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Interview Transcript
Question: What is the single greatest threat to global health?
Paul Nurse: This will be a strange answer but it's: arrogance that we think we know what to do.
There's a variety of diseases out there which are of significance to global health, the infectious disease, but also in more westernized nations, issues to do with cancer, obesity, heart disease and the like.
I think the biggest challenge is arrogance. We still do not know enough about these diseases. We still do not know how to deliver care in the most effective way. Even though there is quite a lot of money sometimes aimed with very benevolent intentions, we think of institutions such as NIH investing in diseases in the developing world, of Gates Foundation, the Welcome Trust and the like. But often we do not know enough about the disease or how to deliver it in our own more advanced societies, let alone in underdeveloped communities in Africa.
We have to accept that we don't know the answers and put more input in to how we deliver that than simply thinking we can go to Tanzania and put a hundred million dollars there and solve the problem, because often it ends up simply not dealing with the problems.
So I think it's arrogance at all levels, both in not understanding the nature of the disease, and thinking all the basic research has been done, it has not. It's thinking that we now know how to treat it in particular ways, often high tech ways, but perhaps not the most effective ways, we should do get better treatments, we still don't know that. And then trying to apply it in countries where there isn't 24 hours electricity every day, so you can't refrigerate samples and so on, means you have to take a completely different approach to how you deliver medicines and health care.
Arrogance is my number one bogey in this. That's what we have to get rid off.
Recorded on: May 20, 2009
Arrogance is the Largest Obstacle to Achieving Global Health
President, Rockefeller University; Nobel Laureate
Nobel Laureate Paul Nurse says benevolent intentions and money alone are insufficient.
June 23, 2009 | In Health & Medicine
Discuss
tim hall on June 23, 2009, 4:21 PM
I agree with Paul on arrogance. We are also arrogant in assuming that the best solution to fight disease is finding a cure. We work in labs all over the world to find antidotes or cures while we should be spending more time on enviroments that promote disease.
We have a hard time learning from past mistakes. When white man first invaded various tribes in Africa and South America, they infected them with disease. As we (USA, EU, China) move forward in our plans to modernize these inhabitants, we need to first stop and research how different races of man, indusrial chemicals, lifestyle change and so on have effect on the bio-chemistry of the native people. We need to first fully understand what parts of their enviroment (plants, animals, air quality) keep them healthy. Every animal including humans evolve according to their enviroment. When you introduce a simple vegtable like the potato, you have to first stop and think what new insects, rodents might cause interference in their chemistry. Thanks Paul.
Luke Star on June 24, 2009, 7:36 AM
I think Dr. Nurse’s idea that that arrogance is the biggest threat to global health is simultaneously accurate and misguided.
I note that he doesn’t pose any solutions to the arrogance problem.
He does refer to the Gates Foundation, et al, but only briefly.
I too am only able to point the finger, so to speak, at the cause.
And yet I wonder ……. arrogance (in my opinon) is almost like chosen ignorance. I think a lot of our health care professionals (health care managers, nurses, etc.) are less arrogance, it’s more like they’re in denial. How do we encourage awareness?
Luke Star on June 24, 2009, 7:51 AM
I just Googled “arrogance” and “health,” and the first search hit/find was a 2001 article. Following is the article. I note that it DOES refer to solutions to arrogance (see paragaph #4), this being what I was bemoaning the absence of in my previous post.
Bristol inquiry faults culture of arrogance
By Michael Durham, Health Correspondent
Wednesday, 18 July 2001
A systematic failure in the National Health Service to meet patients’ needs and a culture of arrogance among doctors will be criticised today in the report on the Bristol heart babies scandal.
A systematic failure in the National Health Service to meet patients’ needs and a culture of arrogance among doctors will be criticised today in the report on the Bristol heart babies scandal.
The report, triggered by the deaths of babies undergoing complex heart surgery at Bristol Royal Infirmary between 1984 and 1995, follows the biggest public inquiry ever held into the NHS. It is expected to lead to far-reaching changes in standards of care.
The inquiry, chaired by Professor Ian Kennedy, is likely to recommend greater openness among doctors in their dealings with parents, more emphasis on informed consent, new safeguards against doctors who fail to live up to accepted standards and an end to the culture of arrogance among doctors.
It is also expected to recommend raising standards in children’s heart surgery by concentrating care in a smaller number of centres of excellence.
The inquiry was set up after three doctors at Bristol Royal Infirmary were found guilty in 1998 of serious professional misconduct by the General Medical Council over the deaths of 29 babies between 1988 and 1995.
Two doctors, James Wisheart and John Roylance, were struck off. A third, Janardan Dhasmana, was banned from operating on children for three years – a ban that has since been extended.
The report will be divided into two parts, one on events at Bristol and a second on implications for the entire NHS.
~~
Article from http://www.independent.co.uk/life-style/health-and-families/health-news/bristol-inquiry-faults-culture-of-arrogance-678166.html
Jim Stiene on June 25, 2009, 1:20 AM
Jim Stiene on June 25, 2009, 1:26 AM
Pride goeth before a fall. They haven’t earned the right to be arrogant. We’ve probably spent a trillion dollars on cancer and AIDs research and they haven’t cured a significant disease since polio. They just come up with long term expensive treatment. Furthermore, America has an estimated 50 trillion in Medicare and Medicaid obligations in the next few decades and no way of paying for it unless we tax everyone at 90%. The bankers will love 50 trillion in debt collecting interest on it, but it isn’t going to happen. The government will default or the dollar crumble before that unless we get rid of HMOs and set limits on rates for sugery to something like $500 an hour insteas of $4,000 or whatever they are charging. 50 trillion is not feasible. And HMOs add nothing to medicine. They are middle men that play the bad cop turning down treatment corporations don’t have the guts to tell employees to their face.
Ramsey Gifford on July 2, 2009, 9:27 AM
Arrogance may be the barrier, but the problem is access. Unless you have a ton of money in the US, you aren’t going to have access to great health care
- that is unless you are employed by a corpooration that provides you with health care. I mean, think about it. Students graduating today from colleges, even from places like Harvard, will mostly be earning around $30$40k a year at best. Can they afford the $300-$500 a month in health care costs? I seriously doubt it. That is upwards of $6000 a year from their post tax income. Access is the real problem in healthcare, and we need to solve it fast. We’re going to have more and more and more uninsured people in this country. Who’s going to cover the cost of them getting sick?tim hall on July 9, 2009, 9:27 PM
We have to cut the fat out of the system. Look at what the Ceo of Tenet Healthcare makes per year. Watch how it’s stock is manipulated for profit takers.
How can a hospital justify charging $2.50 for one individuely wrapped Q-tip. etc, etc, etc
Why is research so expensive? Our we being scammed there?
If you invent a machine that saves lives but cost three hundred million dollars, is it really marketable to the vast majority? Or how about a single pill at twenty five dollars a pop? It is like GM’s electric car at $40,000. I would rather die, thank you.
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