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You, me and foot-and-mouth disease

by Jeffrey P. Kahn, Ph.D., M.P.H.
Director, Center for Bioethics
University of Minnesota

A colleague of mine who works in our university's College of Agriculture, Food, and Environmental Sciences recently returned from England, and reported the first thing he did was throw all of his clothes -- shoes included -- into the washing machine. Why? To prevent becoming a one-man importer of foot-and-mouth disease. While it has serious implications for the economics of raising and selling livestock, it poses no danger to human health. But the same principles that made my colleague decontaminate himself apply to threats to human health as well. Airlines routinely set off insecticide "bombs" on planes leaving countries with endemic malaria and other insect-borne diseases, in an effort to prevent them from spreading to non-infected parts of the world. And the recent case of a woman who fell ill with symptoms consistent with Ebola while flying from Africa to Canada brings home the point that disease is only a plane ride away. How should we think about public health, quarantine and individual rights in an age of easy jet travel and continuing threats to the public's health?

Everybody's problem

In addition to making the world's financial markets increasingly dependent on one another, the global economy has turned the world into something closer to one public health "village." Consider that health problems once restricted to the developing world are cropping up in New York City. Drug-resistant tuberculosis is becoming more commonplace, and there will no doubt be a repeat of last summer's aerial attack on mosquitoes carrying the West Nile virus. So diseases that may have rarely left isolated parts of the world in the past, because their carriers became too sick to travel or died before they could get very far, now have no trouble reaching distant locations in a matter of hours. That makes Russian tuberculosis and the inadequate treatments that create drug-resistant strains a problem not only for Russians but also for the rest of us.

Work at the root of the problem

Countries can't and shouldn't close their borders to international travel or bar their citizens from going abroad, so what is the answer?

Spraying New York's Central Park or quarantining travelers who arrive sick on planes treats the symptom rather than the disease. We should work to cure malaria in areas where it is endemic, and benefit the millions who suffer from disease where they live, as well as protect populations that have never had to face it. For all the technological and scientific wizardry and medical promise embodied in mapping the human genome and identifying human stem cells, their human impact pales in comparison to basic public health measures such as clean drinking water and adequate sewage disposal. These measures can't replace curing diseases when they strike or trying to predict how and when they will -- but need to be in concert with them. Basic public health services such as disease prevention and surveillance will help combat the spread of whatever poses the next disaster -- and it will come, whether in animals or humans. The moral -- we should celebrate the marvels of modern medicine but never forget the value of the public health efforts that allow us to enjoy them.

Visit the
"Ethics Matters" Archive
where you'll find other columns from Jeffrey Kahn
on a wide range of bioethics topics.

"Ethics Matters" is a biweekly feature from the
Center for Bioethics and CNN Interactive.


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