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The Epidemic You’ve Never Heard of…

Image Credit: Faces Helped By Charity captured by Sacca using this license.

Author: Brinda Srinivasan

If you were asked to name a global epidemic, what would come to mind first? Most people will likely name COVID, bubonic plague, HIV/AIDS or, going back a bit, a history buff may mention the Spanish flu. It is safe to bet that no one would name the obscure parasitic disease called Giardiasis. But in reality, Giardiasis is more prevalent than and has harmed far more humans than all of the above infectious diseases combined. 

So why is Giardiasis not on the cover of magazines and discussed on daily news? Before we answer that question, let us learn a bit more about this disease. Giardiasis is caused by a dangerous parasite found in drinking water and is prevalent all over the world, including in North America. Of the more than 184 million people that get infected each year, most are poor and lack access to clean drinking water. Symptoms of this sometimes chronic disease include painful stomach cramps, bloating, nausea, watery diarrhea, and sometimes blood in the stool.  The drugs used to treat this disease are old and are becoming ineffective. Even if the disease is diagnosed correctly and the medicines prescribed appropriately, both of which don’t happen often, their bad side effects make patients often discontinue them. 

Alarmingly, globally Giardiasis infection has been reported in around 15% of children less than 2 years of age.  A giardia infection worsens malnutrition in their small bodies, leading to stunted growth and leads to long-term learning disabilities. Realizing the magnitude of this problem, in 2004, the World Health Organization (WHO) added Giardiasis to the “Neglected Diseases Initiative”. Despite this, Giardiasis research remains grossly unfunded by agencies like the WHO, European Commission, US NIH, UK MRC and the Gates Foundation. As a result, drug resistant parasitic infections are emerging, childhood malnutrition is growing, and related diseases like irritable bowel disease are worsening in the developing world. Explaining how bad the funding neglect is, in the 5 years between 2017-21, NIH allocated a meager ~$16 million for Giardiasis research. In comparison, even an infectious disease like Gonorrhea received $272 million. On the contrary, a well-funded disease like lung cancer receives billions of dollars in NIH funding annually.

So, let’s go back to the question on why even well read and socially conscious people have never heard of Giardiasis? Is this because the disease mainly affects the poor? Or is it because people do not die because of Giardiasis, like perhaps is in the case of HIV or COVID? Or is it because there is no advocacy group or special interest that promotes it? The most likely answer is a combination of all the above and because finding drugs for a disease that primarily affects the poor in foreign countries is not exactly profitable. 

So, instead of turning a blind eye and walking away from this problem, you should choose to become a voice for patients who don’t have one, some of them as young as a few months old, and demand action from our leaders. We have seen that a well-funded and coordinated global action has eradicated infectious diseases like polio or smallpox. We can try to build similar awareness, get global public health organizations to pay attention, invest in creating an effective vaccine, and help make Giardiasis a disease that “once” was a terrible scourge on this world.

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