There is this one scene in “The Matrix” where the antagonist of the film gives a speech to one of the protagonists. Here it is:
The antagonist, Agent Smith, tells Morpheus that humans rejected “The Matrix,” a computer program designed to simulate reality for captive humans, because the reality being shown to humans was too perfect. So the machines who rule the humans redesigned the program to reflect the misery existent in human existence. I tend to agree.
I went to a lecture at Johns Hopkins given today by Dr. Marcos Espinal, an epidemiologist with the Pan American Health Organization. His talk was about how the focus is shifting in the Americas from communicable diseases to chronic diseases. The wealthier countries are pushing this shift because, after all, they provide a lot of the cash for the health interventions in the continent. In the north, Canada and the US want more attention to obesity and diabetes and diseases of an older population, like chronic obstructive lung disease and prostate cancer. In the south, Chile, Brazil, and Argentina want more attention to diseases of an older population, and they don’t want diseases of a privileged population (obesity and diabetes) to get out of control.
Yet there are a whole bunch of countries in the middle for which communicable diseases are still a problem. In Peru, for example, influenza and pneumonia are still big contributors to death and disability. Other countries in the continent are struggling with dengue, tuberculosis, and malaria. Tuberculosis was mentioned with special emphasis by Dr. Espinal. He told us that TB has been around since before recorded history, and we still haven’t gotten rid of it.
It’s true. We have the technology to do away with so many of these diseases, and we won’t. We have safe and effective vaccines against measles, and there are still children catching it, and outbreaks in the United States from it. We have tests to screen for and detect tuberculosis, with safe and effective antibiotics to treat it. We also know that clean water and sanitation can take care of malaria, yet there is still plenty of it in the Caribbean and Central America. (Malaria was endemic in Washington, DC, but it was eliminated.)
When it comes to infectious/communicable diseases, we certainly have the know-how to take eliminate those diseases once and for all. So it is quite embarrassing as a human, especially one who works in public health, to acknowledge that there are things out there like dengue and malaria, or even cholera. If aliens were to land tomorrow, they would probably have a good laugh at us for knowing how to deal with infectious disease but not dealing with them. At the very least, they would find it humorous that we treat people of different ethnicity and nationalities differently. I don’t think it’s funny, but you have to acknowledge that there is a certain degree of “dark comedy” in the fact that we let certain people out in the periphery of progress while we allow others to fully participate in the wealth.
So, while we will never reach a utopia when it comes to public health, we can get quite close. We can eradicate measles, chickenpox, and mumps. We can get rid of cholera again, like we did before. But it seems to me that we can’t handle a utopia. We seem to like for problems to continue to exist because, without those problems… Well, I don’t know. I certainly would have an easier day at work if those diseases didn’t exist anymore. I’d probably focus on other public health problems. Investigating outbreaks of measles take up a lot of time and resources. The same can be said for outbreaks of hepatitis A, another vaccine-preventable disease. It boggles the mind why these things are allowed to continue.
Yes, while other diseases and conditions (and even violence and car accidents) are important to look into and take care of, we cannot take our foot off the accelerator and de-fund efforts against infectious disease to fund efforts against chronic conditions… Which is easier said than done, I know. Yet one more thing to think about for my DrPH adventure.
Featured image credit: Drawn and engraved by F. Bate. Published by “The Association of all Classes of all Nations”, at their institution, 69, Great Queen Street. Lincoln’s Inn Fields, London, 1838. / Foter.com / Public Domain Mark 1.0