Tropical Medicine – the global issue
By Dr Philippa C. Matthews
Image credit: Street by aamiraimer. CC0 Public Domain via Pixabay.
Everyone is vulnerable to threats which wreak their worst effects in the tropics – organisms like Streptococcus pneumoniae (a cause of pneumonia) and E. coli (a cause of diarrhoea and urinary tract infections) are common the world over. In Africa, malaria still kills over 290,000 children every year – that is a child every two minutes. None of us should absolve ourselves of responsibility for continued investment in tackling this humanitarian tragedy.
The Ebola virus (read this freely available chapter), arising out of a tropical situation, was in no way confined by the bounds of Cancer and Capricorn; it had the potential to take hold in situations of poverty and limited infrastructure and then to spread fast, facilitated by its huge infectivity, and fuelled by human behaviour and environments including crowding, migration, and international travel. Other organisms, like cholera, measles, meningitis, and polio rear their heads in disaster situations; in a world so uncertain, none of us knows when this is around the next corner.
Changes in climate and the environment allow creatures that are the reservoirs and vectors of infection to spread to new locations; the concern for the Zika epidemic in South America has been its rapid dissemination by a mosquito that has the potential to become ubiquitous. The spread of organisms that are resistant to multiple drugs is another major threat to global health. One example is Mycobacterium tuberculosis, the organism that causes TB, where multi-drug resistant (MDR) and extensively-drug resistant (XDR) strains are now well-established. Associated with a high burden of disease, high death rates, and difficult, expensive treatment, these organisms are by no means confined to the tropics.
Financial security too has an impact on ‘tropical disease’. Infections that flourish in the tropics continue to cause a catastrophic burden at the level of individual patients, their families, and wider society at national and international level. They impose an enormous economic cost upon healthcare systems and society, related both to providing care and to the lost output of young adults who are unable to contribute to society through work or raising their families. Labelling them as ‘tropical’ identifies a strong association with some of the world’s most vulnerable settings – but perhaps we need to move on from the term ‘tropical medicine’ to considering ‘global health’. The strides we make against ‘tropical diseases’ represent steps forward for us all.
A longer version of this post was first published on the OUPblog.
Philippa C Matthews is a Wellcome Trust Clinical Research Fellow at the Nuffield Department of Medicine, University of Oxford, and is Honorary Consultant in Infectious Diseases and Microbiology at Oxford University Hospitals NHS Foundation Trust.
Follow Dr Matthews on Twitter @pippa_matt.