As the year winds down, STAT reporters are taking a look at the stories they’re most eager to track in 2016. We’ll be running these daily through Dec. 31. Look for more New Year’s predictions here.
Predicting the future in global health is a tough task. Disease outbreaks don’t like to give us warning.
No one prognosticating about the coming year in December 2013 would have envisaged an Ebola epidemic so huge that it would tax the globe’s capacity to respond. And yet, more than 11,000 West Africans died in the ensuing 24 months.
If we’re lucky, the West African Ebola outbreak will be declared done by mid-January. What else does the New Year have in store for us? Here are three key stories to watch:
And they’re off! Candidates jostle to run WHO
Dr. Margaret Chan, the current director-general of the World Health Organization, is set to complete her second and final term on June 30, 2017. That may seem a long way away, but would-be successors are undoubtedly already testing the waters, trying to line up support for a run. The details of the process to replace Chan haven’t yet been announced, but candidates will have to declare their intentions in 2016.
Watch for whether an African candidate can muster the support of a majority of the WHO’s 194 member states. An African has never headed the WHO, and there are people in global health circles who believe it is that continent’s turn.
(For the record, the agency has had three leaders from East Asia and two from Europe, and one apiece from North and South America.)
Whoever wins the top job will take over an institution that has been severely weakened by funding cuts in the wake of the 2008 financial crisis and whose reputation has been slammed because the agency was woefully late to comprehend the scale of the West African Ebola crisis.
A trio of dangerous viruses threaten to spread
These names don’t exactly roll off the tongue, but you can expect to hear about Aedes aegypti and Aedes albopictus in 2016. They’re mosquitoes, but not just any mosquitoes. A. aegypti (sometimes called the yellow fever mosquito) and A. albopictus (the Asian tiger mosquito) are particularly pesty pests.
These mosquitoes can carry several viruses you don’t want to catch: dengue, chikungunya, and Zika viruses.
Dengue and chikungunya make you feel awful. The first is called breakbone fever, because of the bone-deep aches that are its hallmark. The latter’s name means “to become contorted” in Kimakonde, an African language.
Hawaii’s Big Island is currently dealing with a dengue outbreak, and in 2014, Florida saw some local spread of chikungunya.
Zika’s infection is milder — more flu-like. But there are concerns that Zika virus infections during pregnancy may trigger birth defects in the fetus. Brazil, which has had a large Zika outbreak this year, is reporting hundreds of cases of children born with abnormally small heads, a condition called microcephaly. It’s not yet confirmed that the two are linked, but the worry is great enough that the WHO’s regional organization for the Americas issued an alert on Dec. 1.
People travelling in places where mosquitoes are transmitting this trifecta of illness would do well to apply bug repellant liberally.
Polio: the long goodbye
Way back in 1988, the world embarked on an ambitious plan to get rid of polio. Polioviruses only infect one species — humans — so if you can stop transmission of all polio viruses, you can make this crippling disease history.
Smallpox had already been eradicated when the WHO, UNICEF, Rotary International, and the Centers for Disease Control (now Control and Prevention) committed the world to getting rid of polio by the year 2000.
That deadline came and went. So have others. The current goal is to stop polio transmission in 2016. A three-year surveillance period would follow, after which eradication would be certified in 2019.
The situation has never looked this good. Of the three types of polioviruses, only one remains. Africa has gone more than a year without a case, an extraordinary feat. Polio is now endemic (meaning transmission has never been halted) in only two countries, Pakistan and Afghanistan.
There have only been 66 confirmed cases of polio this year, compared to 359 in 2014. There have never been so few polio cases in a year.
But polio is the ultimate whack-a-mole. Many times the prospects have been promising — and then some unexpected and heartbreaking hurdle would arise from thin air.
Can transmission be stopped in 2016? Watch this space.