Anti-Rabies Strategies: Vaccinating Dogs to Save Human Lives

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.

Risk of human rabies, 2011
Risk of human rabies, 2011 (WHO)

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.

“This is a disease of the poorest of the poor who can’t afford the vaccine.” – Dr. Herve Bourhy of France’s Pasteur Institute.

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Polio in Somalia: an intersection of political instability and global health

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.

vaccine photo
Child receives polio vaccine

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.

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Water, Sanitation and Hygiene (WASH) – A Mother-to-Child “Shield” for HIV-affected Families

In the past decades, HIV-affected families have largely 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.

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India’s Headache on Mental Health

Even though depression is estimated to be the leading cause of disability worldwide and schizophrenia is estimated to affect 33 million people in developing countries, mental illnesses are still not acknowledged as major diseases in many developing countries. Since these diseases often cause long term disability rather than death and often have an early age of onset, studies focusing on prevalence or mortality rates largely underestimate the devastating effects. The Institute of Medicine (IOM) estimated in 2001 that brain disorders are responsible for at least 27 percent of all ‘years lived with disability’ in developing countries.  When combining both death and disability from brain disorders it comprise nearly 15 percent of the developing countries burden of disease

In many developing communities diagnoses of mental disorders have no conceptual equivalent, and where they do the illnesses are stereotyped in pejorative language (‘imbecile’, ‘idiot’, ‘stupid’ and ‘mentally-invalid person’, is used to refer to the mentally challenged). Continue reading

Development Assistance for Health: A Tale of Two Accounts

by Jeremiah Norris – Senior Fellow, Hudson Institute

The Institute for Health Metrics and Evaluation (IHME) at the University of Washington measures development assistance for health (DAH), while the Index of Global Philanthropy & Remittances at Hudson Institute publishes annual data on the total U. S. Economic Engagement with Developing Countries.  There are distinct differences in the methodology employed by both groups in the determination of resource flows.

On February 1, the IFC hosted an event  on the subject of “Development Assistance for Health During Economic Crisis”. The key note speaker was Dr. Christopher Murray, Director of IHME.  In November, his unit published Financing Global Health 2010: Development Assistance and Country Spending in Economic Uncertainty. This was another of Dr. Murray’s landmark contributions to the literature of health in the developing world, beginning in 1996 with the ten volume Global Burden of Disease, published in collaboration with WHO, the World Bank, and the Harvard School of Public Health.  Now in its second year, Financing Global Health is a core part of IHME’s mission to measure health and the impact of health policies and interventions. Continue reading

Finally… Some Traction for Advancing NCDs on the Global Health Community’s Agenda

by Jeremiah Norris – Senior Fellow, Hudson Institute

On November 1, the CGD and the Institute of Medicine (IOM) held a timely discussion under the heading of: What’s on the Agenda? Assessing the UN High-Level Meeting on Noncommunicable Diseases. The UN General Assembly will sponsor this Noncommunicable Diseases (NCD) Meeting in September, 2011. Continue reading

Who is in? WHO is out?

Jeremiah Norris – Senior Fellow, Hudson Institute

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.

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