Globalization and the spread of disease
As once impervious national borders come down, because of the neutralizing effect of the modern communications, in tandem with the liberalization of trade, investment flows and the freer global movement of people, the contemporary phenomenon known as globalization is changing the world in a fundamental way.
While it has undeniably opened up new opportunities for countries and their citizens, at the same time it has also exposed them to significant new threats. One example is the relative ease with which contagious diseases, in particular, can spread today from one region to another where they previously were not known to exist.
“Globalization appears to be causing profound, sometimes unpredictable, changes in the ecological, biological and social conditions that shape the burden of infectious diseases in certain populations,” a World Health Organization (WHO) paper observed. “There is accumulating evidence that changes in these conditions have led to alterations in the prevalence, spread, geographical range, and control of many infections, particularly those transmitted by vectors.”
Barbados and the rest of the Caribbean can readily relate to this observation because of the relatively recent entry of new vector-borne illnesses that were previously alien to the region. We speak specifically of chikungunya (CHIKV) which surfaced for the first time three years ago and wreaked havoc before going away. Now, Zika has arrived and the first three cases in Barbados were confirmed last week.
Both viral illnesses are spread by the Aedes aegypti mosquito which previously was associated more with dengue fever. The Aedes Aegypti mosquito is also associated with yellow fever, but this illness is not a major problem in the region.
CHIKV was previously confined to parts of Africa, where it was first discovered, and parts of Asia. Zika, which is particularly dangerous to the unborn children of pregnant mothers, also originated in Africa.
Given the openness of Caribbean countries and their heavy dependence
on foreign trade including tourism, it is quite easy for vectors to make their way into the Caribbean from infected regions. Even with the most effective port surveillance, the possibility still exists that these vectors can hitch a ride, for example, inside containers transporting cargo or on ships and aircraft.
Weighing in on the discovery of the Zika virus which prompted United States authorities last week to issue a travel advisory for the region, Minister of Education Ronald Jones last weekend blamed “nasty people” on the island who litter indiscriminately and engage in illegal dumping. Mr Jones is well known for speaking his mind but, in this particular instance, he has chosen a rather simplistic way of explaining the problem.
While littering and illegal dumping undeniably contribute to creating conditions for the Aedes aegypti mosquito to breed and spread illness, the more critical question is what can Barbados effectively do to block entry of these illnesses in the first place. The Aedes aegypti mosquito has been around for quite a while but CHIKV and Zika previously did not exist here. Therefore, they had to come here from somewhere else.
Even with heightened surveillance at our ports of entry, there are limitations. The easy transmission of disease is an inescapable reality of the inter-connected world of the 21st century. Even though it is our bread and butter industry, tourism also represents a gateway for the entry of illness into the island.
Almost every year, during the winter months in particular, Barbadians tend
o come down with new flu-like illnesses. Tourism is believed to be the culprit.
While Barbadians at an individual and community level must play their part in keeping their surroundings clean to eliminate breeding places for mosquitos, Government has an equally important role to play. It is unfortunate that the Drainage Unit and National Conservation Commission were major casualties of Government cost-cutting in recent years. This decision has effectively lowered the delivery of service.
Government must also do more to locate the owners of vacant lots which are overrun with bush in many communities and ensure, through the imposition of stiffer penalties, that they fulfil their obligations to keep their lots clean in the interest of public health. In some communities, residents sometimes are driven by frustration to clean up these lots, at personal expense, when it is not their responsibility.
Notwithstanding the challenges, let us resolve, nevertheless, to do whatever we can, individually and collectively, to keep the Zika virus and other public health threats at bay, mindful that we are ultimately doing so to safeguard ourselves because the risk of becoming the next victim will always exist once these illnesses are around.