9. Communicable diseases

We’ve all just lived through a pandemic. A global, life-changing, system-changing pandemic. Outside of world-wide conflict, it’s hard to think of something other than communicable diseases that have such a direct impact on the global population. Historically, the field of global health emerged from the study of “tropical diseases”—mostly infectious in nature that were of interest to doctors and researchers in the “global north” and were more prevalent in tropical and resource-poor areas (an early basis for colonialism in global health). The HIV epidemic turned a sharp focus on infectious diseases around the globe with efforts to intervene to stop the spread and save lives. So for decades, communicable diseases—especially the “Big 3”: HIV, Malaria, and Tuberculosis—have been a target for large- and small-scale interventions and are heavily represented in international development goals. This is concurrent to the work done to improve illness and death due to respiratory and diarrheal diseases (predominantly affecting children). And there remains a group of uncommon “Neglected Tropical Diseases” that are caused by infectious diseases that, of course, disproportionately affect the poorest communities and are “neglected” in that there has been little meaningful progress in diagnostic, treatment, and control efforts over the years. Overall, there have been major improvements (though far from anything that looks like eradication) in morbidity and mortality due to communicable diseases worldwide.  

This is a very large topic. And I am an infectious disease specialist, so of course I’d love to discuss everyone of these diseases with you in detail! But, more importantly, this module is intended to help you frame the role of communicable diseases within the context of global health—understanding the “Big 3” outside of what board review materials cover or U.S.-based recommendations for diagnosis and treatment. And the COVID pandemic has called more attention to the need to look forward to coming threats. A widely recognized threat with global impact that has emerged as a global health priority is antimicrobial resistance. For students hoping to spend more time in tropical infectious diseases, emerging infectious diseases, and NTDs, additional resources are provided at the end of the module.