Like many, we were relieved to hear from the Government of Madagascar and WHO in November last year that the pulmonary plague outbreak in Madagascar had been contained. Plague is a disease caused by bacteria called Yersinia pestis that are typically transmitted by rodents through their fleas but can also be transmitted from human to human. Since the onset of the outbreak in early August 2017, there had been 2,300 human cases of plague reported, leading to 207 deaths (WHO update). WHO called for continued vigilance until the end of the plague season at the end of April, as more cases of bubonic plague should be expected and could lead to a resurgence of pulmonary plague. The President of Madagascar also committed to establishing a permanent “plague unit” at the level of the Prime Minister’s office to work on the eradication of plague―rightly so, as experience tells us that addressing risks at the interface of human, animal and environmental health is challenging.
Agriculture and Rural Development
Rising obesity rates are in the headlines – with increasing recognition of the major role that agriculture and food systems play in the epidemic. As agriculture economists interested in human nutrition, we wanted to take a look at what it all means, to look at how agriculture and food systems are part of the problem and how they are part of the solution. While conducting research for a recent report, a few things stood out to us.
When the United Nations negotiators recently met in New York to track progress on the Sustainable Development Goals (SDGSs), a number of side events to the High-Level Political Forum were organized to emphasize the crucial role of agriculture. I attended a couple of these events and took the opportunity to illustrate why investments in livestock will pay dividends for sustainable development, and more particularly for health.
The case for investing in pandemic preparedness is –or at least, should be - completely compelling. Few things could kill as many people as an influenza pandemic. Few threats can cause as much economic disruption as the contagion of fear triggered by a rapidly escalating epidemic. Reinforcing capabilities such as disease surveillance, diagnostic laboratories and infection control would be more effective and cost far less than spending money to contain outbreaks when they occur. Yet, so far, the global community has demonstrably not invested enough in preparedness. As a result, too many lives have been lost and too many livelihoods damaged, and the world remains scarily vulnerable.
Disease Outbreaks: A Constant Threat
The World Health Organization called for “heightened vigilance and strengthened surveillance efforts” last week to prevent and detect human transmission of a highly pathogenic strain of avian influenza or ‘bird flu’. And while no human cases have been reported and WHO itself called the risk “relatively low,” we know the potential devastating impacts of diseases spread from animals to humans.
While the last half century has seen major advances in global health, new challenges are now threatening these hard-won health gains. One of these is antimicrobial resistance (AMR), or drug-resistant infections which can no longer be treated by antibiotics and other antimicrobial drugs. AMR is on the increase globally both in humans and animals.
Today the world is celebrating “One Health Day.” Sometimes great ideas appear simple, even intuitive: the One Health concept was created to demonstrate that the health of people and animals are interconnected, and that these are in turn, inextricably bound to the health of the environment on which all life depends.
It really caught my attention when a friend of mine, an otherwise healthy chest physician in his late 40s, told me recently that he almost died of pneumonia. He had to be hospitalized twice, given an IV cocktail of antibiotics each time, only to recover about a month later, totally drained and weak. He told me that it was caused by Klebsiella pneumoniae -- a bacterial infection increasingly resistant to antibiotics and known to strike the immunocompromised, frail and alcoholics -- which he thought he must have gotten from a patient. He considered himself lucky to have survived.
Agriculture and nutrition share a common entry point: “food.” Food is a key outcome of agricultural activities, and, in turn, is a key input into good nutrition. Without agriculture there is little food or nutrition, but availability of food from agriculture doesn’t ensure good nutrition. Common sense would dictate a reinforcing relationship between the two fields of agriculture and nutrition but, in fact, there is often a significant disconnect.
On sait que l’épidémie d’Ebola a eu un impact dévastateur sur le plan de la santé, avec, à ce jour, 21 000 personnes infectées et 8 000 décédées. On connaît aussi ses effets sur l’économie de l’Afrique de l’Ouest : selon les dernières estimations de la Banque mondiale, la crise Ebola se chiffrera en 2015 à au moins 1,6 milliard de dollars de pertes de croissance pour la Guinée, le Libéria et la Sierra Leone.