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Economist | Polio returns to Venezuela, and threatens the region

HomeMediaEconomist | Polio returns to Venezuela, and threatens the region
The country’s neighbours need to strengthen their defences against infectious diseases

In 1961 Venezuela became the first country in Latin America virtually to eliminate malaria, using a combination of DDT, an insecticide, and drugs. The oil-rich country has now made health history again, this time in a bad way.

On June 7th Venezuela’s health department reported to the Pan-American Health Organisation (PAHO) the first case of polio in South America since 1991. This is a big worry, not only for Venezuela but for its neighbours. The re-emergence of polio strongly suggests that Venezuela’s vaccination programme has failed. With thousands of Venezuelans a day fleeing the country’s political and economic crisis, there is a risk that polio and other highly infectious diseases will spread to more countries in the region.

It is not clear what the source is of the infection reported to PAHO, which occurred in a child nearly three years old from the Warao indigenous community in the rural state of Delta Amacuro. The child might have been infected by someone who had been to a country where polio is still endemic (Afghanistan or Pakistan). Or it could be a rare “iatrogenic” case, caused by a mutation of the polio vaccine itself and passed on through faeces-contaminated water, food or touch. Either way, the occurrence demonstrates the dangers of leaving holes in vaccination campaigns.

Some 2.1m-2.6m babies in Venezuela have never been vaccinated, according to the Venezuelan Society of Public Health (SVSP), an independent group of health specialists. Venezuela waited more than a month to inform PAHO of the case in Delta Amacuro rather than 24 hours, the deadline set by internationally agreed guidelines. That gave the disease time to spread. The SVSP has said it is aware of four possible cases and there may by now be many more. Measles, which was stamped out in the Americas in 2016, also made a comeback in Venezuela. Some 2,000 people have fallen sick there, according to PAHO.

These failures are part of a broader collapse of Venezuela’s health system, caused by the socialist regime’s ruinous policies, which have led to shortages, economic depression and hyperinflation. In 2017, the last time the health ministry published data on disease levels, it reported that in the previous year maternal mortality rose by 66%, infant mortality jumped by 30% and the number of malaria cases increased by 76%. The economy has since worsened. So, no doubt, has Venezuelans’ health.

When they flee, they can bring infections with them. An estimated 1.5m have left in the past four years, many of them settling in neighbouring Colombia and Brazil. They are less likely to use health services in their new countries, creating disease blind spots that make it harder to contain outbreaks. Venezuela’s measles outbreak has now spread to Brazil, Colombia and Ecuador, which have an estimated 1,033 cases between them. All of the 798 cases under investigation in Brazil are in the two states that border Venezuela; in one of them 69% of the people with measles were Venezuelans.

Transmission would be harder if the region’s health services were stronger. This week Paraguay set an example by becoming the first country in the Americas to eliminate malaria since Cuba in 1973. But there are reasons to worry about other countries, even Brazil, which has long been a regional role model, especially in the area of vaccination. The government of President Michel Temer has frozen most federal spending in real terms until 2036 to reduce a massive budget deficit. This comes on top of cuts by previous administrations that reduced spending on health as a share of the budget from 10% to 7.7%. “Hospitals don’t have money to run anymore,” says Jorge Kalil, a professor of clinical immunology at the University of São Paulo and a former director of the Butantan Institute, which produces vaccines.

Public-health campaigns have not been spared, says Ligia Bahia, a professor at the Federal University of Rio de Janeiro (UFRJ) who also works with Fundação Oswaldo Cruz (Fiocruz), Brazil’s other vaccine producer. Fiocruz backed research that led to the discovery of Chagas disease, an insect-borne illness, the eradication of smallpox from the Americas and the containment of the outbreak of the Zika virus in 2015-16.

This year Brazil had its worst outbreak of yellow fever since the 1940s; 237 people have died. The virus appeared in areas where it had never been, which made it hard to deliver vaccines. Scientists say they could have anticipated the outbreak if they had had more resources. The monkeys that harbour yellow fever “were dying like flies in the forest reservations before the outbreak”, says Pedro Lagerblad de Oliveira, the lead researcher of the Institute of Medical Biochemistry at UFRJ. Even after the outbreak, “there was not a single public call” offering grants for research in yellow fever, he says.

Scientists suspect the virus may be able to jump from mosquitos prevalent in forested areas to a type that is common in cities. That could spread the disease to more people. Without government-backed research on that risk, “we simply don’t know”, says Dr Lagerblad. Latin America cannot afford to skimp on disease prevention, as Venezuela has discovered.

This article appeared in the The Americas section of the print edition under the headline “Disease déjà vu”

Bron: The Economist

2 reacties

  1. Beste @matie, een beetje respect voor deze vrouwen het zijn geen hoeren maar vrouwen van lichte zeden of meisjes van plezier. Hoer is een beroep dat zijn meestal dames die het niet persé voor het geld doen maar omdat ze van hun hobby hun beroep hebben gemaakt.

  2. En die Venezolanen komen zomaar naar ons eiland ik vrees voor een epidemie.En betreft geslachtziekten zijn wij daar ook voorbereid?
    Volgens de berichten in de media doen die trago hoeren aan onveilige sex.

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