The growing global health crisis

In 1969, when addressing the American Congress, Surgeon General William Stewart is believed to have said that “it is time to close the book on infectious diseases, and declare the war against pestilence won”. This came at a time of great euphoria around the recent strides made in the field of antibiotics and encapsulates a contemporary feeling that science was winning the battle against disease. And yet, the 21st century has seen diseases like smallpox and polio, almost eradicated in the 1970’s, become increasingly common, and future of global health looks yet bleaker.

“Antimicrobial resistance in a ticking time bomb…for the UK”, says Sally Davies, Chief Medical Officer for the UK. As she states, a major part of the growing health crisis is the problem of increasing bacterial resistance to current antibiotic treatment. This can be attributed to the natural evolutionary process, but also the misuse of drugs by the common person. People are consistently being given a course of medication and stopping the course prematurely, once their symptoms have died down. Already we, as a society, are experiencing some of the effects of this resistance. Dr Ibrahim Hassan, a consultant microbiologist from Manchester, reported to the BBC that “we’re beginning to see that in some hospitals, patients coming in with this infection with no antibiotic that can be used to treat them”. A further factor in the problem of drug resistance is the effect of the increasing privatization of drug production. This has greatly incentivised the production and development of drugs that can act as palliatives to chronic diseases, where the drug will be used for decades, whilst deterring research into new antibiotics which have a short-term use. The fact that no new class of antibiotics has been developed since the 1980’s is a clear indication of the dire current state of antibiotic production, and consequently the dire state of the future of antibiotic treatment.

“The effect of projected climate change indicates that a prolonged transmission season is as important as geographical expansion in correct assessment of the effect of changes in transmission patterns” of infectious disease. As highlighted here by a recent article from The Lancet, global warming is another significant factor in the growing prevalence and effects of disease on the world’s population. For instance, a recent BBC report from Nairobi found that this city, previously protected by its altitude, is now suffering from malaria for the first time. In addition, diseases like malaria are anticipated to spread to higher latitudes, with southern European countries potentially at risk by the end of this century.

A final complicating factor in the fight against disease this century is the fast rates of urbanisation taking place globally. This has had a particular effect on the transmission of infectious diseases as more concentrated human settlement has allowed for easier transmission of disease. Rural to urban migration is a trend only set to continue during this century, making this an ever-growing problem. Moreover, the prevalence of slums with poor sanitation and living conditions in the major cities of LIC’s (Low Income Countries) provides perfect breeding conditions for many vectors, such as mosquitoes, increasing the risk of vector-borne diseases like malaria.

Therefore, it is clear that, along with climate change, terrorism and population growth, global health is one of the biggest issues we must tackle in the 21st century. Unless we act upon the failings of the current global health movement, it is possible that, as Dame Sally Davies reports, “if you get an infection in your bloodstream, in about 10, 20 years it might be untreatable”.

Contributed by Ben Williamson

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