To the Editor:
As a global public health professional there are a few key messages that I have carried with me across the globe: health and economic development are inextricably linked: sick people can’t work; too many unwanted pregnancies weaken mothers and their babies; subgrade living conditions lead to ill health, to outbreaks and poverty, and viruses know no borders. Add them all up and you have economic havoc. I have seen this in Africa and Asia, the chaos, the neglect and the arrogance of power. I would never have expected to see the same chaos, neglect and arrogance, in this deadly mix, here at home.
In 1964, Calvin Schwabe, professor at the School of Veterinary Medicine at UC Davis, coined the term ‘One Medicine,’ later to become ‘One Health,’ a global, multisectoral and transdisciplinary approach to optimize health by understanding through basic research the interconnections between people, animals, plants, and their shared environment. One Health is a call to action. It aims to prevent outbreaks, and when unable to do so, to be ready and prepared for an effective response that involves cooperation between countries, sectors and universities.
Over the years the US government has funded several initiatives to help us prepare for the inevitable outbreak. Although multimillion-dollar projects, the basic premise was that the investment would be small compared to the pay off. But the problem of any preventive health investment is that success is invisible, something would not be happening, a non-event.
There was the USAID-funded PREDICT project that supported universities and laboratories around the world to detect, study and understand what viruses are out there that could jump from animals to humans as population pressures encroach on habitats. PREDICT identified about 800 viruses not previously known to science. There was the STOP AI project that focused on preventing and mitigating the effect of an AI epidemic; there was the P&R (Preparedness and Response) project. Probably there were more, but those I was familiar with.
When it became time to renew these projects under the new administration, their utility was judged through an anti-science and America First lens – too much money for something that would, undoubtedly be far from the beds of Americans. Budget cuts was the reason, as the P&R project was shortened and the PREDICT project shuttered.
Many people are now paying the price for these penny-wise and pound-foolish decisions. These projects were designed to help the world be ready to implement a swift and effective global response to the next outbreak. And now it’s here and we were caught off guard.
The combination of an anti-science and America first philosophy, a health system that favors private and curative health over public and preventive health, and employer-based health insurance, has produced a deadly cocktail. The chickens have come home to roost.
Sylvia Vriesendorp
Manchester-by-the-Sea
