Monday, July 29, 2013

What you don't measure you can't manage well.


HIV/AIDS killed 1.47m people in 2010; viral hepatitis killed 1.44m globally that year. I quote from The Economist Daily Chart:
(V)iral hepatitis killed more people (than AIDS) in 117 of the 187 countries tracked by the Institute of Health Metrics and Evaluation at the University of Washington–including in India, China, Britain and Japan. The map below shows where one disease kills more than the other, distinguished by high and low ratios (determined informally by where initial high rates begin to taper off). Hepatitis is an inflammation of the liver, usually spurred by one of five main viruses. Types A and E are transmitted through contaminated water and food. Types B, C and D are delivered through infected blood (such as dirty syringes) or in the case of B, from intercourse or from mother to child during birth. Hepatitis B and C, in particular, can be blamed for liver cirrhosis and cancer.

When I worked in the Office of Research in USAID  a couple of decades ago, we funded an Israeli-Egyptian research project which found very high rates of Hepatitis C in Egypt, much higher rates than had been previously understood. Perhaps part of the reason that hepatitis has not been seen as of comparable importance to HIV/AIDS is that the prevalence of hepatitis was not as well reported as that of HIV/AIDS until recently. Perhaps also, there is the problem that HIV is a single virus, while hepatitis is a general term for liver ailments caused by five different viruses.

In any case, the success in reducing the spread of HIV in developed countries suggests that we might now focus more effort on hepatitis while not attending less to HIV.

No comments: