Garrett Lectures On Bioterrorism

8 February 2002

By Stentor Danielson
Managing Editor

Laurie Garrett, award-winning journalist and author of Betrayal of Trust: The Collapse of Global Public Health, spoke to members of the Colgate community about the global public health crisis in Love Auditorium on Tuesday.

"No place, from a microbial point of view, is an island," Garrett said.

Garrett's lecture focused on two major themes -- the threat of bioterrorism and the AIDS crisis. Professor of Geography Ellen Kraly said that Garrett is "heavily in demand at this moment in time" because of bioterror concerns. Garrett said that the solution to these problems lies in better public health infrastructure.

While funding for bioterrorism research has increased significantly since the anthrax scare this fall - for example, a 300 percent increase in President Bush's budget - other public health programs are being slashed, "right when we thought we were hearing the words 'public health' on the lips of public officials," Garrett said.

Compared to other potential bioterror threats, Garrett said, "Anthrax is peanuts. Anthrax is nothing. Anthrax is not contagious." If an infectious agent were released, the consequences would be much greater.

"Nobody in this room is immune to smallpox," she warned. Data from the 1950s suggests that smallpox brings with it a 30 percent mortality rate and lifelong scarring and brain damage for survivors. The effects might be even worse today because, according to Garrett, we now have no residual immunity to the disease, AIDS and chemotherapy weakening many people's immune systems, more elderly people and fewer people trained to administer the smallpox vaccine.

She said the anthrax attacks we saw were not very sophisticated, because the perpetrators seemed nave enough to think Senators and prominent figures in the media opened their own mail.

Garrett said that if she were a terrorist, she would circumvent the security measures in the United States and release an infectious agent in a place like the airport in Lagos, Nigeria. She explained that disease does not respect international boundaries. "They travel with humans as microbial hitchhikers ... We can be the vector that takes disease from one nation to another."

Garrett showed slides of her visit to a Soviet bioterror lab in Siberia, where scientists had been manufacturing tons of anthrax each week, genetically modifying organisms and attempting to create super-germs that would be airborne, resistant to drugs and fatal to 80 percent of people exposed. Many of these scientists are still unaccounted for, she said, and may have taken germ samples and their knowledge of these organisms' genomes with them.

The public health infrastructure in the United States is too weak to deal with a widespread bioterror epidemic, Garrett said. Too many people refuse immunizations because of possible side effects, which endangers others because a 90 percent immunization rate is necessary to protect the population. She showed a slide of New Yorkers lined up to get immunized for smallpox during a scare in the 1940s, and said "we could not do this today."

Part of the problem, Garrett said, is the "demeaning" salaries offered to public health professionals. Often health laboratory technicians are paid less than the garbage collectors in the same city. "You're going to get what you pay for -- second-rate personnel, third-rate personnel," she said.

Garrett also criticized the way health spending is allocated in the United States. She said that Costa Ricans are able to live longer than Americans because that nation focuses its few resources on making sure children remain healthy. In the United States, the emphasis is on the end of life. Pharmaceutical companies focus their research on treatments for chronic and genetic disorders while vaccines and medicines to treat basic infectious diseases are scarce.

The disparity in life expectancies between the world's richest and poorest countries will only grow wider if nothing is done to alleviate the health crisis, Garrett said. "You'll have to be like voyeurs, watching the poor of the world die like flies while you live into your 90s."

The battle against AIDS is "a test of our humanity," Garret said. She warned that if AIDS continues to ravage Africa, the whole continent might descend into a situation similar to the boys in William Golding's novel The Lord of the Flies, in which the strongest get what they want by force.

"Almost no African language that I know of had a word for 'orphan'" before the AIDS crisis, Garrett said. Now, the working-age population of Africa is rapidly dying, leaving children to be raised by grandparents and increasingly by other children who are unable to give them an education or pass on their culture.

"It's more than just human beings that are dying, it's cultures," Garrett said.

Garrett offered one African family as an example of how AIDS spreads. The husband contracted AIDS from an extramarital sexual encounter (as is considered his right in that culture). He then infected his wife, who gave birth to an HIV-positive child. If he dies, his property will return to his parents and his wife will be forced into prostitution to feed herself and her child, thus passing the disease to more men.

Garrett blamed much of the problem on the explosive growth of "megacities" like Lagos, Cairo, Istanbul, Shanghai and So Paulo. Bombay, for example, is expected to grow from 18 million people to 26 million people over the next 13 years. Garrett said that New York was able to build a public health infrastructure because its growth was much slower, but third-world cities are being flooded with poor people from rural areas.

The people moving to these megacities have no access to clean water or sewage systems, causing a "pressure cooker effect of more and more Homo sapiens moving into these bizarre ecologies," Garret said.

Misuse of drugs has caused many diseases to develop resistance to treatment, Garrett said. Efforts to eliminate malaria have been thwarted by this problem, and last year more people died of malaria than in any previous year.

The economic damage done by unhealthy populations has begun to get international attention focused on the public health crisis. Garrett said that leaders of corporations like Merck and General Motors are asking "What is the value of having a work force if your work force is so sick?"

Garrett said that if each person contributed $36 per year to a global public health fund, the world would see $360 billion per year in economic benefits due to better health. "I thought that figure was really astounding," senior Dana Farrill said.

Students from many classes and disciplines attended the lecture, often as a requirement for a course. Many classes in the geography department, as well as Medical Anthropology, integrated Garrett's work into their course syllabus.

"What was significant for me was this idea that we have to reevaluate our whole idea of public health," senior Dana Bail said.

Visiting Instructor of Geography Veronica Ouma, who teaches medical geography, said that Garrett "did a good job of trying to bring the audience into the discussion," and that too often society does not make health a priority despite the fact that "without it we are nothing."

Garrett's lecture was sponsored by the Wolk Heart Foundation.

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