~Written by Theresa Majeski (Contact: theresa.majeski@gmail.com)
Not many people probably paid much attention to public health, much less global public health, before Ebola arrived in the US and Spain. Despite the focus on Ebola, there have been other global infectious disease developments in 2014.
Antibiotic Resistance
A major threat to humans worldwide is the emergence of antibiotic resistance. According to the Infectious Diseases Society of America, the CDC, WHO, the European Union, and President Obama, the problem of antibiotic resistance has reached crisis level. This is due to the overuse of antibiotics worldwide and major pharmaceutical suppliers who have basically abandoned antibiotic development because they don’t make enough money to justify the expense. This is a major problem because we could end up going back to death rates akin to the pre-antibiotic era, where something as simple as a minor cut could be deadly. Another fact to mention is the huge use of antibiotics in agricultural animals. Agricultural use accounts for 80% of antibiotic use in the US and that continued usage gives bacteria more exposure to the antibiotics and more opportunity to develop resistance.
Hepatitis C and HIV/AIDS
In case you didn’t hear, in only a 25 year span from the discovery of hepatitis C virus (HCV), we now have a treatment that cures 95% of the people who take the pill once a day for 8-12 weeks. I want you to let that soak in a minute…….because this is huge. HCV affects something like 250 million people around the world and now we can not just suppress the virus, but can actually clear it from someone’s body. Unfortunately, right now the cost of this treatment is $74,000 or more per person, basically putting this cure out of reach of anyone in middle or low income countries. Also in 2014, the world reached the tipping point for HIV/AIDS. That means that for the first time in the 30+ year epidemic, the number of people newly infected was less than the number of HIV positive people who got access to HIV medicines. While not every individual country has reached this milestone, and we still have a ways to go to get everyone access to life-saving medication, this tipping point shows that with continued effort the end of HIV/AIDS may be nearer than we thought.
Vaccine development
Vaccines have been around for a while and humanity has tried to create vaccines for all sorts of diseases. Work is being done to create vaccine platforms that don’t involve a needle such as embedding the “stuff” of the vaccine into a microneedle array (a small disk with several microscopic points that dissolve when embedded in the skin). There is also an effort to create a universal influenza vaccine. A universal vaccine would target viral proteins that are conserved between the different strains of influenza and don’t mutate very often, so the vaccine could be effective no matter what strains are circulating each influenza season.
Epidemics
I just want to touch on a few of the epidemics you may not have heard much about this year. There was an epidemic of enterovirus D68 this year that caused more severe disease than we had expected as enterovirus infections generally only cause mild respiratory symptoms in kids. A mosquito-borne disease, Chikungunya, has been sweeping the Caribbean and causing fever and severe joint pain. Guinea worm, affecting people living in Africa and Asia, grows inside the body and then erupts from anywhere in the body causing severe and debilitating pain. Guinea worm is on target to be the second disease eradicated in human history (after smallpox) and is being eradicated not with the use of expensive medicines but through inexpensive but challenging to implement behavioral change.