The Resurgence of Forgotten Diseases
A Looming Threat in a Volatile World
In an era marked by rapid globalisation, technological advancements, and unprecedented medical breakthroughs, the recent resurgence of once-forgotten diseases like measles, plague, and cholera has sent shockwaves through the global health community. This alarming trend, fueled by a complex interplay of factors, including global conflict, international travel, climate change, and wavering public trust in vaccines, demands our urgent attention and proactive measures to prevent catastrophic consequences.
The first quarter of 2023 has already witnessed measles outbreaks in the United States and the United Kingdom, a global shortage of the cholera vaccine, and even a case of bubonic plague in Oregon. These developments serve as a stark reminder that once considered confined to the annals of history, infectious diseases are far from being eradicated. In fact, according to Paul Hunter, Professor in Medicine at the UK’s University of East Anglia Norwich Medical School, we typically witness one or two significant disease emergences or re-emergences every year on a global scale.
The reasons behind these resurgences are multifaceted and deeply interconnected. Firstly, the constant evolution of viruses, particularly influenza, can lead to “escaped mutations” that enhance their transmissibility and virulence. The COVID-19 pandemic has been a vivid illustration of how quickly a novel virus can mutate and wreak havoc on a global scale. Secondly, the intricate relationship between human activities and the environment has created new opportunities for diseases to jump from animal reservoirs to human populations. The degradation of natural habitats and increased human encroachment into wildlife territories have heightened the risk of zoonotic spillovers, as exemplified by the plague outbreak in Madagascar a few decades ago.
Moreover, the changing climate is reshaping the global landscape of infectious diseases, enabling their spread into regions where they were previously rare or absent. The European Mediterranean coast, for instance, is now witnessing small outbreaks of dengue fever due to warming temperatures. This shift in disease distribution patterns underscores the urgent need for climate action and adaptive public health strategies to mitigate the impact of climate change on human health.
However, the most concerning factor contributing to disease re-emergence is the decline in vaccination availability and uptake. The current measles outbreaks in the UK serve as a poignant reminder of the consequences of complacency and misinformation surrounding vaccines. As younger generations grow up without firsthand experience of the devastating impact of vaccine-preventable diseases, the perceived risk-benefit ratio of vaccination may become skewed, leading to a dangerous drop in coverage rates. We must address vaccine hesitancy through effective public health communication, education, and trust-building measures to maintain the hard-won gains in disease control.
The potential for a re-emerging disease to spiral out of control is a looming threat that demands vigilance and preparedness. While advancements in medical science, such as antibiotics, have greatly improved our ability to treat infections like plague, the risk of societal collapse in the face of conflict, environmental degradation, and economic instability remains a potent catalyst for disease spread. Conflict zones, in particular, are hotspots for infectious disease outbreaks, as the breakdown of healthcare infrastructure, sanitation systems, and social order creates fertile ground for pathogens to thrive.
Among the diseases that pose the gravest threat in the event of a resurgence, cholera stands out as a major concern, particularly in regions like Ukraine and Gaza. The global shortage of the cholera vaccine, exacerbated by the COVID-19 pandemic’s impact on vaccine production and the rising demand due to increasing cholera infections, has left the world vulnerable to devastating outbreaks. The spectre of another influenza pandemic, akin to the Spanish Flu of 1918, also looms large, with the potential to claim countless lives, especially among younger populations.
In the face of these daunting challenges, we must adopt a proactive and multi-pronged approach to combat the resurgence of infectious diseases. This requires sustained investment in global health security, including strengthening disease surveillance systems, bolstering local healthcare capacities, and ensuring equitable access to vaccines and treatments. International collaboration and solidarity are key to addressing the root causes of disease re-emergence, such as poverty, conflict, and environmental degradation.
Furthermore, we must foster a culture of resilience and adaptability in our public health systems, enabling them to respond to emerging threats and mitigate their impact swiftly. This involves harnessing the power of innovative technologies, such as real-time data analytics, artificial intelligence, and telemedicine, to enhance our ability to detect, monitor, and contain disease outbreaks.
Equally important is the need to engage communities as active partners in disease prevention and control efforts. By empowering individuals with accurate information, dispelling myths and misconceptions, and promoting healthy behaviours, we can build a collective shield against the resurgence of infectious diseases.
The return of once-forgotten diseases is a stark reminder that the battle against infectious diseases is far from over. It is a clarion call for renewed commitment, strategic investments, and concerted action to safeguard global health in an increasingly interconnected and volatile world. Our choices today will determine our resilience against the looming threat of disease resurgence and shape the trajectory of human health for generations to come. Let us rise to the challenge with unwavering resolve and forge a path towards a healthier, more secure future for all.
