Sophie Cousins

The 21st International Aids Conference was in Durban last week. The last time it was held here, 16 years ago, Aids denialism in South Africa was rife, people were dying on the front lawns of hospitals, unable to access treatment, and President Thabo Mbeki had announced that Aids was caused not by a virus, but by poverty and poor nourishment. A lot of progress has been made since then.

Ousainou Sarr came to the UK from Gambia more than two decades ago. For two years he experienced typical tuberculosis symptoms – weight loss, profuse night sweats, a persistent cough – but his GP never suspected he might have TB. He was living rough on the streets of London, the TB capital of Western Europe, when the Find & Treat van offering TB screening arrived. The van is a specialist NHS outreach service that aims to tackle TB among homeless people, drug or alcohol users, vulnerable migrants and ex-prisoners across the UK, by providing screening and access to care. More than 9000 cases of TB were diagnosed in the UK last year.

On receiving the 1945 Nobel Prize in Medicine for discovering penicillin, Alexander Fleming finished his lecture with a warning: ‘There is the danger,’ he said, ‘that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.’ Antibiotic resistance is now one of the biggest threats to global health, food security and development. It could kill as many as 10 million people a year by 2050.

When I landed at Kathmandu airport three years ago, not long after the earthquake that killed almost 9000 people, the streets were eerily quiet. Dim street lights shone down on the devastation. Buildings, monuments and houses had been reduced to rubble. Thousands were living in temporary shelters in rough conditions. But the damage to the capital paled in comparison to areas of the country closer to the epicentre of the earthquake, nearly 50 miles west of the city. Two million Nepalis had been made homeless. They had lost everything.

Health officials in Kerala have confirmed a number of deaths from Nipah virus in the south Indian state. In the Democratic Republic of Congo, there is an outbreak of Ebola. Earlier this year, a team of virologists, bacteriologists and infectious disease experts met at the World Health Organisation’s headquarters in Geneva to determine which diseases and pathogens pose the greatest public health risk because of their epidemic potential and an absence of effective drugs and vaccines for treatment and prevention. Both Nipah and Ebola are on the list. The 2018 Research and Development Blueprint, released in March, also includes Zika virus, Lassa fever (a viral haemorrhagic disease occurring primarily in West Africa), MERS-CoV and Sars – and something called Disease X.