FACT SHEET Understanding Infectious Diseases The Basics Infectious diseases cause millions of deaths each year, largely in developing countries.1 They also disable millions of people, diminishing their quality of life, decreasing productivity and creating financial hardship. Many prevention and treatment measures are effective and inexpensive and yet remain unavailable to those most in need.
Fourteen million new cases of tuberculosis (TB) occurred in 2009, primarily in Southeast Asia, the Western Pacific, Eastern Europe and sub-Saharan Africa.2 Approximately four percent of these cases were multidrug-resistant TB (MDR-TB).3 In 2009, 781,000 people died from malaria and more than 225 million became ill with the disease.4 The burden of malaria is overwhelmingly concentrated in Africa. More than one billion people are infected with at least one neglected tropical disease (NTD).5 Intestinal worms, among the most common of the NTDs, are a major cause of malnutrition, stunting and impaired mental development.6 Lower respiratory infections are a leading cause of death for children under five years old and adults over 60.1 Pneumonia, a respiratory infection that can be caused by bacteria or viruses, kills more children each year than malaria, tuberculosis, and HIV/AIDS combined.7
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Making Progress In 2000, the Millennium Declaration set forth eight Millennium Development Goals (MDGs), several of which are aimed at improving health in the least developed countries.11 MDG 6 specifically calls for the reduction of infectious diseases. These goals, along with other calls to action, have helped focus attention on infectious diseases, leading to increased resources and significant achievements in reducing morbidity and mortality.
Between 2006 and 2009, more than 98 million people were treated for the most common NTDs through integrated mass drug administrationâ&#x20AC;&#x201D;targeted packages of medication that cure para-
sitic and bacterial infections.12 Treatment prevents disability resulting from chronic infection and lowers NTD transmission by reducing the level of infection in the community. At least 736,700 children that would have died from malaria were saved by the scale up of insecticidetreated nets and indoor residual spraying of insecticides in Africa during the last decade; child deaths due to malaria dropped by 18 percent between 2000 and 2010.13 Widespread immunization has greatly reduced the incidence of some childhood diseases. Measles deaths declined by 78 percent between 2000 and 2008.10 Polio cases have dropped by 99 percent since 1988; the disease remains endemic in just four countries and current campaigns aim to completely stop transmission by 2013.14
Challenges Despite recent successes in prevention and treatment, infectious diseases remain a threat to global health. The interaction of many factors, including increasingly mobile populations, mutation of pathogens, and continued poverty in many parts of the world, impede efforts to control infectious diseases. A comprehensive approach is needed to address these challenges.
Infectious diseases disproportionately affect poor people. Lack of access to clean water, adequate sanitation, and health care contribute to frequent and more severe infections. Time away from work and money spent on medications put further economic pressure on already poor households, continuing the cycle of poverty. Co-infection, simultaneous infection with multiple pathogens, complicates treatment and speeds up disease progression. For example, both malaria and hookworm cause anemia; the combined effect of these diseases increases maternal and child mortality.15 People living with HIV and latent TB are 20-30 times more likely to develop active TB than those without HIV. More than one-quarter of people with HIV die from TB.16 Growing drug resistance threatens the effectiveness of malaria and tuberculosis medications. In most areas, malaria parasites are already resistant to chloroquine; resistance to artemisinin, a key ingredient in all newer malaria drugs, has been found in Asia.17 In northwest Russia, 24-28 percent of new TB cases are MDR-TB.3 Emerging, re-emerging, and novel infections constantly present new challenges. Cholera, once eliminated from the Americas, re-emerged in Peru in 1991 and caused thousands of deaths when it hit earthquakestricken Haiti in 2010. In 2009, pandemic influenza circled the globe in a matter of weeks despite attempts to contain its spread.
NOVEMBER 2011
References 1. World Health Organization. Global burden of disease report: 2004 update; 2008. 2. World Health Organization. Global Tuberculosis Control 2010. 3. World Health Organization. Multidrug and extensively drug-resistant TB (M/XDR TB): 2010 global report on surveillance and response 2010. 4. World Health Organization. World Malaria Report; 2010. 5. World Health Organization. Neglected tropical diseases: hidden successes, emerging opportunities. Geneva; 2009. 6. Hotez PJ MD, Fenwick A et al. Incorporating a rapid-impact package for neglected tropical diseases with programs for HIV/AIDS, tuberculosis, and malaria. PLoS Medicine. 2007; 3(No 5 e102). 7. World Health Organization. Pneumonia. 2010 Available from: http://www.who.int/mediacentre/factsheets/fs331/en/index.html 8. UNAIDS. UNAIDS report on the global AIDS epidemic 2010. Geneva: UNAIDS; 2010. 9. Hotez PJ, Fenwick A, Savioli L, et al. Rescuing the bottom billion through control of neglected tropical diseases. Lancet. 2009; 373: 1570-75. 10. World Health Organization. Measles. 2009 [cited 2011 March 8]; Available from: http://www.who.int/mediacentre/factsheets/fs286/en/ 11. United Nations General Assembly. United Nations Millennium Declaration; 2000. 12. Linehan M, Hanson C, Weaver A, et al. Integrated implementation of programs targeting neglected tropical diseases through preventive chemotherapy: proving the feasibility at a national scale. American Journal of Tropical Medicine and Hygiene. 2011; 84(1): 5-14. 13. Roll Back Malaria Partnership. Saving lives with malaria control: counting down to the Millennium Development Goals; 2010. 14. World Health Organization. Global Polio Eradication Initiative Strategic plan 2010-2012; 2010. 15. Brooker S, Akhwale WS, Pullan R, et al. Epidemiology of plasmodium-helminth co-infection in Africa: populations at risk, potential impact on anemia, and prospects for combining control. Am J Trop Med Hyg. 2007; 77(Suppl 6): 88-98. 16. World Health Organization. TB/HIV Facts 2009. 2009 Available from: http://www.who.int/tb/challenges/hiv/factsheet_hivtb_2009update.pdf 17. World Health Organization. Global report on antimalarial drug efficacy and drug resistance 2000-2010. 2010. 18. Harris JB, LaRocque RC, Charles RC, Mazumder RN, Khan AI, Bardhan PK. Choleraâ&#x20AC;&#x2122;s western front. The Lancet. 2010; 376(9757): 1961-5
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