Infectious diseases pose serious public heath burden despite focus on NCDs

At this time of the coronavirus outbreak, it may come as no surprise that infectious diseases still pose a serious threat to life in Asia-Pacific. However, shifting priorities and patterns of disease have led to some public health authorities re-thinking their resource allocations in recent years. The current outbreak, and WHO’s figures, may give policy makers pause for thought and will certainly surprise publics on the continuing threat of communicable disease in the region.

WHO’s Top 10 Causes of Death from 2016 in South-East Asia shows six noncommunicable diseases (all related) in the top 10 with coronary heart disease leading the way by some margin (2.2M deaths in 2016). Stroke (1.2M) and chronic obstructive pulmonary disease (1.05M) round out the top 3. Lower respiratory infections (783k), Tuberculosis (651k) and diarrhoeal diseases (526k) come in at 4, 5, and 6. Almost 2M deaths in the region from infectious diseases, many of which could be prevented. Diarrhoeal diseases are the most tractable, actions around basic hygiene, sanitation and safe drinking water could address both deaths and a leading cause of malnutrition. Campaigns targeting the most vulnerable (under 5 year-olds [123k deaths] and over 70 year-olds [222k deaths]) could contribute towards reducing preventable deaths.

Infectious diseases represent a significant burden in South East Asia, and the currently high profile coronavirus is one of several lower respiratory infections that medical professionals deal with on a daily basis. The current global estimate of deaths from influenza is in the range from 290,000–650,000.

As is the case with the realities of death, publics have a hard time putting these figures into perspective. The real risks, heart disease and stoke, are not memorable, the deaths are merely statistics. Will news of 2M deaths per year make any difference to diet and exercise? Probably not.

The alarm about the new coronavirus is understandable, the death toll currently stands at about 2,000. The facts and figures present a rational view of the true state of the outbreak. However, certain factors seem to trigger our inner fears and rational assessment and perspective is lost. Uncertainty and lack of control are key factors, as is dread. Intuitively, we react with fear and anxiety. Used well, these emotions can prompt effective action and response to take simple precautions, recognise symptoms and limit transmission. The fear of fear by authorities is overstated, fear motivates action and the public can adjust and bear more fear than they are given credit for. What they cannot bear are false promises, half-truths and over-reassurance.

Infectious diseases represent a significant health burden in Asia-Pacific, many of the infections are preventable and treatable. Changes in behaviour can address both non-communicable and infectious diseases and the challenge remains how to more effectively understand audiences and their cognitive biases, risk perceptions and emotions to improve campaigns in these areas.

Andrew Roberts

Author Andrew Roberts

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