World Disasters Report Gives Cause For Concern

By Neena Bhandari, IPS, 29 June 2000

LONDON, Jun 28 (IPS)—This year 13 million people will die of preventable diseases in the world, according to the World Disasters Report 2000 released Wednesday in London by the International Federation of Red Cross and Red Crescent Societies.

While natural disasters like floods and earthquakes killed 80,000 people last year, many more died from the unchecked spread of AIDS, tuberculosis, respiratory diseases, malaria and diarrhoea.

Fifty-eight percent of those who die of infectious diseases are among the poorest 20 percent of the world’s population. Most of these deaths could have been prevented by using low-cost, community health driven campaigns. And it would have cost only five US dollars per person, the document said.

According to the report, These silent public health disasters have been fuelled by national governments abandoning their responsibilities for preventive health care, growing urbanisation, climate change and environmental degradation.

The direction many states have chosen to go is by default rather than choice. Governments are slipping on their responsibilities for immunisation and basic preventive health care. 70 percent of the money assigned for national health systems is siphoned off into big hospitals. There is no use having hospitals without doctors and the equipment to run it, says Dr Hakan Sandbladh, senior health officer with the International Federation of the Red Cross.

While international aid flows rise, debt-servicing takes back nine times as much as the aid flow. Current estimates suggest that Mozambique, for instance, will have to spend 45 million dollars a year on debt servicing, more than it spends on primary health care and basic education.

Out of the 52 billion dollar global aid package, only half a billion dollars went to health in developing nations.

Sandbladh adds, We want the North to reappraise the direction aid takes. The money would be better spent on training local people in primary health care. The gap between health care available to the rich and poor is only going to grow.

Public expenditure on health in low-income countries averages just one percent of the GDP compared to six percent in high-income countries. Under such a situation the aid agencies have hard choices to make.

Says Peter Walker, director of disaster policy for the International Federation of the Red Cross: They have to work for health care more than merely responding to natural disasters. The days of ‘quick in, quick out’ are long gone. The Red Cross is now emphasising on investing in people, not just commodities. We take direct action by working with the local community and through quiet advocacy at the government level.

For example, we are trying to put ourselves on the panel of the National Preparedness Committee of a country so that we can persuade the government to make insecticides cheaper and thus prevent malaria. Malaria kills up to 2.6 million people annually and 75 percent of them are children.

The report traces the escalation of AIDS infections in sub-Saharan Africa. Currently 70 percent of those infected with the HIV virus which causes AIDS, or 23 million people, live in Africa. Every hour, 300 people on the continent die from AIDS, according to the Joint UN Programme on HIV/AIDS (UNAIDS).

Over the next decade, AIDS will kill more people in sub-Saharan Africa than all the wars of the 20th century.

By way of example, the report cited the case of Zambia. Some 1,200 Zambians die from AIDS each week, it said; the disease has been responsible for a 14 percent shrink in the country’s gross domestic product (GDP).

Hence, HIV/AIDS is emerging as a major cause of social, political, economic, educational and cultural crisis. The irony is that it is totally preventable. The disaster of HIV/AIDS cannot be rolled back through expensive drugs. It requires basic health education and a health system that can deliver consistent care, says Didier J Cherpitel, secretary general of the International Federation of the Red Cross.

Similarly, in North Korea, a country where tuberculosis or TB had been eliminated, there is only one doctor for 134 families and each year, 40,000 new TB cases are coming to light. Traditional drugs account for 70 percent of hospital drugs.

Cherpitel adds, The reason why investment in research of preventable diseases is less is because there are no returns. This vicious circle has to be broken. Health is not about pharmaceuticals alone. One needs to invest in nutrition, education, safe drinking water, immunisation, mother and child care to prevent future disasters.

The emergence of multi-resistant strains of TB and malaria will cost thousand times more per case. International partnerships with governments, the private sector and financial institutions along with local partnerships with community health workers can go a long way toward preventing future disasters, the report said.