The power of humankind to create a dangerous virus has been laid bare. Scientists in the Netherlands earlier this month shared that they had generated a deadly contagious influenza virus.
This time it was “ethical” scientists; next time, perhaps not.
Scientists are currently debating whether the work from the Netherlands should have been done and, now that it is done, whether it should be published. Regardless, the ability of scientists to create viruses as virulent as those in the movie “Contagion,” together with the continued surprises from Mother Nature, should make everyone pause and reconsider public health priorities. It is the catastrophic threats that will impact our ability to function as a society and if we are unprepared, the scenarios in “Contagion” are all too realistic.
Our defense against infectious diseases, regardless of their origin, lies in our ability to detect and to control disease quickly. We need competency in our health care system and in our nation’s laboratories to diagnose infectious diseases, and we need capacity in our public health system to control the diseases that arise.
Sadly, many of our defenses against infectious diseases and other public health threats are being weakened. The U.S. health system is decreasing its focus on diagnosis and control of many acute infectious diseases even as diseases emerging in recent decades increase and new ones threaten. Medical students are taught to use antibiotics with little emphasis on diagnosis. Young doctors often have little familiarity with the microbiology laboratory, which is frequently not located at the hospital. Nurses and other staff may not know how to take specimens from patients even if the microbiology tests are ordered. And there are far too few trained microbiologists in our nation’s clinical and public health laboratories.
Public health programs in infectious diseases and other catastrophic threats are also diminished or even disappearing. At the Rollins School of Public Health at Emory University, we have had a robust program of preparedness research that has identified measures to fill gaps and increase efficiency and effectiveness of federal resources in preparedness.
Since its inception in 2008, Emory’s CDC-supported program has brought together students, staff and faculty to help build and sustain preparedness networks that utilize existing community resources during a crisis. Although the program is highly productive, it is being terminated this coming year.
Just a few years after inception, the federal government is eliminating its U.S. programs of preparedness training and research in schools of public health. Interested students are being turned away, staffs are losing their jobs and professors are advised to seek grants in other fields of public health. The federal grants to state and local public health programs of preparedness have also been targeted for drastic cuts. Newly gained capacity and knowledge is in danger of being lost.
As we face severe budget cuts in the years ahead, we need to prune carefully and assure the necessary balance among the various public health priorities. Being prepared for a contagious or other unexpected threat is central to the public health mission and the resources should not be as equally unpredictable as the crises themselves.
Dr. Ruth Berkelman is director of the Center for Public Health Preparedness and Research at Emory University.
About the Author
