Experts Target Global Diseases

In the next hour alone, 1,500 people worldwide, mostly children and working-age adults, will die from infectious diseases, the World Health Organization said Thursday.

Developing countries are the most ravaged by infectious diseases, health officials say, and many of the deaths could have been prevented for less than the cost of a few bottles of aspirin.

However, the WHO's new assessment of infectious diseases says the impact goes far beyond impoverished countries. Not only can killer infections spread globally with a simple airplane ride, but developing countries won't grow economically unless their citizens are healthy.

Six illnesses are by far the main killers in developing countries: Tuberculosis, malaria, measles, diarrhea, AIDS and acute respiratory diseases like pneumonia and flu.

Doctors already have low-cost methods of preventing many of these illnesses, and good treatments for some.

"We have the tools, but they are becoming ineffective so we have to use them now," WHO infection chief Dr. David Heymann said in an interview. "This is a wakeup call."

But the bacteria and viruses are evolving to resist therapy, so now is "a window of opportunity" that, if missed, could mean catastrophe for the next century, Dr. Heymann said.

He gave an example of why timing is vital: Smallpox was declared eradicated the year AIDS started to appear. HIV-infected people cannot be vaccinated against smallpox because the vaccine overwhelms their weakened immune systems -- so if smallpox hadn't been wiped out in time, the AIDS era would have ensured it never was.

The WHO listed cost-effective priorities for developing countries:

• Drugs that treat AIDS may be too expensive for many developing countries, but just $14 for a year's supply of condoms could prevent infection in the first place.
• An insecticide-soaked bednet to protect people from malaria-bearing mosquitos costs $10.
• Twenty-six cents buys a dose of measles vaccine.
• Thirty-three cents buys oral rehydration salts that can save a child dying from severe diarrhea.
• Twenty-seven cents buys five days of antibiotics for pneumonia.

Malaria, TB and AIDS together have killed 150 million people since 1945 -- six times the number of soldiers and civilians killed in wars since 1945, the WHO said. Yet global military spending was almost 60 times higher in 1995 alone than spending on treatment and prevention of those three deadly diseases, the report said.

The report also aims to convince governments that illness causes poverty just as much as poverty causes illness, so that national policies reflect sound health programs.

The WHO's report "for the first time lays out a worldwide battle plan," said the Dr. Nils Daulaire of the Global Health Council.

His organization says Americans ovrwhelmingly support helping developing countries fight that battle: Eighty-five percent of 1,200 Americans the council surveyed fear global spread of infections, and 90 percent said fighting the diseases at their source is crucial. The poll had a margin of error of 3 percentage points.

Indeed, half of all infectious disease deaths are among people under 44, and many more of a country's prime workers and farmers are sickened. Rice production in Asia is slowed each year as 30,000 workers in rice paddies catch Japanese encephalitis, the WHO noted.

Sri Lanka's decade-long battle to reduce malaria, in contrast, boosted national income 13 percent, the report said.

Yet many countries have not adopted WHO-recommended disease prevention programs. Only 41 countries provide AIDS education in schools, and only half have instituted the "directly observed therapy" proven to stop spread of drug-resistant tuberculosis.

Written By Lauran Neergaard