Plagues: A Continuous Threat 57 million premature deaths per year 15 (26%) million deaths due to infectious and parasitic diseases per year Every 3 seconds 1 death 1 Jumbo-Jet crash every 20 min H5N1 H7N7 Anthrax Ebola BSE TB, HIV Smallpox SARS FMD

Perceived and Real Killers Lost Anthrax SARS TB / HIV Deaths Anthrax attacks in the aftermath of 9/11: 5 China: 687 World: 774 (Date: 26/9/2003) > 500/h > 12 000/ Day > 4.5 million/ Year Infections Anthrax attacks in the aftermath of 9/11: 22 China: 7438 World: 8098 > 30 000/ Day SARS TBC, HIV Anthrax

The TB and HIV/AIDS epidemic: The example of South Africa People living with HIV: 5 million People living with active TB: 2.5 million (total cases: 556/100 000) Newly diagnosed TB: 1 million (new cases: 226/100 000) Percent TB cases with HIV: 60 % Percent MDR-TB: 1.5 % HIV co-infection increases risk of active TB >30-fold

Amount of money spent on pets in one of the larger EU member states: more than the amount needed to prevent half of the death cases caused by AIDS, TB, Malaria and basic childhood diseases in developing countries

The Big Three At least 20 million children have lost one or both parents to AIDS or TB in the last 10 years. Since 1945, 150 million estimated deaths occurred from AIDS, TB and Malaria

Plagues: A Continuous Threat The global village 1.4 billion airplane passengers per annum 500 million border-crossings per annum  Seclusion impossible

Plagues: A Continuous Threat Microbes do not respect passport controls Integration is better than exclusion

The 10/90 gap Less than 10 % of global health research funding is targeted at health problems of greatest concern to people in developing countries which account for 90 % of the global disease burden 10 % 90 % funding burden

Making a difference: preventing 8 million deaths a year by 2010 … through an annual investment of $66 billion by the year 2007 At any one time hundreds of millions of people – mainly in developing countries – are sick…. Only a handful of diseases… are responsible for most of the world’s health deficits: HIV/AIDS; malaria; TB – diseases that kill mothers and their infants; tobacco-related; childhood diseases… Most deaths and disabilities can be prevented …by taking essential interventions to scale and making them available worldwide, 8 million lives could be saved each year by 2010… A scaled-up response will require…strong commitment by governments to specific actions for reducing health inequality and inequity together with broad support from the international community… Investing in Health (Jeffrey Sachs et al.)

Call for an increase in research and development $1.5 billion per year … for research and development of new vaccines and drugs $1.5 billion per year … to support basic scientific research in health… and long-term research capacity in developing countries Increased outlays for operational research Expanded availability of scientific information Expanded availability of scientific information on the internet Modification of the orphan drug legislation Pre-commitments to purchase … vaccines for HIV/AIDS, TB, and malaria as market-based incentive Investing in Health (Jeffrey Sachs et al.)

Making a difference: preventing 8 million deaths a year by 2010 … through an annual investment of $66 billion by the year 2007 … and generating at least $360 billion annually by 2015-2020 303 million DALY’s worth around $180 billion in direct economic benefits…and another $180 billion from indirect economic benefits Investing in Health (Jeffrey Sachs et al.)

Scientists have a contract with society

Plagues: A Continuous Threat Just imagine: If AIDS occurred 10 years earlier: Premature call-off of small pox vaccination Small pox problem unresolved  We cannot afford to hesitate

The Yin and Yang of Vaccine Development

Plagues: A Continuous Threat Incentives for vaccine industry: Tax reduction for vaccine production Secured future markets in developing countries Tiered price system Reduced interest rates or debt release by the World Bank for specific health issues

– but also for what we do not do” “We are responsible for what we do – but also for what we do not do” Voltaire

The clock of infections is ticking we just do not know what time it is