Mason Barnard. Originally published in the HIR Summer 2013 Issue.
After a long, hard-fought struggle against humanity's oldest scourge, the terror of smallpox—disfiguring and deadly—was no more. The eradication of smallpox in 1979 heralded an era of optimism for the global health community. At WHO Headquarters in Geneva, it was a time for celebration and fortitude. But what appeared to be the first great victory in the long war against contagion proved to be one of the last. Idealistic plans to eradicate malaria, polio, and measles grew in size and success for a time, but now falter in the race towards progress stumbling across mutant strains, civil strife, and international apathy. As Western nations turn inwards to address their own domestic problems, the future outlook of health in the developing world is increasingly bleak. The era of impractical optimism is over. But the era of global health improvement is not. The oversimplified foundations of worldwide public health must be shaken, and the reign of Big Pharma must end. For only by finding solutions to the problems of idealism and profit the twin parasites sucking the lifeblood out of the global health community may the world yet see a brighter future on the horizon.
Global health is a romantic profession. Images of young doctors performing emergency procedures in impoverished lands dominate headlines, creating a new pop culture phenomenon. But it is a phenomenon that complicates the struggle against infection. The most "glamorous" diseases those that are the most difficult to cure, the most controversial, and the most widespread AIDs, tuberculosis, and malaria, receive a disproportionate amount of the funding available for research and programming. Although billions are spent each year on finding a solution to the combined threat of "the big three," there is little progress to show for it. Every year, over 5.6 million people die from these diseases with no cure in sight. Such staggering figures lead to greater investment, greater focus, and greater ignorance. As the international community unites against AIDS, malaria and TB, no one is uniting against Neglected Tropical Diseases (NTDs} a collection of thirteen different pathogens that are problems primarily in developing countries.
Although only 534,000 of the estimated 750 million annual cases are fatal, the socio-economic burden of these diseases acts as a positive feedback loop, reinforcing a state of impoverishment on a sixth of the world's population. Every new patient creates another economic dependency, sapping resources from education, infrastructure, and nutrition. But this cycle of infectious disease can be broken inexpensively. A 2005 study conducted by the Liverpool School of Tropical Medicine and Imperial College London estimated that doctors would be able to reach all patients affected with these diseases in sub-Saharan Africa for $200 million US dollars a year. By rebalancing the priorities of the health community in favor of practicality, not idealism, the failed dreams of the past may yet see the light of the day. But the problem of profit will remain inhibiting aid from reaching those in need.
Just as idealism breeds ignorance, profit breeds apathy, so pharmaceutical corporations and their patients turn a blind eye to diseases plaguing the developing world. Solutions to the most critical health problems worldwide are rarely moneymakers. Most vaccines require only one dosage for lifetime protection, antibiotics are taken only as long as the period of infection, and improvements in infrastructure do as much to solve health issues in developing countries as do miracle drugs. The most valuable merchandise for pharmaceutical companies, therefore, are not solutions to the world's most dangerous diseases, but solutions to more mundane chronic issues, ranging from high cholesterol to baldness to depression issues predominantly found in developed countries. As developing nations continue to struggle with their microscopic oppressors, the pharmaceutical industry will continue to respond by looking the other way, putting resources into researching the loss of hair, not the loss of life.
Disappointment hangs heavy around the offices of the World Health Organization. The dreams of a bygone era are lost, buried deep beneath widespread criticism, failed initiatives, and the rise of microbial resistance. But beneath the failures, the battle goes on. It is no longer a battle against microbes, but against human greed and impracticality.