April 28th, 2009

A vaccine needed for bad statistics

Posted by: Eric Auchard

ericauchard1- Eric Auchard is a Reuters columnist. The views expressed are his own –

If you look no further than the latest headlines, you might think a worldwide flu pandemic was already underway with a very real threat to millions of lives.

While there are many unanswered questions early on in the outbreak of flu from Mexico, it is crucial to remember that the number of deaths and reported infections remain small — even if its spread across the globe has proved worryingly rapid.

While the infected need access to medical care and anti-viral drugs, the rest of the world needs an inoculation against scary statistics and misinformation.

The Internet Age allows facts and rumour to spread almost instantaneously. But knowing of outbreaks across the globe must not be confused with risks of catching the disease.

Already in this outbreak, Lebanon’s health minister has called for a halt to the national custom of greeting one another with kisses. Several countries including Russia and China have banned pork imports from Mexico and parts of the United States in the belief that meat could spread the flu.

So far, up to 149 are reported to have died of swine flu in Mexico. The World Health Organisation has upgraded the level of pandemic threat to four on a scale of six — sustained human-to-human transmission. Stage five signals an “imminent” pandemic.

However, influenza is a big killer every year, with or without a pandemic.

WHO estimates flu kills upward of 250,000 to 500,000 people year after year. “Normal” flu epidemics infect 3 to 5 million a year. Statistics are complicated by inconsistent reporting. Flu often leads to other ailments that end up being listed as the ultimate cause of death.

Flu’s typical victims are the elderly, the infirm or the young. The difference with swine flu outbreak in Mexico is that otherwise healthy adults aged 20-50 are vulnerable.

But so far the new swine flu death rates are lower than other recent pandemic scares, a report by Barclays Capital notes. The 2,200 swine flu infections reported have resulted in deaths in 7 percent of cases. Avian flu has killed 61 percent of the 421 people infected since 1997. The death rate from SARS was around 10 percent.

Outside Mexico, 50 infections have been reported in the United States, Canada, Israel, New Zealand, Spain and Scotland. But health experts are baffled that infections outside Mexico appear to be milder and have caused no deaths.

The world’s most recent flu pandemic 41 years ago was the 1968 Hong Kong outbreak, which claimed one million lives.

Historically, pandemics occur about three times a century. But like predictions of the next big earthquake, medical experts profess they have no idea when to expect the next pandemic.

Inevitably, comparisons end up turning back to the Spanish Flu of 1918-1920, which killed more than 50 million people, or 2.5 percent of the world’s population.

That scourge followed the massive troop movements of World War One at a time of poor communications and before the invention of penicillin and modern healthcare systems. Post-war censorship rules restricted access to news, which limited the ability of communities to make informed decisions to protect themselves against the spread of the flu.

The descent into a global pandemic is not inevitable. Air travel may spread the disease in its early stages, but modern communications and medicine can arm us to respond quickly as the disease evolves.

March 6th, 2009

Toll of malaria high for African women

Posted by: Ray Chambers

rgc-official-photo-21

-- Ray Chambers is a philanthropist and humanitarian who has directed most of his efforts towards children. In 2008, the U.N. Secretary-General appointed him as his first Special Envoy for Malaria. The views expressed are his own. --

Malaria infects one quarter of a billion people each year. Nearly one million of those afflicted die, taxing overburdened health infrastructures and decreasing productivity in Africa, where 90 percent of cases occur.

In some countries on the continent, 60 percent of all outpatient visits are malaria related, with one quarter of worker absenteeism due to the disease. Taking all lost time and productivity into consideration, malaria costs Africa more than $30 billion annually.

The mosquito carrying the deadly malaria parasite makes no distinction when choosing its victim. Young or old, male or female, everyone in endemic regions remains at risk; however, International Women's Day on March 8th prompts us to examine independently the immense burden women shoulder as a result of malaria.

The disease strikes infants, children under five and pregnant women in astonishing disproportion, as these segments of the population account for 90 percent of malaria deaths. Given the dual role of women as both victim and primary protector of victims, malaria clearly belongs under the umbrella of traditional women's health issues.

It deserves particular recognition as a priority in maternal health, which the World Health Organization defines as pregnancy, childbirth and the six-week postpartum period.

Unfortunately, the early stages of motherhood in Africa can entail suffering, ill-health and even death, as one-in-five African newborns will not live to his or her fifth birthday.

Mothers confront an endless series of menaces, from malnutrition to dehydration, but almost nothing poses a greater threat to the well-being of their children than malaria, which claims three times as many young lives as HIV/AIDS.

Even those children who survive the disease often face lifelong challenges, as the disease robs their brain and body of nutrients at an early age. In turn, over 12 percent of children who do survive suffer long-term cognitive deficiencies.

Malaria raises additional implications with respect to maternal health. Pregnancy in Africa carries an inherent risk for mothers, too frequently resulting in maternal fatality.

When a pregnant woman contracts malaria, this risk becomes significantly greater. Moreover, pregnant women who have malaria also have a higher risk of delivering low-birth-weight babies, a major cause of infant mortality.

While the effects and consequences of malaria appear incredibly dispiriting, reason for hope exists, for we know that we can prevent deaths from malaria among women and children through the application of proven interventions, especially by having them sleep under a long-lasting insecticide-treated mosquito net (LLIN).

Equally as important as this knowledge, we also have harnessed the collective global will and resources to turn the tide against malaria.

In 2008, United Nations Secretary-General Ban Ki-moon issued a bold call to action to provide all endemic countries essential malaria control interventions by the end of December 2010, a call that rallied a broad coalition of funding and implementation partners, who have pledged over $3 billion in malaria funding.

At this moment, we can point to definite indicators of progress toward our overall goal of universal provision, with data revealing that LLINs now have been distributed to more than 40 percent of the population in endemic African nations, compared to less than 10 percent in 2005.

Over 140 million LLINs have been distributed over the past three years, offering protection to nearly 300 million people.

At the highest levels, women have led us to this unique moment in history. Dr. Awa Marie Coll-Seck, Executive Director of the Roll Back Malaria Partnership, Margaret Chan, Director-General of the World Health Organization, and Ann Veneman, Executive Director of UNICEF, represent only a few of the women who have had a most profound influence in mobilising support.

Concurrently, women have been galvanizing around malaria at a grassroots level, with advocates such as the mother of African soccer star Michael Essien leading malaria eradication programs.

While these and other women have guided us to a point filled with such promise, we hold no hope of reaching our target without the full engagement of women everywhere.

As evidenced with other issues, the unified commitment of women to a cause historically has yielded dramatic results. The collective contributions of women to the malaria effort will prove absolutely essential, especially as we work to increase LLIN utilisation throughout Sub-Saharan Africa in the next 22 months.

On this International Women's Health Day, the malaria community sits poised to complete an undertaking previously viewed as impossible and, in the process, alleviate the unique and terrible sorrow the disease imposes on women. And it is women on whom the success of this mission so dearly depends.