Burden of Infectious Diseases

The repeated outbreaks of swine flu (H1N1) over the past decade and deaths due to the Ebola virus in Africa have focused our attention on infectious diseases and their lethal impact on people’s lives. Improved public health standards and the antibiotic revolution have resulted in the conquering of infectious disease in the Western world. The upper classes in India have enjoyed similar successes through effective (but selective) interventions in water, sanitation, nutrition, housing, vaccination and access to healthcare. However, decades after the availability of technology and solutions, the larger society in India continues to face disproportionate levels of morbidity and mortality due to infectious disease. Deaths due to malaria and tuberculosis, which seem to disproportionately infect the poor, keep mounting every year.

The situation begs the question why. The answer lies in our refusal to take into account the local reality and social determinants of health. The survival of the human body is best explained by the material explanation which argues that the variation in health and longevity is related to the access to tangible resources. The association between poverty and disease is well recognised. Yet, malnutrition is rampant among children; vaccination coverage is inadequate; housing is substandard; healthcare is unaffordable and unavailable; and elementary education is second rate in rural areas and among the urban poor.