Tuesday, November 11, 2014

Justified focus on Ebola should not compromise efforts against other diseases that kill more people

This blog originally appeared on Global Health TV on Sept. 23, 2014.

Ebola is a terrible disease that has already infected 5,335 people and killed 2,630 as of Sept. 14, according to the World Health Organization (WHO), and threatens to kill many more thousands before its rampage of destruction is slowed down or stopped. WHO designated it as a global emergency on Aug. 8.

“This Ebola epidemic is the largest and most severe and most complex we have ever seen in the nearly 40-year history of this disease,” said Margaret Chan, director-general of the WHO. “This is a global threat that requires global coordination to get it done. We can and we will bring the Ebola epidemic under control.”

Yet another of its terrible legacies may be that it will distract attention and resources from other diseases that are killing far more people.

In the three countries where it has been most virulent — Guinea, Liberia and Sierra Leone — AIDS, malaria and tuberculosis kills many more people than Ebola. Here is the number of people those three diseases have killed in those three countries”

Tuberculosis: 16,400 (WHO)
AIDS: 10,100 (UNAIDS)
Malaria: 6,315 (WHO)

The ten leading causes of death in low-income countries in 2012, according to the WHO, were lower respiratory infections, HIV/AIDS, diarrheal diseases, stroke, ischaemic heart disease, malaria, preterm birth complications, tuberculosis, birth asphyxia and birth trauma, and protein energy malnutrition.

Global health journalist Sam Loewenberg tweeted that in Uganda alone, diarrhea kills almost 20,000 children every year. That’s the number of people the WHO thinks Ebola may eventually claim.

Earlier this month, Columbia University professor Chris Blattman tweeted that “Ebola is the Kardashian of diseases,” that it steals attention away from other global health priorities and that malaria, TB and HIV are what matters. [Note: For those who don’t know what a Kardashian is, it roughly translates to being famous for no substantive reason.]

He wrote a blog entitled “Does Chicken Little have Ebola?” and said this about Liberia: “… the fearful and overblown coverage will do more damage in the long run as businesses and NGOs pull out, or deals in the future never get done. I’d venture a guess that shaving a percentage point off GDP for the next few years will lead to more preventable deaths than the [Ebola] disease will in the end. This is disastrous for the country and it doesn’t help when organizations like MSF say it is ‘spiraling out of control.’”

Others strongly disagree.

I do not think that Ebola is as irrelevant as the Khardasians but I do worry that a singled-mind obsession with it could compromise other global health efforts. Indeed, that may be already happening.

Christine Sow, executive director of the Global Health Council, worries that Congress will use money already allocated for other global health concerns to pay for new funding to fight Ebola.

“Redirecting funds would be a shortsighted strategy to respond to a rapidly growing crisis,” she wrote in the Washington Post. “The U.S. government must provide funding and leadership commensurate with the Ebola emergency while maintaining the country’s place as a global leader in the fight on child and maternal mortality and HIV/AIDS.”

I’m not suggesting that we should not do everything possible to eradicate the scourge of Ebola. We should. But I am urging that we not forget those endemic, preventable and “mundane” diseases that have been around so long that we risk taking them for granted.



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