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Médecins Sans Frontières/Doctors Without Borders (MSF) is particularly concerned about five diseases that have the potential to become epidemics since 2016.
Without proper investment in preventing and responding to outbreaks of cholera, malaria, measles, meningitis and a group of often-overlooked diseases spread by viruses and parasites, they are likely to pose an ever greater threat to people’s health in the year ahead.
Current strategies to prevent major outbreaks of disease show only limited success.
Epidemics continue to occur, often with devastating consequences for some less developed countries by opening cracks in national health systems and exhausting available resources.
“We know that thousands of lives will be at risk in the year to come, although the means exist to prevent these deaths,” says Dr Monica Rull, operational health advisor for MSF.
“Epidemics of cholera, malaria, measles and meningitis take place every year, with these diseases incapacitating and killing many – and this needs to stop.
“At the same time, the threat posed by emerging and re-emerging virus and parasite-spread diseases – such as dengue fever, Zika, Ebola and Kala Azar – needs to be faced.”
Cholera is a water-borne, gastrointestinal infection that causes acute watery diarrhoea and vomiting, which can lead to severe dehydration and death within hours if left untreated.
In 2014, we treated 46,900 people for cholera in 16 outbreaks affecting six countries (Cameroon, Democratic Republic of Congo (DRC), Haiti, Niger, Nigeria and South Sudan).
Malaria is transmitted by infected mosquitoes. Severe malaria can lead to organ damage and death if left untreated.
In 2014, we provided treatment to 2,114,900 patients affected by malaria, and gave seasonal malaria chemoprevention (SMC) to more than 750,000 children below five years of age.
Measles is a highly contagious viral disease, for which there is no specific treatment. In high-income countries, most people infected with measles recover within two to three weeks, and mortality rates are low.
In developing countries, however, the mortality rate can be three to 15 percent, rising to 20 percent during outbreaks and in areas where people are more vulnerable.
In 2014, we treated 33,700 patients for measles and vaccinated 1,513,700 people in response to outbreaks.
Meningitis is the inflammation of the thin membranes surrounding the brain and the spinal cord. It is most often caused by infection – bacterial, viral or fungal.
Meningitis occurs throughout the world, but the majority of infections and deaths are in Africa, particularly across the ‘meningitis belt’, an east–west geographical strip than runs from Ethiopia to Senegal.
In 2014, we vaccinated 75,100 people against meningitis in response to outbreaks.
Outbreaks of dengue, Chikungunya, Zika, Middle East Respiratory Syndrome (MERS) and haemorrhagic fevers have all been reported in 2015. Parasitic infections such as visceral leishmaniasis (kala azar) that were under control are now on the rise again.
In 2014, we treated 4,700 Ebola confirmed patients, 1,700 patients for Chikungunya and 9,500 patients for kala azar including responding to an outbreak affecting South Sudan.
Find out more about our work with neglected diseases, like kala azar
Along with prevention measures, resources must be provided to build effective emergency response systems. This must be part of a broader effort to help countries strengthen their health infrastructure and capabilities and provide health education to local communities.
Rapid alert mechanisms must be accompanied by rapid response activities once a disease breaks out, with free and quality medical care provided to all those affected.
The research and development agenda must be reoriented towards the greater public good, with a recognition that market forces cannot be counted on to deliver effective, accessible and affordable tools for under-served population groups.
MSF emphasises that the first step to global health security is individual health security, including for the sickest and most vulnerable people.
“Current outbreak response strategies are failing the very people they are designed to help,” says Dr Rull. “If we don’t make significant changes, we will be doomed to repeat past mistakes, and must take responsibility for the consequences.”
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