The new World Health Report has been issued. Keywords seem to be emerging disease, global public health, and health security. Hopefully some among us will get a chance to read it and comment soon. Here is the summary from the website:
The World Health Report 2007 – A safer future: global public health security in the 21st century marks a turning point in the history of public health, and signals what could be one of the biggest advances in health security in half a century. It shows how the world is at increasing risk of disease outbreaks, epidemics, industrial accidents, natural disasters and other health emergencies which can rapidly become threats to global public health security. The report explains how the revised International Health Regulations (2005), which came into force this year, helps countries to work together to identify risks and act to contain and control them. The regulations are needed because no single country, regardless of capability or wealth, can protect itself from outbreaks and other hazards without the cooperation of others. The report says the prospect of a safer future is within reach – and that this is both a collective aspiration and a mutual responsibility.
Apropos of this, an article in the Times business section yesterday reports on the new attention being given to vaccine development. This is not my area, but it seems like a marked shift from a few years ago — when some of the biosecurity was beginning to emerge — and the cw was that big pharma would never get involved with vaccines. Again, comments from those more knowledgeable most welcome.
Yes, there has been a stunning return to vaccines in recent years. Novartis developed its Vaccine Unit only a few years ago, with influenza vaccines as their “top growth driver”. The company expects that the demand for regular seasonal flu vaccines will grow in the next few years (400 million in 2006 to 600 million in 2011). There has also been a differentiation of products: egg-based flu vaccine (live or killed), enhanced products, cell-culture based vaccine, and pre-pandemic vaccines.
Governments have invested lots of money into the development of so-called pre-pandemic vaccines as well as into the development of cell culture production techniques.
I think this return to vaccines has also to be seen in the context of the problems of the pharmaceutical industry in bringing new products to the market in recent years.
According to the Report, we live in a transformed world of industrialized food, antimicrobial resistance, urbanization, environmental degradation, high mobility, economic interdependence. There is no escape: “Vulnerability is universal,” writes the Director General in her introduction.
The Report orients international health in the direction of preparedness for catastrophic disease events, or other disasters, under the rubric of “Global Public Health Security”:
“Public health security is defined as the activities required, both proactive and reactive, to minimize vulnerability to acute public health events that endanger the collective health of national populations. Global public health security widens this definition to include acute public health events that endanger the collective health of populations living across geographical regions and international borders. As illustrated in this report, global health security, or lack of it, may also have an impact on economic or political stability, trade, tourism, access to goods and services and, if they occur repeatedly, on demographic stability. Global public health security embraces a wide range of complex and daunting issues, from the international stage to the individual household, including the health consequences of human behaviour, weather-related events and infectious diseases, and natural catastrophes and man-made disasters, all of which are discussed in this report.â€
We might ask: what counts – and what does not count – as an “acute public health event”? Here are some of their examples: epidemic-prone diseases, such as yellow fever or SARS; foodborne diseases such as BSE; accidental or deliberate outbreaks – eg. the anthrax letters, but also toxic chemical accidents (petrochemical waste in West Africa), radionuclear accidents (Chernobyl), and environmental disasters (2003 European heat wave).