Fri, Jun 19, 2009 page9

• Thinking beyond the threat of new pandemic bugs

  • By Ban Ki-moon and Margaret Chan
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  The WHO has now officially declared the (A)H1N1 flu virus to be a global pandemic. Governments, international organizations and people around the world are rightly focused on fighting it.

  The speed with which the (A)H1N1 virus has spread to almost every continent highlights our mutual interdependence. Nowadays, the impact of disease in one country is ultimately felt by all. Any effective response, therefore, must be grounded in a sense of global solidarity and enlightened self-interest.

  We must recognize, yet again, that we are all in this together. When a new disease sweeps the world, access to vaccines and anti-viral medicines cannot be limited to those who can pay for them. Wealthy nations cannot hope to remain healthy if poorer nations do not. Virus samples and information must be shared openly and quickly. Governments and major pharmaceutical companies must be sure that poorer nations receive the medical supplies they need.

  Even as we cope with today’s challenge, however, we must look ahead. Beyond this pandemic, there almost certainly lurks another down the road — potentially far more serious. The same principles of solidarity must guide us as we mobilize to meet the other health challenges that afflict the world populations, and the poorest in particular.

  Around the world, one woman dies every minute in childbirth. More than 1 billion people continue to suffer from neglected tropical diseases — often easy to prevent and easy to control. Just as we once eliminated smallpox, so can we eliminate others. It also bears remembering that 60 percent of the world’s population dies of non-communicable illnesses such as cancer or heart disease.

  That is why, in speaking about development and the stability of nations, we place such emphasis on health, particularly of the most vulnerable, and why at a time of multiple crises we will take up the issue of health this week in New York.

  Continuing to invest in global health makes sense both in terms of lives and dollars saved. Healthy people are more productive. They take fewer days off work. They live longer, go further in school, and tend to bear fewer and more prosperous children as they invest more in the children they do have. Studies have shown that investments in health care can yield a six-fold economic return. To offer but one example: the global impact of maternal and newborn deaths has been estimated at US$15 billion a year in lost productivity.

  And yet, when hard times hit, spending on health is often among the first things to be cut. During past recessions, especially in developing economies, the best care has tended to go to the wealthy; the poor too often have been left to fend for themselves. But the social and economic health of any society depends on the physical health of all its members. When governments cut back on primary health care for their poorer citizens, the entire society ultimately pays a high price. Today, large parts of Africa, Latin America and Asia have still not recovered from mistakes made during previous economic downturns.

  Nothing is more important than investing in maternal health. In the poorest countries, especially, women make up the fabric of society. Disproportionately, they farm the land, carry the water, raise and educate the children, and care for the sick. Investing in maternal health should thus be a high priority. Yet, of all the Millennium Development Goals, maternal health is the slowest to be achieved.

  As a result, worldwide mortality rates in 2005 were 400 maternal deaths per 100,000 live births — barely changed since 1990. In Africa, the ratio is 900 per 100,000. The harsh reality behind these figures is this: Mothers, very often young, are dying for lack of what most of us take for granted in the 21st century — access to affordable health care.

  Maternal health care is also a barometer of how well a health system functions. If women have access to hospitals and clinics, they are less likely to die in childbirth. These hospitals and clinics in turn reduce the burden of illness and deaths from other causes as well.

  Failure to mobilize the resources and muster the political will to put an end to this senseless tragedy would be unforgivable. We have made progress on so many other fronts. We are within a few years of ending deaths from malaria. Mass immunization has largely eliminated polio. Thanks to new programs of oral rehydration and improved water and sanitation, we have seen marked gains in treating dysentery and other parasitic diseases, contributing to a 27 percent decline between 1990 and 2007 in mortality rates for children under five.

  Yes, the world faces its first influenza pandemic in more than 40 years. We must remain on guard against changes in the virus. We must also be prepared for potentially different impacts in parts of the world where malnutrition, HIV/AIDS, and other serious health conditions are prevalent. In short, we must remain vigilant and continue actively to manage this pandemic. At the same time, the pandemic reminds us that we need to think and act beyond it. Only by doing so can we truly protect our people, our countries, our economy and our global society.

  Ban Ki-moon is the secretary-general of the UN. Margaret Chan is director-general of the WHO.

  COPYRIGHT: PROJECT SYNDICATE
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