THE END OF EPIDEMICS

A veteran global health professional explores the methods for preventing pandemics, an ever present threat to humankind.

Quick, an instructor of medicine at Harvard Medical School and chair of the Global Health Council, begins by assessing the many threats: overpopulation and expanded mobility thanks to travel or as a result of war; economic failings; weather disasters that lead to migrant movements and often end with malnourished masses in unsanitary camps; bioterrorism (it is remarkably easy to make ricin or spread anthrax); global warming, which is creating new environs for mosquitoes and other disease bearers; and factory farming, which is already leading to massive destructions of flocks to control bird flu. As a solution, the author offers his “Power of Seven” precepts: strong national leadership; resilient health care systems; research to promote active prevention and constant readiness; trustworthy communications; scientific innovation; resources and investment; strong networks of citizen activists (see what ACT UP volunteers were able to accomplish in the fight against AIDS). These are all fine approaches, and Quick’s chapters elaborating past failures when one or more of these guidelines was lacking are exemplary, as are his success stories. But are they viable in today’s world? For these approaches to work, there would need to be significant political will, doubtful given the trends toward authoritarian and xenophobic regimes. Perhaps the greater hurdle is the polarization of society and a growing lack of trust. The anti-vaccination believers and the West African communities who killed the medical workers who came to tell them not to touch their Ebola-dead relatives are painful examples of fear and distrust that no amount of reason will reverse. What can work is better communication at a local level, from peers. Another positive Quick points to is the success achieved through broad public-private collaborations, which have increased worldwide vaccination rates and expanded access to AIDS drugs in Africa.

Sobering reading for public health officials and infectious disease students and perhaps inspiration for would-be activists to get busy. For general readers: get your flu shot.