World Bank Seminar Series: Global Issues Facing Humanity Diseases without borders.

World Bank Seminar World Bank Seminar Series: Global Issues Series: Global Issues

Facing HumanityFacing Humanity

Diseases without Diseases without bordersborders

Slide 1: Table of contentsSlide 1: Table of contents

Why are Communicable Diseases a Why are Communicable Diseases a Global IssueGlobal Issue

Major Communicable DiseasesMajor Communicable Diseases

Emerging Communicable Disease Emerging Communicable Disease challengeschallenges

Slide 2: Why are Slide 2: Why are Communicable Diseases a Communicable Diseases a

Global IssueGlobal Issue

MagnitudeMagnitude of the Problem of the Problem Annually, about 14.5 million deaths Annually, about 14.5 million deaths

worldwide are caused by communicable worldwide are caused by communicable diseases (=60% of all deaths) diseases (=60% of all deaths)

More than half of all deaths due to More than half of all deaths due to communicable diseases are attributed to communicable diseases are attributed to HIV/AIDS,TB and malariaHIV/AIDS,TB and malaria

Primarily affect children and young Primarily affect children and young adults in their adults in their most productive most productive yearsyears

Slide 3: Why are Slide 3: Why are Communicable Diseases a Communicable Diseases a

Global IssueGlobal Issue ExternalitiesExternalities : spill-over benefits or : spill-over benefits or

losses from one individual to others losses from one individual to others

EquityEquity : Both a cause and : Both a cause and consequence of povertyconsequence of poverty Impoverish the already poor – loss Impoverish the already poor – loss

of productivity, treatment costsof productivity, treatment costs

The poor have a greater share of the The poor have a greater share of the burden of disease and have less access burden of disease and have less access to affordable and quality careto affordable and quality care

Slide 4: Why are Slide 4: Why are Communicable Diseases a Communicable Diseases a

Global IssueGlobal Issue Not contained within national Not contained within national

boundaries – not the problem of just boundaries – not the problem of just one country/regionone country/region

Global action is needed to ensure :Global action is needed to ensure : adeadequate and predictable fundingquate and predictable funding promote awareness and changes in promote awareness and changes in

behavior and behavior and accrue global benefits from R&Daccrue global benefits from R&D

Slide 5: Major Slide 5: Major Communicable diseasesCommunicable diseases

Goal 6:Goal 6: Have halted by 2015 and begun to reverse Have halted by 2015 and begun to reverse

the spread of HIV/AIDSthe spread of HIV/AIDS Have halted by 2015 and begun to reverse Have halted by 2015 and begun to reverse

the incidence of malaria and other major the incidence of malaria and other major diseasesdiseases

HIV/AIDS, malaria and TB are responsible HIV/AIDS, malaria and TB are responsible for 6 million deaths per yearfor 6 million deaths per year

Avian flu is estimated to cause between 2 to Avian flu is estimated to cause between 2 to 7.5 million deaths if a human pandemic 7.5 million deaths if a human pandemic occursoccurs

Slide 6: Magnitude and Slide 6: Magnitude and Trends in HIV/AIDSTrends in HIV/AIDS

60 million infected and 20 million deaths60 million infected and 20 million deaths Half of the 14,000 new infections each Half of the 14,000 new infections each

day occur among young people below age day occur among young people below age 2525

Over 8 million children (<15 years) have Over 8 million children (<15 years) have been orphaned by AIDSbeen orphaned by AIDS

Feminization of the epidemic – In Africa, Feminization of the epidemic – In Africa, rates of infections among young women rates of infections among young women (15-19 years of age) are 5-6X higher than (15-19 years of age) are 5-6X higher than for young men for young men

Disproportionately affects poor countries Disproportionately affects poor countries and the poor in these countriesand the poor in these countries

Slide 7: Most HIV/AIDS Slide 7: Most HIV/AIDS Infected Live in Africa and Infected Live in Africa and

South AsiaSouth Asia

Slide 8: HIV/AIDS - Multi-Slide 8: HIV/AIDS - Multi-sectoral Approachsectoral Approach

HIV/AIDS has health, other social HIV/AIDS has health, other social and economic consequencesand economic consequences exacerbates poverty and inequalityexacerbates poverty and inequality puts tremendous pressure on health puts tremendous pressure on health

and social servicesand social services creates large numbers of orphans creates large numbers of orphans

who need supportwho need support decimates the workforce with decimates the workforce with

enormous economic and social enormous economic and social consequencesconsequences

Slide 9: HIV/AIDS Slide 9: HIV/AIDS InterventionsInterventions

Core set of Core set of prevention and Rxprevention and Rx interventions exist: interventions exist:

-- promoting behavior change promoting behavior change

-- increasing condom use increasing condom use

-- STI management STI management

-- ensuring a safe blood supply ensuring a safe blood supply

-- preventing MTCT preventing MTCT

-- supporting harm reduction supporting harm reduction among IDUsamong IDUs

-- anti-retroviral treatment anti-retroviral treatment

Slide 10: HIV/AIDS Slide 10: HIV/AIDS Prevention ReachPrevention Reach

    Comprehensive prevention could avert Comprehensive prevention could avert 29 29

million of the 45 million new infections million of the 45 million new infections

projected by 2010projected by 2010

However, However, prevention programs prevention programs reach fewer reach fewer

than one in five peoplethan one in five people who need who need themthem

Slide 11: HIV/AIDS Slide 11: HIV/AIDS Treatment ReachTreatment Reach

6 million people need antiretroviral 6 million people need antiretroviral treatmenttreatment

1 million people are currently on ART1 million people are currently on ART

Recent treatment scale-up averted Recent treatment scale-up averted between 250,000 and 350,000 deaths in between 250,000 and 350,000 deaths in 20052005

Annual basic care and treatment for Annual basic care and treatment for AIDS can cost as much as 2-3 times per AIDS can cost as much as 2-3 times per capita GDP in the poorest countriescapita GDP in the poorest countries

Over 12 million persons live with TB Over 12 million persons live with TB and HIV worldwideand HIV worldwide

More HIV-infected persons die due More HIV-infected persons die due

to TB than to any other opportunistic to TB than to any other opportunistic infection infection

Slide 12: Linkages between Slide 12: Linkages between Communicable DiseasesCommunicable Diseases

Slide 13: Magnitude and Slide 13: Magnitude and Trends in TBTrends in TB

8.8 million new cases/1.7 million deaths 8.8 million new cases/1.7 million deaths each yeareach year

95% of cases and 98% of TB deaths occur 95% of cases and 98% of TB deaths occur in the developing worldin the developing world

Africa has the highest TB rates per capita, Africa has the highest TB rates per capita, but Asia carries the greatest absolute but Asia carries the greatest absolute burdenburden

Poor people are especially vulnerable to Poor people are especially vulnerable to TB due to: TB due to:

underlying health statusunderlying health statusadverse living conditionsadverse living conditionslimited access to treatmentlimited access to treatment

Slide 14: Magnitude and Slide 14: Magnitude and Trends in TBTrends in TB

Slide 15: Tuberculosis Slide 15: Tuberculosis TreatmentTreatment

Without any treatment, half of those who Without any treatment, half of those who fall ill will diefall ill will die

Directly Observed Treatment, Short Directly Observed Treatment, Short (DOTS)(DOTS)

cure rates of up to 95% cure rates of up to 95% prevents new infections prevents new infections prevents the development of drug prevents the development of drug resistance resistance

treatment under DOTS is as little as treatment under DOTS is as little as US$ 10 per patientUS$ 10 per patient

Drug resistance is a major challengeDrug resistance is a major challenge

Slide 16: Magnitude and Slide 16: Magnitude and Trends in MalariaTrends in Malaria

500 million new clinical cases per year500 million new clinical cases per year more than one million deaths each yearmore than one million deaths each year 40% of the world’s population exposed to 40% of the world’s population exposed to

malaria risk malaria risk malaria reduces GDP growth by malaria reduces GDP growth by

approximately 1% per year approximately 1% per year Poor worst affected:Poor worst affected:

less access to services, information and less access to services, information and protective measuresprotective measures

less power to avoid living or working in less power to avoid living or working in malaria-affected areasmalaria-affected areas

Slide 17: Magnitude and Trends in Slide 17: Magnitude and Trends in MalariaMalaria

20% of all childhood deaths in 20% of all childhood deaths in Africa are due to malariaAfrica are due to malaria

Slide 18: Malaria -Prevention Slide 18: Malaria -Prevention and Treatmentand Treatment

The most cost-effective interventions are:The most cost-effective interventions are:

- rapid diagnosis and effective treatment- rapid diagnosis and effective treatment

- insecticide-treated bednets- insecticide-treated bednets

- intermittent-presumptive treatment for - intermittent-presumptive treatment for

pregnant womenpregnant women

- epidemic preparedness- epidemic preparedness Resistance to conventional anti-malarial Resistance to conventional anti-malarial

drugs is a major challengedrugs is a major challenge ACTsACTs VaccineVaccine

Slide 19: Emerging Challenge: Slide 19: Emerging Challenge: Avian FluAvian Flu

HPAI is an emerging zoonotic – caused HPAI is an emerging zoonotic – caused 69 deaths and 135 infections69 deaths and 135 infections

animal-to-animal and limited animal-to-animal-to-animal and limited animal-to-human transmission of H5N1human transmission of H5N1

increasing probability of human-to-increasing probability of human-to-human transmission and a global human transmission and a global influenza pandemicinfluenza pandemic

cost of a pandemic could exceed $800 cost of a pandemic could exceed $800 billion/yearbillion/year

control is beyond the scope and control is beyond the scope and resources of a single country or regionresources of a single country or region

Slide 20: Avian Flu- Migratory Slide 20: Avian Flu- Migratory PatternPattern