Background:Concern intensifying that emerging infectious diseases and global environmental changes that could generate major future human pandemics.Method:A focused literature review was undertaken,partly informed by ...Background:Concern intensifying that emerging infectious diseases and global environmental changes that could generate major future human pandemics.Method:A focused literature review was undertaken,partly informed by a forthcoming report on environment,agriculture and infectious diseases of poverty,facilitated by the Special Programme for Tropical Diseases.Results:More than ten categories of infectious disease emergence exist,but none formally analyse past,current or future burden of disease.Other evidence suggests that the dominant public health concern focuses on two informal groupings.Most important is the perceived threat of newly recognised infections,especially viruses that arise or are newly discovered in developing countries that originate in species exotic to developed countries,such as non-human primates,bats and rodents.These pathogens may be transmitted by insects or bats,or via direct human contact with bushmeat.The second group is new strains of influenza arising from intensively farmed chickens or pigs,or emerging from Asian“wet markets”where several bird species have close contact.Both forms appear justified because of two great pandemics:HIV/AIDS(which appears to have originated from bushmeat hunting in Africa before emerging globally)and Spanish influenza,which killed up to 2.5%of the human population around the end of World War I.Insufficiently appreciated is the contribution of the milieu which appeared to facilitate the high disease burden in these pandemics.Additionally,excess anxiety over emerging infectious diseases diverts attention from issues of greater public health importance,especially:(i)existing(including neglected)infectious diseases and(ii)the changing milieu that is eroding the determinants of immunity and public health,caused by adverse global environmental changes,including climate change and other components of stressed life and civilisation-supporting systems.Conclusions:The focus on novel pathogens and minor forms of anti-microbial resistance in emerging disease literature is unjustified by their burden of disease,actual and potential,and diverts attention from far more important health problems and determinants.There is insufficient understanding of systemic factors that promote pandemics.Adverse global change could generate circumstances conducive to future pandemics with a high burden of disease,arising via anti-microbial and insecticidal resistance,under-nutrition,conflict,and public health breakdown.展开更多
In 2008 the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases(TDR)commissioned ten think-tanks to work on disease-specific and thematic reference groups to identify top resear...In 2008 the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases(TDR)commissioned ten think-tanks to work on disease-specific and thematic reference groups to identify top research priorities that would advance the research agenda on infectious diseases of poverty,thus contributing to improvements in human health.The first of the thematic reference group reports-on environment,agriculture and infectious diseases of poverty-was recently released.In this article we review,from an insider perspective,the strengths and weaknesses of this thematic reference group report and highlight key messages for policy-makers,funders and researchers.展开更多
文摘Background:Concern intensifying that emerging infectious diseases and global environmental changes that could generate major future human pandemics.Method:A focused literature review was undertaken,partly informed by a forthcoming report on environment,agriculture and infectious diseases of poverty,facilitated by the Special Programme for Tropical Diseases.Results:More than ten categories of infectious disease emergence exist,but none formally analyse past,current or future burden of disease.Other evidence suggests that the dominant public health concern focuses on two informal groupings.Most important is the perceived threat of newly recognised infections,especially viruses that arise or are newly discovered in developing countries that originate in species exotic to developed countries,such as non-human primates,bats and rodents.These pathogens may be transmitted by insects or bats,or via direct human contact with bushmeat.The second group is new strains of influenza arising from intensively farmed chickens or pigs,or emerging from Asian“wet markets”where several bird species have close contact.Both forms appear justified because of two great pandemics:HIV/AIDS(which appears to have originated from bushmeat hunting in Africa before emerging globally)and Spanish influenza,which killed up to 2.5%of the human population around the end of World War I.Insufficiently appreciated is the contribution of the milieu which appeared to facilitate the high disease burden in these pandemics.Additionally,excess anxiety over emerging infectious diseases diverts attention from issues of greater public health importance,especially:(i)existing(including neglected)infectious diseases and(ii)the changing milieu that is eroding the determinants of immunity and public health,caused by adverse global environmental changes,including climate change and other components of stressed life and civilisation-supporting systems.Conclusions:The focus on novel pathogens and minor forms of anti-microbial resistance in emerging disease literature is unjustified by their burden of disease,actual and potential,and diverts attention from far more important health problems and determinants.There is insufficient understanding of systemic factors that promote pandemics.Adverse global change could generate circumstances conducive to future pandemics with a high burden of disease,arising via anti-microbial and insecticidal resistance,under-nutrition,conflict,and public health breakdown.
文摘In 2008 the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases(TDR)commissioned ten think-tanks to work on disease-specific and thematic reference groups to identify top research priorities that would advance the research agenda on infectious diseases of poverty,thus contributing to improvements in human health.The first of the thematic reference group reports-on environment,agriculture and infectious diseases of poverty-was recently released.In this article we review,from an insider perspective,the strengths and weaknesses of this thematic reference group report and highlight key messages for policy-makers,funders and researchers.
