Diseases are turning into silent disasters warns Red Cross/Red Crescent disaster report
28 June 2000

While earthquakes and floods capture media headlines and donor dollars, the uncontrolled spread of infectious disease takes the most lives. Shocking figures are contained in this year's World Disasters Report released today by the International Federation of Red Cross and Crescent Societies.

The death toll from infectious diseases (such as AIDS, malaria, respiratory diseases and diarrhoea) is 160 times greater than the number killed in last year's natural disasters including the massive earthquakes in Turkey, floods in Venezuela and cyclones in India. And the situation is getting worse.

"Once a disease like AIDS reaches the kind of proportions we see in sub-Saharan Africa it is no longer a disease, it is a disaster, " says Peter Walker, director of disaster policy for the International Federation. "Such a widespread disease destroys the workforce and shatters the economy."

This year's report traces the growth of public health disasters from escalating AIDS infections in sub-Saharan Africa, and chronic malnutrition in North Korea, and to the ongoing public health and psychological needs that arose from the Kosovo refugee crisis.

This emerging brand of public health disaster is fueled by a combination of factors: governments abandoning their responsibilities for preventive health care while growing urbanization, climate change and environmental degradation increase the range of public health risks.

Due to deteriorating public health systems, diseases which were once under control are re-emerging. Malaria is appearing in countries like Azerbaijan, and Tajikistan. In North Korea 40,000 new tuberculosis cases have been reported this year. In Russia, syphilis infections have increased 40-fold since the collapse of the Soviet Union.

According to the report, produced annually by the International Federation, the 1998 level of emergency aid rose for the first time in four years while funding for primary health care continued to drop. Health funding for developing nations from members of the Organisation For Economic Co-operation and Development (OECD) sank to the lowest levels since 1991.

Data in the report shows cases where basic health care has been sacrificed for the sake of economic restructuring. A 1995 World Bank survey of 53 countries showed a 15 per cent average decline in the health spending per person following structural adjustment.

Unfortunately, infectious diseases create silent disasters, which often go unrecognized and unreported. Unlike the "sudden strike" events such as hurricanes and earthquakes, they fail to attract the media spotlight or trigger the flow of donor dollars into primary health care.

While infectious diseases claim the most lives, they are also the most preventable disasters. The report says that most of last year's 13 million deaths from infectious disease could have been prevented at a cost of US$ 5 per person.

The successes of low-cost, community-driven health campaigns are documented in the report. They include: herbal healers in Uganda helping HIV sufferers, volunteers in Cambodia reducing the hold of dengue fever, communities promoting meningitis vaccination in Sudan and Red Cross/Red Crescent psychosocial volunteers assisting those mentally scarred by the trauma of disasters in Chernobyl, Turkey and Kosovo.

"Governments are slipping on their responsibilities for immunization and basic preventive health care. But pouring money into national health systems is not cost effective because 70 per cent of it gets siphoned into big hospitals," says Dr. Hakan Sandbladh, senior health officer with the International Federation.

Changing people's behaviour saves more lives than spending money on expensive equipment and hospitals. Impressive real results come from widespread community health programmes to vaccinate children against preventable diseases and encouraging people to protect themselves from malaria by using treated bed nets or from AIDS by using condoms.

The report concludes international aid has to stop overwhelming countries with the wrong kind of help. "In Turkey, dozens of countries sent search-and-rescue teams," says Peter Walker, "but the money would be better spent on training local people in search and rescue techniques." The same local-level approach is needed for primary health care. The key to success lies in stronger partnerships with communities facing the threat of public health disasters.

World Disasters Report Highlights

Chapter 1: Public Health – has it fallen of the map?
* Since 1945 an estimated 150 million people have died from AIDS, TB and malaria, compared to 23 million from war.
* Every hour, 300 people die from AIDS.
* Malaria kills up to 2.6 million annually – 75 per cent of them are children.
* Public expenditure on health in low-income countries averages just 1 per cent of gross domestic product (GDP), compared to 6 per cent in high-income countries.
* Global military spending in 1995 topped US$ 864 billion, compared to an estimated US$ 15 billion spent on prevention and control of AIDS, TB and malaria.

Chapter 2: Assessing and targeting public health priorities
* In May 1999, 108 drug donations lists were submitted to the Albanian health ministry. Just 41 per cent had less than one year remaining on their shelf life and 56 per cent had no shelf life information at all.
* By autumn 1999, 400 different aid agencies had converged on Pristina, Kosovo.

Chapter 3: AIDS in Africa – no longer business as usual
* Over 23 million Sub-Saharan Africans are estimated to be HIV-infected, 70 per cent of the global total.
* 1,200 Zimbabweans a week die of AIDS.
* Over 90 per cent of infected Africans are unaware they have HIV.
* 55 per cent of infected adults are women. Girls aged 15 to 19 are six times more likely to be infected than boys.
* By 2005 southern Africa's average gross domestic product (GDP) will shrink by 14 per cent, because of AIDS.
* In September 1999, nine Sub-Saharan countries declared HIV/AIDS to be a natural disaster requiring emergency response. ( Burkina Faso, Lesotho, Malawi, Mozambique, republic of Congo, Swaziland, Tanzania, Zambia and Zimbabwe)

Chapter 4: North Korea's public health pays the price of isolation
* Hospital occupancy in the Democratic People's Republic of Korea (DPRK) can average just 15 to 20 per cent in winter, due to lack of equipment, drugs, food and transport.
* Many people still supplement up to 40 per cent of their daily food with "substitute foods" such as indigestible grasses and corn husks.
* Government figures claimed 222,000 died due to malnutrition and the 1995 floods. Close observers estimate the number ranges from 800,000 to 3 million people.
* Infectious diseases are re-emerging. TB afflicts 40,000 new victims every year.
* The International Federation together with the DPRK Red Cross supports 1,678 hospitals.

Chapter 5: Chernobyl: a chronic disaster
* 2 million of the survivors, including 500,000 children, still lack adequate health care.
* Thyroid cancer figures are expected to peak in 5 years.
* Down's syndrome, and deformed limbs and organs have increased 83 per cent in children of heavily contaminated areas, 30 per cent in mildly contaminated areas, and 24 per cent in 'clean areas'.
* In the region hardest hit by Chernobyl, cancers in children have risen more than 60 per cent, blood diseases by 54 per cent and psychological disorders have doubled since the accident.
* 3 million people might be suffering from chronic stress disorders as a result of Chernobyl.

Chapter 6: Kosovo – the humanitarian Klondike
* Personal safety remains threatened by 425 minefields throughout Kosovo.
* According to leading medical aid organizations, mental trauma represents a principal health concern in Kosovo today.
* A June 1999 audit by WHO of drugs received by Albanian authorities revealed that 400, 000 tablets and 1,200 large-volume intravenous fluids had already expired.

Chapter 7: Surprise upturn in global aid
* The amount of official development assistance (ODA) committed to health was the lowest since 1991, and the shares continue to fall.
* US$ 2.5 billion was committed to important health related services for clean water and sanitation. This was the lowest figure since 1992.
* According to debt campaigners, over 50 countries actually need relief and their outstanding debt amount to over US$ 300 billion.
* Today, 96 per cent of all deaths from natural disasters occur in developing countries.
* The International Federation of Red Cross and Red Crescent Societies has established a Disaster Relief Emergency Fund, which was used 48 times in 1999, releasing a total of CHF 5.1 million.

For further information, or to set up interviews, please contact:

Solveig Olasfdottir, Information Officer (41 22) 730 4296
Media Service, Geneva Mobile tel: (41 22) 416 3881

The Geneva-based International Federation promotes the humanitarian activities of 176 National Red Cross and Red Crescent Societies among vulnerable people. By coordinating international disaster relief and encouraging development support, it seeks to prevent and alleviate human suffering.
The Federation, National Societies and the International Committee of the Red Cross together, constitute the International Red Cross and Red Crescent Movement.