Health

Of bugs and bugbears

April 20, 2012

Africa

April 20, 2012

Africa
Iain Scott

Senior Strategic Analyst, Global Life Sciences Centre

Iain Scott is a lead analyst at Ernst & Young's Global Life Sciences Center, where he manages thought leadership programmes and conducts research across the sector.

In 1995 I was given a book whose cheerful title, The Coming Plague: Newly Emerging Diseases in a World Out of Balance, inspired my friend to inscribe on the flyleaf, "new and wonderful ways to die—happy birthday".

The book, by science journalist Laurie Garrett, was a brilliant capitalisation on the Western world's then terror of microbes: HIV/AIDS, Ebola and Marburg, toxic shock syndrome. According to a reviewer in Foreign Affairs at the time the book was published, "the writing has a distinctly panicky edge, but on balance, after reading this work one begins to think a note of hysteria may be justified."

Now fast-forward to 2011, when I conducted a survey which sought to ascertain what global business executives—not healthcare experts—were thinking about health issues. The first question asked: "What do you see as the biggest health issues facing your country?" One of the most surprising findings of the survey was that right down at the very bottom of the list of respondents' concerns, with a score of just 4%, was "Communicable diseases, eg. HIV/AIDS".

What has happened in the last 15 years to assuage our fear of microbes? The bugs haven't gone away, so why do these survey respondents consider communicable diseases less of a threat to their country's health than traffic accidents (10%)? The answer is in the two top-ranked responses to the question. The bugs haven't gone away, but they have been replaced in the public imagination by two new bugbears: ageing societies (54% of respondents), and non-communicable diseases such as diabetes and cancer (31%).

Journalists love a ticking time-bomb. In 1995 it was HIV/AIDS; in 2012 the two big ones are ageing and diabetes/obesity. Both issues are incendiary, in media terms. A chapter in an IMF report on the financial impact of longevity risk sparks tens of thousands of headlines. Meanwhile, more about the impact of diabetes and obesity—in terms of economic, social and personal health—is revealed every day. The two issues are related—as we live longer, more and more of us are living with at least one chronic condition, such as diabetes.

In its history, the United Nations has only twice passed strong resolutions on specific diseases. The first was HIV/AIDS, and the second was diabetes. Both remain huge problems. In 2009 there were 33.3m people living with HIV, well up on the 1999 figure of 26.2m. But HIV rates are now massively eclipsed by those for diabetes.

The heroes of The Common Plague were the epidemiologists and immunologists of the US Centers for Disease Control, who toiled night and day to beat the bugs. But equally crucial to the success of tackling both HIV and diabetes is whether policymakers are able to implement prevention and health promotion strategies, and involve multiple stakeholders, including industry. The best big ideas for breaking the diabetes curve may not come from a lab, but a conference floor.

Next week, I'll be in Copenhagen to chair the European Diabetes Leadership Forum, a unique event aimed at sparking ideas and strategies along exactly those lines. I hope that in another 15 years we can point to the event as one of the catalysts that helped to turn around the epidemiology of diabetes, and offer a blueprint for tackling other diseases.

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of The Economist Intelligence Unit Limited (EIU) or any other member of The Economist Group. The Economist Group (including the EIU) cannot accept any responsibility or liability for reliance by any person on this article or any of the information, opinions or conclusions set out in the article.

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