Disease is a Powerful Change Agent
August 26, 2021
It’s easy to focus on the negative at a time when our world is being turned upside down by COVID-19. But in the midst of the disruption and ongoing threats, there’s cause for optimism: we may be on the cusp of one of the greatest periods of health advancement in human history.
Disease is a powerful change agent. Most people tend to focus on the loss that comes from health threats, which is understandable. History offers a counterpoint, however. During the past century the societal and technological transformation that has occurred in response to major diseases has propelled us forward in profound ways.
The great influenza pandemic in 1918-19 showed us the power of effective public health and forged America’s preeminence in medical education. The quest for a polio vaccine in the 1950s created diplomatic openings during the Cold War and ushered in a golden age for vaccines. And only recently, SARS, Ebola and Zika outbreaks revealed our global interconnectedness and the importance of a coordinated response to health threats in different regions.
The seismic shift that we are experiencing now goes beyond anything we’ve experienced, revealing a level of solidarity for public health with the potential to trump our divisions. When was the last time public health was a topic of daily conversation in homes and communities around the world? Or when airlines, restaurant chains and sports teams proclaimed their support for vaccines? The answer is never. At least not at this scale.
And that’s important for where we go next.
Just as the pandemic has revealed the depths of our inequity and partisanship, it also has changed how we confront public health issues and infectious diseases, while providing a blueprint for addressing other planet-sized issues like climate change.
It begins with harnessing the collective consciousness that people, businesses and governments have for the value of public health. Way back in 2019, a pandemic-level infectious disease threat was an abstract notion for most people. Now billions of people have a concrete example of an invisible enemy with the ability to upend the world. Businesses large and small have been impacted by the pandemic and may be more supportive of adopting long-term programs to support better health for their employees, customers and communities. And there is a growing call by some of our most experienced health leaders to allocate a defined, protected level of budgetary funding for pandemic prevention. With the right support from different sectors, this moment has the potential to turn into a movement.
We also have an opportunity to reinforce the stark reality of COVID-19 infections, co-morbidities and health system weaknesses to guide a new discussion about how health is perceived and managed by the generation of people living through the pandemic today. This is especially true of adolescents who are coming of age in the midst of a plague and have been shaped by it. Despite dire forecasts, there are signs their optimism for the future remains intact, but issues that affect their health are a clear concern. Investing in public health education in schools and through cultural touchpoints can deliver massive long-term returns that strengthen individual and systemic health.
The flip side to witnessing the destructive power of a pandemic is the global appreciation for how rapidly science met the threat head on. For many people, the idea of technology that impacts their lives is a mobile phone. A growing number now have a clear understanding of how novel science can be applied to save lives and livelihoods – not in some far-off future, but today. That awareness can’t come at a more consequential time as we enter one of the most dynamic periods in medical history.
Few people associate vaccines with technological revolutions. Yet, that is just what mRNA vaccines may herald. Proven safe and effective in the fastest, broadest real-world trials in history, mRNA technologies may completely upend how we develop, produce and distribute vaccines. At the very least, they could provide a strong complement to our existing arsenal of highly effective recombinant and conjugate vaccines. It’s tempting to search for analogies in the tech world and the way we still produce seasonal influenza vaccines is akin to punching out equations in a warehouse full of vacuum tubes. mRNA is a quantum leap for public health with the potential to solve many of our most elusive disease challenges – HIV, RSV, universal influenza, to name a few – in ways that could be accessible to most humans on the planet.
Such a renaissance for vaccine technologies, playing out on the world stage, has weighty implications for the future of public health and the role that many different sectors can play in supporting common sense steps to improve how we stay healthy and prepare for future threats. When enough people see the value of science and health in their lives, that is invaluable social proof for companies, governments and communities to invest in proven public health measures.
Trust and effective communications are the threads that connect all of these possibilities. Just as the scientific response to COVID-19 has fostered confidence in our ability to meet large challenges, the inability of many players – notably government officials – to communicate competently in this kind of crisis has eroded public trust.
If this pandemic was a dress rehearsal for how we respond to an even deadlier disease or existential threat like climate change, we have a duty to do better. Scientific principles need to be easily understood; communications scenarios need to be included in every disaster-planning simulation, with journalists and patient advocates in the room; and we can make significant inroads by engaging businesses, local leaders and communities sooner with real-time data and the tools to act swiftly.
This is the opportunity we must seize.