Science To Life

Vaccines, indoor plumbing, antibiotics and a better understanding of geography. These are some of the responses I obtained when I posed the following question to a panel of scientists, journalists, authors and public health experts:

What scientific advancements do you think have made the greatest impact on global health and why?

Their responses, I hope, will initiate and engage conversation about the impact of science on human life. Do you agree, disagree, have anything to add? Your opinions are always welcome.

1. Ruth Levine Ph.D.
Vice President for Programs and Operations, Center for Global Development, Washington DC; Contributing writer, Global Health Policy.

Vaccination
The invention of vaccination by Edward Jenner has to rank close to the top of any list of scientific advances that have benefited health around the world. Vaccination holds this place by virtue of what has already been accomplished, saving many millions of people throughout the world from dying of infectious disease, including small pox, measles, polio and others. Compared to many other interventions in the medical armamentarium, it is a health intervention that can succeed in settings where health systems are relatively weak and continuing contact between families and health care providers is not the norm. National Immunization Days, mop-up campaigns, pulse immunization, integration of immunization into routine health services and other strategies can work to reach children and mothers that may have only rare contact with the formal health system. Compared to many other life-saving interventions, immunization is highly cost-effective (even cost-saving under some circumstances), the demands on the quantity and skill-level of health workers is quite low, and vaccination doesn't require an extensive network of functioning laboratories or other ancillary services. And, because it successfully prevents the spread of infectious disease, the positive impact of immunization extends far beyond the individuals who are vaccinated.

Vaccination also deserves to be recognized for its potential. The current generation of new vaccines against pneumococcal disease, HPV and rotavirus, and the in-development vaccines to prevent malaria and HIV, are absolutely essential to combat the leading causes of death and disability in poor countries. I think we will look back in 25 years and see that immunization programs, combined with other basic public health measures, have contributed the most to reducing illness and death in the developing world.

Ruth Levine is also the co-author of the books, The Health of Women in Latin America and the Caribbean (World Bank, 2001); Millions Saved: Proven Successes in Global Health (CGD, 2004), which has been on the required reading list at more than 33 schools and universities in the US and abroad; and the reports Making Markets for Vaccines: Ideas to Action (CGD, 2005); and When Will We Ever Learn? Improving Lives Through Impact Evaluation (CGD, 2006).

2. Christine Gorman
Health journalist; Author of The Health Media Watch and Global Health Report; Contributor, TIME Magazine.

Indoor plumbing and antibiotics
Too many choices! I guess I'd have to start with indoor plumbing and antibiotics. Cities like New York--where I live--could never have grown to the size they are without effective plumbing and sewage treatment. Good sanitation and clean drinking water are the foundation for a healthy virtuous circle. Another example: in sub-Saharan Africa, student enrollment--especially among girls--goes up if separate latrines and handwashing facilities are provided at school.

As for antibiotics, I shudder to think what life would be like if all pathogenic bacteria became totally resistant to antibiotics. But we may find out if we can't get our problems with methicillin-resistant staph aureus, drug-resistant tuberculosis and other resurgent germs under control.

Christine Gorman spent 22 years at TIME Magazine, in which she wrote hundreds of bylined articles on health and medical topics, including 21 covers. After 22 years she has decided to get more involved in public and global health issues. In August 2007 she will be at Harvard University as a Nieman Foundation Fellow in Global Health Reporting. Christine remains a TIME Contributor.

3. David Zaks
Graduate research assistant, Center for Sustainability and the Global Environment, University of Wisconsin, Madison WI; Contributing Writer, WorldChanging.com

Understanding geography and information technology
While answers pointing to access to medicine, food and education might be obvious, taking a holistic global view, I believe that a better understanding of geography has had a great impact on global health. From John Snow mapping the cholera outbreak in London to measuring and monitoring intercontinental air pollution, the ability to understand our local and global environment has and will continue to aid in prevention and treatment of disease. Collecting and analyzing data ranging from morbidity statistics to broader climatic and biophysical parameters is often the first step in painting the bigger picture of disease emergence and subsequent spread. While patterns of disease might not emerge from all data collected, having the infrastructure in place to collect and monitor key health parameters is vital. While collecting information is important, without public access, it might as well be locked up at Fort Knox. The Internet has provided a means to gather, analyze and distribute information, especially related to health. The Global Public Health Intelligence Network (GPHIN) in Canada and the International System for Total Early Disease Detection (INSTEDD), proposed by Larry Brilliant are mechanisms that show the power that information has over emergent diseases. As we move toward a more information and reputation based economy, sources of information will become more distributed and with the help of web 2.0 tools such as whoissick.org, a tap of precious epidemiological data has been turned on. In the past, availability of data has been the limiting factor in the fight against many diseases, but with the rapidly developing Internet based infrastructure we must now tune the tools we have to meet the needs of the poor, sick and uninformed.

David Zaks' research uses computer models to look at the tradeoffs between human land-use decisions and ecosystem goods and services. At Worldchanging.com he is responsible for covering the topics of sustainability science and the intersection of policy and science.

4. Arri Eisen Ph.D.
Senior Lecturer, Biology; Director, Emory College Program in Science and Society; Associate Faculty, Ethics Center, Emory University, Atlanta GA.

Clean water
I can't be especially short on this one, so just a few thoughts. The question implies that science is good and helps us and helps health. But probably, it's mostly science having to scramble (via drugs and other technologies) to make up for other screw ups (environmental, other drugs, processed food, etc.) that science and technology introduced in the first place. That's my real answer. Given that, I could say the most basic thing is methods that provide water and clean water at that.

Dr. Eisen believes in teaching science as a thinking and fun discipline that does not exist in a vacuum, but is intimately connected to history, medicine, the development of thought, sociology, communication, psychology, and the environment.