Pandemics Essay ⋆ Essays on Controversial Topics ⋆ EssayEmpire

A pandemic is the spread of a highly infectious disease across a large area, such as a continent or worldwide. In the World Health Organization (WHO) definition, the microbial agent that causes a pandemic must be a new one, never before found in human beings, and spread easily and comfortably among humans. SARS (severe acute respiratory syndrome) and avian flu are among the most recent examples. Concern about these diseases has resulted in intense debates within the scientific community and various nation-states, as well as within international organizations such as WHO and in the media.

WHO first identified the SARS microbe—the coronavirus—as a virus never before seen in humans in March 2003. SARS posed an immediate threat because the virus spread rapidly, either by droplets or by direct and indirect contact. The fear was that, at a time when people and things traveled from one point of the globe to another at an almost dizzying pace, and large numbers of people with no respiratory protection came into close contact with each other, the virus would in no time enter and thrive in new hosts. The medico-scientific community immediately suggested a threefold preventive strategy: detection of cases, their isolation, and identification of close contacts. Similarly, avian flu, despite its insignificant risk to travelers, prompted a global plan, whereby an international consortium of countries and agencies like WHO would monitor the possibilities of an influenza outbreak propagated by infected birds. The rationale underlying these programs is that in an age when globalization encourages widespread travel, any infectious disease can in no time become a pandemic.

Further compounding that concern are the limitations of available drugs and vaccinations. The last three influenza pandemics—the Spanish flu of1917-18, the Asian flu of 1957-58, and the Hong Kong flu of 1968-69—confirmed that newer and more formidable strains of the flu virus can emerge for which no vaccination may be immediately available. Further, the extensive reliance on antibiotics has been waning, because a condition called antimicrobial resistance (AMR) looms large on the horizon. AMR constitutes the biggest global health crisis according to many health experts. For example, evidence exists of resistance to crucial antiretroviral drugs, the “weapon” of choice in the battle against HIV/AIDS. Production of bulk and generic antiretroviral drugs and their common use have created a possibility that antiretroviral resistance might become a global phenomenon. For example, tuberculosis (TB) has resurfaced with a vengeance in recent years, both in the developing and in the developed world, including the United States. Approximately 1.5 million people die annually from TB, and 1 to 2 percent of them are dying from the multi-drug resistant strains.

Diseases like SARS and avian flu have led many scholars to argue that in order to explain the emergence of these new ailments, there is a need to critically study the new, neoliberal world order. Economic processes like globalization can serve as powerful forces exacerbating economic, political, and social inequalities that can quickly convert an infectious disease into a destructive pandemic form. Global inequalities created through an aggressive market order in turn contribute to major disparities in health resources. Excessive foreign debt, negative economic growth, and increasing levels of foreign aid have impoverished the social welfare structures of many developing countries. The debt repayment burden and a concern to integrate with the global economy further impoverished the social welfare programs in these poor countries.

Globalization has resulted in a number of processes that have led certain low-income countries to spiral into the worst nightmares of global pandemics like AIDS. For example, accompanying the steady economic and political deterioration of rural Haiti is one of the worst epidemics of HIV/AIDS. While not a cause and effect, behind the deepening AIDS crisis lie poverty, inequality, and political disturbances. Intense population pressures (Haiti is one of the most densely populated nations in the world), deepening economic catastrophe (through the decline of agricultural land and production), and “structural violence” against poor Haitian women have pushed the AIDS crisis in Haiti truly beyond control.

Ebola, Lassa fever, Legionnaires’ disease, and toxic shock syndrome are more than freak occurrences of disease caused by novel bacteria and viruses. On the contrary, the mutation of new viruses and bacteria become possible because of errant human activities. The global order can go awry epidemiologically when the trio of poverty, war, and drugs contribute to the depletion of valuable resources that can protect people from epidemics.

The realization that any infectious disease, if formidable enough, can quickly become a pandemic in turn emphasized the importance of another crucial issue: restoration of public health services decimated by war, poverty, or deteriorating infrastructure. While medical technologies may advance future medical research, numerous scholars and activists argue that, beyond a certain threshold, medical technologies and drugs can hardly save the global human populations from threats like avian flu or Ebola. Therefore, public health emerges as a vital element.

According to some, public health is at a crossroads—split between a narrow focus on individual health and a broad agenda on major health problems of human populations. Unfortunately, public health has been eroding in many rich and poor nations. Epidemiology and public health must have a strong alliance with public policy. Public health movements should be rooted within communities, and responsible international organizations should practice a form of global communitarianism. Pandemics, therefore, cannot be treated as simple epidemiological issues that can be tackled only by developing better drugs and vaccinations; they require a new vision of health in which development of new drugs and vaccinations, social concerns, and public health are intrinsic elements of a war of strategies to contain their widespread impact.

Bibliography:

Beaglehole, Robert and Ruth Bonita. 2004. Public Health at the Crossroads: Achievements and Prospects. 2nd ed. Cambridge, England: Cambridge University Press.
Farmer, Phil. 2001. Infections and Inequalities: The Modern Plagues. Berkeley, CA: University of California Press.
Gandy, Matthew and Alimuddin Zumla. 2003. The Return of the White Plague: Global Poverty and the “New” Tuberculosis. London: Verso.
Garrett, Laurie. 1994. The Coming Plague: Newly Emerging Diseases in a World Out of Balance. New York: Farrar, Straus & Giroux.
Garrett, Laurie. 2000. Betrayal of Trust: The Collapse of Global Public Health. New York: Hyperion.
Reichman, Lee B. and Janice Hopkins Tanne. 2002. Timebomb: The Global Epidemic of Multi-Drug Resistant Tuberculosis. New York: McGraw-Hill.

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