Saturday, July 04, 2009

The Pandemic Dilemma For Developing Nations



# 3437



Today there appears an article in the Saturday Star that all but dismisses the Swine Flu Pandemic as a `non-event’; at least according to a South African Health Department Official.


Swine flu: Department not worried

    July 04 2009 at 03:42PM

By Candice Bailey and Thabiso Thakali

South Africa can expect a spike in the number of reported swine flu cases in the next few months - but health authorities are not concerned about the spread.


The country currently has 13 cases of swine flu, six of which have been reported this week alone.


But National Institute for Communicable Diseases head, Lucille Blumberg, on Friday said they were not aiming to contain the H1N1 virus.



"We should expect lots more cases. Other countries have experienced large outbreaks. There is no concern. Most of the cases will not even receive medical attention. We are not aiming to contain it. It is very mild."



At first glance, one might wonder what in blazes this person is thinking?  


There is no concern?


To understand this reaction, I suppose we have to put pandemic influenza in context with the other health disasters confronting South Africa (and other developing nations), and what – realistically - public health officials can actually do about it.


Over the past 20 years,  life expectancy in South Africa has dropped by more than 20%, with HIV playing a huge role.  The average life expectancy in that country is now under 50.


Among females aged 25-29, the incidence of HIV is estimated to be 33%, while nearly 25% of all males between the ages of 30 and 39 are believed infected.





Each year, a quarter of a million South Africans between the age of 25 and 50 die – most from AIDS or AIDS related diseases – which is more than all of those who die over the age of 50 in that nation.


South Africa is on the verge of losing a third of an entire generation to HIV.   So one can appreciate how an influenza pandemic that they think might only claim 1% or 2% really is insignificant in comparison.


And the problem isn’t much better in a lot of other countries.

Sub-Saharan Africa has, on average, some of the lowest life expectancy rates in the world.  HIV, Malaria, Cholera, Tuberculosis, diarrheal diseases, (among others) along with extreme poverty all conspire to lower life expectancies on that continent.





And these countries afflicted with these diseases are the countries least able to deal with a pandemic.   They have underfunded, and badly over burdened public health systems as it is.  


They have almost no chance of seeing any quantity of vaccine this year – and will probably only see a token amount in 2010.  Antivirals and antibiotics for the masses, in many of these countries, simply aren’t going to be available.


For hundreds of millions of people living in many of the poorer developing countries, there is very little that their public health infrastructure can offer right now other than reassuring words.


So one can understand, at least a little, why downplaying this pandemic makes sense to some health officials.  


One hopes that health officials will at least try to spread the word about staying home if ill, or covering coughs and washing hands . . . but often this sort of advice is simply impractical to those who must work every day to feed their families, or to those who live without running water.


If all of this sounds hopeless, the good news is there are agencies and NGOs working in these countries trying to alleviate some of this suffering.


Agencies like the Red Cross, Red Crescent, CARE, Save The Children, UNICEF, and others are working around the world every day to combat poverty and disease, and are going to be on the front lines during any pandemic.


To get an idea of what some of these agencies are dealing with, I would invite you to visit some of their websites.



They could use your support.


A couple of months ago, I highlighted a new project called H2P, or the Humanitarian Pandemic Preparedness project.



The H2P project is geared towards promoting community & district-level pandemic flu preparedness and response in developing countries.  


Many of the resources are available in multiple languages.


This Initiative comes through the hard work of a number of NGO’s and partner organizations, including USAID, IFRC, CORE Group (including American Red Cross, CARE, & Save the Children), AED, InterAction, & several UN agencies, including WHO, WFP, & UN OCHA:


H2P is a resource rich website which offers Guidance and Policy documents, Planning Tools, Training Modules, Focus Areas and Communication and Advocacy information.



One of the intriguing items on the H2P webpage is this interactive map, which allows you to `drill down’ and examine the types of humanitarian projects underway in countries around the world.



(click map to interact)


No matter how badly a pandemic affects North America, or Europe, or the developed nations of Asia and the Pacific regions, it  will likely pale in comparison to what poorer, developing nations go through.


In many countries, we’ll never know the true impact of this (or any other) pandemic. Surveillance and reporting is often less rigorous than in developed nations, and many deaths simply won’t be tallied.


If we are lucky enough to only see a `mild’ pandemic, we need to remember that for much of the world, it probably won’t be mild at all.

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