STEMMING THE TIDE OF INFECTIOUS DISEASES IN AFRICA.
Infectious disease is a serious global health problem. However, its negative impact is felt more in
sub Saharan Africa. Epidemiological figures have shown that the burden of infectious disease is
highest in the African continent especially in sub Saharan Africa. A majority of people leaving in
sub Saharan Africa are poor and their exposure to infectious disease worsens their poverty situation.
Aside impoverishing infected individuals, infectious diseases also directly negatively impact
the economy of the country involved, reducing economic growth and productivity. Diseases like
malaria, HIV, tuberculosis TB, and other epidemic prone diseases like Cholera and Ebola constantly
pose a threat to economic development in Sub Saharan Africa. It is therefore pertinent to
invest in disease prevention strategies to curb the burden and reduce the impact of infectious
diseases on the economy of countries in sub Saharan Africa. This mini review re-echoes the burden
of infectious diseases and discusses ways and strategies to reduce the burden of these diseases
and the economic benefits that will be accrued at the long run.
Economic Burden of Malaria HIV/AIDS and Tuberculosis Malaria has caused untold hardship in Sub-Saharan Africa. Malaria is a mosquito-borne parasitic infectious disease caused by a protozoa organism called plasmodium. It is common in tropical areas of the world especially in sub Saharan Africa . Plasmodium falciparum is the predominant specie responsible for severe infections in Sub Saharan Africa . Malaria accounts for about 400 to 900 million yearly cases of febrile illness and about 75% of these are in children in Africa. Children are more predisposed because of rudimentary antiparasitic and clinical immunity . Parents of infected children spend 25% of their house old income on treatment . Malaria has been ranked as the second highest contributor to the Disability Adjusted Life Year (DALY). The DALY is an estimation of a disease’s direct cause of mortality and morbidity . There is decrease economic growth in country with severe malaria burden about 1.3% less than those without malaria . Aside the snail speed economic growth, it was estimated that 25 of these countries lose 15% of their GDP to the disease [14]. HIV/AIDS also creates huge problems for the economies of many countries in Sub -Saharan Africa. It is caused by human immunodeficiency virus chiefly transmitted through exchange of body fluids, semen and blood. HIV infection usually progress to Acquired Immunodeficiency syndrome, a condition in humans characterized by progressive failure of the immune system leading to life-threatening opportunistic infections 68% of people that leave with HIV globally reside in the African continent . Those infected are usually in the productive phase of their life. It is estimated that HIV/AIDS contributes to 72 million DALY and each AIDS death equals 34.6 D.A.L.Y lost on the average in 1999. These represent, in economic terms about 35.1% of GDP if each DALY is valued 3 times per capita income. Tuberculosis on the other hand causes similar havoc to personal, family and national economies, having negative impact on working hours . It is an infectious disease caused by mycobacterium tuberculosis. It is transmitted through droplets infection when persons with active infection sneeze and cough, releasing the infectious mycobacterium in the air . Tuberculosis is principally a disease of poverty being very much linked to overcrowding and malnutrition . It causes 20% - 30% loss of house hold earnings. About 8.4 million people are living with tuberculosis worldwide, causing about 30% average loss of productivity leading global economy loss of about I billion US dollars yearly .
Economic Burden of Epidemic Diseases Other epidemic diseases,
though not present at all times have the potential to cause economic loss. They disrupt trade and commerce and put the economies of these countries in untold hard ship. Epidemic of emerging and reemerging diseases have the capacity to cause hardship and economic strain on nations affected. Diseases like cholera and Ebola cause severe strain on the poorly, underfunded health care resources of most countries in subSaharan Africa and by the time the epidemic is over thousand are dead especially those in the productive years of their life, and the economy is in tatters. Cholera is one of the causes of diarrhea. It is an infection of the small intestine caused by vibrio cholera. It is characterize by profuse diarrhea and vomiting leading to massive loss of body fluids . It is a disease that occurs commonly and repeatedly in sub Saharan Africa because majority of the population live in poor conditions and surroundings that favour the spread of this disease. Conditions like overcrowding, poor sanitation, improper sewage disposal, lack of portable water and lack of personal hygiene. In 2007, a total of 110,837 cases were reported to WHO from countries in Africa, with an estimated economic loss of 60 million dollars . Ebola is a viral hemorrhagic fever of humans caused by the ebolaviruses . A very virulent disease that kills 25% to 90% of those infected [26]. It is a highly contagious disease spread mainly by contact with body fluids . The present Ebola crisis is a true example of what an epidemic and a re-emerging disease can do to a country’s economy. Guinea, Seria Leone and Liberia are worst hit and have lost considerable manpower and income since the outbreak. World Bank estimates for 2014 shows that these three countries lost a significant amount of GDP growth which amounts to a total of US$359 million. There are also recorded revenue shortfalls due to reduced economic activities, coupled with increased expenditures on health, security, and social protection. The financing gaps for the three core countries, summed up to over US$290 million. If the epidemic continues there will be even greater financing gaps by the end of 2015.
Control and Prevention Strategies
It will not be difficult to deduce at this juncture that preventing and controlling infectious disease will help in
improving the lives of people and the economies of countries in sub Saharan Africa. Investing in measures to
control and prevent this disease will indeed be good business for countries in sub-Saharan Africa. One can’t help
but imagine what it will be like if the African continent was not plagued with these diseases, Africa would have
grown to realize her full potential taking her rightful place as a world power.
Scaling up Already Existing Prevention and Control Program
One of the sure ways to go in preventing and controlling infectious diseases is to scale up existing prevention programs. Investment in the scale up and upgrade of the present prevention and control programs will certainly be good business. It is very evident that the various control programs are yielding positive results. Malaria burden is gradually decreasing in most parts of sub Saharan Africa [28]. Progress was noted few years after the WHO three-prong approach was widely deployed in malaria endemic areas in Africa with increasing amount of coverage achieved [29]. In the same vein the control programs for HIV and TB have made progress in controlling these diseases [30]. Africa has not yet achieved the millennium developmental goals (MDG) but lessons to be learnt from these control programs is that if Africa keeps doing the right things she will win the fight against infectious diseases. Thus, it is apt to keep investing in already existing control programs by way of monitoring, evaluating and scaling up these programs.
. Active Infectious Disease Surveillance System
Lack of infectious disease surveillance system is the bane of health care and public health in sub Saharan Africa. There is dearth of surveillance system in Africa . This is the main reason why epidemic-prone infectious disease like cholera, Ebola and others are ravaging Africa at will. A good surveillance system in place for a particular infectious disease can be utilized for any emerging epidemic-prone infectious disease. A typical example is the Ebola epidemic in Nigeria. Nigeria was largely successful owing to the fact it called up its own polio surveillance response structure and manpower and established an Ebola response unit. From the polio response team, 40 of the Nigerian doctors trained in epidemiology were reassigned. This gave Nigeria a head start and advantage to eradicate Ebola in record time against all odds
Economic Burden of Malaria HIV/AIDS and Tuberculosis Malaria has caused untold hardship in Sub-Saharan Africa. Malaria is a mosquito-borne parasitic infectious disease caused by a protozoa organism called plasmodium. It is common in tropical areas of the world especially in sub Saharan Africa . Plasmodium falciparum is the predominant specie responsible for severe infections in Sub Saharan Africa . Malaria accounts for about 400 to 900 million yearly cases of febrile illness and about 75% of these are in children in Africa. Children are more predisposed because of rudimentary antiparasitic and clinical immunity . Parents of infected children spend 25% of their house old income on treatment . Malaria has been ranked as the second highest contributor to the Disability Adjusted Life Year (DALY). The DALY is an estimation of a disease’s direct cause of mortality and morbidity . There is decrease economic growth in country with severe malaria burden about 1.3% less than those without malaria . Aside the snail speed economic growth, it was estimated that 25 of these countries lose 15% of their GDP to the disease [14]. HIV/AIDS also creates huge problems for the economies of many countries in Sub -Saharan Africa. It is caused by human immunodeficiency virus chiefly transmitted through exchange of body fluids, semen and blood. HIV infection usually progress to Acquired Immunodeficiency syndrome, a condition in humans characterized by progressive failure of the immune system leading to life-threatening opportunistic infections 68% of people that leave with HIV globally reside in the African continent . Those infected are usually in the productive phase of their life. It is estimated that HIV/AIDS contributes to 72 million DALY and each AIDS death equals 34.6 D.A.L.Y lost on the average in 1999. These represent, in economic terms about 35.1% of GDP if each DALY is valued 3 times per capita income. Tuberculosis on the other hand causes similar havoc to personal, family and national economies, having negative impact on working hours . It is an infectious disease caused by mycobacterium tuberculosis. It is transmitted through droplets infection when persons with active infection sneeze and cough, releasing the infectious mycobacterium in the air . Tuberculosis is principally a disease of poverty being very much linked to overcrowding and malnutrition . It causes 20% - 30% loss of house hold earnings. About 8.4 million people are living with tuberculosis worldwide, causing about 30% average loss of productivity leading global economy loss of about I billion US dollars yearly .
Economic Burden of Epidemic Diseases Other epidemic diseases,
though not present at all times have the potential to cause economic loss. They disrupt trade and commerce and put the economies of these countries in untold hard ship. Epidemic of emerging and reemerging diseases have the capacity to cause hardship and economic strain on nations affected. Diseases like cholera and Ebola cause severe strain on the poorly, underfunded health care resources of most countries in subSaharan Africa and by the time the epidemic is over thousand are dead especially those in the productive years of their life, and the economy is in tatters. Cholera is one of the causes of diarrhea. It is an infection of the small intestine caused by vibrio cholera. It is characterize by profuse diarrhea and vomiting leading to massive loss of body fluids . It is a disease that occurs commonly and repeatedly in sub Saharan Africa because majority of the population live in poor conditions and surroundings that favour the spread of this disease. Conditions like overcrowding, poor sanitation, improper sewage disposal, lack of portable water and lack of personal hygiene. In 2007, a total of 110,837 cases were reported to WHO from countries in Africa, with an estimated economic loss of 60 million dollars . Ebola is a viral hemorrhagic fever of humans caused by the ebolaviruses . A very virulent disease that kills 25% to 90% of those infected [26]. It is a highly contagious disease spread mainly by contact with body fluids . The present Ebola crisis is a true example of what an epidemic and a re-emerging disease can do to a country’s economy. Guinea, Seria Leone and Liberia are worst hit and have lost considerable manpower and income since the outbreak. World Bank estimates for 2014 shows that these three countries lost a significant amount of GDP growth which amounts to a total of US$359 million. There are also recorded revenue shortfalls due to reduced economic activities, coupled with increased expenditures on health, security, and social protection. The financing gaps for the three core countries, summed up to over US$290 million. If the epidemic continues there will be even greater financing gaps by the end of 2015.
Control and Prevention Strategies
Scaling up Already Existing Prevention and Control Program
One of the sure ways to go in preventing and controlling infectious diseases is to scale up existing prevention programs. Investment in the scale up and upgrade of the present prevention and control programs will certainly be good business. It is very evident that the various control programs are yielding positive results. Malaria burden is gradually decreasing in most parts of sub Saharan Africa [28]. Progress was noted few years after the WHO three-prong approach was widely deployed in malaria endemic areas in Africa with increasing amount of coverage achieved [29]. In the same vein the control programs for HIV and TB have made progress in controlling these diseases [30]. Africa has not yet achieved the millennium developmental goals (MDG) but lessons to be learnt from these control programs is that if Africa keeps doing the right things she will win the fight against infectious diseases. Thus, it is apt to keep investing in already existing control programs by way of monitoring, evaluating and scaling up these programs.
. Active Infectious Disease Surveillance System
Lack of infectious disease surveillance system is the bane of health care and public health in sub Saharan Africa. There is dearth of surveillance system in Africa . This is the main reason why epidemic-prone infectious disease like cholera, Ebola and others are ravaging Africa at will. A good surveillance system in place for a particular infectious disease can be utilized for any emerging epidemic-prone infectious disease. A typical example is the Ebola epidemic in Nigeria. Nigeria was largely successful owing to the fact it called up its own polio surveillance response structure and manpower and established an Ebola response unit. From the polio response team, 40 of the Nigerian doctors trained in epidemiology were reassigned. This gave Nigeria a head start and advantage to eradicate Ebola in record time against all odds
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