Infectious Diseases in the South-East Asia Region

 

Researchers at CDDEP, in collaboration with leading experts in the field, have produced the Infectious Diseases in the South-East Asia Region report, which examines cross-boundary challenges in communicable disease control in countries in the South-and South-East Asia region. The report emphasizes infectious diseases related to other sources of disease burden in the region and communicates overall trends in the health and economic burden they impose.

Despite substantial progress in recent years, which has seen reductions in deaths from HIV and malaria and an increase in tuberculosis treatment coverage, the South-East Asia region continues to bear a significant proportion of the communicable disease burden worldwide. South Asia has the third largest HIV epidemic globally and the highest TB burden, accounting for more than a quarter of the global burden. The second highest incidence of malaria, amongst all WHO regions, occurs in the southeast Asia region, and India bears the third-highest proportion of malaria cases globally.

Malnutrition makes the South-East Asian population particularly vulnerable to neglected tropical diseases (NTDs) alongside emerging infectious diseases from arbovirus infections, dengue, chikungunya, Japanese encephalitis, and the continuing concern of a pandemic influenza outbreak. Furthermore, drug- resistant infections cause 58,000 deaths in newborns every year, in India alone, and continue to threaten the effectiveness of life-saving antibiotics across the region.

Covid-19 has disrupted the control of other infectious diseases in myriad ways, hindering routine vaccination programs, impeding the distribution of bed nets against malaria, and reducing TB services, among others. With the rollout of vaccines against the novel coronavirus and the ebbing of Covid-19, it will be essential to devote our full collective attention to the control of infectious diseases that have long plagued this region and continue to constitute a significant proportion of the avertable disease burden.

Estimating the burden of disease

 Evidence based decision making in health requires the availability of sound data, but good quality information on the occurrence of infectious diseases is unavailable from most of South Asia, especially on premature mortality and loss of healthy life years in adult populations. Thus calculations of disease burden using techniques such as disability adjusted life years (DALYs) are fraught with difficulty; deaths and disability caused by infections such as meningitis, encephalitis, chronic hepatitis, leishmaniasis, congenital infections, rabies, and post-streptococcal rheumatic heart disease in South Asian populations remain hidden and unmeasured.

Risk factors for disease and death

 

People in South Asia are at a higher risk of developing infectious diseases and dying from their illness than people in industrialised countries.³ The root causes are poverty and its associated problems of unhygienic living conditions, malnutrition, illiteracy, and poor access to clean water, toilet facilities, and quality health care.

In South Asian children, poor nutrition and deficiencies in micronutrients (vitamin A and zinc) are important underlying risk factors for death due to infectious diseases.^4-6 Around half of the children in South Asia are underweight or stunted, and malnutrition contributes to an estimated 55% of deaths in children.