by Joanna

I came across this little tidbit yesterday on my news feed sections that is dedicated to African news. It definitely set off some bells and whistles in my head.

Johannesburg — A new study into the linkages between rain, temperature and cholera shows scientists may be able to predict epidemics in time to save people from the life-threatening disease.

After analysing several years of disease and weather data from cholera-endemic areas of Zanzibar, Tanzania, scientists from the International Vaccine Institute (IVI) in Seoul, Korea, found that if a more than one degree Celsius increase in the average monthly minimum temperature and a 200mm increase in monthly rainfall were recorded in a month, a cholera outbreak was imminent in the following month.

“A mere one degree Celsius increase in the average monthly minimum temperatures was a warning sign that cholera cases were likely to double within four months,” said Mohammad Ali, a senior scientist at IVI, and one of the authors of the study published in the June 2011 issue of the American Journal of Tropical Medicine and Hygiene.

Rita Reyburn, a research associate at IVI and the study’s lead author, said in a statement: “Our work validates the notion that rainfall and temperature increases are often precursors to cholera outbreaks in vulnerable areas.”

Climate experts have predicted that hotter and wetter climate in many cholera-endemic areas could see higher caseloads.

“We are getting very close to developing a reliable forecasting system that would monitor temperatures and rainfall patterns to trigger pre-emptive measures – like mobilizing public health teams or emergency vaccination efforts – to prepare for an outbreak before it arrives,” she added. SOURCE

My first thought was that these scientists were motivated more by the money that can be made by the vaccine industry than by any attempt to save lives. Vaccines are big business, and it is not too far fetched to believe that when the supposed predictive factors listed by scientists are present, a man made cholera epidemic could arise in order to sell more vaccinations to vulnerable populations. In other words, I can very easily believe that when the rainfall and temperature increases, outside forces could introduce cholera into a community and make the claim that the climate changes were the determining factor that caused the outbreak.

The article predictably went on to push vaccines as the solution to the problem posed by cholera in African and Asian communities.

The mounting evidence of links between higher temperatures and cholera incidence should add a sense of urgency to efforts to make cheap cholera vaccines available to poor communities in cholera-endemic countries, he said. Hotez pointed out that there are only two oral vaccines available in the world: Dukoral manufactured in Sweden, which costs US$60-80 (for the required two doses) and the much cheaper and very new alternative Shanchol or mORCVAX, manufactured in India, which costs around $2 An injectable vaccine is manufactured in some countries, but is not recommended by WHO because of its limited efficacy. Shanchol was developed in collaboration with IVI, with funding from the Bill & Melinda Gates Foundation by modifying a vaccine used in Vietnam, said Ali. After trials in Vietnam and India, the vaccine was approved in India in 2009. “We are awaiting approval from WHO to allow its purchase by UN agencies and internationally.” Hotez said the world needed to enhance production of the vaccines to maintain a global stockpile as cholera cases mount. SOURCE
I think one of the most important factors that is largely glossed over in this story is the role of poverty and systemic inequalities that make cholera more prevalent in certain communities. After all, vaccinating people against a disease is far easier than addressing such issues as access to clean drinking water and better sanitation systems.

The real problem here is NOT higher temperature or more inches of rainfall. The solution is NOT vaccinating a population against cholera. The REAL solution is to enhance access to clean water. Why is there this willingness to invest money in producing vaccines rather than in improving sanitation to poor communities in Asia and Africa, where cholera is most common??

See, vaccines can be used for years and years to come. And they make money, so the people who provide the seed money to research vaccines can get a return on their investment for a long time. Improving conditions in poor communities does more for the people of those community, but little for the investor. After all, the bottom line is the almighty dollar, right?

Solving the problem of cholera with vaccines is treating the symptom rather than the disease. The disease is poverty. Treating cholera by pushing vaccines without addressing the problem of gross social inequality is like using a band-aid to treat  a stab wound. It may stem the blood flow for a few minutes, but eventually the patient is going to die.