A review of THE COMING PLAGUE: NEWLY EMERGING DISEASES IN A WORLD OUT OF BALANCE by Laurie Garrett. Part 2
Introduction
By the time my Uncle Bernard started his medical studies at the University of Chicago in 1932 he had already witnessed the great influenza pandemic of 1918-19. He was seven years old when he counted the funeral hearses that made their way down the streets of Baltimore. Uncle Bernard was introduced to tropical medicine during World War II, when he served in the Army Medical Corps at Guadalcanal and other battlefields in the Pacific. That’s when he learned firsthand about diseases of which he’d heard very little in medical school: malaria, dengue (breakbone fever), and a variety of parasitic diseases.
Something strange was going on in Africa
During the summer of 1976 I had reason reconsider much of my Uncle Bernard’s wisdom. As I tried to make sense of my graduate research project at Stanford University Medical Center, the news seemed overfull of infectious disease stories. The U.S. government was predicting a massive influenza epidemic that some said would surpass that of 1918 – a global horror that would claim over 20 million lives. An American Legion group met in a hotel in Philadelphia and something made 182 of them very sick, killing 29. Something else especially strange was going on in Africa, where, according to garbled press accounts of the day, people were dying from a terrifying new virus.
Will something worse emerge – something that can spread from person to person in the air?
The shock of the AIDS epidemic prompted many more virus experts in the 1980s to ponder the possibility that something new was, indeed, happening. As the epidemic spread from one part of the world to another, scientists asked, “where did this come from? Are there other agents out there? Will something worse emerge – something that can spread from person to person in the air?’
Ill equipped to anticipate or manage new epidemics
By 1988 an impressive group of American scientists, primarily virologists and tropical medicine specialists, had reached the conclusion that it was time to sound the alarm. On May 1, 1989, the scientists gathered in the Hotel Washington and began three days of discussions aimed at providing evidence that the disease-causing microbes of the planet, far from having been defeated, were posing ever-greater threats to humanity. In February 1991 the Institute of Medicine (IOM) convened a special panel with the task of exploring further the questions raised by the 1989 scientific gathering and advising the federal government on two points: the severity of the microbial threats to U.S. citizens and steps that could be taken to improve American disease surveillance and monitoring capabilities. In the fall of 1992 the IOM panel released its report, Emerging Infections: Microbial Threats to Health in the United States, which concluded that the danger of the emergence of infectious diseases in the United States was genuine, and authorities were ill equipped to anticipate or manage new epidemics.
$12 billion annually
After the release of the report, the U.S. Centers for Disease Control and Prevention in Atlanta began a soul-searching process that would, by the spring of 1994, result in a plan for heightened vigilance and rapid response to disease outbreaks. The slow responses to the emergence of HIV in 1981 had allowed the epidemic to expand by 1993 to embrace 1.5 million Americans and cost the federal government more than $12 billion annually in research, drug development, education, and treatment efforts.
Efforts worsened the plight of the average individual in the Third World
By 1990 the world’s major donor institutions would be forced to conclude that modernization efforts seemed only to have worsened the plight of the average individual in the Third World, while enhancing the power, wealth, and corruption of national elites and foreign-owned institutions.
An ambitious global Marshall Plan
In 1992 the United States elected a Vice President who espoused an ambitious global Marshall Plan to protect the environment. Albert Gore warned that nothing short of a massive worldwide shift in human perspective, coupled with elaborate systems of international regulation and economic incentives, would be adequate to ensure that survival of the planet’s ecology. “Those who have a vested interest in the status quo will probably continue to stifle any meaningful change until enough citizens who are concerned about the ecological system are willing to speak out and urge their leaders to bring the earth back into balance.”