How to Win the War For Global Health | Big Think

How to Win the War For Global Health

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Global health expert Laurie Garrett has witnessed the technology used to fight disease all over the world. These are her best ideas for the changes needed to change the world.

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Laurie Garrett :

Laurie Garrett is the Senior Fellow for Global Health, Council on Foreign Relations.

She is a Pulitzer prize-winning science journalist and writer of two bestselling books: "The Coming Plague: Newly Emerging Diseases in a World Out of Balance"(Penguin; 1995), and "Betrayal of Trust: The Collapse of Global Public Health" (Hyperion; 2001).

She was awarded the Pulitzer Prize for Explanatory Journalism in 1996 for a series of works published in Newsday, chronicling the Ebola virus outbreak in Zaire.

Garrett has been honored with two doctorates in humane letters honoris causa, from Weslayan Illinois University and the University of Massachussetts, Lowell.

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TRANSCRIPT:

Topic: The Battle for Global Health.

Laurie Garrett: I think the state of global health is that all the money that has poured in over the last 8 years, which had been a substantial increase over anything previous to that, has paid off.

I'm Laurie Garrett, Senior Fellow for Global Health at the Council on Foreign Relations.

Question: How much progress have we made on global health in the last five years?

Laurie Garrett: A decade ago, it would have been almost inconceivable that Mexico could have tracked down all the various traces of H1N1 in rural parts of that country, and today it was done almost as if it were a matter of routine. That is extraordinary. We still have a long ways to go, but at least the money and the commitment has panned out to help us at this time.

Question: Is the world prepared for a global flu pandemic?

Laurie Garrett: We don't have a global supply of vaccine. We don't have a global supply of Tamiflu adequate to meet the challenge or a distribution system, and then this global solidarity could quickly fall apart, and we would see rich countries getting the tools necessary to treat, and poor countries not, and real rage and anger and retribution actions akin to what Indonesia has been doing for the last three years, refusing to share samples of bird flu, some viruses, on the grounds that only the wealthy world would profit off of them, and the vaccines would never be available to the poor.

Question: What technologies are needed for improved action?

Laurie Garrett: Well for many years, I've argued that the biggest, most important missing piece were rapid diagnostics. Even here in the United States, if you're sick and doctors aren't quite sure what's wrong with you, and they order basic microbiology tests to see if you have staphylococcus or tuberculosis or what have you, for the most part they are ordering tests performed that haven't improved much at all in decades. The technology is pretty much the same darn crap we've been using to determine whether you have strep or staph, since the '60s.

The irony is that if you go to the academic level, or in the biotech industry, you see tool kits being used now, based on DNA, that are extraordinary that do things like diagnose previously unknown organisms, that we don't even know what it might be. Find it, identify it, put it in a class of viruses and tell you that answer in a matter of hours. And yet these tools are not getting put to use in any routine clinical settings, not in the United States, not in poor countries. This is just an absurd problem.

The reason they haven't been in use, in places like the United States, has to do with insurance reimbursement, with how hospitals structure their whole pathology departments. Just stupid stuff that government or good corporate intervention could fix.

In poor countries, it's still about the cost and the specifications of the test. When you hear, for example, that RCDC has developed a so-called rapid screening test for H1N1, well yes and no. It's rapid in that it takes six hours instead of three days, but it has been performed by skilled personnel inside of a laboratory with relatively sterile hygienic conditions and safety precautions for the scientist that perform it. And it would require a scientist.

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