Saturday, October 25, 2014

TB and Polio

It is perhaps understandable that the current Ebola epidemic in West Africa should dominant the news but we also cannot ignore the tragedy and toll of other diseases that are inflicting many around the world.

In 2013 nine million people had developed TB around the world, up from 8.6 million in 2012, the World Health Organization estimates. About 1.5 million people had died in 2013 from TB, including 360,000 people who had been HIV positive, the WHO said in its Global Tuberculosis Report 2014. And in 2012, there had been 1.3 million tuberculosis deaths.

WHO said its report underlined that a "staggering number of lives are being lost to a curable disease and confirms that TB is the second biggest killer disease from a single infectious agent".

WHO said that insufficient funding was hampering efforts to combat the disease. An estimated $8bn (£5bn) was needed each year, but there was an annual shortfall of $2bn, it said.

Medecins Sans Frontieres said that the rise of drug resistant TB, especially in the former Soviet Union, was of "critical concern". For example, in Belarus, 35% of new cases were drug resistant.

"Access to proper treatment is drastically low: only one person in five with multidrug-resistant TB receives treatment; the rest are left to die, increasing the risk to their families and communities and fuelling the epidemic," said Medecins Sans Frontieres TB advisor Dr Grania Brigden. "This dismal news must serve as a wake-up call for governments, donors and drug companies."

Polio is an infectious viral disease that invades the nervous system and can result in paralysis within hours. The goal is to deliver a polio-free world by 2018.  Southeast Asia ( 1.8 billion people) was declared polio-free earlier this year, its 11 countries – Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste – joining the ranks of those nations that live without the polio burden. High-performing countries like Sri Lanka, the Maldives and Bhutan eradicated polio a decade-and-a-half ago while India, once considered a stubborn hotbed for the disease, clocked its last case in January 2011, thus bringing about the much-awaited regional ‘polio-free’ tag.  Afghanistan and Pakistan blight Asia’s happy tale. Together with Nigeria, these two nations are blocking global efforts to mark 2018 as polio’s last year on this planet.

According to the Global Polio Eradication Initiative (GPEI) immunisation drives reached some 7.5 billion children over the course of 17 years, not just in city centres but also in remote rural outposts. During that time, the region witnessed some 189 nationwide campaigns that delivered over 13 billion doses of the oral polio vaccine.

Shyam Raj Upreti, chief of the immunisation section of Nepal’s child health division credits his country’s success to a high degree of social acceptance of the importance of child health in overall national development. “Female health volunteers play a key role in making the community understand why immunisation is important,” he said, adding that these volunteers provide services to some of the poorest segments of the population. “... service delivery was decentralised, and access was made easie.”  Ashish KC, child health specialist at UNICEF-Nepal, said that immunisation programmes didn’t stop even during the ‘people’s war’, a brutal conflict between the Maoists and the Nepali state that lasted a decade and killed 13,000 people.

In the Philippines getting the vaccine out to distribution centres on the smaller islands obviously poses a logistical challenge, but the Philippines has proven it’s really good at that. Using strong networks of community health workers have enabled the Philippines to move into the “endgame”, the last stage in global eradication efforts that will require the 120 countries that aren’t currently using the IPV to introduce it by the end of 2016, representing one of the biggest and fastest vaccine introductions in history.

A 2012 Taliban-imposed ban has effectively prevented over 800,000 Pakistani children from being immunised in two years, health officials told IPS.  The Taliban has used both violence and terror to spread the message that ploio vaccination is a ploy by Western governments to sterilise the Muslim population. In 2014 alone, Pakistan has recorded 206 cases of paralysis due to wild poliovirus, the most savage strain of the disease. Last week, 19 new cases of this strain were brought to the attention of the authorities. Pakistan is responsible for nearly 80 percent of polio cases reported globally, posing a massive threat to worldwide eradication efforts. Altaf Bosan, head of Pakistan’s national vaccination programme, said 34 million children under the age of five are in need of the vaccine but in 2014 alone “about 500,000 children missed their doses due to refusals by parents to defy the Taliban’s ban.”


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