Arrogance Is the Largest Obstacle to Achieving Global Health
Paul Nurse, Ph.D, is a British biochemist. He was awarded the 2001 Nobel Prize in Physiology or Medicine with Leland H. Hartwell and R. Timothy Hunt for their discoveries regarding cell cycle regulation by cyclin and cyclin dependent kinases. He became Rockefeller University's ninth president in 2003.
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
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Physics without time<p>In his book "The Order of Time," Italian theoretical physicist Carlo Rovelli suggests that our perception of time — our sense that time is forever flowing forward — could be a highly subjective projection. After all, when you look at reality on the smallest scale (using equations of quantum gravity, at least), time vanishes.</p><p style="margin-left: 20px;">"If I observe the microscopic state of things," writes Rovelli, "then the difference between past and future vanishes … in the elementary grammar of things, there is no distinction between 'cause' and 'effect.'"</p><p>So, why do we perceive time as flowing <em>forward</em>? Rovelli notes that, although time disappears on extremely small scales, we still obviously perceive events occur sequentially in reality. In other words, we observe entropy: Order changing into disorder; an egg cracking and getting scrambled.</p><p>Rovelli says key aspects of time are described by the second law of thermodynamics, which states that heat always passes from hot to cold. This is a one-way street. For example, an ice cube melts into a hot cup of tea, never the reverse. Rovelli suggests a similar phenomenon might explain why we're only able to perceive the past and not the future.</p><p style="margin-left: 20px;">"Any time the future is definitely distinguishable from the past, there is something like heat involved," Rovelli wrote for the <a href="https://www.ft.com/content/ce6ef7b8-429a-11e8-93cf-67ac3a6482fd" target="_blank"><em>Financial Times</em></a>. "Thermodynamics traces the direction of time to something called the 'low entropy of the past', a still mysterious phenomenon on which discussions rage."</p>
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