Wednesday, April 23, 2003

SARS not
top threat, WHO
leader warns

A UH grad who will head
the global agency says AIDS,
TB and malaria are deadlier

Health talk tomorrow

By Helen Altonn

Severe acute respiratory syndrome is a serious global threat that must be controlled, but older infectious diseases remain bigger immediate problems, says the World Health Organization's next leader, a University of Hawaii graduate.

Dr. Jong-Wook Lee, 58, appointed to a five-year term as WHO's director-general, starting in July, discussed the SARS epidemic and other public health issues at a news conference and later interview after arriving yesterday from Japan.

Lee, who earned a UH master's of public health degree in epidemiology in 1981, said the WHO must increase international efforts to fight "the three big killer diseases" -- HIV-AIDS, tuberculosis and malaria.

Malaria is the leading killer of children under age 5 in Africa and TB kills about 2 million people a year, he said.

In many places, the No. 1 cause of death for HIV-AIDS patients is tuberculosis because of a weakened immune system, he said, stressing that the trend must be stopped.

There is hope to control HIV-AIDS because of drugs, reducing it to a chronic disease in the United States and Western Europe, he said. "People live with it for years."

The challenge is to make the drugs affordable and available and offer more counseling as part of treatment in third world countries, he said.

Lee said the World Health Organization is planning to provide drugs and a health system to treat 3 million HIV-AIDS cases in about two years with $15 billion committed by President Bush and $2 billion in a global fund to fight HIV-AIDS, TB and malaria.

Now, even if drugs were available, Lee said, they couldn't be distributed because developing countries lack personnel, infrastructure and storage facilities. Health systems must be developed, he said.

He said it was believed in the 1970s that all infectious diseases or agents were known and no virus or bacteria was looming. Then came Legionnaires' disease, HIV-AIDS and SARS, all infectious diseases.

"This is a new world," he said.

Antibiotic-resistant bacterial infections also make them increasingly difficult and costly to treat, he pointed out.

Lee focused on the status of deadly SARS at the news conference with state Health Director Chiyome Fukino, state epidemiologist Paul Effler, Deputy Director Linda Rosen and UH epidemiology Professor DeWolfe Miller.

He said WHO can't ignore the importance of the SARS epidemic and Hawaii, with a big travel industry, "can't be too careful about the problem.

"In a globalized world, one cannot be safe in isolation," he said. "You have to really look at the big picture, what's happening in the world."

SARS is a good example, he said, starting in Hong Kong and the Guangdong Province in Southern China. "In no time, it became a problem in many other places."

Lee said Hawaii must be vigilant to maintain its reputation as a good visitor destination and he noticed on arrival at Honolulu Airport from Tokyo that the state has a good surveillance system in place.

U.S. Centers for Disease Control officials met his airplane, talked to passengers and gave them information about SARS.

Globally, thus far, he said there have been 2,500 SARS cases, with 180 deaths. The mortality rate of about 4 percent "isn't very high," he said. "The good news is there are very few secondary cases.

"All epidemiological information on SARS shows global surveillance networks are working," he said.

Effler said Hawaii so far has had five suspect cases, none confirmed, and health officials are investigating two probable cases.

He believes all of the suspect cases will be eliminated after CDC completes blood tests because of minor symptoms. Nationwide, all cases tested by CDC so far have been ruled out as SARS, he said.

"In my mind, the SARS epidemic really indicates the important role WHO can play" because it's a multinational outbreak, he said.

"The ability to put out information in a timely manner with daily briefings and updated numbers has really helped guide our perceptions and our ability to calculate risk," Effler said.


Talk will cover
global health

Dr. Jong-Wook Lee, the World Health Organization's director-general elect, will discuss "WHO in The New Millennium" at 7 p.m. tomorrow in the Keoni Auditorium of the East-West Center's Hawaii Imin International Conference Center.

Lee's talk, open to the public, is part of the University of Hawaii's Distinguished Lecture Series. It's sponsored by the UH-Manoa Department of Microbiology and Department of Public Health Sciences and Epidemiology.

A reception will be held for Lee at 6:30 p.m. in the garden level of the conference center.

Star-Bulletin staff

World Health Organization

E-mail to City Desk


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