Marking November 12, 2010 – World Pneumonia Day: Where are we, where are vaccines?

Abstract

Infectious diseases such as smallpox, pneumonia, rotavirus, malaria and measles have inflicted untold pain, suffering and death on the human population. The fingerprints of these deadly diseases can be found across the pages of history. The harrowing effects of pneumonia on the human body were described by Hippocrates as early as 460 B.C.;¹ smallpox scarring can be found on Egyptian mummies dating back more than 3,000 years ago;² and the Persian philosopher and physician Rhazes detailed the devastation of measles in the 10 century A.D.³ Without the benefits of modern medical interventions, our ancestors had little to no defense against infectious disease, and mortality rates were staggering. In 1531, for example, measles was responsible for the death of half the population of Honduras.⁴ Furthermore, some historical estimates indicate case fatality rates as high as 90 percent during smallpox epidemics among Native American populations in the early part of the 15th century.⁵ Yet as science advanced, humanity developed defenses against infectious disease in the form of lifesaving interventions, including vaccines, medical products (e.g., bed nets), therapeutics, and behavioral interventions.⁶ Across the developed world, these interventions quickly turned the tide against infectious disease. In the United States, infectious disease mortality declined 95 percent during the first 8 decades of the 20th century, from 797 deaths per 100,000 in 1900 to 36 deaths per 100,000 in 1980.⁷ The success of vaccination programs in the United States and Europe ushered in the 20th-century the concept of "disease eradication"—the idea that a specific disease could be eliminated from the planet. In 1977, after a decade-long campaign involving 33 nations, smallpox was eradicated worldwide—approximately ten years after it had been eradicated from the United States and the rest of the Western Hemisphere.⁸ But for millions living in the world’s poor and developing countries, it is as if these live-saving interventions were never developed. The World Bank defines developing countries as those making less than US $11,905 gross national income per capita per year. People living in developing countries make up more than 80 percent of the world’s population.⁹ A child born in a developing country faces many of the same risks her ancestors did 1,000 years ago. She is 237 times more likely to die of Hib disease than a child born to parents living in a high-income country.¹⁰ She’s also 118 times more likely to die from rotavirus diarrhea,¹¹ 89 times more likely to die from pneumococcal disease,¹⁰ 57 times more likely to die from HIV/AIDS,12 and 29 times more likely to die from tuberculosis.¹² For such children, life-saving medical interventions are few and far between. That is why child mortality rates in the developing world remain as high as 60 times those in developed countries,¹³ and life expectancies are shorter by almost a quarter century.¹⁴