Balaram Chaulagain

Many factors are involved in the causes of new or the re-emergence of old diseases. Emerging diseases can be caused by infectious pathogens like viruses, bacteria, fungus and other microbes present in the atmosphere. Since the 1970s, about 40 diseases like Sars, Mers, Ebola, Chikungunya, Avian flu, Swine Flu, Zika and, most recently, COVID-19 have surfaced in this universe.
In the past, smallpox was a highly contagious and fatal disease before the invention of a vaccine against this dreadful malady. With the invention of the vaccine, this disease has been wiped out from the surface of the earth. Likewise, COVID-19 will also be wiped out in the near future as the vaccine against it has been invented.
Human alteration of local, regional and global ecosystems are leading to the inception of previously unseen diseases. The disease does not concern itself with political or geographical boundaries. The prevalence of a disease in one part of the world, therefore, is a constant threat to all other parts of the world. For better or worse, the existence of many diseases has been influenced by human movement from one part of the globe to other parts.

Enormous Efforts
The enormous efforts applied by medical science which has successfully brought under control the highly communicable and dreadful diseases like smallpox, poliomyelitis, tuberculosis, measles and a few other ailments.
Human factors are believed to be the main cause behind in emerging of new types of communicable and non-communicable diseases. When the underlying causes and mechanisms of new emerging infectious diseases problems are studied carefully, it is found that human behaviour is often involved.
It is sometimes emphasised that it is human carelessness, excesses, ignorance or habits of conquest or leisure which contribute directly to the biological niches that micro-organisms are all too capable of exploiting. We must look at ourselves as the engines of microbial opportunism. It is not likely that we will ever conquer the microbial world; we must look instead to control the human factors that contribute to emergence. Moreover, the ecology of the earth is changing as a result of modern technology. The forces involved are huge and complicated and are poorly understood. The release of greenhouse gases on a large scale as byproducts of industrial processes is also a major cause of emerging diseases. Excess fertility, poverty, under-education, poor sanitation are other causes of disease prevalence in society.
Besides, tool-making technology, changing ecology, pollutants, conflicts etc are also believed to be the main predisposing factors of new emerging communicable and non-communicable diseases. The top five infectious diseases that may yet erupt in a new round of deaths are pneumonia, diarrheal diseases, tuberculosis, malaria and measles. These have exacted a heavy toll on millions of lives worldwide with the bulk of deaths more than 90 per cent in developing countries.
The outbreak of such diseases could arise from lack of clean water and proper sanitation, cutbacks in health services, human crowding, and susceptibility of people and widespread misuse of antibiotics and others chemicals. Unless people get to understand the life cycles of diseases and the ecology of infection to prevent outbreaks, infectious diseases will remain the leading cause of death in the world. Smallpox was globally eradicated in 1979. Measles, polio and few other infectious diseases appear to be on the way out. But cases of drug resistance pneumonia plague industrial countries where antibiotics are widely overused. Drug resistance strains of plasmodium protozoan have led to the resurgence of malaria in South -East Asia.
Microbes have an uncanny ability to replicate, mutate and adapt to new medicine and treatment. This makes infectious diseases truly contagious and communicable. The resurgence of Malaria, Tuberculosis and other infectious diseases demonstrates that tampering with the natural balance of microbes and hosts can lead to more diseases. Despite the effectiveness of immunisation against major killer contagious diseases, a lot of people are not immunised.
This is due to the dearth of inexpensive treatment and lack of money on the part of people. Another setback to progress is the lack of basic information on health and the environment. Cases of under-reporting and misdiagnosis of diseases pose problems in many places which often lead to confusion concerning disease identification. These and other disease reporting and data collection systems are often hampered because of financial constrain. Case study, prevalence rate and data collection call for the implementation of immediate and specific preventive measures to control infectious diseases.
Among these are improved vaccination campaigns, limited use of antibiotics, expanded public health education, access to clean water and provision of basic health care services. In the long run, prevention is the best effective weapon against infectious diseases. Any failure to control them could mean rising health care costs and a world in which the majority of poor and marginalized people live in fear of plagues as certain as evolution itself.

Infectious Diseases
Major infectious diseases like malaria, tuberculosis, recently emerged covid-19 and such others are becoming more frequent and more severe. The devastating effects they have on development and social stability have focused on the attention of scientists, technicians and policymakers. New ways to prevent or at least mitigate the effects of disease burden on people and human development have been projected. The recent outcome of medical science is the invention of a vaccine against the coronavirus within a limited period of one year.
For this, scientists, technicians and policymakers of many nations involved in the field of producing vaccines have to be given a round of applause. In absence of a strong policy and commitment on the issue of new causes of newly emerged diseases whether to bring policymakers into the people's protection rule has become a subject of intense debate between government and mass media. In our context, the protection of patients' rights in health care service has always remained ineffective because of vagueness and lack of national health policy.
To begin with, the provision of health information, education and communication that bring the government authority to the public's woe must be initiated from all sectors of societies. Let us hope in the days to come priority would be accorded in combating newly appeared and highly contagious diseases. For this, a suitable plan of action must be considered to avoid disaster.

(The author is a retired public health officer and can be reached at balaram.sharmac@ gmail.com)