Diseases Affecting the Privileged Overshadow Those Affecting the Poor

January 10, 2025

News reports on the spread of Human Metapneumovirus (HMPV) are bringing back memories of the initial alerts regarding COVID-19 a few years ago. While HMPV is not typically fatal, its capacity to infect individuals across all demographics has raised significant public concern. However, it must not become part of a recurring pattern in global health responses: illnesses that also affect the privileged often dominate headlines and governmental priorities, overshadowing diseases that primarily affect marginalised groups and less developed countries.

HMPV, a virus that causes respiratory infections resembling common colds, is far less severe compared to COVID-19. Research indicates that while HMPV, first identified in 2001, can cause severe symptoms in young children, the elderly and immunocompromised individuals, its mortality rate is negligible.

However, the media coverage and public fear surrounding it may consume resources and attention, overshadowing ongoing battles against diseases like tuberculosis, malaria and cholera.

For example, tuberculosis claimed about 1.6 million lives in 2021, predominantly in low-income regions, yet lacks the global mobilisation seen during the COVID-19 pandemic. Cholera outbreaks, often fuelled by poor sanitation and lack of clean water, persist in developing nations, leading to thousands of deaths each year. Malaria, primarily concentrated in sub-Saharan Africa, accounts for hundreds of thousands of deaths annually, mostly among children under five.

These illnesses, disproportionately affecting impoverished communities in developing nations, kill millions annually but receive less urgency in public health narratives.

Besides, other more common causes of respiratory issues pose serious health risks. A study in July 2024 showed that even small increases in fine particulate matter (PM2.5) could raise the daily death rate. Published in The Lancet Planetary Health, this study analysed data from 2008 to 2019 across 10 Indian cities: Ahmedabad, Bangalore, Chennai, Delhi, Hyderabad, Kolkata, Mumbai, Pune, Shimla, and Varanasi. It found that air pollution contributed to 33,000 deaths annually in these cities.

During the COVID-19 crisis, healthcare resources were diverted to combat the pandemic, causing disruptions in routine immunisation programs and treatment campaigns for diseases like measles and HIV/AIDS. This reallocation not only increased the burden of neglected illnesses but also reflected the systemic bias in prioritising diseases perceived as threats to wealthier populations.

For instance, a 2022 report by UNICEF revealed that global childhood immunisation rates fell to their lowest levels in decades, resulting in surges of measles cases in countries already grappling with fragile healthcare infrastructure.

The recurring prioritisation of “non-discriminatory” illnesses over those that predominantly affect marginalised groups demonstrates a failure to address health inequities effectively. If this pattern continues with illnesses like HMPV, governments risk perpetuating these imbalances.

For example, the prevalence of tuberculosis is closely linked to overcrowded living conditions and limited access to medical treatment, while malaria thrives in areas with poor mosquito control measures. Addressing these root causes requires sustained investment in healthcare infrastructure, sanitation and education, particularly in developing regions.

The logical approach is to view HMPV and similar viruses as manageable concerns rather than crises, thereby reducing unnecessary public panic. Quiet and efficient monitoring, paired with contingency planning, can mitigate risks without compromising resources for diseases disproportionately affecting the poor.

At the same time, global health systems also must prioritise equitable investments in endemic disease management, ensuring that neglected illnesses receive sustained attention and funding. Strengthening healthcare infrastructure in underserved regions and addressing root causes of health disparities are essential steps toward a more just and effective public health system.

Treating HMPV as a non-issue, while quietly preparing for any major developments, would reflect a strategic and balanced approach. At the same time, addressing health inequities must remain central to public health policies, ensuring that the needs of the most vulnerable populations are not overshadowed by the fear of universal illnesses.