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Out of Order: Out of the Mayan pan
January 2013
SHARING OPTIONS:
Congratulations. If you are reading this commentary, the
Mayans were wrong, and the world did not end on Dec. 21 as foretold in the
records. (I'm more inclined to believe we've misinterpreted the records, but
that's another story.) Yet again, the human race has escaped
apocalypse. Put
the four horses back in their stables.
But before we get too complacent in the narcoleptic
afterglow of way too many turkey leftovers, and in the spirit of the new year,
I think it's important to take a look over our shoulders and see what
might be
coming up behind us.
Over the last couple of months, I have been watching reports
out of the Middle East that don't alarm me, so much as make my skin prickle a
little. Aside from the usual strife in this region, there is a more
insidious
enemy that is making its presence known—a microbial presence that has killed
five people in the region (as of this writing).
While five people don't sound like much (aside from the
personal devastation to their families and
friends), it is the name associated
with this microbial presence that has me wary—SARS—and the location of this
outbreak.
As a Torontonian, I remember reading daily reports about
what the SARS epidemic was doing to my community (I lived
in the Washington,
D.C., area at the time); how it left scars that were not just physical, but
emotional, psychological and economic. Toronto didn't
suffer the worst of the
SARS epidemic, but it was the highest profile city and served in some respects
as a beacon of Western vulnerability to emerging
disease coming from elsewhere.
And therein lays the second component of my tingling Spidey
sense. The SARS that
hit Toronto arrived from Southeast Asia, much like the
bird flu and swine flu before it. Ebola, which luckily (for us) did not spread
to the Western
world, arose from Central Africa.
This new SARS-like microbe, however, is raising its head in
the Middle East, a major economic hub, center of international travel and
frighteningly close to Europe. All this to say that emerging diseases emerge
from anywhere and when global travel is as easy as logging into a website, the
world becomes an increasingly smaller place.
Case in point, the West Nile Virus that routinely makes the
evening news throughout the United States was not named
for the city of Niles,
Ohio. Furthermore, as global economies become more intertwined, Western
capitals can no longer sit back from their imperial
thrones and take an
"us-versus-them" attitude, because morally and economically, they are us.
At the
end of November, The
Lancet published a special
series on zoonoses—pathogens shared by humans
and animal species—that looked not just at the natural history of the microbes,
but also at the
socioeconomic impact of the diseases arising from these
organisms. In a podcast about the series, Princeton University professor of
ecology and evolutionary biology Andy Dobson echoed the
sentiments on global
vulnerability and unity in crisis.
"We're coming out of a period of forgetting about
zoonotic
diseases," Dobson said in the podcast. "We've tended to focus on diseases that
are purely human diseases, and then we're realizing as we
massively develop the
rest of the world, our exposure to zoonotic diseases, diseases we share with
wild animals, has begun to increase."
What happens in Central or South America very much impacts
what happens in Baltimore. Pathogenic events in
Southeast Asia or Central
Africa represent very real threats to San Francisco and Madrid.
Elsewhere in this issue,
I recount a conversation I had with
Jim Tartaglia, Sanofi
Pasteur's vice president and head of North American new
vaccines, on the challenges and opportunities of vaccine development (see "No
vaccine is
an island," page 27), which included lengthy discussions about work
going on in the developing world, whether on HIV, dengue fever, tuberculosis or
hepatitis.
I raised the question of ROI, and Tartaglia was quite blunt.
"The more we do to bolster public health in these countries
bolsters the economies of these countries, and that builds stronger markets
around the
world for everybody," he explained. "There is also the need to share
risk, share investment and share the benefits to be able to effectively develop
vaccines in these areas of the world, especially when thinking of our
shareholders. We are in business."
To flip Tartaglia's sentiment around, we truly cannot share
the benefits until we are ready to share the risks—and more importantly,
when
we are ready to step up and mitigate them. For everyone's sakes, we have to
stay on the ball and be ready to jump in and lend a helping hand at
any moment.
The microbes don't really care who we are or where we live. And we could find
the Mayans were right, just not about how or
when. Back |
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