Transcript World Bank Seminar Series: Global Issues Facing Humanity

World Bank Seminar Series:
Global Issues Facing Humanity
Diseases without borders
Slide 1: Table of contents

Why are Communicable Diseases a Global Issue

Major Communicable Diseases

Emerging Communicable Disease challenges
Slide 2: Why are Communicable
Diseases a Global Issue

Magnitude of the Problem
Annually, about 14.5 million deaths worldwide are
caused by communicable diseases (=60% of all
deaths)
 More than half of all deaths due to communicable
diseases are attributed to HIV/AIDS,TB and malaria


Primarily affect children and young adults in
their most productive years
Slide 3: Why are Communicable
Diseases a Global Issue

Externalities : spill-over benefits or losses from
one individual to others

Equity : Both a cause and consequence of
poverty

Impoverish the already poor – loss of productivity,
treatment costs

The poor have a greater share of the burden of
disease and have less access to affordable and quality
care
Slide 4: Why are Communicable
Diseases a Global Issue

Not contained within national boundaries – not
the problem of just one country/region

Global action is needed to ensure :
 adequate and predictable funding
 promote awareness and changes in behavior
and
 accrue global benefits from R&D
Slide 5: Major Communicable
diseases
Goal 6:
 Have halted by 2015 and begun to reverse the
spread of HIV/AIDS
 Have halted by 2015 and begun to reverse the
incidence of malaria and other major diseases


HIV/AIDS, malaria and TB are responsible for 6
million deaths per year
Avian flu is estimated to cause between 2 to 7.5
million deaths if a human pandemic occurs
Slide 6: Magnitude and Trends in
HIV/AIDS





60 million infected and 20 million deaths
Half of the 14,000 new infections each day
occur among young people below age 25
Over 8 million children (<15 years) have been
orphaned by AIDS
Feminization of the epidemic – In Africa, rates
of infections among young women (15-19 years
of age) are 5-6X higher than for young men
Disproportionately affects poor countries and
the poor in these countries
Slide 7: Most HIV/AIDS Infected
Live in Africa and South Asia
Slide 8: HIV/AIDS - Multi-sectoral
Approach
HIV/AIDS has health, other social and
economic consequences
 exacerbates poverty and inequality
 puts tremendous pressure on health and social
services
 creates large numbers of orphans who need
support
 decimates the workforce with enormous
economic and social consequences
Slide 9: HIV/AIDS Interventions

Core set of prevention and Rx interventions exist:
- promoting behavior change
- increasing condom use
- STI management
- ensuring a safe blood supply
- preventing MTCT
- supporting harm reduction among IDUs
- anti-retroviral treatment
Slide 10: HIV/AIDS Prevention
Reach

Comprehensive prevention could avert 29
million of the 45 million new infections
projected by 2010
However, prevention programs reach fewer
than one in five people who need them
Slide 11: HIV/AIDS Treatment
Reach

6 million people need antiretroviral treatment

1 million people are currently on ART

Recent treatment scale-up averted between 250,000
and 350,000 deaths in 2005

Annual basic care and treatment for AIDS can cost
as much as 2-3 times per capita GDP in the poorest
countries
Slide 12: Linkages between
Communicable Diseases

Over 12 million persons live with TB and HIV
worldwide

More HIV-infected persons die due to TB than
to any other opportunistic infection
Slide 13: Magnitude and
Trends in TB




8.8 million new cases/1.7 million deaths each year
95% of cases and 98% of TB deaths occur in the
developing world
Africa has the highest TB rates per capita, but
Asia carries the greatest absolute burden
Poor people are especially vulnerable to TB due
to:
 underlying health status
 adverse living conditions
 limited access to treatment
Slide 14: Magnitude and Trends in TB
Slide 15: Tuberculosis Treatment

Without any treatment, half of those who fall ill will
die

Directly Observed Treatment, Short (DOTS)
 cure rates of up to 95%
 prevents new infections
 prevents the development of drug resistance
 treatment under DOTS is as little as US$ 10 per
patient

Drug resistance is a major challenge
Slide 16: Magnitude and Trends in
Malaria





500 million new clinical cases per year
more than one million deaths each year
40% of the world’s population exposed to malaria risk
malaria reduces GDP growth by approximately 1% per year
Poor worst affected:
 less access to services, information and protective
measures
 less power to avoid living or working in malaria-affected
areas
Slide 17: Magnitude and Trends in Malaria
 20% of all childhood deaths in Africa are
due to malaria
Slide 18: Malaria -Prevention and
Treatment
The most cost-effective interventions are:
- rapid diagnosis and effective treatment
- insecticide-treated bednets
- intermittent-presumptive treatment for
pregnant women
- epidemic preparedness
 Resistance to conventional anti-malarial drugs is a
major challenge

ACTs
 Vaccine

Slide 19: Emerging Challenge: Avian Flu





HPAI is an emerging zoonotic – caused 69 deaths
and 135 infections
animal-to-animal and limited animal-to-human
transmission of H5N1
increasing probability of human-to-human
transmission and a global influenza pandemic
cost of a pandemic could exceed $800 billion/year
control is beyond the scope and resources of a
single country or region
Slide 20: Avian Flu- Migratory Pattern