On 2nd November 1698, Scottish colonists landed on the coast of modern-day Panama carrying approximately a quarter of their nation’s wealth. Their intention was to start a colony in the new world. Their plans didn’t go well.
The settlers were quickly devastated by malaria, a disease carried by the mosquitoes endemic to the area. The second group of colonists met the same fate. Eventually, only around a hundred of the original 2500 colonists survived to return to Scotland. The country was bankrupt. Its dreams of an empire were over, and it turned to England for financial aid. The English crown agreed on the condition of a political union. And so, in 1707, the two kingdoms of Scotland and England became the United Kingdom. A mosquito may be tiny, but its impact on society can be huge.
If an infectious disease can change the course of history, can individual people alter its course? Or does it require a more collaborative approach to fight it?
A burden beyond boundaries
Neglected, tropical and vector-borne diseases, like malaria, don't just exist in someone’s genetics, or in their lifestyle choices. They are diseases whose conditions are grounded in the very land on which people live and work, in the climate, and in the interaction of different ecosystems.
And they don’t just impact people on an individual level. Such diseases impact society on a massive scale – more than three billion people globally are at risk from tropical diseases.
Malaria, for example, is predominantly a rural disease, and the mosquitoes that transmit it thrive on the same three key elements required for agriculture – heat, water and people. It means that the 500 million smallholder farmers, responsible for around 80% of the food consumed in developing countries, are particularly at risk of infection. And if those farmers cannot tend to their fields and cannot maintain their livelihood, it hurts their family, the local community and wider society.
Public health issues such as these are global problems that affect people at a local level. There is no such thing as a one-size-fits-all solution, each case, each environment is different. They need to be tackled holistically, collaboratively and beyond borders, utilizing a package of globally available solutions which are implemented locally to suit the specific situation.
What is public health?
The World Health Organization defines ‘Public Health’ as “the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society.” In practice this means a three-pronged approach to tackling infectious diseases: prevent the causes, provide cures, and raise awareness.
- It starts with surveillance – monitoring and reporting disease outbreaks and analyzing data to shed light on the underlying causes. This then informs us how best to bring outbreaks under control and prevent ongoing transmission.
- Stopping the spread of infection is critical – not just in humans but also, for zoonotic diseases, in animals. This requires integrating multiple disciplines from physicians and veterinarians administering vaccinations to implementing vector-control interventions such as indoor residual spraying or bed nets, to encouraging and educating those at risk to adopt personal protection, such as using insect repellent.
- Improving access – both for diagnosis and treatment. Having systematic screening for early-stage disease detection is crucial to make sure the right medicines can be provided early enough to prevent spread of infection.
- Engaging local communities – raising awareness of these diseases and their risks is critical. School and community education programs help bring behavioral changes that can reduce the risk of infection, or the impact of an outbreak.
Towards an NTD-free future
Neglected, tropical and vector-borne diseases disproportionately affect the poorest nations in the world. Many of the people most at risk typically have poor sanitation systems, weak health surveillance systems, and lack access to early-stage disease detection.
Overcoming these challenges requires a coordinated global effort. In 2012, a group of NGOs, charities and companies including Bayer came together to sign the London Declaration on Neglected Tropical Diseases. Its intention to work together to eradicate, eliminate or control certain neglected tropical diseases by 2020.
Since its signing, more than one billion people in over 130 countries received treatment for at least one NTD. Over one million drug distributors, surgeons, nurses and government health officials have been trained by NTD programs, and US$17 billion worth of medicine has been donated by life sciences companies.
Similarly, in April 2018, members of the agriculture industry signed a declaration called ZERO by 40. It is a commitment by industry partners to collaborate on the research, development and supply of innovative vector control solutions with the aim of eradicating malaria by 2040.
The world has made huge strides in reducing the ruinous effect of tropical vector-borne diseases, but we still have a long way to go if we want to eliminate them. It is a local problem that requires a global solution.