If people let the government decide what foods they eat and what medicines they take, their bodies will soon be in as a sorry state as the souls who live under tyranny - Thomas Jefferson


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Infectious-disease outbreaks not only have the potential to destabilize societies, they pose a threat to international economies, as well.

What should public-health officials and businesses be doing to prepare?

Physicians Thomas Frieden, the head of the Centers for Disease Control and Prevention, and Susan Desmond-Hellmann, chief executive of the Bill and Melinda Gates Foundation, sat down with Wall Street Journal Assistant Managing Editor Laura Landro to discuss this issue...

MS. LANDRO: I don’t know how many of you have seen the movie “Contagion.” How close are we to a scenario like that? Something that can’t be contained?

DR. FRIEDEN: Every year on average we identify one new pathogen. And every day on average, we at CDC start a new investigation that could detect a new pathogen.

But frankly, pandemic influenza is what worries us most.

Bill Gates has said there are really only two things that could kill 10 million people around the world. Nuclear war and a biological event, either intentional or natural. It has happened before—in 1918 and 1919, 50 million to 100 million people were killed. Even the 1957 influenza pandemic, which most people haven’t heard of, cost 3% of the world’s gross domestic product. Even SARS, a relatively small outbreak, cost about $30 billion. We don’t know when the next one will come, where it will come from or what it will be. But we’re certain there will be a next one.

MS. LANDRO: How does the Gates Foundation see this in terms of the danger to the world? The idea that business will be disrupted, there will be all sorts of social unrest?

DR. DESMOND-HELLMANN: What we learned from Ebola is that there are a couple things that are underutilized and not ready. One is governance. Who makes the call when things happen? The second thing is having the right tools, which is why global health research-and-development is a big focus of our foundation.

And the last thing is, even though the world is worried about something really super scary like in “Contagion,” we all saw last summer how something like Zika, which wasn’t thought to be a big threat, actually is a particular threat for women who can get pregnant because it causes a catastrophic birth defect.

From a business standpoint, everyone in this room probably had young people who were going to travel on business who were concerned about their risk should they or their partner become pregnant. So understanding these new pathogens, understanding what we need to do from a governance standpoint, and having tools, starting with diagnostics so we can spot new pathogens, are a big focus.

MS. LANDRO: What are the components of a global-health security agenda?

DR. FRIEDEN: We have to find things better, stop them faster and prevent them where possible. And for each of those three aspects of global health security, institutions need to be strengthened and tools need [to be developed].

Everyone should have heard about something called the Joint External Evaluation.

If you want to know if a country is ready to deal with an emergency from the health sector, currently there’s no way to really do that. So what we’ve done over the past few years is get a global consensus on an accountable, independent, objective and transparent public rating of all countries that agree to do it.

It holds the country accountable. It also holds the world accountable. If a poor country isn’t ready, we’re all at more risk. Let’s channel our assistance to close those gaps, because a blind spot anywhere is a vulnerability everywhere.

Biggest killer

MS. LANDRO: Dr. Frieden, you did a public-health piece for the New England Journal of Medicine recently in which you said tobacco was still the largest cause of underlying disease in the world.

DR. FRIEDEN: Tobacco use continues to kill millions of people globally—in fact, more than infectious diseases combined. And it can be stopped. If you look at countries and communities that have taken tobacco prevention seriously, they’ve been able to drastically reduce tobacco use.

Mike Bloomberg and his foundation, along with the Gates Foundation, worked to come up with a very concrete set of policies to help countries drive down smoking rates. In New York City, we were able to help 400,000 people quit smoking in just a few years, saving over 100,000 lives and extending life expectancy by three years over just a few years.

DR. DESMOND-HELLMANN: It is a profoundly positive intervention.

The other intervention we’ve invested in is nutrition. Globally, we see both overnutrition and undernutrition and poor nutrition. Very simple things like exclusive breast-feeding for six months, making sure pregnant women have access to good nutrition, understanding micronutrients and what’s needed—these kinds of global health interventions are incredibly cost-effective. That magic time of your first 1,000 days from conception isn’t just important for your stature, it’s important for your cognitive development. These are the kinds of things that emerging countries—and businesses working in those countries—are extremely interested in. Because that is your future workforce and your future consumers.

DR. FRIEDEN: And this is very relevant to health-care costs. A nonsmoker costs drastically less to care for than a smoker. An ex-smoker costs at least $1,000 less to care for each year than a smoker. In the U.S. today, there are 10 million fewer smokers than there were in 2009. And if you think of the payoff, how much higher our health-care costs would be if that weren’t the case, it’s quite substantial.

Source: Laura Landro, What Global Disease Threat Worries Public-Health Officials Most?, The Wall Street Journal, November 21, 2016.

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Last Updated : Saturday, November 23, 2019