By Vanessa Cort
OVER the years, the world has faced many health crises, some reaching pandemic proportions, like the recent COVID-19 outbreak. However, countries have come together to devise scientific and social solutions and have managed to control the spread of many dangerous diseases.

With the formation of the World Health Organization (WHO) in 1948, the world has been able to adopt a more coordinated and cohesive approach to fighting disease.

Since then, we have seen the enormous contribution made by vaccines to health across the globe with two infections – small pox and rinderpest – eradicated.

With the WHO’s Expanded Programme of Immunization in 1974, and the Global Alliance for Vaccination and Immunization in 2000, global coverage of vaccination against serious infections has been greatly enhanced.

Polio has been almost eradicated and success in controlling measles makes eradication likely. However, development of vaccines for more complex infections, such as HIV, malaria and tuberculosis has had limited success.

Still, six and a half million children die each year from infectious diseases which could be prevented by vaccination. And enhanced circulation of the relevant vaccines is expected to reduce childhood mortality.

While vaccination has been heralded as a major contributor to global health, research has shown that improvements in sanitation, the introduction of clean water, better housing and nutrition have also played an important part in the decline in mortality.

However, experts point out that it is “indisputable” that vaccination has made a huge contribution to both human and animal health, particularly in developing countries.

Deaths from smallpox and measles were widespread prior to the development of vaccines, with nearly half of the population dying from smallpox and slightly less from measles, in vulnerable populations.

An English physician and scientist, Edward Jenner, pioneered the smallpox vaccine and is credited with vaccine development as a public health tool, which was then adopted by Europe and the United States. Even back then, there was huge opposition to this, especially when vaccination became compulsory in the UK in 1871.

To date, smallpox is the only human infection that has been eradicated along with rinderpest, which attacks and kills cattle, causing suffering among poor people who depend on cattle for their livelihood.

The treatment of any disease or infection is dependent on its being recognised, monitored and reported. This put developing countries at a distinct disadvantage because of the general lack of funds to oversee such initiatives and limited health programmes.

World Chagas Day, marked last Friday and first celebrated in 2020, takes a closer look at another disease affecting mostly people in poor countries, who have little access to healthcare or who are without a “political voice”.

The first case of this disease, which has been termed, “silent or silenced” was reported in Brazil in 1909 and was once endemic to Latin American countries. It earned the terminology because it can be asymptomatic, progresses slowly and affects mostly impoverished people.

However, in recent decades, the disease has been spreading and the WHO declared World Chagas Day to raise awareness of what it terms “this neglected tropical disease, which is often diagnosed in its late stages…”

The disease is vector and food borne and can be transmitted from mother-to-child or through infected blood and organ transplants. It is spread in the faeces or urine of the triatomine bug, also known as the ‘kissing bug’, which lives in the wall or roof cracks of poorly constructed homes, chicken coops and pens. It can also be found in warehouses in urban areas,

In the first stage of the disease, parasites circulate in the blood with mild to no symptoms. In the latter stage, these parasites hide mainly in the heart and digestive muscles, eventually causing gastro-intestinal and heart problems and even sudden death.

This year’s theme – “Time to integrate Chagas disease into primary health care” – aims to promote surveillance and universal care at the “most decentralized level of the health system, which would involve instituting specific health practices at the community level.