Bitter Pills:Medicines & The Third World Poor | Page 14

TROPICAL AND VECTOR-BORNE DISEASES
Nearly one thousand million people - a quarter of the world's population - are
affected or threatened by tropical diseases. "6I The most prevalent of these
include malaria, schistosomiasis, filariasis, trypanosomiasis, leishmaniasis and
leprosy.
Of these, malaria is a major killer, each year causing the death of about one million
children under the age of 14 in Africa alone. (l7> Chagas' disease, a South
American form of trypanosomiasis affecting over 10 million people, is also often
fatal in children. <18) But the effects of most tropical and vector-borne diseases
are severely debilitating and crippling, rather than fatal. One example is
onchocerciasis, or river blindness, a form of filariasis transmitted by blackfly,
which is endemic in parts of Africa and Latin America. In the upper basin of the
Volta River in West Africa about a million people are thought to be suffering
from partial blindness caused by worms that grow under the skin where the blackfly
have bitten. The disease is progressive and leaves thousands completely blind."9'
The parasites that cause many of the different tropical diseases attack the blood
and vital organs like the liver. They cause painful and debilitating symptoms such
as recurring bouts of fever. In common with the mass of infectious diseases, they
can perpetuate poverty by their constant debilitating effect. For example, a poor
family of subsistence farmers may have their livelihood destroyed if an attack
of malaria leaves them too weak to work at critical times of the year, especially
when crops need to be planted and harvested.
In many poor communities parasitic diseases are a fact of life for the majority.
Many are easily transmitted because of lack of sanitation and clean water supplies.
The prevalence of these parasitic diseases is well illustrated by studies from Sri
Lanka, Bangladesh and Venezuela showing that over 90% of 6 year olds examined
had some form of worm infestation. (20)

URBANISATION AND DISEASE
Finally, industrialisation and the rapid growth of the cities are beginning to change
the pattern of ill-health. Over half the population of Latin America now lives
in urban areas, and rural people are also migrating to the towns throughout Asia
and Africa. Today the urban poor are exposed to infectious diseases from
insanitary living conditions in the shanty towns and the new hazards of industrial
accidents, pollution and traffic accidents. Even the rural poor bear the brunt of
pressures from the consumer society as they are enticed away from local foods
and encouraged to consume expensive factory- produced food and drinks and
high-tar cigarettes.
The fact that life expectancy is now longer, particularly amongst the affluent
minority, means that cancer, cardiac and coronary-artery disease and other major
problems of industrialised societies are becoming more significant. But the
incidence of these c onditions is proportionately minute compared to the mass
of nutritional, infectious and tropical diseases, suffered by the poor.