What Are The Paths To A Disease-Free World And How Can We Achieve Them?

What are the paths health systems can take to a more disease-free world?

And related to that, why do we talk about the total “eradication” of some diseases, like polio, whereas for others, “elimination as a public health problem” or simply disease “control” that shrinks an epidemic into an endemic disease is a more realistic option?

In this episode of the “Global Health Matters” podcast, host Garry Aslanyan answers these questions and more with the help of three public health leaders who talk about experiences tackling key disease threats, including onchocerciasis, malaria and polio.

“Infectious diseases have had a profound effect on the health of millions of people,” Aslanyan says. “They also have detrimental effects on the economies of many nations, which can lead to a cycle of poverty. The ultimate goal of public health is to control, eliminate and finally eradicate diseases that pose a threat to human health.”

But only one human disease has been successfully eradicated worldwide, which means having achieved permanent reduction to zero of incidence of infection: smallpox.

In terms of disease control, Uche Amazigo shares lessons she learned during her tenure as the director of the WHO African Programme for Onchocerciasis Control.

The parasitic disease, transmitted by blackflies that live near fast-flowing streams and rivers, is commonly known as river blindness, and it infects around 18 million people each year, according to the World Health Organization, mainly in West Africa but also in parts of Latin America, leaving people with debilitating skin disorders and blindness among older people .

Today, with community-led mass administration of treatments such as ivermectin, and now recently moxidectin, which reaches over 200 million people annually, the numbers of people suffering serious side effects from onchocerciasis has shrunk, and four countries in Latin America have been certified as oncho-free.

Distribution of onchocerciasis infections

Amazigo said that to help manage disease she has learned the importance of “listening to the people” and “engaging the poor and target beneficiaries of programs, to co-design ways to implement and improve their health.”

“Today, I consider the degree of involvement or engagement of beneficiaries as the most essential ingredient of success in health,” she said.

Meanwhile, David Reddy of Medicines for Malaria Venture discusses the new and exciting innovations being tested for malaria elimination, from vaccines to new tests and treatments.

“The role of new interventions will help accelerate progress,” Reddy said. “One of the key ones is the RTS,S vaccine. It’s the first vaccine that we have had for malaria, and we shouldn’t understate the importance of that.”

He also mentioned breakthrough next-generation drug pipelines to counter drug resistance and monoclonal antibody treatments.

Finally, Aidan O’Leary, director for polio eradication at WHO, makes the case for pursuing worldwide eradication of polio, which has already been eliminated in most countries and many regions.

“The human species has been battling wild polio virus since ancient Egyptian times, so for millennia, and what we’ve basically had with the Global Polio Eradication Initiative is an initiative that started in 1988, at a time when we had almost 1,000 children per day across 125 countries across the world were being paralyzed as a result of this disease. Where we stand now, at the start of 2022, is a situation where we’ve had just six children paralyzed during the course of the past 12 months in just three countries,” explained O’Leary. “But it’s still six children too many.”

He said there are three keys to polio eradication in any country: The ability to identify and assess risk; coordination of the operational response; and accountability and oversight.


Join us in this discovery of what is needed to reduce or remove the risk of infectious diseases.

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Listen to the previous podcast episode: Championing Health Equity in South Africa

Image Credits: TDR, WHO.

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