The Rise Of Vaccine-Preventable Infectious Diseases In Yemen

On January 22, 2018, Saudi Arabia announced that $1.5 billion worth of aid would be provided to the people of Yemen. The country vows to expand Yemen’s port capacity in order to allow more fuel, food and medicine to enter into its borders, as well as establishing safe passageways for the movement of aid to humanitarian agencies inside the war-torn nation. This comes at a critical time in Yemen, as the International Committee on the Red Cross (ICRC) reported that last month, approximately 1 million Yemeni citizens have contracted cholera over the last 18 months, and 2,230 people have died of the disease since April. In December, officials at the World Health Organization (WHO) reported that Yemen is also on the brink of a diphtheria outbreak. Despite being effectively eradicated around the world as a result of preventative vaccines and treatment, cholera and diphtheria are now threatening the health and livelihoods of Yemeni people today.

This resurgence of vaccine-preventable infectious disease is occurring during a period of intense conflict in Yemen. As the poorest country in the Middle East, Yemen has experienced a relentless crisis since early 2011. A revolution formed against then-President Ali Abdullah Saleh, dividing the country’s citizens into two main factions: those who remain loyal to Saleh, and those who rebel against his leadership. The Yemen crisis has also represented a proxy war between Saudi Arabia and Iran. Fearing that the Iranian-backed rebels were encroaching on its territory, Saudi Arabia desired to thwart their efforts to protect its own borders. As a result, the nation began to lend its support to the Saleh loyalists’ efforts against rebel fighters.

According to the United Nations, Yemen is currently facing what has been described as the “worst humanitarian crisis in the world.” It is reported that over 10,000 people have been killed, 50,000 wounded, and 2 million displaced since March of 2015. Save the Children has also estimated that 50,000 children died in Yemen throughout the year of 2017, and more than 22 million people are in serious need of humanitarian assistance. Yemen traditionally imports 90 percent of its essential foods, fuel, and medicine in order to sustain its 27 million people. However, the crisis has plunged Yemen into a state of complete instability.

In November 2017, Saudi Arabia closed all of Yemen’s air, land, and sea ports after intercepting a ballistic missile launched by Houthis near the capital. Saudi Arabia’s Crown Prince, Mohammed bin Salman accused Iran of actively supplying weapons to the rebel forces, and declared their actions as “direct military aggression.” While Saudi Arabia blocked off the ports in an attempt to prevent smuggling of Iranian weapons to rebel forces, and did so without consideration for how the Yemeni people would survive without access to humanitarian aid. Ultimately due to this blockade, Saudi Arabia has retaliated against Iran at the expense of the Yemeni people.

The lack of humanitarian aid and basic life necessities in Yemen has made people highly susceptible to contracting the rampant infectious diseases. Malnutrition, inadequate healthcare, unsafe drinking water, and poor sanitation conditions are merely a few factors that can lead to a compromised immune system. The World Food Program reports that over 400,000 children are currently suffering from acute malnutrition, and the United Nations estimates that 17.8 million people are “food insecure” in Yemen, meaning that they do not know where they will get their next meal. The United Nations also reports that 16.4 million people do not have access to adequate health services and the ICRC claims that 15.7 million people lack access to safe drinking water and sanitation services. These staggering numbers provide perspective on just how many people are being negatively impacted by the Saudi blockade.

Cholera is an infectious disease caused by the Vibrio cholera bacterium. It reportedly dates back as far as the Hippocrates era in the Indian peninsula. Although the disease has caused seven pandemics since the early eighteen hundreds, it has become effectively eradicated as a result of the invention and widespread use of preventative vaccinations. The cholera vaccine consists of a killed whole-cell Vibrio cholerae, which makes the vaccine incredibly effective. However, the Yemen crisis has put the country into a state of disorder such that, the vaccine is not being distributed effectively. This consequently leads to cholera is being spread through unsafe water and unsanitary conditions, both of which are prevalent at this time.

Diphtheria is a bacterial infection of the nose and throat caused by the Corynebacterium diphtheriae bacterium. Antibiotics can cure this vaccine-preventable infection; however, if it is not treated properly, diphtheria leads to breathing problems, heart failure, paralysis, and death. According to the WHO, there were nearly 400 cases of suspected diphtheria in Yemen as of late December, resulting in 38 deaths. Unfortunately, most of these deaths occurred in children under the age of 15, who were likely immunocompromised due to malnutrition. Without the ability to import vaccines and medication, Yemen is on the verge of an outbreak of infectious disease that could cost countless lives.

The humanitarian crisis in Yemen has left millions of people in need of assistance and without access to the most basic necessities of daily life. The bloody stalemate between the Saleh loyalists and the Houthis has lead to an ongoing battle in Yemen, one of the poorest country in the Middle East. The Iranian-Saudi influence has exacerbated the problem on the ground, and innocent Yemeni people are consequently suffering the worst impacts. While opening Yemen’s ports is an important step toward reconciling the problem, it is not enough to end this crisis. The lives of these innocent bystanders must be recognized by both sides in this conflict in order to end this stalemate. By opening a peace-building dialogue between the opposing groups, some form of compromise may be possible.