Action and Reaction: The unintended impact of our relentless pursuit to eradicate infectious diseases

"Chronic diseases are becoming deadlier and more burdensome to the poor. By 2015, says the World Bank, these ailments will be the leading cause of death in low-income countries." As the prior posts discussed the Millenium Development Goals, which emphasize the need to tackle infectious diseases such as HIV/AIDS, malaria and tuberculosis, a recent article in The Economist cautions us to also pay attention to increasing mortality from chronic diseases such as heart disease, cancer and diabetes. Ironic perhaps, that the projection above, with its eye on 2015, is concurrent with the end of the MDGs impact period...

As I read the article, I was reminded of a few, rather unsettling, things:

1. How easy it is to temporarily forget that just because a lot of people are paying attention to one problem doesn't mean it is, necessarily, the biggest problem. Globally, for example, chronic diseases vastly outpace infection as the leading causes of death. And even in the poorest nations, infectious diseases account for about 50% of deaths.

2. That for every positive step we take on an issue the world changes, often in ways we don't anticipate, but to which we need to pay close attention. In this case, the fact that we ARE making headway on infectious diseases means there are more children surviving who, in middle age, are more susceptible to chronic disease.

3. How easy it is to be seduced by "curing" rather than "improving." The article argues that one of the reasons we pay such attention to infectious diseases is because they can be cured rather than "managed" (HIV/AIDS being the exception.) "If you inoculate a child against malaria, you considerably reduce his or her chances of dying from that disease, since most deaths from malaria occur among children under ten. If you lower someone's risk of getting a heart condition at 50, you might well find they get it at 60. The disease can only be managed."

Popularity is a potent drug. Supporting the cause d'jour is appealing, in some extremely justifiable ways, including the fact that you know you are co-investing with others and thereby giving your dollars significant scale. But, it's helpful to be reminded, as this Economist article does, that the cause d'jour is only ever a part of the issue (e.g. improving global health)...not the issue itself. And if we allow ourselves to get caught up in the popularity for too long, we can actually make the future tougher in another area by ignoring its growth. The article ends with a pretty aggressive challenge: "To concentrate so much on infections is to add to the health burden of the next generation in what are already the world's poorest, unhealthiest places."

So, what's your next move?

Nancy DeFauw