Nahid Bhadelia: Poor countries are the front line against disturbing new diseases
Those who survive commonplace infectious diseases such as malaria or tuberculosis—or never contract them in the first place—are free to seek work in a complex economy, to reside in cities or migrate abroad in search of greater opportunities, to raise families and grow old with them, and to do all the other things that healthy people do. Yet humanity’s dramatic progress against specific infectious diseases has far outstripped the pace of investment in good health-care systems, responsive governance, dependable infrastructure, and the other more reliable guarantors of health. These basic factors are crucial, when a new disease such as COVID-19 suddenly emerges, in establishing how fast and how far it will spread and how may will perish because of it.
The progress against plagues and parasites throughout Europe and the United States in the 19th century extended globally after World War II with the increased availability of antibiotics, the development of more vaccines, and medical advances against diseases such as malaria. The horrors of World War II also inspired global leaders to build new institutions like the World Health Organization and UNICEF to promote economic development and confront humanitarian crises. In the decades that followed, international agencies, local governments, and foreign-aid donors worked together on successful campaigns to eradicate smallpox, vaccinate millions of children, and increase access in poor nations to lifesaving medicines for tuberculosis, HIV/AIDS, and other diseases.
Even in countries with the most rudimentary health systems, the international investment in developing and disseminating medical advances has yielded longer lives, fewer dead children and grief-stricken families, and less human suffering more generally. Yet it has also made many nations more vulnerable to contagious viruses for which there are no available drugs to treat and no vaccines to prevent infections, and against which people have no preexisting immunity.
Successful outbreak control works like this: Patients report their symptoms to health-care workers. Those health-care workers then report unusual cases to local public-health officials who investigate the illness. Those officials may isolate ailing patients, identify others with whom they have come into contact, and monitor those individuals. The results of these investigations are reported to government officials, who communicate reliable information about the outbreak and its causes to the public and the press. That information enables those who are not sick to take measures, such as hand washing and avoiding crowds, to prevent themselves from getting infected and spreading the outbreak. The promise of reliable information and competent, supportive medical care convinces others who are suffering symptoms to come forward so that new cases are identified, tracked, and treated. This cycle continues until the virus stops infecting new people, the people already infected get well or perish, and the outbreak burns out.