Poverty, Migration & War
Throughout history, poverty and infectious disease have been intimately connected.
In makeshift and overcrowded shantytowns and slum neighborhoods located on the outskirts of major cities in the developing world, lack of access to clean water and improper sanitation services spread diarrheal diseases
. Worldwide, 780 million people do not have access to an adequate water supply, and 2.5 billion lack basic sanitation services. An estimated 2 million deaths per year can be attributed to unsafe water supplies; about 90 percent of those who die from diarrheal diseases are children in developing nations.
Growing numbers of people are moving within and across national borders after being forced from their homes by war, poverty, or famine.
People in poor nations often suffer from more than one infection because poverty breeds many diseases at once, including human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS
, respiratory and intestinal infections, and neglected diseases of poverty such as intestinal worms, Chagas disease, and dengue fever
, diarrhea, and malaria are among the leading causes of death in the developing world in children under age 5. When there is a lapse in political will to support disease prevention efforts, such as childhood vaccinations
, disease can emerge rapidly, as seen in the 2008 spread of polio from northern Nigeria to West Africa. Since then, vaccination efforts have increased. The last case of polio
in Nigeria was reported in 2012.
In addition, developing nations face public health hurdles such as weak health care systems and long distances to health care facilities. Limited availability of drugs and widespread use of poor-quality or counterfeit medications has led to drug resistance in the poverty-associated infections of HIV, TB, and malaria.
Refugee camp in Sudan. (USAID)
Growing numbers of people are moving within and across national borders after being forced from their homes by war, poverty, or famine. In 2014, 59.5 million people were displaced, the highest number ever recorded. According to some estimates, 1 billion people could be displaced by 2050. Displaced people often bring their livestock, plants, or companion animals with them, increasing the variety of pathogens and vectors
that accompany such journeys. Such refugees frequently live in crowded, unsafe conditions that exacerbate the transmission of infectious diseases. Rural-to-urban migration, for example, has led to increased HIV transmission in Africa. A more recent threat is mushroom poisoning among the Syrian refugees who arrived in Germany during the 2015 refugee crisis that has affected (and continues to affect) much of Europe. In just the first 2 weeks of September 2015, 40 deaths were reported. Since 2014, Germany has experienced an increase in malaria thought to be due to an influx of Eritrean refugees.