By: Alanna Shaikh
I like good news, and this week has sure been short on it. Today, for example – we have added massive landslides in China to the floods in Pakistan and the forest fires in Russia. We could all use a good success story with interesting implications and – hey – I’ve got one:
The Stop Buruli consortium has successfully gene sequenced the bacteria that transmit Buruli. Buruli ulcer, for the unfamiliar, is a disgusting flesh-eating disease that leads to open sores and deformities. It generally affects children and young people, and it’s primarily found in West Africa (though it also shows up in Asia, Latin America, and Australia. I am hoping they mean some part of Asia far away from Central Asia, where I live.) And – this is fun – we’re not sure exactly how it is transmitted. It has a mechanism beyond just skin-to-skin contact. It seems to be linked to slow moving water. Maybe.
Efforts to fight Buruli have severely hampered by the confusion over transmission. Eliminating environmental transmission of a disease is a tall order; witness the massive effort that has been required to battle Guinea Worm. Trying it to get rid of the conditions that transmit a disease when you don’t know what they are? Very, very hard.
That’s what is so cool about the gene sequencing. Sequencing the bacteria that causes an ulcer doesn’t seem like a big deal on their surface – well, it didn’t to me when I got the press release, anyway – but if we can gene sequence the bacteria, we can track transmission. We can finally figure out how Buruli infection travels. And then we can figure out how to put a stop to it.
So there’s the good news portion of this blog post. We will now enter the speculative part. The Buruli news got me to thinking in general about disease transmission, and about John Snow. John Snow was the physician who basically invented modern epidemiology by tracking a cholera outbreak. He ended up proving that cholera wasn’t spread through air, but by contaminated water. And he stopped the outbreak by removing access to the infected well.
He didn’t need to understand cholera – or germ theory – to stop its spread. He just needed to find a way to interrupt the transmission. I think we can all learn a lot from that. We’re facing global health problems of unprecedented complexity, as a result of climate change and more accessible travel. It’s easy to get overwhelmed by magnitude of the situation.
But the fact is, we don’t have to understand every last detail about NTDs to put a stop to them. We just need to find one tiny method to attack them. With Buruli ulcer, it may be our ability to track disease movement through gene sequencing. With others, it may just be our knowledge that mass drug administration interrupts the spread of disease. But we just need one tiny way in.
We can stack the odds of finding that way, too. Supporting research makes a difference. So does building the capacity in developing countries to respond to all health problems, not just NTDs. And, of course, funding matters. It’s a lot easier to fight disease when you’ve got a reliable budget for it.
Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’
