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Published online 20 February 2008 | Nature | doi:10.1038/news.2008.612
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Disease monitors 'looking in the wrong places'
Health leaders need global strategy for spotting disease threats.
The world's health watchdogs are looking in the wrong places for the next dangerous epidemics, according to an analysis of global trends in emerging disease outbreaks over the past few decades.
The study gives a fresh perspective on global disease by tracking the history, from 1940 to 2004, of the emergence and spread of 335 infectious diseases.
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If the red spots are the areas where more diseases originate: The red spot around the border of Germany and the Netherlands was not mentioned in your article.
Hi, “The world's health watchdogs are looking in the wrong places for the next dangerous epidemics� The observation on the development of emerging new diseases is quit simple. In the western world social behaviour is indicative. What’s very important is to look at Africa the continent that is burning, a Petri dish for all sorts of things. The computerisation of the diagnostic (not personal part) part of medical records is very important. Looking through the wrong end of the telescope at the past is expensive, take SAR’s or H2H5 for example. In Switzerland more people have died through road accidents per year than from these diseases. Regards Dr. Terence Hale
Disease minitoring globally by national and international agencies will be a welcome measure to contain the spread of new diseases. Orientation towards this direction will be of great help to humanity.
Sven: RE: the red spot centred on Germany and the Netherlands. The story states that Western Europe was indeed a disease hotspot during the 20th century, as is reflected in the map. Cheers Michael Hopkin
The hotspots of Africa will continue to expand and get hotter, so long as Africa refuses to tackle the issues of disease prevention and control. The world will be the loser on the long run. As the West comes to help Africa, each time there is an outbreak of a disease, so more and more will the West become experts on diseases that are NOT endemic or emerging in their territory. Africa on the other hand, will become less and less able to tackle her diseases control and prevention problems. Just remember the outbreaks of Ebola, think of the resurgence of yellow fever, consider the devastation caused by cerebrospinal meningitis; you will see what I mean. Each time, we have those epidemics in Africa, the West rushes her experts and Africa looks on helplessly. At the end, the the Western experts return home, with enhanced capacity, while Africa retires less capable and unable to handle future and repeat epidemics. Each disease outbreak becomes a training ground for Western scientists, who end up, more and more, as experts on handling local and endemic African diseases. The current plan by Wellcome Trust to support projects that will strengthen research capacity and disease surveillance of African scientists is a proposal that should be supported, if Africa must stop being a burden to the entire world!
The previous comment by Oyewale Tomori is very important. Like the Wellcome Trust, the Gates Foundation too is striving to encourage African scientists to do the work on key African problems. This does not mean that those outside of Africa cannot be helpful, but it is crucial that the know-how on how to tackle specific diseases and issues is present on a long-term basis within Africa. Robert Kahn
I believe that the next large epidemic will go unnoticed until it is too late. I think it will be a cross between HIV and Lyme disease and that medicine will mistreat it at first because those affected will have psychiatric issues. Instead of searching out possible hotspots for new diseases, I think we should focus on refining our methods for infectious disease diagnosis. The US medical system has trouble diagnosing multisystemic diseases because specialists are trained intensely in specific body areas. By investing energy in quick diagnosis, no matter where the illness stems from, medicine will be better capable to meet new challenges.
While the general thrust of the article is correct, that more effort needs to be focused on enhancing the capacity for infectious disease surveillance in areas of the world such as South-East Asia and Africa,it does not acknowledge the important work being conducted by regional disease surveillance consortia such as the Mekong Basin Disease Surveillance network (MBDS) and the Middle East Consortium for Infectious Disease Surveillance (MECIDS). While the initiative for organisations such as these comes from within the regions themselves they do have support from international agencies such as the WHO, OIE, World Bank and major private foundations. This 'bottom up' means of enhancing surveillance needs greater support and and should bring great rewards. In particular more effort needs to be brought to bear on nascent regional disease surveillance networks in Africa and South Asia. This approach is spelt out in the Bellagio "Call for Action" at www.ghsi.org. Terence Taylor, Director, Global Health and Security Initiative.