Covid-19 and Other Diseases
As the world continues to grapple with the Covid-19 pandemic, it can be difficult to remember that there are other pressing global health issues. Age-old diseases like tuberculosis don’t get the widespread attention they deserve because they don’t disrupt the lives of the wealthy. But even in a global pandemic, as almost everyone’s lives have been affected in one way or another, there are stark inequalities in the distribution and outcome of infectious diseases.
The new coronavirus is a threat to billions of people around the world, but the risk is compounded for people who live in overcrowded homes; who don’t have access to safe drinking water or nutritious food; or who rely on the provision of mosquito nets to protect themselves from malaria.
According to figures compiled by researchers at McGill University, the Covid-19 pandemic is predicted to cause an additional 400,000 malaria deaths this year; an additional 700,000 HIV-related deaths in Africa alone; 15 million unintended pregnancies; and up to 1.4 million additional tuberculosis deaths by 2025. The list continues: at least 80 million children under one are at risk of vaccine-preventable diseases such as measles, rubella and polio, as routine immunisation services have been disrupted in almost 70 countries. There could be an additional 113,000 maternal deaths in the next 12 months because of disruption to care before, during and after childbirth. Global poverty, a major driver of poor health, is set to worsen. Mathematical modelling can only describe a range of possibilities – possibilities that are highly sensitive to our actions. But these numbers should nevertheless give us pause.
In 2015, all United Nations member states adopted the 2030 Agenda for Sustainable Development, making a commitment to work together to end poverty, improve health and education, reduce inequality, spur economic growth and take action on climate change. One of the targets is to eradicate TB, HIV, malaria and a host of other communicable diseases. Already elusive before the pandemic, it seems even more unattainable today.
Do these goals – which also aim to end poverty and hunger by 2030 – need to be rethought and rewritten in the face of the crisis confronting us right now? (And what about future crises, that we cannot yet see or imagine?) Or do we need such ambitious targets to help us keep in view how the world could be remade after the pandemic?
As Covid-19 continues to wreak havoc on our societies, old threats – from unsafe childbirth to neglected tropical diseases – remain. If we shift all our resources and attention to the pandemic, we risk undoing all the extraordinary progress that has been made in global health. To aim to eradicate HIV without a vaccine, less than fifty years after the first Aids cases were reported, is testament to how powerful – and transformative – global public health measures can be.
In The White Plague: Tuberculosis, Man and Society (1952), Jean-Baptiste and René Dubos describe TB as ‘the first penalty that capitalistic society had to pay for the ruthless exploitation of labour’. How will Covid-19 and its aftermath be remembered?