Tournament of Pandemics - Tuberculosis vs Chikungunia - Part 2

by Isaac Holeman · 2009-03-23 16:35:00 UTC
Topics:

(photo credit: ms. Tea)

This post is part of the ongoing Tournament of Pandemics.

How Chikungunia could be the next pandemic:

The bottom line is that this disease is not usually fatal. Even if global warming and spreading to other species enabled the disease to affect many more people than it currently does, it is extremely unlikely that Chikungunia would become a devastating global pandemic.

How Tuberculosis could be the next pandemic.

TB wins this match, and I think XDR-TB is going to win the tournament of pandemics. TB has a killer social strategy: continue to plague the world's poor and let those with the resources to stop TB think they are safe, meanwhile taking advantage of ineffective treatment to build up resistance to all of our antibiotics. The drugs that treat XDR-TB are very expensive and we do not currently have infrastructure in place to produce them at a scale that would be necessary to treat a pandemic or even a significant epidemic. In the next 2-10 years XDR-TB could easily break out in a region with sluggish health infrastructure and high co-infection with HIV.  If it does, there are not very many reasons to believe that we could stop it before it became a pandemic more devastating than HIV. We need to continue to scale up vaccination (sadly only effective for children right now) and treatment, and slow the development of drug resistance very aggressively if we are to prevent XDR-TB from getting loose and spiraling out of our control.

Perhaps the strongest argument for TB winning the tournament is the observation that tomorrow is already today: How many of the world's poor does this disease need to infect before we call it the next pandemic?

A note about personification: The purpose of describing a disease's "social strategy" is to highlight the fact that diseases adapt to the collective behavior of groups as well as they adapt to the biological defenses of individuals. I am personifying these bugs because I have found that it can help our social brains move past biomedical individualism; when we understand that diseases can target group behavior, then we can critique and change social conditions rather than implicitly blaming individuals by focusing on their risk factors. If the notion of "pathogenic social strategy" helps you understand how social systems pattern the distribution of disease, I hope you will empower others by introducing them to this idea.

Isaac Holeman
PREVIOUS STORY:
Bringing Clean Water One Premium at a Time
NEXT STORY:
A letter from Bettina Siegel, "Pink Slime" petition creator

COMMENTS (0)

    Comment Policy

    · All fields are required to comment.

    [X]

    Comments on Change.org are meant for further exploration and evaluation of the campaign on Change.org. To that end, we welcome constructive comments. However, we reserve the right to delete comments which, as determined solely in our discretion: (1) are offensive, abusive, or off-topic; (2) include content solely intended to personally attack the campaign creator, (3) are designed to subvert or hijack comment threads rather than contribute to them; and/or (4) violate our terms of service and/or privacy policy. Repeat offenders may be permanently removed from the site at our discretion. Please also be advised that: (A) we do not actively curate and/or monitor in any manner whatsoever the comments made on the Change.org platform, and (B) the creator of each campaign on Change.org may remove any comment at her/his/its discretion.