disease do not end with the infected individuals and their families. Bloom explained that the economic repercussions touch everyone in the developing countries and deepen the cycle of poverty that is the breeding ground of disease. Too many people are dying before they can use their education to contribute to the society through work. WHO estimates that the short life expectancy in the least developed countries (49 years) compared to the 77 years of people in the industrialized world results in an annual economic growth deficit of 1.6 percent, which becomes an enormous difference over time. …