IN a world that seems currently to be so full of bad news, the announcement by the World Health Organization that it is expecting that polio will be eradicated as a disease by the end of this year ought to be deeply heartening. A suspended inoculation campaign in northern Nigeria has resumed and the WHO believes that this last stronghold where the disease has been endemic will be wiped out in the next six months.
The fight against diseases such as polio, tuberculosis and malaria has consumed hundreds of millions of dollars in the last fifty years. The pattern is that the First World develops the treatments, sees to its own citizens first and then passes on the technology to the Third World. Unfortunately the campaigns against infections are rarely static. New variants of old diseases emerge and as SARS and AIDS have shown, conditions are capable of crossing species and infecting humans. Worse, drugs that initially prove effective in combating an epidemic lose their power as the infectious organism mutates to become resistant to the treatment. The most obviously aggressive changes are in the influenza virus.
Often relatively benign, this illness should not be dismissed simply as “a touch of ‘flu”. After World War I a worldwide outbreak of what was called “Spanish Flu” killed more people in some nine months than had been slain in the opposing armies during the previous four years of murderous conflict.
The arrival of antibiotics caused health professionals to predict an end to many diseases that had once been devastating. Unfortunately this hope has proven illusory. Though scientists continue to develop the power of medicine’s antibiotic armory, the diseases that these drugs once defeated are learning how to fight back by changing their structure. Thus tuberculosis is returning in Europe and North America and the strains involved can no longer be eradicated by the antibiotics that drove them out a few decades ago.
The process of drug resistance has been accelerated by the overuse of antibiotics. Swallowing tablets at the slightest sign of indisposition stops the body from mounting its own natural fight back. Not completing the necessary antibiotic course further undermines the future effectiveness of what were once thought to be wonder drugs.
Added to this must be the fact that our increasingly aseptic world is robbing our systems of encounters with a range of beneficial bugs and mild infections which used to immunize us from far worse doses of the diseases.
The WHO’s battle against polio is an honorable one but it should not blind us to the reality that the target organisms have and will continue to resurface. The assumption implicit in the wealthy West that health care can eradicate all risk of disease and even drive back mortality is both vain and unrealistic.
What is far more important than the assault on conditions like polio is the provision of safe water and decent hygiene to those many parts of the world that still lack what the First World takes for granted. At the same time maybe the moment has come for a fundamental reassessment of the extreme degree to which wealthy countries seek to pasteurize their food and have an excessive reliance of powerful drugs to cope with infections that in truth are not life threatening. We cannot overcome Nature. We can only work with it and the reality is that disease is part of the natural world.
