Friday, 10 July 2015

Public Health Threats !

Medical panic swept through Australia when the words  "Mad Cow disease " appeared on news broadcasts.  Probably a lot of people dropped beef from their menu from fear that our cattle stock was infected, but it seems that we have little to fear.   Creutzfeldt-Jakob disease - or CJD as it is known - is one of two strains and the one that is killing a man here can not be spread by infection and has nothing to do with what we eat.  It occurs sporadically and the chances of it appearing in our genes is similar to winning the jackpot in Lotto.

The other variation is a disease of cattle and outbreaks in Europe have led to the mass killing of dairy herds and the burning of their bodies in crematoriums .  Thankfully, this disease has never been experienced in Australia.

This Mad Cow scare has come at an opportune time.  The world disease fighting body setup by the United Nations is under heavy criticism for it's performance during the recent Ebola outbreak in Africa.   We came very close to a world catastrophe and for a while it was touch and go as to whether Ebola would escape the confines of Sierra Leona, Liberia and Guinea and sweep through the rest of the world.  The fact that it remained basically contained in Africa and killed only 11,000 people was not due to the efforts of the World Health Organization  ( WHO ) who are supposed to be our guardian against mass disease.

Doctors without Borders is a private charity and it's people battled Ebola while the WHO initially did nothing  !  It wasn't until August 2014 that the WHO declared an emergency and even then communications between the field and head office were mismatched - and the danger was disregarded.  WHO failed to marshal world countries to provide the supplies and medical staff to isolate those infected and dispose of bodies, allowing the infection to gain ground.

It was noticeable that there was a vast difference between the effort to save lives in Africa and the reaction when an Ebola  victim turned up in a western country.  Medical resources swung into action and that person was whisked away into isolation.  Medical teams were given the proper equipment to avoid contamination and no expense was spared in limiting the outbreak.   In comparison, the incidence of those fighting the disease in Africa and catching Ebola because of sub standard facilities was high.

The WHO top tier of management now admit that the Ebola outbreak was handled badly.  The question is whether they have learned and put in place the coordination to react swiftly the next time a threat appears - and that could be a freak of nature or the intentional act of war launched against the civil populations by jihadists.  Not so long ago a mass attack with Anthrax seemed likely and it seems that most countries have at least dabbled in the development of both chemical and biological weapons.

Once Bubonic Plague killed at least a third of the population of Europe and we worry that nature may allow the passage of diseases from animals to humans.  In particular, the danger is rising in avian and swine colonies and it seems that Ebola makes this passage when jungle animals are killed and eaten as "bush meat ".   There have been outbreaks of both bird flu and swine flu and some scientists think that the emergence of a completely new disease is inevitable.  It is only a matter of time.

The world was lucky that a charitable foundation entirely funded by public donations stepped into the gap and held the fort when Ebola burst onto the world scene.   Doctors without Frontiers was more effective than the WHO, the Red Cross and the Red Crescent combined.  All three have evolved into giant bureaucracies with extended command chains - and the inevitable fiefdoms that come into conflict with one another and slow decision making.

Next time, we may not be so lucky.  Now is the time to kick butts and slim down the bureaucracy into a working model that has the power to mobilize health workers and support facilities - and reform the WHO to do the job it was created to do !

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