Health challenges are becoming more numerous as new infectious diseases such as SARS, West Nile virus, and avian flu emerge. In addition, the accumulation of chemical pollutants in the environment is starting to take a toll. While infectious diseases are fairly well understood, the health effects of many environmental pollutants are not yet known.

Among the leading infectious diseases, malaria claims more than 1 million lives each year, 89 percent of them in Africa. The number of people who suffer from it most of their lives is many times greater. Economist Jeffrey Sachs estimates that reduced worker productivity and other costs associated with malaria are cutting economic growth by a full percentage point in heavily affected countries.

Although diseases such as malaria and cholera exact a heavy toll, there is no recent precedent of a disease affecting as many people as the HIV epidemic does. To find anything similar to such a potentially devastating loss of life, we have to go back to the smallpox decimation of Native American communities in the sixteenth century or to the bubonic plague that took roughly a fourth of Europe’s population during the fourteenth century. HIV is an epidemic of epic proportions that, if not checked soon, could take more lives during this century than were claimed by all the wars of the last century.

Since the human immunodeficiency virus was identified in 1981, it has spread worldwide, leading to the deaths of more than 25 million people. Today 22 million HIV-positive people live in sub-Saharan Africa, but only 2 million or so are being treated with anti-retroviral drugs. Infection rates are climbing. Without effective treatment, the areas of sub-Saharan Africa with the highest infection rates face a staggering loss of life. Countries like Botswana and Zimbabwe could lose more than a fifth of their adult populations within a decade.

The HIV epidemic affects every facet of life and every sector of the economy. The downward spiral in family welfare typically begins when the first adult falls victim to the illness—a development that is doubly disruptive because for each person who is sick and unable to work, another adult must care for that person. Food production per person, already lagging in most countries in sub-Saharan Africa, is now falling fast in some as the number of field workers shrinks.

Education is also affected as the ranks of teachers are decimated by the virus. With students, when one or both parents die, children are forced to stay home simply because there is not enough money to buy books and to pay school fees. The epidemic is leaving millions of orphans in its wake. The effects on health care are equally devastating. In many hospitals in eastern and southern Africa, a majority of the beds are now occupied by AIDS victims, leaving less space for those with other illnesses. With health care systems now unable to provide even basic care, the toll of traditional disease is also rising. Life expectancy is dropping not only because of AIDS, but also because of the deterioration in overall health care associated with it.

The HIV epidemic in Africa is now a development problem, threatening not only to undermine future progress but also to eliminate past gains. It threatens food security, undermines the educational system, and dries up foreign investment. Stephen Lewis, when he was the U.N. Special Envoy for HIV/AIDS in Africa, said that the epidemic can be curbed and the infection trends can be reversed, but it will take help from the international community. The failure to fully fund the Global Fund to Fight AIDS, Tuberculosis and Malaria, he said, is “mass murder by complacency.”

While the HIV epidemic is concentrated in Africa, air and water pollutants are damaging the health of people everywhere. A joint study by the University of California and the Boston Medical Center shows that some 200 human diseases, ranging from cerebral palsy to testicular atrophy, are linked to pollutants. Other diseases that can be caused by pollutants include an astounding 37 forms of cancer plus heart disease, kidney disease, high blood pressure, diabetes, dermatitis, bronchitis, hyperactivity, deafness, sperm damage, and Alzheimer’s and Parkinson’s diseases.

Nowhere is pollution damaging human health more than in China, where deaths from cancer have now eclipsed those from heart ailments and cerebrovascular disease. A Ministry of Health survey of 30 cities and 78 counties that was released in 2007 reveals a rising tide of cancer. Populations of some “cancer villages” are being decimated by the disease.

Pan Yue, vice minister of China’s Environmental Protection Administration, believes his country “is dangerously near a crisis point.” The reason, he believes, is that Marxism has given way to “an unrestrained pursuit of material gain devoid of morality. Traditional Chinese culture with its emphasis on harmony between human beings and nature,” he says, “was thrown aside.”

The new reality is that each year China grows richer and sicker. Although there are frequent pronouncements urging steps to reduce pollution, these official statements are largely ignored. There is not yet a real commitment in the Chinese government to control pollution. China’s Environmental Protection Administration has fewer than 300 employees, all located in Beijing. The U.S. Environmental Protection Agency (EPA), in contrast, has 17,000 employees, most of whom work in regional offices around the country where they can observe and monitor pollution at the local level.

Yet the United States is also still feeling the effects of pollution. In July 2005 the Environmental Working Group, in collaboration with Commonweal, released an analysis of umbilical cord blood from 10 randomly selected newborns in U.S. hospitals. They found a total of 287 chemicals in these tests. “Of the 287 chemicals we detected...we know that 180 cause cancer in humans or animals, 217 are toxic to the brain and nervous system, and 208 cause birth defects or abnormal development in animal tests.”

The World Health Organization reports an estimated 3 million deaths worldwide each year from air pollutants—three times the number of traffic fatalities. In the United States, air pollution each year claims 70,000 lives, compared with the country’s 45,000 traffic deaths.

A U.K. research team reports a surprising rise in Alzheimer’s and Parkinson’s diseases, and in motor neuron disease generally, in 10 industrial countries—6 in Europe plus the United States, Japan, Canada, and Australia. Over an 18-year period, death rates from these diseases, mainly Alzheimer’s, more than tripled for men and nearly doubled for women. This increase in dementia is likely linked to a rise in the concentration of pesticides, industrial effluents, car exhaust, and other pollutants in the environment. A 2006 study by the Harvard School of Public Health found that long-term low-level exposure to pesticides raised the risk of developing Parkinson’s disease by 70 percent.

Scientists are becoming increasingly concerned about the various effects of mercury, a potent neurotoxin, which now permeates the environment in virtually all countries with coal-burning power plants. In 2006, 48 of the 50 states in the United States (all but Alaska and Wyoming) issued a total of 3,080 fish advisories warning against eating fish from local lakes and streams because of their mercury content. EPA research indicates that one out of every six women of childbearing age in the United States has enough mercury in her blood to harm a developing fetus. This means that 630,000 of the 4 million babies born in the country each year may face neurological damage from mercury exposure before birth.

No one knows exactly how many chemicals are manufactured today, but with the advent of synthetic chemicals the number of chemicals in use has climbed to over 100,000. A random blood test of Americans will show measurable amounts of easily 200 chemicals that did not exist a century ago. Most of these new chemicals have not been tested for toxicity. Those that are known to be toxic are included in the Toxics Release Inventory (TRI), a list of nearly 650 chemicals whose discharge by industry into the environment must be reported to the EPA. Since the TRI was inaugurated in 1988, reported toxic chemical emissions have declined dramatically. But with 700 new chemicals entering the economy each year, it is clear that this program is inadequate in protecting the public from toxics in the United States.

Adapted from Chapter 6, “Early Signs of Decline,” in Lester R. Brown, Plan B 3.0: Mobilizing to Save Civilization (New York: W.W. Norton & Company, 2008), available for free downloading and purchase at www.earth-policy.org/books/pb3.