HEALTH: WHO Proposes New Model to Fight Infectious Disease

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Jan 31 2002 (IPS) - Health strategies that up to now have focused mainly on disease prevention must incorporate treatment with drugs, according to a new report released by the World Health Organisation (WHO).

“Today as opposed to five years ago, the paradigm for the control of infectious disease is not only prevention,” said David Heymann, executive director of communicable disease programmes in the WHO.

If applied, the new policy could cut the number of deaths caused by malaria and tuberculosis in half and the number of AIDS deaths by 25 percent by 2010, according to the United Nations agency.

WHO officials pointed out that the agency traditionally dedicated most of its efforts to prevention, but that things changed with the advent of AIDS.

HIV, the AIDS virus, which is transmitted to 15,000 people a day worldwide, forced the WHO, under the pressure of patients and UN member countries, to reconsider its position and put a greater focus on treating the ill.

Heymann said the new strategy represented “an important shift in thinking” among the international health community, and added that greater access to medicine can prevent deaths, improve health and help pull people out of poverty.

Heymann presented the new WHO report, “Scaling up the Response to Infectious Diseases: A Way out of Poverty”, in Geneva Thursday.

The study will be distributed Saturday in New York at the World Economic Forum, an annual gathering that brings together CEOs of transnational corporations, neo-liberal thinkers, and leaders of developing countries, and which has been held until now in the Swiss ski resort town of Davos.

The WHO document states that “Today, perhaps for the first time in history, it is possible to launch a truly global response to the major infectious diseases that keep people in poverty,”

The report offers a “road map” pointing out how countries and the international community can “scale up” successful interventions against infectious diseases, especially the leading killers like AIDS, tuberculosis and malaria.

It highlights successful efforts in various countries. For example, the number of cases of tuberculosis fell 50 percent in Peru from 1991 to 1995, thanks to the application of a strategy recommended by WHO, based on the timely and regular provision of medicine to patients.

And between 1992 and 1997, Vietnam drastically reduced the number of deaths caused by malaria, by a full 97 percent, by distributing mosquito screens treated with insecticides and high- quality antimalarial drugs, and by carrying out indoor spraying with insecticides.

In Uganda, meanwhile, which had one of the highest rates of HIV- AIDS in the world in the 1980s, the spread of the disease among pregnant women and young people was reduced by 50 percent.

Up to around five years ago, international development agencies turned down requests for funds for medicine to treat malaria, tuberculosis, and AIDS, on the argument that spending on drugs was neither socially nor economically sustainable, said Heymann.

The new paradigm was strengthened by the results of the Commission on Macroeconomics and Health, set up by the WHO and presided over by prominent U.S. economist Jeffrey D. Sachs, to study the link between health and economic development.

In its report, released last December, the commission said that in developing countries, health spending not only saved lives, but provided an essential boost to economic development.

Taking up that idea, the WHO pointed out in its new report that the tools for fighting infectious disease, which account for half of all deaths in developing countries, already exist.

For the biggest killers, there are drugs that can cure the disease or prevent transmission and prolong life, as in the case of AIDS, Heymann noted.

However, one of the report’s authors, José Esparza with WHO’s department of policy, strategy and research on vaccines, warned of the risks of excessive optimism.

Excessive confidence could lead us to believe that all of the tools needed to prevent and control diseases are already available, and must simply be applied on a larger scale, said Esparza.

But the number of people infected with HIV every day shows that we do not yet have the necessary resources, he underlined.

On the contrary, smallpox was eradicated due to the existence of an effective vaccine, and polio is on its way out for the same reason, while inroads have been made against dysentery due to the widespread application of the simple oral rehydration technique.

On the other hand, in the case of AIDS we cannot say antiretroviral drugs are ideal, said Esparza, because they are toxic, expensive and difficult to administer.

The WHO official said that what was needed was a balance between prevention and treatment. He also called for greater efforts to develop new tools for fighting malaria, tuberculosis and AIDS, which together claim 5.7 million lives a year.