Monday, November 02, 2009

Let us compare epidemics

There is always something a bit distasteful about comparing human tragedies, but it is also inevitable. The tsunami in 2004 was terrible, but was it as bad as the ongoing HIV/AIDS epidemic in Africa, which has taken millions of lives over the last decades? Darfur is bad, but has it really reached Rwandan genocidal proportions? We inevitably make these sorts of comparisons in order to get some sort of grip on what people ought to care about, and what nations ought to respond to with their finite resources. And we often lose our way.

The H1N1 virus has captured media attention, as well as substantial funding for task forces, response plans and research, particularly as increasingly more deaths have been linked to it. As has been observed many times, the 'media life' of a virus depends in large part on the extent to which citizens (especially ordinary citizens) of North America and Europe are affected by it, or are likely to be affected by it. When the centers of the world's power is under viral threat, vast resources may be mobilized, even if the numbers in terms of morbidity and mortality are, relatively speaking, small. Worse epidemics, elsewhere, receive much less press and support.

The point was not lost on those aware that today was World Pneumonia Day. Pneumonia is the greater killer of children worldwide. It is responsible for more deaths in children (2 million a year) than HIV/AIDS, measles and malaria combined. The tragedy is that we long ago developed effective vaccines to prevent it, and antibiotics to treat it, but it generally affects children away from the centers of the world's power, particularly in sub-Saharan Africa and South-East Asia. While many lives could be saved in delivering known effective medicines to these populations, there is not much money to be made in the endeavor, so rallying support for pneumonia initiatives tends to be an uphill battle. But it is a matter of fighting the good fight, a matter of trying to regain some sense of proportion, and a matter of not being entirely distracted by the latest virus on the 24-hour news cycle.

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Blogger Daniel Goldberg said...

Stated, as usual, with your excellent understatement and eloquence.

I, however, tend to get much more indignant, a la Farmer, about the normative choices we make and do not make that result in the funneling of resources away from the places, communities, and societies which bear disproportionate burdens of disease, and away from the most promising strategies (eg., SDOH) for ameliorating those burdens.

5:15 PM  
Blogger Jenna said...

It seems to me that when such simple strategies--like vaccination, breastfeeding, and antibiotics--are available and could prevent a million deaths a year, pneumonia control is a no brainer. Thanks for reminding us that while all preventable human deaths are tragic, its important to consider where we can have the biggest impact.

1:09 PM  

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