Posted May 1, 2007
Emerging diseases remain a global concern
Infectious diseases are responsible for 26% of mortality worldwide.
Submit a Comment Email Print SAN DIEGO — Global emergence and re-emergence of diseases remain a challenge because of the microbes’ abilities to replicate and mutate, according to Anthony S. Fauci, MD.
Fauci, director of the National Institute of Allergy and Infectious Disease, described three types of disease challenges: emerging, which he said includes HIV and severe acute respiratory disease (SARS); re-emerging and resurging, which includes West Nile virus in the United States; and deliberately emerging, which includes bioterrorism, such ...view middle of the document...
The “matrix” of infectious diseases, or the leading infectious diseases worldwide, includes respiratory diseases, HIV/AIDS, diarrheal diseases, tuberculosis and malaria, he said.
The world exists in a delicate balance of survival, Fauci said. The mutation of microbes tips the balance, and further research, vaccines and therapeutics might tip the balance back. These recent advances have given researchers and scientists the upper hand, according to Fauci.
HIV/AIDS is the leading cause of mortality due to an infectious disease in the world and in history, according to Fauci. About 39.5 million people worldwide have HIV; 90% of these cases occur in developing nations. About 1.4 million people in the United States are infected with HIV, he said.
HIV is a prototypical emerging disease. In 1981, the first reports involved about 20 gay men in New York, Los Angeles and San Francisco; 26 years later, it is one of the most catastrophic health crises that civilization has experienced, along with the bubonic plague and the influenza pandemic of 1918, Fauci said.
Since 1981, federal funding for HIV/AIDS has reached $190 billion, with almost $23 billion spent last year alone, according to Fauci. Researchers developed the first antiretroviral in 1987, and since then, the FDA has approved more than 22 other antiretrovirals, which is more than all the other antivirals combined. Antiretrovirals saved 3 million life-years in the United States between 1996 and 2006, which surpassed the cost-benefit ratio of every other life-saving measure, including bypasses, renal transplants, dialysis and drugs, such as atorvastatin (Lipitor, Pfizer) and antihypertensives, Fauci said.
International programs, such as the President’s Emergency Plan for AIDS Relief (PEPFAR), are designed to increase access to antiretroviral access in developing nations. Before September 2004, less than 10,000 people in Africa were receiving antiretroviral treatment, according to Fauci. Now, 822,000 people are receiving antiretrovirals. Combined with treatment from the Global Fund to Fight AIDS, Tuberculosis and Malaria, 1.6 million people are receiving antiretrovirals. Despite these programs, only 25% of people who need treatment are receiving it, Fauci said.
The world cannot keep up by only treating HIV, according to Fauci. A multifaceted approach that includes condoms, syringe exchanges and interruption of mother-to-child transmission are all key to prevent HIV, Fauci said.
A recent Lancet study in which researchers found that male circumcision reduced new HIV infections by 48% in Uganda and 53% in Kenya is very promising, according to Fauci.
Old diseases, ongoing issues
Malaria results in 1.3 million deaths each year, mostly in children younger than 5, Fauci said. Approximately 350 to 500 million clinical episodes occur each year, which are “dreadfully neglected,” and every 30 seconds, a child – usually in Africa – dies from malaria, he said.