Germs and the Global Market
Can the global marketplace be best for our health?
July 12, 2004
According to the World Health Organization, the SARS epidemic of 2003 cost the global economy at least $30 billion.
That was because of delayed tourism, reduced consumer spending — and disruptions in international trade and investment. That figure doesn’t begin to cover the billions of dollars public health officials spent containing the spread of SARS and treating those infected with it.
This enormous bill should remind us that our struggle against deadly microbes is endless. Scourges that have plagued human beings since the ancients still threaten to unleash themselves.
New maladies are brewing that have yet to make their appearance in the headlines. Lethal germs employed as weapons of warfare and terrorism have again emerged as a worldwide menace.
Regardless of their mode of attack or cohabitation, microbes exist solely to multiply, thrive and find new hosts. The most egalitarian of living beings, they cross all national boundaries and every social class — attacking without prejudice. Simply put, germs travel.
Doctors and public health officials have long advocated combating contagious diseases around the world primarily on humanitarian grounds. Alas, that noble approach has gotten us only so far.
Despite stunning medical advances, 1,500 people died of an infectious disease in the last hour alone — most often in developing and impoverished nations.
This problem is especially critical today because people and deadly germs can travel anywhere in less than 24 hours — making the health crises of Guandong or South Africa intimately related to people living in New York, London, Sydney, Toronto or Moscow.
Setting humane concerns aside, however, there are compelling financial incentives for attacking this age-old problem.
Indeed, the global market just may be the singular force that protects us all against the deadly spread of epidemic diseases.
Take the SARS epidemic. In late 2002 and early 2003, for more than three months the Chinese government refused to tell their colleagues in other nations about this strange and very catchy illness.
Once SARS spread to Hong Kong, Vietnam, Singapore and Canada, the rest of the developed world hauled out the time-honored mechanism of quarantine against anybody or anything that came from southern Asia.
These costly quarantines were accompanied by stern warnings to the Chinese government that the global community would not tolerate the suppression of such critical health information.
If we were dealing with China of only a few decades ago, international finger pointing or trade restrictions in the form of public health edicts would probably go unnoticed in the governmental halls of Beijing.
But in today’s global marketplace where China wants — and needs — to play a significant role, it simply cannot afford to be secretive about epidemics that are brewing within its borders and threaten to head elsewhere.
A 2004 SARS outbreak was easily contained because of forthright efforts by the Chinese health authorities and their constant communication with colleagues from around the world.
A similar story might be told about the nations of the former USSR with tuberculosis, or Africa with malaria and AIDS. If these countries want to do business with the developed world — and they do — they will have to work as hard on their public health as they do on their business plans.
Greater openness among countries about emerging infectious diseases — and sharing health care resources and medicines — reliably translates into greater returns on investments. But since developed countries are business partners with many nations where epidemics are emerging, they have to help too.
The United Nations recently estimated that if everyone living in a wealthy country sacrificed the price of a movie and a box of popcorn each year, the proceeds would amount to $50 billion.
If that was donated to a global public health fund, we could half the annual cases of AIDS, TB and malaria.
It could additionally reduce the infant-maternal mortality rate by 66% and reduce the number of people in the world who do not have access to clean water or adequate food by 50%.
This plan could save 21,000 lives a year, and the savings are immense — at least $360 billion a year in lost productivity and health care expenses.
Sadly, humanitarian concerns will never be inspiring enough to gather together the resources needed to protect the entire planet from deadly germs.
But we may still have a chance as we finally accept the fact that epidemics cost us all a ton of money and completely disrupt the business of the world when we respond to them after the fact — rather than before.
Take it from a doctor who stays up at night worrying about the next big epidemic: We should not only embrace the global market, we should love it — it just may save our lives.
Director of the Center for the History of Medicine at the University of Michigan Dr. Howard Markel is a professor of pediatrics and communicable diseases and the George E. Wantz Professor of the History of Medicine. He is also the Director of the Center for the History of Medicine at the University of Michigan. He […]