The invisible disease

Posted by Pierre-Antoine Ullmo

May 6th, 2020

“The world community must understand that so long as COVID-19 is somewhere, we need to act as if it were everywhere. Beating this pandemic will require an unprecedented level of international funding and cooperation.”

This statement of the Gates Foundation rightly expresses the global dimension of the pandemic. However, it says more than the commonly agreed statement: “somewhere” also means places that are usually below our radar.

Jean-Claude Ameisen, immunologist and researcher in biology, Director of the Center for Life Studies of the Paris Institute of Humanities, Paris Diderot University and former President of the National Consultative Ethics Committee, wrote an article back in 2007 about the flu pandemic that remains incredibly relevant:

“Another more stable, underlying border between us and the others is often overlooked in the event of an epidemic. Whether globally or nationally, contagious human-to-human infectious diseases are most often the diseases of the poor – socially, economically and culturally marginalized people.”

First conclusions have already been reached about how the new pandemic is exacerbating social inequalities. UNESCO argues that “the emergency of the moment exposes the inability of most systems around the world to socially, economically, and medically protect the most vulnerable in societies.” Specific studies (see van Dorn, Cooney and Sabin in The Lancet) have been made, for instance in the US, which conclude that “deaths due to COVID-19 are disproportionately high among African Americans compared with the population overall.” 

The question therefore arises: Are we ready for this fight and will it be a priority when the lockdown is over and developed economies are struggling to recover?

The example of malaria is illustrative. Quique Bassat, Head of the Malaria Programme at ISGlobal in Barcelona and author of the EXP: Malaria, the Invisible Disease, said:

“Nearly 500,000 deaths and more than 200 million cases should not be occurring for the very reason that malaria is an easy disease to cure. This is a scandal. The problem with malaria is that it doesn’t affect the rich part of the world and remains below our radar.”

COVID-19 on the contrary does affect the richest countries but it is another perfect example of the inequities and health disparities in the world. Solving the pandemic will rely on the discovery of a vaccine, which, contrary to malaria and other diseases, is mobilising an infinite amount of financial resources and human talent in the richest countries.

But what will happen then? What will happen with the health infrastructures in less developed countries or in the most impoverished areas of our first world cities?

Bassat raises a key question for malaria: How can we expect malaria-endemic areas to thrive if we are not capable of lifting such a heavy burden from their shoulders?

This question which remains largely unanswered for malaria is likely to be (re)raised for COVID-19.

Photo by ISGlobal


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