The School of Public Health showcased some of its research when Associate Professor of Epidemiology Mark Lurie and Professor of Behavioral and Social Sciences, Epidemiology, and Psychiatry Matthew Mimiaga presented an overview of their work at a Commencement forum titled “Responding to Existing and Emerging Infectious Diseases: A Public Health Perspective.”Noting that one-third of the world population is now believed to be infected with tuberculosis, Lurie described the changes in our world that are making such diseases far easier to spread widely. As a case study, he showed slides of a “wet market” in China, where various species of live animals are piled up in cages and sold as food. Many of these animals would have no contact with one another in the wild, keeping the spread of disease in check, but in such markets diseases easily flow from one species to the next. SARS is believed to have gotten its start when a bat passed the virus to a civet in just such a market.
Such scenarios did not occur to the surgeon general in 1967, when he issued a report saying we could “close the book” on infectious diseases. Instead, international outbreaks of infectious diseases have been spiking upward since 1990. Lurie listed the reasons: (1) a world population that has swelled to 7.4 billion, with most growth occurring in less developed countries; (2) an increased number of people in extreme poverty (“Poverty and infectious diseases … play well together,” Lurie said); (3) a lack of access to clean water and adequate sanitation; and (4) a rapidly urbanizing population, as the number of megacities continues to grow across the world.
A fifth reason is how easy international travel has become, making it easy not just for infected people to infect others in more than one country, but for infected animals and products to be shipped anywhere. Add industrial meat production and climate change, Lurie said, and the future for preventing new outbreaks looks decidedly grim.
Mimiaga, who works on AIDS, had a slightly more hopeful presentation. Rates of HIV infection have been generally declining, but certain populations—intravenous drug users, young men who have sex with men, especially young male sex workers—remain in crisis.