chapter 4 - DRK

Strictly under embargo until Wednesday 22 September at 00:01 GMT (02:01 Geneva time)Getting public healthinformation to allurban dwellers,including those inremote or informalsettlements, is essentialto stop the spreadof disease. Here aMalagasy Red CrossSociety volunteer tellsinhabitants of thecapital, Antananarivo,about a vaccinationcampaign for children.© BenoitMatsha-Carpentier/IFRCNew research suggests that HIV may have been around in central Africa for far longerthan was initially suspected. It was possibly only with the growth of urban centres, suchas Kinshasa, the capital of the Democratic Republic of the Congo, that the disease tookroot and then picked up the momentum to spread quickly around the world. In mostparts of the world, HIV / AIDS is a predominantly urban phenomenon. UNAIDS, theUN’s Joint Programme on HIV / AIDS, estimates that, on average, HIV is 1.7 timesmore prevalent in urban than in rural areas. This is largely explained by the fact thatmany of the risk factors, such as injecting drug use, are also more common in cities. Sexworkers or men who have sex with other men, two other high-risk groups, are also morenumerous in cities, if only because of the higher population density. But even in sub-Saharan Africa, where HIV is transmitted principally through unprotected heterosexualsex, research shows that urban women are more likely to be infected than rural women.New diseases can emerge by jumping the species barrier from animals to humans.This was certainly the case in one of the two diseases that have most alarmed internationalhealth officials in recent years – the H5N1 flu virus, more commonly knownas ‘bird flu’ or ‘avian flu’, which is believed to have originated in wild fowl. It was alsoprobably true of the other, SARS (severe acute respiratory syndrome). Both diseasesdemonstrated how dense, urban living conditions provide the ideal breeding groundfor new viruses.102