The comeback of forgotten diseases

 

 

 

 

 

 

 

 

 

There are many diseases which Europe had presumed to be cured and therefore forgotten. For decades, diseases like polio and tuberculosis (TB) have been associated with developing countries and not those in the EU however recently, we are starting to see a worrying increase in incidents of these diseases across the EU and its neighbouring countries. Whether as a result of antimicrobial resistance or increased migratory flows from other regions of the world, we are now being reminded of what we had once forgotten.

Let’s take polio as our first example. Europe has been declared Polio free since 2002 however conflicts in Northern Africa have led to its re-emergence in a number of countries like Syria and Egypt. More than $10 billion has been invested to eradicate the disease worldwide, largely through immunization efforts. The polio vaccine is inexpensive and easily administered. While polio has been eliminated in much of the world, and these efforts are supported by sophisticated monitoring systems (the WHO keeps a weekly epidemiological record of polio cases globally), the real threat to its resurgence are dangerous vaccine coverage gaps in a number of countries in Northern Africa but also within the EU.

Tuberculosis on the other hand, is a multi-drug resistant form (MDR-TB). Unlike polio, TB is far from being eradicated. According to the WHO, in 2013 an estimated 9.0 million people developed TB and 1.5 million died from the disease worldwide. As a result of inadequate diagnostic infrastructure, insufficient funding and poor patient adherence, drug-resistant strains of the TB pathogen have developed and are spreading. As resistance grows, not only are adequate treatment options increasingly scarce but having the appropriate diagnostics to determine TB type, and as such avoid exacerbating problems of resistance, are also sorely lacking. Inadequate diagnostics mean that monitoring the epidemiology and spread of TB, and MDR strains, is also very difficult. MDR-TB affects Europe in particular and out of the 27 high MDR-TB burden countries worldwide, 5 are EU Members further indicating that this is very much a European problem.

Both Polio and MDR-TB are highly contagious diseases and therefore constitute a serious cross-border health threat. The EU has recently tried to step up its efforts in this area though the Decision on Serious Cross-Border Health Threats and the setting up of the Health Security Committee which is meant to create a platform between Member States to address such threats. These are laudable efforts in particular if the tools the EU has put in place are used to tackle diseases which are currently affecting the Region, such as MDR-TB.

At the same time however, the EU’s actions should also look beyond its borders to ensure those diseases which are currently affecting other regions of the world will not resurface in the European Region in the future. Polio is a perfect example of how a half-accomplished success can lead to a resurfacing of the threat you had assumed was long gone from your borders.

Similar mistakes should not be repeated in dealing with Ebola. Ebola was first detected many months before the epidemic became an international media story, and for months after it was difficult for health authorities to know how to tackle the spread of the disease, simply because the health systems needed to diagnose and monitor it were not in place. As the Ebola crisis is slowly being substituted by other “more pressing” news in the media, it is now more important than ever to ensure the EU and its Member States continue to provide support to Western African countries to effectively eradicate the threat, ensure monitoring structures are in place so that any re-emergence can be quickly reacted to, and make sure it is not forgotten in the short term only to come back and knock on our doorstep in the longer term.

Emanuele Degortes is a Director at FTI Consulting Brussels

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