Professor David Molyneux, former dean of the Liverpool School of Tropical Medicine, addressed the global health issues of rising trends in infectious diseases as well as successful control and surveillance programs Thursday evening in St. Mary’s Hall. Invited to speak by Georgetown’s International Health Director and former World Bank officer Bernhard Liese, Molyneux presented comprehensive information regarding the political, social and medical barriers to stabilizing the world’s most deadly diseases, including HIV/AIDS, malaria and tuberculosis.

“These are the major diseases on the international health agenda and are currently being worked on with the Roll Back Malaria project, anti-microbial resistance programs developing new treatments and methods of early diagnosis and surveillance to prevent serious problems,” Molyneux said.

As the current director of the recently established Lymphatic Filariasis Support Center in Liverpool, Molyneux has direct experience with infectious disease programs that have been effective in eradicating fatal illnesses such as riverblindness, guinea worm disease and Chagas disease. Using strategies of vector control with nets sprayed with insecticide, public health education and water sanitation, Molyneux’s programs in partnership with the World Health Organization and Centers for Disease Control and Prevention have significantly decreased the prevalence of the Chagas disease in South America. The disease is transmitted by “kissing bugs” that are accustomed to living in the cracks of rural clay houses in countries such as Paraguay, Uruguay, Brazil, Chile and Argentina.

“The control programs were effective as a result of our strict monitoring system,” Molyneux said. “The impregnated nets served as highly efficient devices that captured the majority of the bugs, eliminating the vector mode of transmission.”

Also successful was the control of Lymphatic Filariasis, a parasitic disease prevalent in Africa, which in the 1960s infected 60 percent of the people in the villages and caused blindness in 10 percent of the adult population. Through partnerships with several

international organizations with long term perspectives on treating and preventing the illness, the prevalence of Lymphatic Filariasis was decreased to less than five percent in 2001.

“Through strengthening the infrastructure of the public health surveillance systems in these developing countries, as well as strategic research conducted by officials such as Dr. Liese, 30 million people were prevented from blindness,” Molyneux said. “LF is no longer a public health problem – 50 thousand cases were prevented in 10 African host

countries, as a result of a $550 million eradication program.”

Despite the successes of eliminating major illnesses such as Chagas and LF, there is still a worldwide epidemic of HIV/AIDS, TB and malaria. The prevention and treatment of these illnesses are thwarted by political, social, and medical barriers such as anti-microbial drug resistance, lack of funding for proper treatment, corrupt marketing of counterfeit drugs by local street vendors and fragmented health infrastructure systems in third world countries, Molyneux said.

“Drug resistance is an enormous problem with regards to alaria, the number one parasitic killer in the world. By under-dosing proper prescriptions, providing poor quality drugs that are often literally fake and over-diagnosing a prevalent illness, drug resistance creates extreme difficulty in providing effective treatment,” Molyneux said.

The cost of creating new non-resistant treatments and distributing them to those in need demands highly unrealistic funds that are non-existent in the target countries, according to olyneux. Along with other infectious disease experts, he believes it is unrealistic to depend on money to relieve the current epidemics such as malaria resulting in high mortality rates.

“Many people adopt the school of thought that if a country receives a large amount of money that goes to AIDS, malaria, where the attention is, the disease will mysteriously disappear,” he said. “This is not the case – as David [Molyneux] explained, what is needed is a long-term commitment to strengthening the public health control methods in the country and concentrating on preventing transmission,” Liese said.

Finally, Molyneux encouraged student awareness of international infectious disease epidemics, as the majority of the world’s population is affected and struggling to overcome developing barriers. Intended future speakers in the field of global health consist of representatives from the United States Agency for International Development, the Pan American Health Organization and the Department of Health and Human Services.

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