Rabies is a terrifying disease that kills approximately 60,000 people worldwide each year. Though scientific innovation has created vaccines that are effective before and after exposure to the virus, there is no way to cure rabies once symptoms have begun. Rabies is a zoonosis, meaning that it is transmitted from animals to humans. Rabies is a threat in about 150 countries, but its fatalities are constrained to the developing world with 95% of rabies cases occur in Asia and Africa. Over 99% of deaths from rabies occur in developing countries, one-third in China and India alone.
Rabies is a neglected disease and most commonly affects poor, young, and vulnerable populations. Children are particularly at risk– 40% of those bitten by a suspected rabid animal are under 15 – and the risk is highest in rural areas, where required vaccines may not be readily available. While rabies is always present in the wild, most human cases are caused by dog bites. Canine rabies threatens more than 3 billion people in Asia and Africa.
While many perceive polio as a largely eradicated disease of the past, a recent resurgence of new cases in politically unstable regions of the world has brought the disease back into the news. Polio is devastating and highly infectious: it affects the nervous system and can cause irreversible paralysis and death, primarily in young children. While there is still no cure for polio, five vaccines are able to prevent transmission of the polio virus. Global immunization and other strategies have decreased cases by 99% in approximately two decades. However, since most people infected with polio do not show symptoms, the World Health Organization (WHO) treats any confirmed case as a potential epidemic. Although evidence has shown that polio eradication is possible through widespread immunization, the disease is still endemic in three countries (Afghanistan, Nigeria, and Pakistan) and tackling the last 1% of polio cases around the world has proved a challenging task.
All countries currently remain at risk for ‘imported’ cases of polio, particularly states bordering endemic areas or when political instability or other factors inhibits necessary immunizations. So far in 2013, there have been 192 reported cases of polio worldwide. Of those reported cases, 108 were in Somalia, a non-endemic war-torn country whose political instability and violence has made providing necessary medical services, like immunizations, dangerous and difficult.
In the past decades, HIV-affected families havelargely benefited from effective medical interventions such as antiretroviral medications (AVRs) to sustain parents’ health and prevent mother-to-child transmission. But the lack in WASH programming – water, sanitation and hygiene can alter the effectiveness of such interventions. Water and sanitation has been found to decrease infections by helping HIV drugs get absorbed, rather than flushed out of the system due to chronic diarrhea.
Often in rural African villages the only water source for villagers is a basin with collected surface water which can be contaminated with bacteria and microorganisms. This untreated water is used for a wide range of daily activities from food preparation to treating people with health issues. Lack of sanitized public toilets and garbage removal exasperate the problem.
The unhealthy nature of the water exposes people to various water-borne diseases, including diarrhea and cholera. While diarrhea is a fairly ubiquitous symptom of HIV , the lack of water and sanitation perpetuates the cycle of illness. Persistent diarrhea due to lack of adequate water and sanitation can inhibit the effectiveness of the ARVs taken to treat HIV, which can accelerate the progression of HIV/AIDS, thus further threatening HIV-infected mothers and their children.
In 1962, Thomas Kuhn authored a book entitled: The Structure of Scientific Revolution. He pointed out that progress in science takes place because fundamental paradigms shift. That is, over time facts that are observed to be true do not match previous predictions about those facts, and—gradually, a whole new worldview emerges.
Such a shift is occurring in international health: the shift from old aid dependency to new private sector involvement.