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Carlos Gamazo, Full Professor of Microbiology

Small stings: big threats

Mon, 07 Apr 2014 11:07:00 +0000 Published in Navarra Newspaper

On April 7, 1948, the World Health Organization (WHO) was officially established at an International Health lecture , hence this date is commemorated every year, and with good reason. At meeting, different countries from very different cultures, with irreconcilable political or religious ideals, joined forces towards a common goal , health. First of all, they agreed agreement to define health as a state of physical, mental and social well-being, and not merely as the absence of symptoms or disease. They would define it, and must continue to do so, as a fundamental human right, regardless of race, social or economic status. The WHO is playing an essential role in the well-being of this globalized world and yet its role, or rather, its effectiveness, has been severely criticized. Take the case of the 2009-10 flu pandemic, for example. A new virus entered the scene, creating well-founded international alarm. The 50 million people who died of influenza in 1918-20, or the more than two million who died from the same cause in 1957-58, were not so far away. After fourteen months of maximum alert (we are in August, 2010), the WHO officially ended the pandemic phase of what became known as the new variant of influenza A. This was great news, since it was only after fourteen months that the pandemic was officially over. This was great news, since only 19,000 deaths had occurred. Here is the great paradox: what was undoubtedly good news, for some was a good excuse to attack the WHO. We were lucky with the new flu virus, it was not as lethal as they had predicted, it was not necessary to use the millions of doses of vaccine that had been produced just in case. However, the anti-everything demagogues see it differently: what a barbarity, what a waste! The hurricane warning passes and we have to unnail what has been nailed down, and probably throw away the ribbons, but we congratulate ourselves on our luck. Too bad not everyone sees it that way. It's very simple, they lack information. A goal of WHO is transparency of information. The 2009-10 flu pandemic was an example of up-to-the-minute information. Never before has statement been so accurate about the evolution of an infectious disease. WHO will continue to recommend full transparency and consistency. WHO experts use statistical data , scientific evidence, and with all this they make their estimates. All actions can be improved, science works with numerous variables that are still unknown, and for this reason we should trust and be grateful for the actions and decisions of the WHO.

When WHO was founded (1948), smallpox infected 50 million people each year. In the 20th century, an estimated 200 million human beings died of smallpox infection, more than double the number of deaths resulting directly or indirectly from armed conflict. In 1979, the WHO declared smallpox eradicated. Today this virus is locked up, very well guarded, in laboratories in Siberia and Atlanta (USA). This feat, which can be recounted in a couple of lines, is considered the greatest success of the health internship of all time and was achieved thanks to the trust placed in the WHO. In 1959, thanks to the strong support of the Soviet Union, the start of an unprecedented war against a pathogenic microorganism was approved, with a single goal, its eradication. Weapons: a vaccine; strategy: mass vaccination throughout the planet; problems: it is impossible to vaccinate all mankind. WHO experts estimated that goal could be achieved by vaccinating at least 80% of the population. Success? absolute. On December 9, 1979, the disease was officially declared eradicated. It was a twenty-year struggle against the elements, with enormous political and financial problems. Imagine the efforts of the pharmaceutical industries to produce this vaccine at very low cost, the difficulties to keep it active during transport to the most remote countries, the incalculable issue of health workers involved. And all this with a single weapon, a vaccine, not without risk, since it was a live virus (attenuated) that caused the death of 1-2% of those vaccinated. But even so, it was not an obstacle for parents to let their children be vaccinated, since smallpox was killing, let us not forget, some 15 million people every year.

A success that deserves to be remembered from time to time by the WHO, for example today, April 7. The WHO's slogan for this day is "Small bites: big threats" as it wants to raise awareness about infectious diseases transmitted by insects and other vectors. Raise awareness to prevent. When a mosquito bites us, it sucks our blood to feed. If we are infected, and more specifically, if a pathogen is circulating in our blood, it will pass into the mosquito's intestinal contents. The pathogen will multiply inside the mosquito, and when it bites another person, it will be introducing these parasites. This is precisely how malaria, dengue fever, Chagas disease, yellow fever and leishmaniasis, among others, which currently cause more than one million deaths worldwide, are transmitted. Malaria alone caused the death of 627,000 people in 2012, mainly children. An estimated 500 million people contract the disease each year, which, in addition to the terrible deaths, is a huge social and economic burden in the affected countries. The WHO's plan is simple: to raise awareness of the threat posed by a "small bite" so that families will adopt protective measures, such as, for example, the employment mosquito nets. Indeed, insecticide-impregnated mosquito nets, a very cost-effective measure leave and without side effects. This campaign is not new and is already bearing fruit. Thus, in a very short period, WHO's efforts to control malaria have saved the lives of 3.3 million people (estimated figures for the period 2000-2012: Currently, an estimated 3.4 billion people are in high-risk areas for malaria, so investment in these and other measures must continue so that deaths caused by insect bites are no longer one of the greatest tragedies of the 21st century.

In any case, and while research continues on new vaccines capable of protecting us against these pathogens, just as they did against smallpox, polio and so many other infectious diseases, let us give our full support to the WHO and its prevention and control measures so that we can continue to wish for our health. The most precious good. Greetings to all.