Emerging and Reemerging Infectious Diseases -- How prepared is the future...

A peep at the movie world war Z attests to an undeniable fact that an end to global world pandemics, diseases can never be attained.

It is obvious that with each passing generation, the universe will witness one form of affliction or the other. Was the world designed thus or are there forces responsible for these occurrences. It is not established but what is obvious is the striking evolution of the field of infectious diseases and the changing perception of the importance and relevance of the field by both the academic community and the public.

In a December 2022
Interview with Dr. Anthony Fauci, an ex director of the National Institute of Allergy and Infectious Diseases, he told the reporters that he completed his residency training in internal medicine in infectious diseases and clinical immunology at NIAID. Unknown to him however, he said, certain scholars and pundits in the 1960s were opining that with the advent of highly effective vaccines for many childhood diseases and a growing array of antibiotics, the threat of infectious diseases and perhaps, with it, the need for infectious-disease specialists was fast disappearing.

He noted that despite his passion for the field he was entering, he was almost tempted to have reconsidered his choice of a subspecialty, being known of this skepticism about the discipline’s future.

At that time however, he said malaria, tuberculosis, and other diseases of low- and middle-income countries were killing millions of people yearly.

Several years later, he continued, Dr. Robert Petersdorf, an icon in the field of infectious diseases, published a provocative article suggesting that infectious diseases as a subspecialty of internal medicine was fading into oblivion.

It was also Dr. Petersdorf who gave voice to a common viewpoint that lacked a full appreciation of the truly dynamic nature of infectious diseases, especially regarding the potential for newly emerging and reemerging infections.

In the 1960s and 1970s, most physicians were aware of the possibility of pandemics, in light of the familiar precedent of the historic influenza pandemic of 1918, as well as the more recent influenza pandemics of 1957 and 1968. However, the emergence of a truly new infectious disease that could dramatically affect society was still a purely hypothetical concept.

That all changed in the summer of 1981 with the recognition of the first cases of what would become known as AIDS. The global impact of this disease was staggering. At the start of the pandemic, reports had it that more than 84 million people had been infected with HIV, the virus that causes AIDS.

In 2021 alone, an estimate of about 650,000 people died from AIDS-related conditions, and 1.5 million were newly infected. Today, more than 38 million people are living with HIV universally and continues, exacting a terrible toll in morbidity and mortality, 41 years after it was first diagnosed.

Dr. Petersdorf in one of his articles readily admitted that he had not fully appreciated the potential impact of emerging infections
and enjoined young physicians to pursue careers in infectious diseases which prompted many foreign students, health sector workers and even the government take proactive steps to avert future unknown

As we all can attest, the threat and reality of emerging infections did not stop with HIV/AIDS.
During Fauci's tenure as NIAID director, the world was challenged with the emergence or reemergence of numerous infectious diseases with varying degrees of regional or global impact like the H5N1 and H7N9 influenza which turned out to be the first pandemic of the 21st century in 2009 caused by H1N1 influenza, we also had multiple outbreaks of Ebola in Africa, Zika in the Americas, severe acute respiratory syndrome (SARS) caused by a novel coronavirus, Middle East respiratory syndrome (MERS) caused by another emergent coronavirus and of course Covid-19, the loudest wake-up call in more than a century.

The devastation that Covid-19 has inflicted globally is truly historic and highlights the world’s overall lack of public health preparedness for an outbreak of this magnitude expecially in Africa.

It is on records that millions of lives were lost around the globe and left the developing country's economy fully grounded while it lasted .

Given the current trends in incidence and underlying healthcare systems vulnerabilities, Africa could become the next epicenter of most infectious diseases and pandemic if proactive measures are not put in place.

As pandemics transitions to more widespread community, how can the lessons learned thus far be consolidated to effectively curb the spread of emerging infectious diseases while minimizing social disruption and negative humanitarian and economic consequences should be Africa's primary objective and focus.

If anyone had any doubt about the dynamic nature of infectious diseases and, by extension, the discipline of infectious diseases, our experience over the four decades since the recognition of AIDS should have completely dispelled such skepticism.

Today, there is no reason to believe that the threat of emerging infections will diminish, since their underlying causes are present and most likely increasing because the emergence of new infections and the reemergence of old ones are largely the result of human interactions with and encroachment on nature.

As human societies expand in a progressively interconnected world and the human–animal interface is perturbed, opportunities are created, often aided by climate changes, for unstable infectious agents to emerge.

As we move into the forth year of the global pandemic caused by COVID-19, it’s important to ask what we have learned and what we have done to prepare for the next infectious-disease crisis.

It could be an outbreak of Lyme disease, an epidemic of measles or another full-blown global pandemic of influenza or coronavirus. It could be a threat that emerges from the ongoing challenge of antimicrobial resistance and the steadily fading power of established antibiotics, it could also result from the effect of global warming but
one thing is certain, COVID-19 will not be the last challenge of our time. And even while we are striving to tame the current pandemic, we need to prepare for the next challenge, using evidence and knowledge.

For most of human history, infectious diseases have been the leading cause of death, preying mainly on the very young, the old and the most vulnerable among us.

Our ability to control it through public health measures such as clean water, developing vaccines, antibiotics, antiviral and antiparasitic agents, huge and constructive investment in the health sector and being proactive in our approach to issues matters a lot and will change the way we live resulting in less impact on the African continent.

Finally, it is faithly believed that ' it is not over until it is over',
we can now extend that axiom to emerging infectious diseases, it’s never over.
As infectious-disease specialists, as a global village and as humans, we must be perpetually prepared and able to respond to the perpetual challenge.


Idemudia Franca
Serial marketer, Writer, Public Relations Expert and Broadcaster.

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