future infectious diseases: recent history shows we can never again be complacent about pathogens

it could be an outbreak of lyme disease, an epidemic of measles or another full-blown global pandemic of influenza or coronavirus. it could be a threat that emerges from the ongoing challenge of  antimicrobial resistance  and the steadily fading power of established antibiotics.

infectious diseases

for most of human history,  infectious diseases have been the leading cause of death , preying mainly on the very young, the old and the most vulnerable among us.

our ability to control infection through  public health measures such as clean water and by developing vaccines, antibiotics, antiviral and antiparasitic agents has changed the way we live — and the way we die.

statistics canada data show that controlling infectious diseases has bought us more than  two decades of extra life , on average. it’s a remarkable achievement, and as a result, diseases of aging —  cancer, cardiovascular illness, chronic ailments, and degenerative neurological diseases such as alzheimer’s  — are now the major causes of death.

the 1970s saw the emergence of  swine flu  and  legionnaire’s disease . the ‘80s brought  hiv/aids , the ’90s witnessed  ebola  and the early 2000s brought the return of  influenza with h1n1 , the  first sars crisis  and  middle east respiratory syndrome (mers) .

during that same period, the pharmaceutical industry  put antibiotic discovery on the back burner , favouring the invention of more profitable treatments for chronic diseases, with their endlessly renewable prescriptions.

without alternatives to penicillin,  antimicrobial resistance has become, like climate change, a slow-moving but inexorably advancing global crisis .

infection control

at the same time, we have been able to benefit from ongoing advancements in fundamental research and development. these advancements have enabled swift response to the current crisis with  multiple vaccine platforms ,  do-it-yourself diagnostic tests  featuring unprecedented sensitivity,  new antiviral drugs and antibodies , and the real-time production of robust evidence and information to keep pace with every turn in the pandemic saga.

information technology has developed with amazing speed, providing the opportunity to disseminate critical information instantly. the  complete genome sequence of sars-cov-2 , for example, was available to researchers across the globe well before the covid-19 virus arrived on their doorsteps.

still, this same technology has also  provided a platform for those who would discredit these scientific advances , oppose public health sector leaders, and even interfere with front-line workers caring for patients.

one health

infectious diseases are almost always what we call  one health  problems. the term refers to the intimate link between human and animal health, agriculture and the environment.

microbes that cause disease often move easily between reservoirs in the environment, animals and people. human encroachment into previously remote regions continues at an alarming rate,  exposing us to previously isolated viruses, bacteria and parasites .

climate change is creating new vectors to spread these diseases , such as ticks and mosquitoes migrating into newly warmed environments.

complacency

public-health   infrastructure , research into  infectious diseases  and the development of new therapies have been neglected for decades.

we must anticipate and  prepare for more outbreaks ,  epidemics  and  pandemics .

we need to establish robust research networks and be able to mobilize them quickly  when new problems emerge .

we need to invest in  biomedical and biomanufacturing infrastructure  that can respond urgently to these challenges enabling us to  rapidly produce new vaccines and drugs .

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future infectious diseases: recent history shows we can never again be complacent about pathogens

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