Saturday, May 02, 2009

Church Times Leader (1 May 09) - World specialises in diseases of the rich

A MUTANT VIRUS is unpredictable, and for this reason the first reaction to the prospect of a swine-flu epidemic was naturally fearful. Virologists, who were expected to acquire instant expertise concerning the new strain of influenza, have been cautiously reassuring, however. The virus appears to be treatable, and a combination of early treatment and natural immunity may well help to contain it. Political pressure helps. Since government officials approve, regulate, and stockpile medicines, they have to assume a degree of responsibility for public health. The two most recent health scares, SARS in 2003 and avian flu in 2005-06, exposed a lack of preparedness. Now the Government reports that it has more than 30 million doses of a drug that combats the effects of flu, and political squabbling is confined to delays in setting up a helpline.

The feeling of reassurance that this prompts is tempered, though, by the knowledge that such a response is possible only in the wealthier nations. The inference drawn from the lack of fatalities in developed nations so far is that this variety of swine flu is relatively mild, and responds well to treatment. This must be contrasted with the number of deaths attributed to the disease in Mexico. Were the epidemic to spread to other countries with smaller public-health budgets even than Mexico’s, the world would be facing a much greater challenge.

Or perhaps not. The relative lack of investment in public health in the developing world is an indication of the limited scope of globalisation. The lowest-income countries, which account for 2.6 billion people — 38 per cent of the world’s population — also account for just five per cent of the world’s health expenditure. In 2006, government expenditure on health in the UK was £1668 per capita; in Zambia, for example, it was just under £20.

The thinking that informs investment in anti-flu drugs is very straightforward. It has been estimated that a serious pandemic could cost the world economy $3 trillion. SARS is thought to have cost China £25.3 billion in 2003. Even an outbreak of an animal infection, foot-and-mouth disease, cost the UK £7 billion in 2001. Potential losses such as these can easily justify expenditure on disease prevention. Why, then, are the same arguments not applied globally?

Last Saturday was World Malaria Day. Half the world’s population remains at risk from the disease. Nearly a million people die every year. The World Health Organisation estimates that malaria alone reduces economic growth in the worst-affected countries by 1.3 per cent each year. And yet the case for investing in prevention to produce a direct economic benefit is not heard. It is hard to know why, but nationalism, global competition, ignorance, and indifference all play a part. Christ’s definition of “neighbour” has still to be adopted by the world at large.


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