4.b. Mitigation strategies to combat global pandemics and overcome physical barriers

The millennium development goal to halt and reverse the spread of HIV has been more or less achieved. But, the world fell short of MDG 6a, whose objective was to...

achieve universal access to treatment for HIV/AIDS sufferers by 2010. But, in the past 35 years, major progress made in reducing the prevalence of HIV/AIDS.

1981: Human Immunodeficiency Virus was first identified in the US. HIV/AIDS pandemic has declined in intensity, it hasn't disappeared. 35mn have HIV. 2013: 2.1mn new HIV cases and 1.5mn AIDS deaths. The disease affect...

all countries but 70% of cases are in sub-Saharan Africa.

HIV Diagnosis and Treatment - Huge reductions in mortality and morbidity have been achieved using...

antiretroviral drugs (ARVs), which suppresses the HIV virus and halt the disease's progression.

HIV Diagnosis and Treatment - Early diagnosis can be achieved by HIV antibody screening blood and saliva samples. This method is...

common in ACs where health services are well resourced.

Even in the wealthiest countries with the most sophisticated health systems, HIV/AIDS remains a...

major health issue. In the US, 1.1mn people have HIV and there's around 55,000 new cases annually. Strategies used to fight the HIV/AIDS pandemic focus on 3 main areas: prevention, diagnosis and treatment.

Relief can make it...

difficult for response teams to access communities suffering with a disease outbreak.

HIV Education - 3. Societies' more tolerant attitude encourages...

these groups to access health programmes.

According to UNAIDS : There were approximately 36.7mn people worldwide living with HIV/AIDS at the end of 2016. Of these, how many were aged under 15?

2.1 million were children (<15 years old).

According to UNAIDS : There were approximately...

36.7mn people worldwide living with HIV/AIDS at the end of 2016.

What are some indirect positive of natural hazards as a physical barrier?

> Can restrict movement of people. > Heavy rainfall/winds e.g. Hurricanes can wipe out some vectors. > Can mobilise response units quicker particularly from NGOs.

Remoteness of Communities as a physical barrier - What are the positives?

> Reduces the threat of infection and the spread of disease.

Relief, as a physical barrier to disease has two positives...

> Stop the spread of diseases through vectors like mosquitoes due to climate. In Ethiopia, mosquitoes and thus malaria are restricted to peripheral lowland areas and less common in the majorly mountainous, central regions of Ethiopia. > Restrict movement of people between areas.

Many governments, supported by multilateral agencies and NGOs, have their own strategies to counter the HIV/AIDS epidemic. But, the poorest, particularly in...

Africa, often struggle to fund comprehensive prevention and treatment programmes.

HIV Education - 5. Meanwhile, better data gathering by governments and agencies improves understanding of...

HIV epidemiology, allowing funding for prevention to be better targeted.

Botswana, one of the most developed countries in sub-Saharan Africa, implemented two...

HIV/AIDS programmes between 2004 and 2016. While substantial progress was made, in 2013 nearly ¼ of the population aged 15 - 49 was HIV positive, and there were nearly 5700 AIDS deaths out of 2mn.

Excess water as a physical barrier - 1519: There were approximately 25mn people living in what is now called Mexico when...

Hernando Cortes arrived. A smallpox epidemic killed between 5 and 8mn of the native population in the following two years. Over the next century, less than 2mn survived this and other communicable diseases brought by European explorers.

What is the positive of excess water as a physical barrier?

The Earth's surface is 70% water, and so has historically been the biggest isolator to diseases - preventing communicable diseases from spreading across the globe.

HIV Education - 4. Circumcision reduces infection risks, but...

cultural obstacles often limits its acceptance.

HIV Diagnosis and Treatment - It's known that...

early diagnosis reduces the chance of HIV carriers developing AIDS.

HIV Diagnosis and Treatment - 80s: Media campaign against HIV/AIDS in ACs was especially effective in reducing risk. Progress in sub-Saharan Africa met...

greater cultural resistance, but gradually messages relating unsafe sex and drugs abuse to HIV/AIDS are being accepted.

Natural Hazards - Pakistan and Nepal experienced major earthquakes in 2005 and 2015 respectively. Endemic, water-borne disease like typhoid, cholera and dysentery presented the...

greatest threat in isolated rural areas, which medical teams and emergency aid had difficulty reaching. In the remote Gorkha region of Nepal, many settlers are one/two days walk from the main village. During the 2015 earthquake these settlements were cut off by landslides and were without clean water and medical supplies. Inaccessibility meant that it took two-weeks for medical help to arrive, giving time for epidemics to take hold. Cholera, e.g. can be easily contained in its early stages if protective vaccines are available.

HIV Education - 2. Prevention also addresses human rights. Promoting human rights and equality for...

high risk groups from HIV/AIDS, e.g. women, girls and gay men, reducing discrimination.

Thanks to funding by governments, multilateral agencies (WHO and UNICEF), and the Global Fund and its partners, new HIV...

infection was 33% lower in 2013 than 2001 levels.

Until the mid-20th century the vast rainforest of the Amazon Basin isolated hundreds of indigenous Indian tribes from the outside world. For many tribes the isolation was disastrous. With no immunity to common 'western' diseases like influenza and...

measles, contact with cattle ranchers, oil explorers and loggers often proved fatal. In Peru, ½ of the Nahua tribe, contacted for the first time in the early 1980s, was wiped out by disease following oil exploration on their land.

A similar tragedy to the Nahua tribe, when the...

neighbouring Murunahua tribe, contacted for the first time in the mid-90s by illegal mahogany loggers.

HIV Diagnosis and Treatment - In poorer countries some...

newer and more effective drugs are too expensive.

An estimated 1.8 million individuals worldwide became...

newly infected with HIV in 2016 - about 5,000 new infections per day.

International organisations like WHO set goals for governments and national organisations to aim towards. One of the Millennium development goals was to halt and reverse the spread of HIV/AIDS (and other diseases like Malaria) by 2015. This goal was partly achieved. But, the world didn't achieve part two of the goal, universal access to treatment for HIV/AIDS sufferers by 2010. But, in the past 35 years, major...

progress made in reducing prevalence of HIV/AIDS. Thanks to funding by governments, multilateral agencies (WHO and UNICEF), and the Global Fund and its partners, new HIV infection was 33% lower in 2013 than 2001 levels. This shows that when given specific aims, organisations in corroboration can successfully mitigate against diseases more effectively than in isolation.

HIV Education - 1. Publicising dangers of drug abuse via injection, and...

promoting safe sex through condom use, helps people to protect themselves.

Prevention aims to modify high-risk behaviour associated with infection, relying on education (fundamentally of transmission) and better public understanding of HIV.Educational programmes, aimed at...

raising individual awareness of the epidemiology and spread of the diseases, are an important aspect of prevention.

Remoteness of communities - The Ebola virus first appeared in equatorial Africa in the 80s. But, the communities affected were...

so isolated in the Congo rainforest that the disease was contained.

HIV Diagnosis and Treatment - Today low-cost ARVs are widely available: 8mn are currently receiving drugs to...

treat HIV/AIDS, of whom 6mn (mainly in developing areas) are supported by the Global Fund.

Physical barriers often isolate communities and restrict population movements. Self-imposed Barrier/Isolation - e.g. native...

tribes of forested areas choose not to mingle with the outside world.

Excess water as a physical barrier - 1917 - 38: In Maryland, USA, Chesapeake Bay divides the state into...

two distinct regions. The bay, acting as a barrier to population movements, limited the spread of measles.

What is the negative of excess water as a physical barrier?

χ Bodies of water have restricted the movement of people and technology between areas. Resulting in the decreased immunity of populations and subsequent historic use of diseases to cripple populations.

Remoteness of Communities as a physical barrier - What are the negatives?

χ Disease outbreaks within isolated communities may delay the arrival of medical assistance and emergency aid.

What are some indirect negatives of natural hazards as a physical barrier?

χ Water-borne disease outbreaks, resulting from poor hygiene and contamination of water supplies, often accompany natural disasters like earthquakes and floods. χ In difficult to access, remote regions, disease can χ Quickly get out of control and assume epidemic proportions. χ Infrastructure and homes destroyed.