Is it really helpful to talk about communicable and non-communicable diseases

separately?

Effrossyni Gkrania-Klotsas

Yes, it is helpful

• We are losing the forest for the tree! NCDs are the real danger!

WHO

• We are winning in CDs, let some money flow towards the NCDs!

WHO, 2011 Malaria Report

UNAIDS/WHO Global HIV Case Response 2011

UNAIDS/WHO Global HIV Case Response 2011

No, it is not helpful

I don’t know if we are really winning

Morbidity Prevalence, 2004

• Total prevalence of communicable diseases 2.4 billion

• Total prevalence of non-communicable diseases 2.4 billion

WHO

WHO, Global Immunization Data, 2010

Estimated annual childhood deaths from vaccine preventable diseases,

2010• Hib: 260 000

• Pertussis: 195 000

• Measles: 118 000

• Neonatal tetanus: 59 000

• Tetanus (non-neonatal): 2 000

• Pneumococcal disease: 520 000

• Rotavirus: 527 000

WHO

• 57m deaths worldwide in 2008

• 16m communicable diseases

• 7.5m neoplasms (300k lymphomas, 270k leukemias, 413k oesophagus, 281k mouth and oropharynx,695k liver cancer…)

• 428k congenital anomalies…

• 4.2m respiratory diseases

Zur Hausen, Virology, 392(1); 15 September 2009, 1-10

It is not so simple

Bill and Melinda Gates Foundation

David M. Morens, Gregory K. Folkers & Anthony S. FauciNature 430, 242-249(8 July 2004)

Infectious Diseases are affected by climate change

We are losing conceptual tools

Different classification systems (cause-based, outcome-based)

Many infections have become chronic illnesses (HIV)

Much morbidity and mortality in NCDs from CDs (SARS and Diabetes)

No public health research in the interface

Loss of analytical tools

CD and non-CD?

• Good for funding, awareness, politics, advocacy

• Bad for science, methodology, speed of reaction

• Bad timing?