Beyond COVID-19: How Pandemics Continue to Exist and Emerge

Pandemics, though familiar to most in recent history, tend to ‘disappear’ disproportionately faster in the Western world than they do in the underdeveloped world. While rich countries have virtually eradicated a disease or virus, poorer countries tend to feel its impacts for a longer period of time. As a result, the implications and difficulties associated with pandemics are exacerbated by the West’s neglect for its other countries around the world who often do not have the resources, infrastructure, or power to respond, prevent, and fight against pandemics. It is the responsibility  of governing health agencies and international governments to do all they can to help other governments respond to pandemic outbreaks. This is important for global safety because, given the opportunity, many viral infections will mutate and become increasingly drug-resistant and will have further deleterious effects on international economies and international trade. So, while some may believe that these far-away problems are “irrelevant,” they may be more relevant than we think they are. 

The example of cholera is a devastating, but nonetheless salient, representation of how diseases virtually eradicated in the West tend to linger in other parts of the world. Cholera is an acute diarrhoeal infection caused by the ingestion of water and foods contaminated with Vibrio cholerae bacterium, which is fatal without treatment. The precise date of the first appearance is unknown, but in 1817, a cholera outbreak emerged out of the Ganges Delta, affecting Jessore, India, then made its way across Southeast Asia, decimating populations. The disease established itself along important European trade routes, eventually travelling to England. The Broad Street cholera outbreak in London, 1854, resulted in a groundbreaking discovery by Dr. John Snow who, through a process of early contact-tracing, recognized that infected peoples used the same water pump. His investigation of cholera in the Soho district of London determined that “contaminated water from the Broad Street pump was the source of the disease and, consequently, the removal of the handle led to cessation of the epidemic.” Snow’s discovery ushered in a new age of water sanitation practices, which proved effective at combating the disease and “stopping the spread.” The disease however, lingers on today in many underdeveloped parts of the world.

According to the Center for Disease Control and Prevention, “an estimated 1.3 to 4 million people around the world get cholera each year and 21,000 to 143,000 people die from it.” An overwhelming majority of those affected by cholera live in developing countries. The disease is virtually eradicated in the West; in Canada, “the annual number of reported cases of cholera. during 1995 to 2004 ranged from 1 to 8. Most cases in Canada result from international travel to an affected region.”

Vaccines, such as Dukoral, are effective at preventing cholera, but the most effective way to eradicate the disease is to establish systems of wastewater disposal and water sanitation. This solution is one which requires both resources, and appropriate infrastructure, two things which are often out of reach for the developing regions most affected by cholera. They need the West’s help.

Global health organizations are working to respond to diseases like cholera, but their efforts also require support. The World Health Organization’s Ending Cholera: a Roadmap to 2030, focuses on three strategic axes: “early detection and quick response to contain outbreaks” [through revamping surveillance mechanisms, increasing laboratory capacity, and improving health systems and supply mobilization], preventing cholera recurrence [by focusing attention on regions where cholera is particularly present], [and establishing] effective mechanism[s] of coordination for technical support, advocacy, resource mobilization, and partnership at local and global levels [to support and contribute to national cholera-prevention efforts, by providing technical, financial, and human resources].” In addition, Doctors Without Borders is “today running cholera programs in 10 countries (Kenya, Ethiopia, Somalia, Cameroon, Nigeria, Haiti, Lebanon, Syria, Malawi and Democratic Republic of Congo). Our teams are involved in cholera prevention: they do health promotion, water and sanitation works, and cholera vaccination. We’re also running cholera units to treat patients in medical facilities, and have set up bigger, separate cholera centers where hundreds of cholera patients can be admitted simultaneously.” Working collaboratively with local governments is imperative to eradicate cholera globally, and other diseases of the same nature.

The exceptionalistic understanding of cholera as “a figment of the past” held in the West, is more properly understood as a reflection of the ‘out of sight, out of mind’ phenomenon, exacerbated by the media. While contemporary discourse is more interested in catastrophizing trendy world issues, and soon thereafter forgetting about those same issues, we continue to overlook long-established global problems which continue to devastate a significant percentage of the world’s population. 

This is especially true when it comes to diseases and pandemics. Cholera is but one example of this phenomenon. COVID-19 is another: as COVID-19 continues to spread globally, the attention it is getting from the media has significantly decreased, suggesting that the disease is “long-gone”, or simply a traumatizing memory from our Netflix-binging, toilet paper-hoarding isolation days. The role of media is that of a bridge, which connects the formal world of scientific discourse with the informal everyday life of those who listen. It is imperative that we educate people on these issues and urge our governments to do what they can to help. 

Another aspect of this issue is the commonly held belief that something happening on the other side of the world does not affect our contemporary realities. This belief pertains to many forms of international issues, including wars and humanitarian crises; however, as we have seen, the effects of pandemics can also be extraordinarily damaging on a global scale. COVID-19 affected developed, wealthy nations and underdeveloped, relatively poorer nations indiscriminately, but the burden on developing nations was far greater than it was on wealthier ones. We are still grappling with its effects: economic hardships, domestic tensions, and personal tragedy are just some of the issues which this global pandemic caused. Another threat of “faraway pandemics” is the risk of antimicrobial and vaccine resistance, in which illnesses mutate and become resistant to established treatments, thereby evolving into  new challenges which could potentially cross national boundaries and create another global pandemic. These seemingly faraway issues suddenly become more relevant when understood this way. 

As we learned from COVID-19 — or as we should have learned — it is imperative that we continue to work collaboratively to develop mechanisms and establish infrastructure to combat and eradicate pandemics. In a globalized world, highly transmissible illness and disease have the opportunity to spread at unprecedented rates. As with COVID-19, it does not take long for the entire world to be affected. While a significant part of the world grapples with long-established diseases, we must turn our attention to helping these counties deal more effectively with their impact and strive to establish preventative and preparative measures to fight pandemics which are likely to emerge  in the future and which will most certainly have universal effects.

Featured image “Louisiana National Guard COVID- 19 Response”  courtesy of Staff Sgt. Garrett L. Dipuma is licensed under CC BY 2.0.

Edited by Jihan Dahanayaka.