America’s attention and resources, following the vicious attack by terrorists on September 11, 2001, have been focused on the Global War on Terrorism (GWOT). The United States (U.S.) has been forced to become more vigilantly aware of the threat posed by terrorists due to the increasing successes of terrorist plots, and this last decade stands as a testament to their increasing success or determination. The first bombing of the World Trade Center (1993), Khobar Towers (1996), two U.S. Embassies (1998), and the USS Cole (2000) are a few of the more pronounced episodes, but terrorists stepped too far with their second attack on the World Trade Center on September 11, 2001. The deadly strike, here at home, killing thousands of innocent civilians without warning and without provocation was the event that convinced the U.S. to take the offensive. The President’s current strategy is to “preemptively” destroy the training camps of would-be-terrorists in Afghanistan before their diabolical plans are even conceived. The U.S. is wagering that age-old adage that “an ounce of prevention is worth a pound of cure,” which may be cheaper in the long run and defiantly safer for all Americans. Given these serious challenges now facing the U.S. are there any compelling reasons why we (the U.S.) should care about the generally accepted poor health care and rampant infectious disease occurrences afflicting the people of Sub-Saharan Africa?
As a region,
Sub-Saharan Africa (SSA) is characterized by having the greatest infectious
disease burden, the weakest public health infrastructure, the highest birth
rates, lowest per capita annual income, poorest economic outlook, highest
illiteracy rates, largest number of displaced persons, and a long history of
corrupt governments.[i] If this were not
enough, Human Immunodeficiency Virus (HIV), Ebola, Monkeypox and West Nile
virus all originated in this region as well.
One need only examine the HIV infection rates to witness a startling
example of the disproportional disparity of diseases in Africa. Currently, SSA sports some alarming statistics:
72% of the world’s HIV infections and 80% of
the world’s HIV-positive women are in 10% of the world’s population, and with
adults in SSA 30 times more likely to be infected
with HIV than those in Brazil or India.
Given these alarming statistics it would seem prudent for the Western
world to put a fence around the region, declare it persona non gratis, and
focus attention on the bigger problems like terrorism.
Two years prior to
9/11, in August of 1999, New York City (NYC) came under attack from a previously
unnoticed killer, West Nile virus (WNV).
The introduction of this virus into NYC was the first time that WNV had
been diagnosed in the Western Hemisphere.
WNV, a mosquito borne virus, moves between infected birds to humans and
is common in SSA. In 1999 WNV was
responsible for the deaths of 7 New Yorker residents and infected thousands of
others. By 2003 the virus has spread to
46 states and was responsible for over 200 American deaths and hundreds of
thousands more people being infected.
West Nile virus exceeded all epidemiologists’ predictions by spreading
across the U.S., literally like wild fire, in just 4 years after its debut
in New York City. The U.S. is spending
millions of dollars each year in an attempt to control this new menace, but the
cold reality is, it is a disease we will have to live with because we cannot
stop it. The cost in both human lives
and to our national treasury--over the years—will eventually far exceed the
costs suffered on September 11.
In addition to WNV,
there are countless other human and animal infectious diseases circulating in
Africa that ultimately pose a significant threat to the national security of
the United States. The introduction of
diseases like Rift Valley fever, yellow fever, and malaria would result in
thousands of American’s dying as well as the concomitant financial burden and
negative impact to the overall health status for Americans. If this matter were not dire enough, there
are over 25 million Africans infected with HIV, and therefore, immuno-compromised. These people are vulnerable to any and all
infections and the potential to develop drug resistant bacteria and viruses is
without question. These infected individuals
will not be helped by the possible development of an effective vaccine,
anti-retroviral medicines will not reverse their condition, and their deaths
will impact SSA and the world in ways not yet imagined.
The seriousness of these issues has not escaped
the current administration. President
Bush signed legislation on May 27, 2003 authorizing a new five-year $15 billion
Emergency Plan for AIDS Relief. While
this plan is a step in the right direction it underscores the lack of
understanding of the real threat to all Americans. We cannot continue to view the infectious disease
threats of Africa through the lens of humanitarianism, we need to see the
threat for what it is…a ticking time bomb that will not go away or die
out! Spending large amounts of the
national treasury trying to extend the lives of people already stricken with
disease does not lessen the threat or reduce the disease burden, it just makes
the U.S. feel better and gives the worldly appearance that we (the U.S.)
care.
The United
States--with the help of other countries--needs to develop and provide sustainable
universal disease control and preventive medicine programs aimed at improving
the overall education and health care of all Africans. Preemptively the “national strategic” goal
must be to stop, or at least control, the infectious diseases in SSA before
they have a chance to find their way into the virgin human and animal
populations.
The threat of
terrorism is clear. All Americans still
carry the indelible image of the World Trade Center collapsing etched in their
mind; reminding us to what lengths the enemy is willing to go. We do not, however, have a clear of image of
the threat posed to us by the spread of infectious diseases. The process, with rare exceptions such as the
Flu Pandemic of 1918, is methodical, less dramatic, killing a few thousand and
infecting hundreds of thousands in a year, and happens without bombs or burning
buildings but rather slowly, without notice, potentially destroying the American way of
life.
What can we do? In recent years a new phrase has erupted among
people working with Africans, “African
solutions for African problems.”
Translation: “We (the U.S.) don’t
know how to solve these problems, do you?”
The approach that needs to be undertaken is the “preemptive policy” and
this solution, just like GWOT, takes commitment, money, vision, and popular
support. The U.S. needs to leverage her
knowledge, people, and assets against the problems of SSA by helping to improve
the overall health and education of its peoples while working to improve disease
control.
It is time to place
the same “preemptive” philosophy used for battling terrorism, vis-à-vis GWOT,
to controlling diseases in SSA. If we do
not stand and fight these diseases in SSA we will have to fight them in the
continental U.S. and when we fight them here at home…the battle will have
already been lost.
[i]
Jennifer Brower and Peter Chalk, The Global Threat of New and Reemerging
Infectious Diseases. Rand Publishing, Pittsburgh, PA, 2003, p 42
No comments:
Post a Comment