Most people deny, ignore, or are oblivious to the consequences of the synergistic effect of global warming, population growth, global population aging, obesity, substance abuse, sexually transmitted diseases, hepatitis, tuberculosis, malaria, antibiotic-resistant bacteria, and the impending shortage of skilled caregivers.  Therefore, they go about their tasks and aspirations; unaware that we are being permeated and overtaken by plagues whose outcome is disaster.

 Global warming will cause dramatic climate changes that will cause droughts, floods and increase the spread of disease.  Population growth will compound this forthcoming dilemma.

 With global population aging alone, we will have an imminent worldwide epidemic. Global population aging will increase beyond the ability of medicine; it will bring about a shortage of trained doctors, nurses and hospital facilities.  America’s older population will be about 70 million by 2030.  Obesity, heart disease, cancer, stroke, Alzheimer’s disease, and diabetes are the big killers.  By the year 2025, Alzheimer’s will have crippled more than 22 million Americans and over 22 million Americans will have developed diabetes.  Diabetes is a leading cause of blindness, kidney failure, amputations, and dramatically raises the risk of heart attacks.  The effect of global population aging on the nation’s health care costs will be overwhelming.

 Research shows that the number of overweight people around the world has climbed to 1.1 billion.  Obesity contributes to many diseases including: heart disease, stroke, diabetes, gallbladder disease, osteoarthritis, respiratory problems, and certain cancers.  It also raises the stress on joints, often causing injury and pain.  Obesity is no longer simply a medical problem—but an epidemic that threatens global well-being.

 In the United States 61 percent of all adults are overweight.  It’s estimated that obesity-related diseases cost Americans nearly 100 billion dollars annually (and climbing). 

 As of September 2000, nearly half of all Americans suffer from at least one chronic disease.  The nation is unprepared to cope with the growing burden of chronic diseases, infectious diseases, and sexually transmitted diseases.

 The total economic cost of tobacco, alcohol and other drug abuse on the U.S. economy exceeds $238 billion per year.  In addition, about $140 billion dollars is spent annually treating conditions and complications related to tobacco, alcohol, and other drug abuse.  Substance abuse disorders severely affect the non-abusing population as well.

 The United States has one of the highest rates of sexually transmitted diseases of all industrialized countries in the world.  STDs affect one in four U.S. citizens over a lifetime. As of September 2000, more than 65 million Americans are infected with one or more sexually transmitted diseases.  There are an estimated 15 million new infections annually, a quarter of them among teenagers.  The risks associated with STDs range from sterility—to cancer—to death.  It is just a matter of time before major illnesses reach a critical level.

 An effective way to reveal the future of HIV is to parallel it with genital herpes—another virus with no incubation period.  Overall, genital herpes infections jumped 30% in the United States from 1976 to 1994, with about one in five Americans over 12 years of age having the sexually transmitted infection.  The data gathered suggest that over 45 million Americans are infected with the genital herpes, high-risk behavior is prevalent, and mother-child infection is widespread.  It is estimated that 75% to 90% of all Americans have some form of herpes.

 As of September 2000, AIDS has killed almost 20 million people worldwide and 2.6 million of those deaths were in 1999.  Globally it is estimated that there are over 40 million people infected with HIV.  There were about 5.4 million newly infected people in 1999.

 The percentage of HIV-positive cases turning up at anonymous testing centers in the United States has nearly tripled between 1997 and 1999 to reach 3.7%—a level comparable to some areas of sub-Saharan Africa.  As of September 2000, about 1 million Americans are infected with HIV, and roughly, 40 percent are co-infected with hepatitis C; there are over 44,000 new HIV infections every year, and it is estimated that over half of the cases occur in teens and young adults.

 While the number of new AIDS diagnoses in the United States declined in 1999 due to AIDS drug cocktails, the incidence of HIV and HIV co-infected with hepatitis C continues to increase.

 There are three viruses A, B, and C that are responsible for the vast majority of cases of acute and chronic virus-associated hepatitis.  There is another form identified as autoimmune hepatitis, which is a chronic hepatitis that is caused by a loss of tolerance against liver components in genetically susceptible individuals.  These  major forms of hepatitis attack the liver and can cause liver cell injury.

 Hepatitis A is found in food and water.  Annually about 200,000 Americans and 10 million people worldwide contract hepatitis A.  What is increasing concern now is that people that are already chronically infected with hepatitis B and C face a high risk of dying if they contract hepatitis A.  Different viruses cause all three types of hepatitis.  Infection with one virus type offers no immunity from infection by another.

 Hepatitis B is transmitted by human body fluids such as blood, seminal fluid, vaginal secretions, breast milk, tears, saliva, and open sores.  Its methods of transmission include mother to baby, during sexual contact, deep kissing, and through the use of improper injection techniques.  HBV is 100 times more infectious than HIV.

 HBV is preventable with a vaccine.  Nevertheless, more than two billion individuals alive today have been infected at some time in their lives with HBV, and approximately 350 million are chronically infected carriers of this virus.  HBV is one of the most common human pathogens, and it is the most prevalent chronic virus infection worldwide.  An estimated 140,000 Americans are infected each year with hepatitis B.  Approximately one to one and a quarter million Americans are chronically infected and are considered to be carriers of the hepatitis B virus.

 Carriers of HBV are at high risk of serious illness and death from cirrhosis of the liver and primary liver cancer, diseases that kill more than one million carriers per year.  In addition, these carriers constitute a reservoir of infected individuals who perpetuate the infection from generation to generation.  A carrier is infectious and can transmit hepatitis B even though he/she has no signs or symptoms.

 As of September 2000, it is estimated that 5 million Americans (some estimates go as high as 15 million) are infected with hepatitis C; that there are up to 230,000 new hepatitis C infections in the U.S. every year.  About 8,000 to 10,000 Americans die of HCV annually, and the toll is expected to triple in the next decade or two.

 It is estimated that globally there are over 200 million people chronically infected with hepatitis C, and this large reservoir of infected persons constitutes a daunting source of potential new infections.  HCV infection is the most common type of chronic viral hepatitis in the developed world.  People who are already infected with HCV can get re-infected with different sub-strains of HCV.  Over the next 10-20 years, chronic hepatitis B and C will become a major burden on the health care system as patients who are currently asymptomatic with relatively mild disease progress to end-stage liver disease.

 If you have had a blood transfusion before 1992, a tattoo or body piercing; if you have shared a straw used for inhaling drugs, used IV drugs, been exposed to blood, had sex with anyone at risk, or deeply kissed anyone who could be infected you should be tested for hepatitis B and C.  (Sharing personal care items such as razors, toothbrushes, pierced earrings, fingernail files, and clippers can put you a risk of contracting HBV and HCV.)

 After almost forty years of decline, tuberculosis is again on the upswing.  According to the World Health Organization (WHO) nearly 2 billion people or one third of the world’s population is currently infected with the TB bacillus.  Someone in the world is newly infected with TB every second.

 Tuberculosis is an increasing and major worldwide problem, especially now that many immune weakening diseases and circumstances facilitate active TB.  HIV/AIDS, hepatitis, diabetes, old age, homelessness, malnutrition, heavy smoking, and drug or alcohol abuse (to name but a few factors) weaken the immune system, placing people at higher risk to get active TB.  Globally, there are an estimated 8 million cases and 2 million deaths from tuberculosis every year.  TB is the leading cause of death from a single infectious agent in adults worldwide.

 It is estimated that nearly 1 billion people will become infected with tuberculosis, 200 million will become sick, and 70 million will die worldwide between now and 2020.  These figures do not take into consideration that the drugs used to fight TB are harmful to the liver, which affects millions of people who are co-infected with chronic hepatitis.  Furthermore, these figures do not reflect the onset of MDR TB (multi-drug resistant tuberculosis).  MDR TB is a very dangerous form of tuberculosis.  Some TB germs become resistant to the effects of the drugs used to fight TB.

 The effects of TB and MDR TB will be increasingly common and will intensify with the progression of the other diseases.

 Compounding this imminent medical disaster is that people with HIV/AIDS or weak immune systems are more likely to develop malaria.  Annually over 500 million people (mostly children) become ill with malaria and several million die.  Every 30 seconds, a child somewhere dies of malaria.

 In addition, antibiotic-resistant bacteria is becoming increasingly common, and it will have a quite serious effect on nearly every community. 

 Topping off this disaster is that fewer young people are taking up the nursing profession in the United States.  This will result in an acute shortage of registered nurses in the United States starting in 2010, when today’s nurses start to retire.

 These episodes illustrate the volatility of infectious disease death rates and the unpredictability of disease emergence.

 There is compelling evidence that the aforementioned scenarios will have a profound impact on future rates of infant, child and maternal mortality, life expectancy, and economic growth.  These unprecedented impacts at the macro-level are matched by the intense burden of suffering among individuals and households. These factors are unique in their devastating impact on the social, economic, and demographic underpinnings of development.

 The world’s population was about six billion in 2000.  The way the population is growing; there could 8.9 billion people by the year 2030.  The way the these viruses and medical problems are spreading, many experts agree that if left unattended, the affect on the world’s health care costs will procure a major disaster if the trends continue.

 The full impact of the aforementioned scenarios in terms of related illness, orphaned children, medical expenses overriding their exchangeable value, unproductivity, and mortality, is hard to perceive.