The World Health Organization (WHO) is main international disease fighting body. Based in Geneva, it is affiliated with the United Nations and has 192 members and an annual budget of $1.6 billion. Other organizations involved with international health including the Atlanta-based U.S. Center of Disease Control (CDC), the Pasteur Institute in France; Liverpool School of Tropical Medicine; and the London School of Hygiene & Tropical Medicine.

In a 2007 World Health Organization (WHO) report on tackling fast-spreading new diseases the organization said that “diplomacy, cooperation , transparency and preparedness” are the keys. Also important are dealing with the “unprecedented rate” of human mobilization offered by planes, trains and ships and keeping an eye of migrant populations.

The WHO has a secretive 15-member emergency committee that makes non-binding decisions about when health alerts are issued and diseases are declared pandemics. The committee advises the WHO Secretary who makes final decisions. As of 2010 the committee was headed by Australian infectious disease expert John Mackenzie. The WHO bunker is the nickname of a $5 million facility built in a former movie theater that is the screen-filled nerve center for tracking new strains of influenza and the deadly diseases.


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Immunizations have already cut deaths worldwide from about 5 million in 1960 to less than 1.5 million in 2001. In the 1990s and 2000s child mortality dropped below 10 million thanks mainly to measles vaccinations. At least 800,000 more lives a year can be saved by widely implementing the Hib and pneumococcal vaccine program, something the Gates Foundation is very active trying to do. To improve the delivery of vaccine, researchers are developing vaccines that don’t need refrigeration or needles.

As of 2010 the WHO recommended that in the first nine months of life children should get vaccinations for tuberculosis, diphtheria, tetanus, whooping cough, polio and measles. At that time in the United States, a child received 28 doses of vaccine by age two if the complete schedule of immunization recommend by the Centers for Disease Control and Prevention is carried out. Seventy-seven percent of kindergartners are completely up to date with their vaccinations in part because schools require it. Among the diseases that children receive vaccines for are 1) hepatitis B; 2) diphtheria tetanus and pertussis (whooping cough), with the Dtap vaccine; 3) polio; 4) meningitis and pneumonia with the Hib and PCV7 vaccines; 5) rotavius (diarrhea and vomiting); 5) influenza; 6) measles, mumps and rubella (German measles) with the MMR vaccines; 7) chicken pox; and 8) hepatitis A.

According to a study in Lancet released in 2009 many infants in poor and middle-income countries get their vaccines weeks later than doctors recommend and they therefore face increased risks of sickness and death. The GAVI Alliance is a group dedicated to immunizing children in the developing world. As of 2007 it had immunized 100 million children, averting some 600,000 deaths in a single year. The group has also developed a creative approach to the bond market and has raised over $1 billion to buy more vaccines.

Disease Fighters

EPI-AID (short for epidemic aid) is group of doctors and epidemic specialists that drop whatever they are doing to hop on flights to remote parts of the world to investigate potentially epidemic-causing outbreaks of disease. Made up of scientists and doctors from WHO, the Pasteur Institute in France and the U.S. Center of Disease Control, EPI-AID resembles the until lead by Dustin Hoffman in the film “Outbreak”.

When entering a "Hotzone," EPI-AID personnel bring examination gloves, disposable boots, bubble suits with impermeable linings, syringes, needles, generators and refrigerators to store samples of blood, kidney and liver, plasma, and body bags. After a hard days work the health workers take a shower in Lysol. They often they have to pressure terrified pilots to take them to the infected areas.

Studying Diseases

On a scientist studying Anopheles mosquitoes, the carries of malaria, Jerry Adler wrote in Smithsonian magazine: “In a laboratory in London, behind three sets of locked doors enclosing negative-pressure containment vestibules, Andrew Hammond, a doctoral student in molecular genetics, picks up a clump of Anopheles eggs on a small paintbrush and lines them up on a microscope slide. Hammond looks for the narrow end, where the germ line cells that will form the next generation are located. With delicate nudges of a joystick, he maneuvers a tiny needle through his field of vision until it just penetrates the egg membrane, and the click of a button releases a minute squirt of DNA. Whether the genetic material reaches and binds to its target region is then a matter of luck, and luck is, generally, with the mosquito. Hammond’s success rate, of which he is very proud, is around 20 percent. [Source: Jerry Adler, Smithsonian magazine, June 2016]

"The injected eggs will hatch into larvae. The ones harboring the mutation are identified by a “marker” gene, which glows under a microscope when viewed in certain lights. The mutants of interest are then returned to the warm, humid air of the mosquito rooms, to stacked trays with walls of white plastic mesh. On one side, there’s a long socklike tube, ordinarily tied in a knot, through which researchers can insert an aspirator to gently vacuum up specimens. If you hold your hand nearby, the females, sensing the nearness of blood, gather on that side. When it’s time for their blood meal, which will nourish the hundred or so eggs a female will lay at one time, an anesthetized mouse is laid belly-down on the cage roof, and the females fly up to bite it through the mesh. (The males, which live on nectar and fruit in the wild, feed on a glucose-water solution, wicked up from a small glass bottle.) These insects live up to a month longer in the controlled environment of the cages than in the wild, where they often don’t survive more than a week or two.

“The next phase of the research takes place in Perugia, Italy in a secure lab, with six ceiling-high “field cages,” each with an area of 50 or 60 square feet. Signs on the doors warn away visitors who might have been exposed to malaria, since they could infect an escaped mosquito if it bit them. The air inside is tropical. Instead of live mice, females are fed on small dishes of bovine blood, warmed to body temperature and covered with paraffin, to give them something to land on. The females are attracted to the pheromones in human sweat, especially from the feet. Lab workers say they sometimes wear their socks all weekend and bring them to work on Monday to rub on the feeding dishes.

“Inside, the lighting changes to simulate a 24-hour tropical day, and environmental cues trigger the swarming behavior that is crucial to mating. “That is how many insects mate,” explains the chief entomologist, Clelia Oliva. “The males swarm, and the females fly through the swarm and find a mate, and they come together in the air. If you cannot replicate that, you cannot determine if your line is going to succeed in the wild.” An escapee from one of the cages flits past Oliva as she is talking, and she dispatches it with the slap she perfected while studying mosquitoes on Reunion Island, in the Indian Ocean.

Image Source: Centers for Disease Control and Prevention except smoker Ray Kinnane

Text Sources: Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services; World Health Organization (WHO) fact sheets; National Geographic, New York Times, Washington Post, Los Angeles Times, The New Yorker, Time, Reuters, Associated Press, AFP, Lonely Planet Guides and various websites books and other publications.

Last updated May 2022

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