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World Bank Seminar Series:
Global Issues Facing Humanity
Diseases without borders
Slide 1: Table of contents
Why are Communicable Diseases a Global Issue
Major Communicable Diseases
Emerging Communicable Disease challenges
Slide 2: Why are Communicable
Diseases a Global Issue
Magnitude of the Problem
Annually, about 14.5 million deaths worldwide are
caused by communicable diseases (=60% of all
 More than half of all deaths due to communicable
diseases are attributed to HIV/AIDS,TB and malaria
Primarily affect children and young adults in
their most productive years
Slide 3: Why are Communicable
Diseases a Global Issue
Externalities : spill-over benefits or losses from
one individual to others
Equity : Both a cause and consequence of
Impoverish the already poor – loss of productivity,
treatment costs
The poor have a greater share of the burden of
disease and have less access to affordable and quality
Slide 4: Why are Communicable
Diseases a Global Issue
Not contained within national boundaries – not
the problem of just one country/region
Global action is needed to ensure :
 adequate and predictable funding
 promote awareness and changes in behavior
 accrue global benefits from R&D
Slide 5: Major Communicable
Goal 6:
 Have halted by 2015 and begun to reverse the
spread of HIV/AIDS
 Have halted by 2015 and begun to reverse the
incidence of malaria and other major diseases
HIV/AIDS, malaria and TB are responsible for 6
million deaths per year
Avian flu is estimated to cause between 2 to 7.5
million deaths if a human pandemic occurs
Slide 6: Magnitude and Trends in
60 million infected and 20 million deaths
Half of the 14,000 new infections each day
occur among young people below age 25
Over 8 million children (<15 years) have been
orphaned by AIDS
Feminization of the epidemic – In Africa, rates
of infections among young women (15-19 years
of age) are 5-6X higher than for young men
Disproportionately affects poor countries and
the poor in these countries
Slide 7: Most HIV/AIDS Infected
Live in Africa and South Asia
Slide 8: HIV/AIDS - Multi-sectoral
HIV/AIDS has health, other social and
economic consequences
 exacerbates poverty and inequality
 puts tremendous pressure on health and social
 creates large numbers of orphans who need
 decimates the workforce with enormous
economic and social consequences
Slide 9: HIV/AIDS Interventions
Core set of prevention and Rx interventions exist:
- promoting behavior change
- increasing condom use
- STI management
- ensuring a safe blood supply
- preventing MTCT
- supporting harm reduction among IDUs
- anti-retroviral treatment
Slide 10: HIV/AIDS Prevention
Comprehensive prevention could avert 29
million of the 45 million new infections
projected by 2010
However, prevention programs reach fewer
than one in five people who need them
Slide 11: HIV/AIDS Treatment
6 million people need antiretroviral treatment
1 million people are currently on ART
Recent treatment scale-up averted between 250,000
and 350,000 deaths in 2005
Annual basic care and treatment for AIDS can cost
as much as 2-3 times per capita GDP in the poorest
Slide 12: Linkages between
Communicable Diseases
Over 12 million persons live with TB and HIV
More HIV-infected persons die due to TB than
to any other opportunistic infection
Slide 13: Magnitude and
Trends in TB
8.8 million new cases/1.7 million deaths each year
95% of cases and 98% of TB deaths occur in the
developing world
Africa has the highest TB rates per capita, but
Asia carries the greatest absolute burden
Poor people are especially vulnerable to TB due
 underlying health status
 adverse living conditions
 limited access to treatment
Slide 14: Magnitude and Trends in TB
Slide 15: Tuberculosis Treatment
Without any treatment, half of those who fall ill will
Directly Observed Treatment, Short (DOTS)
 cure rates of up to 95%
 prevents new infections
 prevents the development of drug resistance
 treatment under DOTS is as little as US$ 10 per
Drug resistance is a major challenge
Slide 16: Magnitude and Trends in
500 million new clinical cases per year
more than one million deaths each year
40% of the world’s population exposed to malaria risk
malaria reduces GDP growth by approximately 1% per year
Poor worst affected:
 less access to services, information and protective
 less power to avoid living or working in malaria-affected
Slide 17: Magnitude and Trends in Malaria
 20% of all childhood deaths in Africa are
due to malaria
Slide 18: Malaria -Prevention and
The most cost-effective interventions are:
- rapid diagnosis and effective treatment
- insecticide-treated bednets
- intermittent-presumptive treatment for
pregnant women
- epidemic preparedness
 Resistance to conventional anti-malarial drugs is a
major challenge
 Vaccine
Slide 19: Emerging Challenge: Avian Flu
HPAI is an emerging zoonotic – caused 69 deaths
and 135 infections
animal-to-animal and limited animal-to-human
transmission of H5N1
increasing probability of human-to-human
transmission and a global influenza pandemic
cost of a pandemic could exceed $800 billion/year
control is beyond the scope and resources of a
single country or region
Slide 20: Avian Flu- Migratory Pattern