Re: why do we get infections , and why peopel die from it

Dear Maja,

You are absolutely correct that the combination of vaccines, good 
sanitation, personal hygiene, and drugs should be very effective in 
preventing morbidity and mortality from many infectious diseases. There 
are several reasons for this unfortunate situation, some scientific but 
others political and economic. I am most qualified to discuss the first 
of these and will comment briefly on the others.

Vaccines are not yet available for some of the most devastating 
infectious diseases, AIDS being a prime example. Although there has been 
a lot of research in this area, and even some clinical trials of 
candidate vaccines, none have been very promising. HIV, the cause of 
AIDS, is a very crafty virus that can incapacitate the immune system. 
This makes developing a virus vaccine a real challenge.  

Many of the infectious diseases you are thinking about are more of a 
threat in developing rather than industrialized nations. There are some 
vaccines that require, for example, refrigeration to maintain activity 
and/or multiple immunizations for effective immunity. Both of these 
requirements are problematic in the developing world. Consistent 
refrigeration is not always available and there is often no established 
health care system in place so that patients can be followed up for re-
vaccination. Some of these vaccines are expensive and this can also be 
prohibitive. Finally, sanitation may not be optimal.

Cost unfortunately becomes an issue with drugs as well. For example, a 
combination of drugs called “Highly active antiretroviral therapy” 
(HAART) has significantly prolonged the lifespan and quality of life of 
AIDS patients. However these drugs are very expensive. Some effort has 
been made to get them into developing countries where HIV infection is 
rampant, but success has been less than it should be.

Even when there is a cheap and relatively effective vaccine there are 
sometimes political/religious issues that prevent its widespread use. As 
you may know, there is currently a worldwide effort underway to eliminate 
polio. There have been recent problems in parts of Nigeria, where 
vaccination has been suspended because of unfounded fears that polio 
vaccine is contaminated with HIV, cancer causing compounds, or anti-
fertility agents.

So, there are many problems left to solve, only some of which can be 
solved by scientists. I do not want to paint too bleak a picture though, 
because despite all these temporary impediments there has been great 
progress in eliminating the threat of infectious diseases throughout the 
world.