Historically, infectious diseases have been a constant battle against humans. As societies formed, governments grew more complex to the point where they could issue policies and laws that would either help prevent infectious diseases from spreading or would help spread infectious diseases. Using a few examples from the US and Japan this essay is going to investigate the relationship between nation-state and diseases. In particular, the essay will discuss ways through which nation-state both inhibit and help in the spread of diseases.
Nation-states chose to treat the infectious disease that they encountered in its own relationship. For example, when the polio vaccines, the trivalent inactivated poliovirus vaccine (IPV) and the trivalent oral poliovirus vaccine (OPV) were introduced in 1955 and 1963 respectively, the US embarked on mass immunization campaigns which saw a total eradication of the disease in the country. Before the invention of the vaccine, this extremely infectious and dangerous paralysis-causing disease used to cause approximately 15000 cases of paralysis in the US yearly 1 . Despite being eradicated in the US, cases of polio sneaking back into the country through travelers have been reported with a case happening in 1993. As such, the best strategy which the US has taken to guard itself against polio is by maintaining a high immunity against polio in its population. This has been achieved through routine vaccination coverage, maintenance of high surveillance against the disease while also having high lab capacity which can easily sense new cases and importations 2 .
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Cholera is another disease which was so common in the US in the 1800s but it has since been contained. The spread of the disease has been eradicated by the modernization of the country’s water and sewage systems. Today, cholera cases reported in the country emanates from tourists and the country nationals who travelled to areas with the disease 3 . Another cause of the disease in the country is an outbreak in neighboring countries such as Haiti and the Latin America. Contaminated seafood coming into the country have been another avenue through which Vibrio cholera, the cholera bacteria have gained entry in to the country causing food borne cholera outbreaks. The eradication of these highly infectious diseases is could be a major step towards achieving the goals of global public health; eradication of infectious diseases.
There are various ways in which Nation-States inhibit the spread of disease. However, world’s efforts to control and manage the spread of infectious disease have continually been challenged by microbes’ ability to evolve and adapt or develop resistance against the practices man employ to eradicate them. The diseases present serious health and economic concerns for all nations, developed and developing nations. World health governing bodies and CDC have all come together to come up with ways and frameworks of improving people’s ability recognize, control and prevent known infectious diseases. One way of preventing the spread of diseases is though proper hygiene and sanitation.
One good case example of how to inhibit the spread of disease can be learnt from Japan whose cities by 1700 had a high population exceeding 1million people per city. A very important question has been on how Japan managed to support such huge population and without the modern sewerage or water system in place. The main reason, though by default, which enabled Japan to maintain a higher level of hygiene and probable inhibit the spread of diseases is that an economic value was attached to waste. Japan recycled human waste to manufacture fertilizer which was used in farms to support the expanding population 4 . As such, waste disposal was handled carefully and the prevailing government at the time ensured the same. Proper regulation on waste disposal and economic value attached to waste enabled Japan to prevent the spread of infectious diseases.
Today, the US in conjunction with the CDC and World Health Organization are working towards reducing the risk of spread of infections through several campaigns such maintenance of hand hygiene, mass immunizations, and safe sex amongst others. Other ways involve quick responses to handle an outbreak of rare diseases in separate red zones and provision of well equipped labs which can early detect and cure several diseases. In particular, the World Health Organization has helped inhibit the spread of diseases through its development of cross-sectional, multidisciplinary WHO initiative for Prevention and Control of infections associated with healthcare 5 . These initiatives ensure the use of evidence-based infection control measures taken in health care settings in their response to public health emergencies with the potential to affect several nations.
On the other hand, Nation-States also help in the spread of Disease. There are several factors such as climatic and environmental factors which influence transmission and spread of diseases. Other factors include trade, travel, and conflicts which also help in the spread of diseases across wide geographical areas. During the age of exploration followed by England industrial revolution, many European migrated to the US in search for jobs. With this migration and the resultant population increase in the US, the demand for houses increased with a corresponding decrease in the quality of houses built. As a result, slums cropped up where people lived in cramped and poorly constructed houses with little regard to sanitation and hygiene. With poor and dirty living conditions numerous diseases emerged and by virtue of the high number of people living in close proximity, the spread of infectious diseases was high. Also, through the change of environment and living conditions, new forms of diseases which were deadly emerged hence enhanced the spread of diseases in the US. To reduce such social mixing and increase social distance in response to cases of epidemics within communities or crowded places, mechanisms such as voluntary separation or community restricts can be employed. This strategy is further enhanced by the development of social media and other communication technology which allows members of a family to stay in contact across vast geographical distance.
Today, out of globalization and modernization, new modes of transport have positively allowed people and product to travel across vast spaces and distances in the shortest time possible. However, these new modes of travel have also opened ways to transcontinental movement of diseases and vectors. With globalization people from different countries come together in close contact e.g. in planes where they contract diseases which show very little symptoms until they get back home. In the process, they expose other people destined to different destination causing a multiplier effect in the spread of the infectious diseases and an enormous challenge in containing the outbreak. One example is the West Nile virus in 1999 6 , which was brought to the US by a mosquito travelling on a wheel of a plane. Though globalization has come with several advantages, it has also come with a serious threat of spreading diseases and another challenge of containing the spread once an outbreak at a national or international level has taken place. This calls for strict international travel boarder controls.
In conclusion , infectious diseases have continued present serious health and economic concerns every nation across the world. The fight against infectious diseases still has a long way to go due to the challenge of microbes’ evolution and adaptation to the numerous practices employed to eradicate them. Also, through globalization, people from different backgrounds come together and the chances of spreading of disease or even mutation of new diseases are quite high. However, despite all these challenges, different world nations in conjunction with world health bodies have responded by coming up with various laws and policies to check the spread of infectious diseases. Some of the strategies employed by the nations include enforcement of medical countermeasures such as mass immunization, disease and hygiene surveillance and strict international travel boarder controls. Moreover, the whole world needs to work together and in unison to eradicate some of these infectious diseases. We have eradicated cow and small pox and the world is almost wining in complete eradication of polio. This is evidence that together the world can win against these infectious diseases.
Bibliography
Centre for Disease Control and Prevention. Cholera Elimination in the United States. Nov 7, 2014. Accessed October 29, 2016, http://www.cdc.gov/cholera/usa/index.html
Centre for Disease Control and Prevention. Polio Elimination in the United States. Jun 21, 2016. Accessed October 29, 2016, https://www.cdc.gov/polio/us/index.html
Hanley, Susan. ‘Urban sanitation in preindustrial Japan.’ Journal of interdisciplinary history , 18(1) 1987:1-27
World Health Organization. Infection prevention and control in health care. 2016. Accessed October 29, 2016, http://www.who.int/csr/bioriskreduction/infection_control/en/
Knobler Stacey, Mahmoud Adel, Lemon Stanley & Pray Leslie. ‘ The impact of globalization on infectious disease emergence and control.’ The National Academic Press, 2003. Accessed October 29, 2016, https://www.nap.edu/read/11588/chapter/1
The Kaiser Family Foundation. The U.S. Government and Global Polio Efforts. Jun 10, 2016. Accessed October 29, 2016, http://kff.org/global-health-policy/fact-sheet/the-u-s-government-and-global-polio-efforts
