Listen to actual chat audio on selected questions!
Rick: Welcome to T2A web chat for December 12th. We’re learning about Tracking Global Disease with Dr. Colin Mathers, a senior scientist in the Evidence and Information for Policy Cluster at the World Health Organization in Geneva. Dr. Mathers recently completed new projections of global, regional, and country mortality and burden of disease from 2002 to 2030. Dr. Mathers has spearheaded the efforts of the World Health Organization Global Burden of Disease project.
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Answer audio
Colin: The World Health Organization needs estimates of numbers of people who died from diseases and injuries to support its planning and policy making. I've been heavily involved in using all available sources of information available to make the best possible assessments.
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Dr. A.K. Mehta, India (email): What are the chances that previously unknown or entirely new diseases will appear by the year 2030?
Answer audio
Colin: New diseases do appear from time to time and in the last generation we've seen HIV/AIDS appear and more recently Avian Flu and it's quite possible that there may be a new disease or two appearing in the next decade or two.
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Aliyu Baba, Nigeria (email): Why is it that there is no medicine for HIV/AIDS?
Answer audio
Colin: Anti-retroviral drugs are now available that can keep HIV/AIDS patients alive for 10 years or more. WHO along with UNAIDS is spearheading efforts to help those who need these drugs get access to them. At the moment between 10 to 20 percent of those needing the drugs in Africa are getting them. We aim to increase that to nearly everybody within the next 5 years.
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Anil Kumar Upadhyaya, India (email): Does the World Health Organization have any future plans to attempt to reduce the effect of HIV/AIDS in India?
Answer audio
Colin: The WHO is working with the Indian government and other groups to reduce the spread of HIV and to provide drug treatment for people who are already infected.
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A.C. Rathinavel, India (email): How will mankind be able to fight future diseases and make medical assistance readily available?
Answer audio
Colin: The WHO along with other international organizations and governments, are working to ensure that research is focused on identifying and treating the diseases causing the most burden of suffering within different regions of the world. An important component of this is to work to ensure that national health systems are functioning efficiently and are able to focus on priority diseases.
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Jim: There are a lot of people graduated in medical sectors and are jobless in their countries but some other countries or region of the world has no personnel to carry out the tasks. Why don't you do something to balance these big matters?
Answer audio
Colin: The WHO does have a program to address human resource issues. A big problem is that developing nations do train medical and nursing staff who later leave their countries to work in countries where they could earn more money. The WHO is working with national governments to develop incentives for people to stay and practice medicine in their own countries. Also there are organizations that provide opportunities for Doctors from developed countries to work in other countries with shortages and great need for Doctors.
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Rick: What disease does the world need to be paying more attention to?
Answer audio
Colin: I guess the problems of chronic disease and cancer in developing countries is greater than many people realize. There's probably inadequate focus in these areas. Other areas that are neglected are tropical diseases that have been around for a long time, such as sleeping sickness.
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Rick: What is projected to be the most dangerous or life-threatening disease in the next 20 years?
Answer audio
Colin: In terms of numbers of deaths - coronary heart disease will be the leading cause of death in 20 years time throughout the world. But many of those deaths are at relatively older ages and in terms of healthy years of life lost some of the childhood conditions such as low birth weight and pneumonia are also important causes of lost years of life.
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Rick: What is the Global Burden of Disease Project?
Answer audio
Colin: The Global Burden of Disease project is an effort to estimate the lost years of healthy life for all causes of death and disability for all regions of the world. The first attempt to do this was carried out for the World Bank in 1993 to inform health priorities for developing countries. WHO has updated these analyses for more recent years and also estimated the proportion of deaths and disability attributable to issues such smoking, high blood pressure, malnutrition and other risk factors.
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Rick: How is data gathered for the Global Burden of Disease Project and what are the findings used for?
Answer audio
Colin: The Global Burden of Disease project draws on a large number of data sources and studies concerning causes of death and the incidence, prevalence and severity of diseases in all regions of the world. WHO collects death registration data from 120 countries and various WHO programs are closely involved in monitoring mortality and incidence of many diseases. We estimated that the most recent Global Burden of Disease analysis drew on approximately 10,000 data sets and studies. Despite that, there are regions of the world and diseases were data remains inadequate.
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Rick: What is projected to be the most widespread disease in the next 20 years?
Answer audio
Colin: In terms of the disease that is most prevalent - there are some diseases that are common, but are not life threatening or in many cases were not so severe. To quote the number of people with these diseases would not provide an adequate picture of the problem. The most common diseases are depression, hearing loss, vision problems, and migraine. Episodes of diarrhea in children from the poorest developing countries and the common cold are extremely common.
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Marcien Fossuo, (Cameroon): In 2001 the World Health Organization (WHO) considered Arthemisine to be an excellent molecule to fight against Malaria. But in 2006, they recommended that Arthemisine should no longer be used as a single drug to overcome Plasmodium Falciparum and that we should associate it with other molecules and biotherapy. Why this brutal change in short time? Was there a fear of arthemisine resistance by the bacteria?
Answer audio
Colin: Drug resistant malaria has become much more common in Africa and the WHO is responding to the change in the organism by recommending multi-drug therapy. We learn more with time so recommendations are revised as we learn more about the most effective ways to fight disease.
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Rick: Which region of the world is experiencing the highest mortality rate due to disease? Why does this particular region have such a high mortality rate?
Answer audio
Colin: Africa is the region of the world with the highest mortality rates. This is due to a combination of factors; underdevelopment and very high maternal and child death-rates due to measles and other infectious diseases, high level of tropical diseases such as malaria, which effects Africa much more than any other part of the world, and very high levels of HIV infection (the reasons for which are still hotly debated). In addition, there are a number of African countries with populations in crisis, due to conflict or state failure.
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Hio Tiao Lim: Why is it that Vitamin-C is not so much used, even though its efficacy has been proven?
Answer audio
Colin: Although this is really outside my area, I would say that the WHO strongly promotes a healthy balanced diet with adequate levels of vitamins and other micronutrients. We estimate that over 3 million children under 5 years of age die each year because of inadequate nutrition. But, the evidence for very high levels of supplementation for vitamins is more controversial.
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Nima, Iran: What work does the World Health Organization do with children in particular?
Answer audio
Colin: The WHO has a very strong priority for programs to address the causes of the 10 million child deaths that occur each year. In the last decade, we have nearly eliminated polio and reduced measles deaths in children by 90%. We have programs addressing water and sanitation issues to reduce water borne diseases and intestinal parasites and such. We also have programs to vaccinate children against a range of common diseases and to provide needed supplements.
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Hio Tiao Lim, Philippines: Why is it that people in developed countries seem to not have the same resistance to disease as those who are living poorer developing nations? It is said that if children in slum areas get to survive living in harsh conditions, they could be better protected from disease as compared to more the affluent individuals.
Answer audio
Colin: While it is true that exposing people to high levels of infectious disease will result in survivors who are more resistant to disease that is at the cost of very high levels of mortality and sickness. There are better ways to increase immunity through vaccination and good nutrition. In fact, generally children in richer countries with better nutrition and access to medical care are much less susceptible to disease.
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Answer audio
Colin: I've very much enjoyed the opportunity to talk with people about global efforts to improve health. More information on WHO activities is available on the WHO web site www.who.int.
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Rick: That's it for this week's chat. Thanks so much for joining us today. For those of you who submitted questions, please be sure to email us your complete mailing address so that we can send you a T2A sling pack or T2A water bottle. Be sure to join us again on Wednesday 19 December 07 when we meet Explorer, writer and filmmaker Jon Bowermaster.
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