The gap in life expectancy between the richest and the poorest countries now exceeds 40 years—in large measure owing to the toll of infectious diseases. Safe water supplies, sewage treatment and disposal, improved food safety, and vaccination programs are urgently needed in resource-poor nations. A major barrier to achieving these improvements is the underlying weakness of public health systems in resource-poor countries, including a shortage of health care workers, which hinders efforts to immunize, treat, and monitor the status of patients. To address this concern, a strong public health infrastructure achieved through leadership at the country level is needed. Activities promoted by leaders include developing strategies for improving health literacy, which can be achieved by providing educational opportunities to local health care professionals. Poor nations also lack disease surveillance programs and up-to-date laboratories, which are essential to the mission of finding, diagnosing, and containing infectious diseases.

Of further concern is the fact that life-saving vaccines and medications are not distributed equitably around the world. More than half of those suffering from human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) who need drug treatment are not receiving it. About 23 percent of people with multidrug-resistant tuberculosis received the right medications in 2014, an increase of 14 percent from the previous year. Yet only 50 percent of this group was treated successfully: 16 percent died, 24 percent did not have their treatment documented or it was interrupted, and in 10 percent of the population the treatment failed. And while children in wealthy countries are routinely immunized with vaccines that protect against childhood pneumonia and diarrhea, children in poor countries are not; for each child who dies from pneumonia in an industrialized country, more than 2,000 children die from the infection in developing countries.

 

Many factors influence whether poor nations can obtain affordable drugs of good quality. Most drug research and development is not geared toward the needs of people in poor countries because they are not a big market. As a result, a large percentage of the money spent worldwide on health care research is dedicated to problems affecting a small percentage of the world’s population. Social and political challenges to the distribution of medicines are factors as well. Foundations, pharmaceutical companies, and other organizations are making efforts to overcome these challenges by providing funding, research, and donations of medications. The tragedy of global infectious disease is not only that so many lives are lost or damaged, but that so many of these infections could be prevented or treated effectively with low-cost drugs.