- THE NETHERLANDS -- According
to a recent National Academies of Sciences report,* (infectious) diseases
now can circle the globe with "near telephonic speed, making long-distance
connections and intercontinental infections almost as if by satellite."
This warning emerged from their 2006 workshop on the impact of globalization
on infectious disease control. This workshop was attended by the most
eminent disease-control scientists in the world, all members of the Board
on Global Health**. (For a summary of their names, see the NOTES below.)
- These scientists concluded that "the increasing
cross-border and cross-continental movements of people, commodities, vectors,
food, capital, and decision-making power that characterize globalization,
together with global demographic trends, have enormous potential to affect
the emergence and spread of infectious diseases."
- "From international tourists to war-displaced refugees,
more people are on the move than ever before. They are also traveling
faster and are regularly visiting what used to be very remote parts of
the world. This movement has the potential to change dramatically the
factors involved in the transmission of infectious disease.
- "Of particular concern over the next 15 years, as
the global population continues to grow and economic and social disparities
between rich and poor countries intensify, the world will likely continue
to witness rapidly growing numbers of migrants in search of employment
or a better quality of life. In fact, many political scientists and demographers
already refer to the twenty-first century as the "century of migration".
- "Re-emerging infectious diseases (among migrant
populations) have been implicated as a key causal factor in the global
spread of such diseases, most notably drug-resistant tuberculosis (TB),"
these eminent scientists have established.
- LINK: http://www.nytimes.com/2007/06/22/world/22who.html?ref=health
- Indeed data from Doctors Without Borders (MSF) also describes
the TB +HIV co-infection epidemic in South Africa as a 'ticking time-bomb"
-- and these combined warnings should be ringing the medical alarm bells
worldwide, especially as there will be a sudden jump in travel to the
forthcoming Soccer World Cup 2010 in South Africa, which some 350,000
healthy young soccer fans are expected to attend from all over the world.
- LINK: http://www.doctorswithoutborders.org/news/tuberculosis/
- Their latest data shows about 9-million active infections
of Tuberculosis developing worldwide annually - which even with all the
great many antibiotic drugs available worldwide still leads to an annual
two-million deaths of "ordinary TB.
- 2-million South Africans have already died of XDR-TB
- But the greatest danger to global health comes from the
co- infection of Tuberculosis and HIV-Aids in South Africa, where more
than 2-million people have already died since 2001. This co- infection,
referred to as the 'terrible twins' in that country, makes carriers so
resistant to any drugs that they die very rapidly from it - and they remain
highly infectious to all others as these patients cough these mutated
aerobic TB+HIV bacillae out in large clouds. Today, about 30 percent of
40 million people are co- infected with TB+HIV -- and the vast majority
of these patients live in southern African countries, with the epicentre
in South Africa.
- There, Doctors Without Borders run two unique clinics
which specifically treat TB+HIV co-infected patients - the "terrible
twins" as South African doctors refer to them.. One dedicated young
Belgian doctor Dr Gilles van Cutsem, has also been working hard at the
MSF's Khayelitsha clinic near Cape Town to find a much faster way to diagnose
these 'terrible twin' diseases. Until a faster diagnosis can be found,
many millions of unidentified XDR-TB patients will continue to pose a
danger to the rest of the world community: it takes at least 2 months
before a diagnosis can be confirmed with present tests and this mutated
South African TB-HIV strain infects via the airborne TB-bacillus.
- In South Africa, XDR-TB is allowed to flourish mainly
due to the unscientific policy of the South African regime itself - which
views any enforced isolation of such highly infectious TB+HIV patients
as a 'violation of human rights' and has issued a directive to its national
health facilities to this effect:
- See this official South African policy statement on a
video newsclip on state-controlled TV:
- Dr Van Cutsem said one reason why so many TB+HIV co-infected
patients also develop Extremely-Drug-Resistant Tuberculosis, is their
problematic treatment.At the moment, treatment consists of a complicated
cocktail of up to 16 drugs a day which need to be taken under close supervision.
Patients have to report to the clinic every day. This so-called 'DOT"
treatment method is problematic, very expensive and so cumbersome that
many patients drop out of the drug-treatment programme -- and thenr apidly
develop drug-resistant tuberculosis and die.
- "These patients have to take between 13 and 16 pills
a day. Also, there are interactions between AIDS and TB treatment which
cause often unpleasant side effects like liver problems or allergies,"
highlights Dr. Van Cutsem.
- MSF's TB treatment centres worldwide;
- According to the latest data from Doctors Without Borders,
about nine million active infections of 'ordinary' TB develop annually,
leading to about two million deaths even with all the available drug-treatments.
Moreover, TB is one of the most common infections among the HIV-infected
and the is thetop killer of people with AIDS globally. A World Health
Organization report finds that the rise in drug-resistant TB strains corresponds
directly with the world's fastest-growing HIV infection rates. Multidrug
resistant strains of TB (MDR-TB) are particularly deadly and number up
to 424,000 annually at the moment. The extremely-drug-resistant strain
is particularly deadly in south Africa where the killl-rate is more than
85%. In South Africa, it has now taken on epidemic form countrywide, being
diagnosed in hospitals and clinics all over the country.
- NOTES AND LINKS
- *National Academies of Sciences report, publ. by Board
on Global Health: 'The Impact of Globalization on Infectious Disease
Emergence and Control: Exploring the Consequences and Opportunities,'
Workshop Summary - Forum on Microbial Threats (2006);
- National Academies of Sciences (USA): http:// www.nationalacademies.org/
- The Board on Global Health represents the most eminent
medical scientists in the USA:
- Margaret Hamburg, M.D.(Chair) Vice President for Biological
Programs, Nuclear Threat Initiative (founded by Ted Turner);http:// www.nti.org/
- George A. O. Alleyne, M.D. Director Emeritus, Pan American
Health Organization ;http://www.paho.org/
- Yves Bergevin, M.D., MSc, FRCP(C), FCFP Coordinator Reproductive
Health / Africa Division, United Nations Population Fund; http:// www.unfpa.org/
- Donald M. Berwick, M.D. Clinical Professor of Pediatrics
and Health Care Policy, Harvard Medical School and President and CEO,
Institute of Healthcare Improvement ;http://www.ihi.org/
- Jo Ivey Boufford, M.D.Professor, Robert F. Wagner Graduate
School of Public Service, New York University;
- David R. Challoner, M.D. (IOM Foreign Secretary).Vice
President for Health Affairs, Emeritus, University of Florida ;
- Ciro de Quadros, M.D., M.P.H.Director, International
Programs, Sabin Vaccine Institute http://www.sabin.org/
- Sue Goldie, M.D., M.P.H. Associate Professor of Health
Decision Science, Department of Health Policy and Management, Center for
Risk Analysis, Harvard University School of Public Health;http:// www.hcra.harvard.edu/
- Richard L. Guerrant, M.D.Thomas H. Hunter Professor of
International Medicine, Director, Center for Global Health, University
of Virginia School of Medicine http:// www.hopkinsglobalhealth.org/
- Jerry Keusch, M.D.;Assistant Provost for Global Health
at Boston Univ. School of Medicine and Associate Dean for Global Health
Boston Univ. School of Public Health; http://www.massgeneral.org/ globalhealth/
- Jeff Koplan Vice President for Academic Health Affairs,
Emory University https://admin.emory.edu/StrategicPlan/reports/ StrategicPlan4.11.06/Theme%20Participants.doc
- Sheila Leatherman Research Professor, Department of Health
Policy & Administration, UNC at Chapel Hill School of Public Health;
- Michael H. Merson, M.D. Anna M.R. Lauder Professor, Yale
University School of Medicine;
- Mark L. Rosenberg, M.D. Executive Director, The Task
Force for Child Survival and Development, Emory University http:// www.sph.emory.edu/center_tfcsd.php
- Phillip K. Russell, M.D. Professor Emeritus, Johns Hopkins
University, Bloomberg School of Public Health; http:// www.jhsph.edu/?