I’ve written about universal health coverage (UHC) before in the context of what’s covered under UHC in one country is not the same as another [Universal health coverage gains momentum in 2016] although there are agreed basics, the essential health services to deliver “health for all”. The World Health Organization is focusing its efforts on supporting countries moving to UHC, and keeping the pressure on by running high profile events throughout 2018 on UHC beginning with World Health Day, April 7th.
Our guestblogger is Dr Manoj Aravind, a researcher in Community Medicine, Hyderabad, India and member of the health information forum HIFA2015. Under World Health Day 2014's theme "Small bite, big threat" with its goal of better protection against vector-borne diseases, he describes the case for community action against dengue in his home state of Andras Pradesh. He can be contacted directly by email: firstname.lastname@example.org
Dengue is the fastest growing vector-borne disease (VBD) worldwide, and Andhra Pradesh (a Southern Indian state) is no exception. Here, the cases of dengue reported have been steadily rising from 313 in 2008 to 2299 in 2012. The issue of missed cases due to the partial reporting of dengue positive cases by private hospitals and clinics, which are the most commonly used heathcare facilities in our state, make us sceptical of the true burden of this potentially deadly disease. Having a tropical climate, with increasing urbanization, mostly unplanned, and not much “people participation” in health issues increases our cause for concern.1
Mosquitoes are the most common insects today that city dwellers encounter and one species, Aedes aegypti, are the vector for dengue, transmitting the disease to people via their bite: they are day-biting and breed in clean water collected inside and around houses, especially in urban areas.2 As dengue does not have vaccine or cure, the emphasis is on prevention. The World Health Organization is using this year's World Health Day to build awareness about VBDs and reinforce the need for community empowerment in terms of protecting against these small creatures which are a huge threat to the health of the entire community.3 Andhra Pradesh’s state health machinery is using this opportunity to reach out & empower different stakeholders with effective communication and information.
Awareness of people regarding dengue
When there is no biological vaccine for a disease, knowledge of how this disease spreads and how to prevent this becomes very important. It may then be apt to say that health education leading to healthy behaviours acts as a social vaccine.
From guest blogger: Dr Joseph Ana, Editor-in-Chief, BMJ West Africa and member of the steering group of the health information forum HIFA2015 . He can be contacted directly by email: email@example.com
It is right that the World Health Organisation (WHO) should focus on vector borne diseases this year, and by so doing raise awareness, disseminate information and improve, hopefully prompt, more effort at preventing and managing the myriad diseases that vectors inflict on man, especially in the Tropics and Sub-tropics.
Whether it is from the arthropod invertebrates of mosquitoes (malaria, dengue, yellow fever), sandflies (skin and systemic Leishmaniasis), bugs (Louse-borne typhus), and ticks (Lyme disease); or from crabs/crayfish (paragonimiasis) and snails (schistosomiasis), or from vertebrate vectors like bats (rabies, ebola disease), vectors are responsible for a large chunk of the disease burden thathealth systems across the globe have to deal with, particularly in the poorer tropical and sub-tropical parts. There is a popular saying that the Traditional African way of cooking all meals ‘well done’ and avoiding eating raw sea food (crabs and crayfish) has helped to keep to a minimum diseases from these vectors. Snail is also a very popular delicacy which is served ‘well cooked’ for the same reason.
The World has experienced increased incidence of arthropod borne disease since the 1970s 1,2,4, especially in the regions with the weakest health systems such as the tropics and subtropics. But for several reasons the temperate parts of the globe are also affected, which is why it is apt and timely that the WHO is focusing world attention on vector-borne diseases this year (2014). The reasons that account for the global nature of the menace of vector-borne diseases include increased travel by all modes; poor public health practice and infrastructure; massive population increases with urbanization and slums; poor surveillance and control measures; changing agricultural practices and deforestation; lack of effective drug and insecticide control leading to resistant vectors and pathogens; inadequate political will; etc.
The World should recognize, support and assist those countries where good public health practice has shown that control (and elimination) of vectors leads to decrease in vector borne diseases and help to extend such best practices to regions that are lagging behind. A good example of such best practice in the tropics is Cross River State of Nigeria which has a deliberate Public Health Policy of making its major urban areas ‘Clean and Green’ beginning from Calabar, the state capital.
ITS not often that speakers forgo the chance to present in favour of opening up debate, but this is exactly what happened here at the World Congress Public Health 2012 (Addis Ababa, Ethiopia,Tuesday April 24), in the session “Law: a public health tool”. Moderator, Michele Forzley, chose not to talk on access to medicines in favor of a longer group discussion, following presentations from 3 African speakers on law related to women’s rights, public health emergencies, and setting up NGOs.
Split into small groups, we, the audience, were asked to identify public health issues which persisted despite knowing the cause and cure, and despite the existence of laws providing protection. The speaker panel then commented on the identified issues, relating them to existing law in their various countries and suggesting why the law had failed to protect.. Michelle Forzley supplied the international perspective.
Issues identified by the groups related to LMICs (low and middle income countries) and included khat use by young people in Ethiopia; environmental pollution from mining; migrant rights; counterfeit drugs, poor quality breast milk substitutes; training needs of public health workers to enable them to defend and advocate effectively for public health law enforcement; and food labelling/quality, particularly of imported foods.