Global Health and the Impact of Colonialism

I recently finished reading Prof. Peter Kennedy’s book ‘The Fatal Sleep’. It tells the story of Human African Trypanosomiasis (African Sleeping Sickness). HAT is one of the WHO’s neglected tropical diseases. The disease is complex, but in the late stages, the disease can reach the central nervous system (CNS) and without treatment is 100% fatal. Fortunately there is a treatment, but the treatment itself has a 5% mortality rate. Such a treatment would never have been accepted, if made today, but the fact is that Melasoprol was invented in 1949 and is the only effective treatment for HAT after it has reached the CNS. Melarsoprol is a pretty nasty drug, it even has to be kept in glass, because it would corrode a plastic container, so it’s no surprise it burns when injected into patients. No alternative drug has been developed for HAT with CNS involvement since 1949. This is due to several reasons, but primarily lack of funding and a lack of interest from big-pharma. The disease only affects certain areas of Africa, and those areas are also predominantly LEDCs (Less Economically Developed Countries). So the potential for profit is almost non-existent. Due to the vast costs of developing a drug, so far, no one from Big-Pharma has tried to develop a cure. This is not only the case for HAT, but for many of the WHO’s neglected tropical diseases. If there’s no potential profit, there’s almost no incentive for businesses to develop drugs.

Interestingly, many of the treatments for these neglected diseases were developed during colonial occupation or shortly after. I do not believe that this is coincidence or purely benevolent. Rather, perhaps people invested in these diseases when there was a greater potential profit. The wealthy people who emigrated to the colonies would be exposed to similar diseases to the local population, and therefore, it is possible that business and nations, chose to invest in these areas more during that time. Colonialism is a very difficult topic as so much harm was caused during these times. However, it would be wrong to say that no good was done at all. Colonialism did see a rise in education and healthcare, although for a long time, these were reserved for the more wealthy migrants, not the local population. One of the core issues with colonialism, is that after these nations gained their independence, they were not supported to develop the good infrastructures and facilities that had been put in place. It is certainly right that people should have their freedom, but when the money was lost to finance these institutions of healthcare, they expectedly began to fall apart. Post-colonialism, healthcare had become unsustainable and unstable in many developing countries.

Fortunately, now philanthropists and governments around the world, are doing their best to invest in healthcare in these areas, without the incentive of profit. But we are lagging behind as we try to catch-up with the post-colonial destruction. The Bill and Melinda Gates Foundation, have done more to improve healthcare in the developing world than any other organisation. We are no closer to the eradication of polio, and possibly even to a cure for HAT. Hopefully, with health, the world will become a more equal place.

 

This article, was a response to Prof. Kennedy’s book, The Fatal Sleep. I understand that people may disagree with the views I have here expressed, and confessedly, I have not thought about it a great deal myself and would gladly explore other thoughts and theories. So if you agree or disagree, feel free to comment below – I’d really appreciate it.

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