Chapter 3: Containing Infectious Disease

Dennis Pirages

The biggest threat to human security, when measured by premature deaths and associated physical suffering, is infectious disease. All of the wars of the twentieth century are estimated to have resulted in the deaths of an average of 1.1 million combatants and civilians per year. But at present, communicable diseases are killing fourteen times that number of people annually. Advances in medical research have led health officials to repeatedly claim victory in the campaign against infectious disease; yet over the last three decades, old maladies such as tuberculosis, malaria, and cholera have spread geographically and more than thirty previously unrecognized diseases such as Ebola, HIV, Hantavirus, and SARS have emerged as new threats to human well-being.

Large-scale disease outbreaks occur when something happens to disturb the evolutionary equilibrium that normally exists between people and pathogens. More than one-quarter of the estimated 57 million deaths worldwide in 2002 were due to communicable disease, with a major impact on life expectancy. The “healthy life expectancy” for newborns in Japan, Sweden, and Switzerland was more than 73 years, while it was less than 34 years in poor and disease ravaged countries such as Sierra Leone, Lesotho, Angola, and Zimbabwe.

Scientists, physicians, and health officials are faced with evolving challenges from the microbial world caused by the accelerating pace of globalization. At present, a slow-moving HIV/AIDS virus has killed more than 20 million people, and it is infecting an additional five million people per year. Additionally, there is deep concern among health officials that an influenza virus, perhaps a communicable and lethal variant of the avian flu that has swept through Europe and Asia, could spread rapidly around the world leading to millions of human casualties before an effective vaccine could be developed.