The Problem

The development of antibiotics in the second half of the 20^th century, and successful global effort against infectious diseases, which had reached its peak with the eradication of smallpox, created the illusion that infectious diseases were being relegated into the past. But this proved to be wishful thinking. Contagious diseases are back, threatening the lives, health, and advance of millions of people in all parts of the world. Suffice it to say that TB, which seemed to be left forever in the 19^th century, in the novels of Dumas and Remarque, is killing up to two million every year at a rate of four people per minute! New diseases like HIV, have emerged. AIDS, caused by this virus, has taken a toll of more than 25 million people since 1981. Another 40 million are sentenced to death without adequate treatment.

Infectious diseases have become a break on economic progress. In many African countries, it has ground to a halt, and has even been reversed by HIV. East European and Asian countries, which were gripped by the epidemic much later, may be in for similar problems. The influenza has not yet become a pandemic, but is already causing heavy economic damage by upsetting international commerce and tourism.

This is why G8 nations have repeatedly focused on measures against different infectious diseases (HIV/AIDS and TB, for example) at previous summits, and have welcomed Russia's proposal to put this question high on the agenda of the upcoming summit in St. Petersburg.

Russia has amassed enormous organizational and scientific experience in countering infectious diseases, including the study of infection-causing viruses, development of methods of diagnostics and immunological prophylaxis, adoption of anti-epidemic measures, and monitoring of infectious diseases. Russia's current system of state epidemiological surveillance, which is virtually unique, makes it possible to implement anti-epidemic measures both in normal life, and in emergencies.

As distinct from the previous summits, in St. Petersburg G8 nations will discuss a whole range of problems involved in the struggle against infectious diseases - from specific issues of fighting HIV/AIDS, TB, malaria, and measles to concerted effort to prevent the outbreaks of infectious diseases during natural and technological disasters, and a search for ways of making treatment of infectious diseases accessible to as many people as possible. The summit will focus on the following issues:

1. Consolidation of Global Network on Monitoring and Controlling Infectious Diseases

Timely identification of emerging epidemics and an ability to predict ways of their dissemination are crucial for an adequate reply of the health system. In this context, it is important to achieve better coordination of national services (for instance, by urgently adopting international medical and sanitary rules), exchange understandable information, and enhance the potential of epidemiological services in the developing nations on timely identification and response to outbreaks of infectious diseases. It is very important to develop a system, which would help predict the ways of disease dissemination based on the information on the number of cases among humans and animals, and prevailing trends.

2. Countering Avian Influenza and Preparing for Influenza Pandemic

Remaining mostly an avian disease, the H5N1 influenza strain has already done heavy damage to mankind by killing people and affecting many more with the economic aftermath of the poultry epidemic. The beginning of the influenza pandemic is the worst-case scenario. It may happen if the virus develops an ability to infect humans. A influenza pandemic may have grave consequences. It is enough to recall that in 1918-1919 the Spanish influenza killed more people than World War I. The World Health Organization (WHO) is calling upon all nations to closely follow the development of the avian influenza epidemic, and, in case of man-to-man transmission, take every effort to contain its spread. By way of preparing to a potential epidemic, it is necessary to intensify information exchange at the expert level, to explain to the public the facts about the disease; enhance the lab potential in high-risk areas; facilitate the development of national monitoring systems in close cooperation with the World Organization for Animal Health and the UN Food and Agriculture Organization (FAO); build up reserves of medicines affecting the virus, and develop vaccines for nipping in the bud the pandemic-causing virus.

The economic consequences of panic may be as dangerous as the virus. It is important to reduce the negative effect of a potential influenza pandemic on international trade and economic cooperation.

3. Fighting HIV/AIDS, TB, and Malaria

G8 sessions have often focused on fighting these leading killers. The previous commitments in this sphere, and the focus on countering them calls for continued efforts to develop the vaccine against HIV, and enhance regional cooperation in Eastern Europe and Central Asia. It is necessary to establish a broad coalition of the civil society and commercial structures for fighting the epidemic, and taking adequate preventive measures. It is important to acknowledge the fact that the anti-HIV/AIDS effort should be multi-faceted, and should concentrate on backing the development of healthcare systems, which would be capable of carrying out preventive and treatment programs.

4. Eradication of Poliomyelitis

Mankind is about to win a major victory in the drive against infectious diseases. It has almost completely eradicated poliomyelitis, which killed and incapacitated children in the 1940s and 1950s. Individual cases occur in few countries, but inoculation programs will soon eliminate them for good. It is necessary to find the funds for a final attack against poliomyelitis.

The victory is around the corner, and the experts are already discussing the use of the volunteers and organizations, involved in fighting poliomyelitis, for the struggle against other infections.

5. Measles and Other Preventable Diseases

Although there exists an effective and safe vaccine against measles, it continues killing thousands of children all over the world. Mankind has the vaccine which could save children, and wipe off measles for good. It is necessary to deliver it to those areas, which are in need of it. G8 nations support the initiatives of the Global Alliance for Vaccines and Immunization, and urging the WHO to start implementing its plans on preventing and eradicating measles.

The upcoming G8 summit will also focus on so-called forgotten diseases - different infections, which are causing suffering and death in the tropic regions, but which enjoy much less attention.

In addition, it is important to concentrate on the resistance of viruses to medicines and on the need for global cooperation to resolve this problem.

6. Access to Treatment and Prevention

Finances and personnel are essential for planning the fight against infectious diseases. Limited potentialities of the healthcare systems are a major barrier to prevention and treatment of infectious diseases. It is therefore essential to build them up, and primarily, to enroll professionals in the effort. The WHO should find ways of achieving this goal, which must be supported by donor organizations.

Improving healthcare staff resources and treating patients requires financing. In this respect, different innovation financial mechanisms could be of use, as they could find money to implement programs fighting infectious diseases.

7. Prevention and Struggle Against Epidemics Caused by Natural Calamities and Technological Disasters

Tsunamis in Asia, hurricanes in America, and earthquakes in South Asia have demonstrated the importance of fast and coordinated response to natural calamities. History shows that the destruction of the healthcare infrastructure, which is often a result of major natural and technological disasters, makes the onslaught of infectious diseases much more likely. Therefore, it is necessary to boost the ability of the developing nations to cope with the aftermath of disasters, and to coordinate the use of the available resources.

To grasp the importance of the problems, raised by Russia, remember that while you were reading these lines, two kids have died of malaria, TB has killed six people, and 15 have contracted HIV.