Week 5 ~ Vaccinating Against Poverty

When I typically think of poverty, I think of how it can lead to diseases that affect millions. But just like poverty can result in disease, disease can also cause poverty. It can go either way, and I never really thought about this before. An article I found by Dr. Peter Hotez, Science for the Poor: Making Vaccines to Combat Poverty (2014), asks the question: "Is it possible to vaccinate against poverty?" I'm guessing that if the average person were to hear this question, he or she would initially find this question somewhat odd or amusing. Some may understand the meaning right away, but for others it may take some time to really grasp the interpretation of the question.

My answer to this question is yes, it is possible to vaccinate against poverty. Of course it's not possible to create a vaccination or medication that directly prevents or treats poverty. Although, that would be very cool :) But it is possible to vaccinate against diseases that usually lead to poverty and/or keep people trapped in this impoverished state, thereby, also helping to vaccinate against poverty. When thinking about epidemiology, it is important to consider various connections, causes, risk factors, trends, correlations, etc., and how one action may lead to more than one type of change. Sometimes it can be a domino effect, so it is important to think of all the possibilities that can occur and how one change can either negatively or positively impact another aspect of health.

According to Dr. Hotez's article, there is an estimated 2.4 billion people who live on less than $2 per day, as well as 1.2 billion people who live on less than $1.25 per day (known as the bottom billion). Most of the bottom billion and many of the people living on less than $2 a day are held prisoners of poverty due to a group of diseases called neglected tropical diseases (NTDs). These are a group of parasitic and bacterial infections that cause significant illness for these people. Some include trichuriasis, hookworm, lymphatic filariasis, trachoma, Chagas disease, and ascariasis. 

The CDC website states that "NTDs impair physical and cognitive development, contribute to mother and child illness and death, make it difficult to farm or earn a living, and limit productivity in the workplace" (2011). All of these factors then lead to poverty because people can't function the way they need to. Even though most children don't need to work right now, their physical and/or intellectual development could become stunted: this can greatly impact their ability to work and support their families in the future. This just shows that NTDs are not only negatively affecting people today, but it is also affecting their lives to come. 

It is very hard to end this nightmare because disease and poverty can be a never-ending cycle: disease leads to poverty, which leads to the continuation and possible addition of new diseases, which keeps poverty going strong, and so on. It can be scary to think about, but it is definitely possible to put a halt to this sequence. Of course it will take a lot of time and effort, but any great change starts with making the first step. One current approach toward limiting these diseases is an annual mass treatment consisting of a package of essential medicines. They target several NTDs at once and cost just 50 cents per person. The WHO describes this method as "preventive chemotherapy." Over time, and with other supportive measures, it is leading to the elimination of lymphatic filariasis and trachoma, as well as river blindness in some cases.

The development and testing of some "antipoverty vaccines" are also underway. Like I discussed earlier, these vaccines would improve health, while also helping to lift the burden of poverty. Hookworm infection is a leading cause of anemia and childhood malnutrition in Africa, Asia, and the Americas, so a prototype hookworm vaccine has been developed and is now going through clinical trials. Modifications of this vaccine are also being worked on so it can target other parasitic infections as well.  There is also a new schistosomiasis vaccine being created that will soon undergo clinical trials.

These different approaches toward the fight against disease and poverty are all substantial steps being made that will hopefully make a vast difference in many people's lives. The creation of certain vaccines and new discoveries being made can help us advance toward being able to successfully and effectively vaccinate against poverty and end the harsh, brutal cycle for good.



References
1. Hotez, P. (2014). Science for the poor: making vaccines to combat poverty. Huffington Post. Retrieved from http://www.huffingtonpost.com/peter-hotez-md-phd/science-for-the-poor-maki_b_4731187.html
2. CDC. (2011). Neglected tropical diseases. Retrieved from http://www.cdc.gov/globalhealth/ntd/ 
3. Photo (top): http://www.newerapolitics.org/uploads/1/3/2/0/13202651/5049487_orig.png
4. Photo (middle): http://cdn.bionews-tx.com/wp-content/uploads/2013/04/size_550x415_P152HammondRwanda04.png
5. Photo (bottom): http://www.fairlawnavenueunited.ca/images/end_poverty.jpg