What Are the Biggest Global Threats to Public Health?
Dr. Larry Brilliant played a key role in eradicating smallpox from the world – so what are the biggest dangers humanity faces now? Brilliant rates politics as on-par with infectious disease.
Larry Brilliant, MD, MPH, is the author of Sometimes Brilliant: The Impossible Adventures of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History. Dr. Larry was Vice President of Google and Executive Director of Google.org. He is board-certified in preventive medicine and public health and co-founder of The Seva Foundation, an international NGO whose programs and grantees have given back sight to more than 3.5 million blind people in over 20 countries. Dr. Larry lived in India for more than a decade working as a United Nations medical officer where he played a key role in the successful World Health Organization (WHO) smallpox eradication program in South Asia. He currently serves as the acting Chairman of the Board of the Skoll Global Threats Fund whose mission is to confront global threats like: pandemics, climate change, water, nuclear proliferation and the Middle East conflict.
Larry Brilliant: If I were asked what are the greatest global threats to health today I would divide that into two parts. One, of course, would be the biology the Ebola, Zika, bird flu, swine flu world and I will talk about that. But far more than that are the kind of centrifugal forces that are pulling us a part as a nation, pulling us apart as a world, the deterioration of all of the international and national organizations that we depend upon to keep us safe. The World Health Organization, which failed to protect the world against Ebola and didn't do a great job on Zika either and it will have a new leader in May of this year. There are a couple of candidates who are terrific and some that aren't so good, but either way WHO is going to be going through a period of years of introspection and re-organization.
We have a new Secretary General of the UN. He's a good guy. He's from Portugal, Gutierrez. He just started. It will be a while before he can find all the bathrooms in the UN buildings. We've just lost the head of CDC. We have a new acting head of CDC, who is also good. But CDC will go through a headless period. And then we have Trump and we have a White House which would almost reflexively discard anything that had the word of public in it and one of those words is public health. And they have not shown a keen interest in pandemics. And the whole idea of America first, which might be good for many things, is singularly not good for a global pandemic. It's an oxymoron. It doesn't work. These centrifugal forces that put us in a period of vulnerability are the gravest threats.
On the biology side, in the last 30 years we've had 30 novel here before unknown diseases that jumped from animals to humans, they're almost all viruses. In addition to Ebola and Zika and bird flu and swine flu we have coronaviruses like SARS and MERS, we have arboviruses and a lot of other viruses that continue to jump at the rate of about one a year. That rate is increasing slightly. I don't think it's increasing at a catastrophic rate. The causes of its increasing are that animals and humans are living in each other's habitat now more than ever. Part of that is the clear cutting of forests to grow soybeans and things of that nature. Another reason is that as countries have gotten slightly more wealthy they begin to consume more protein and more animal protein.
I remember when I work at a Google I gave a talk to 3000 young Indian Googlers in Hyderabad and I asked them to raise their hand if their grandparents were vegetarian. They all raised their hand. Then I asked them to raise their hand if their parents were vegetarians and about half raise their hand. And then I asked them if they were vegetarians and no one raise their hand. And I think that's leads to the increase in chickens and pigs that we've been saying in China and India, not pigs so much in India. And that means the kind of way in which Asia houses and farms are all together and you can go to Laos and see a pancake house that has pigs on the ground floor, chickens in the middle, and humans up on top. When pigs are eaten what's left to them is fed to the chickens, and when the chickens are eaten what's left of them is fed to the pigs. And of course everything is fed to humans. That's like a natural virus experiment. You really wouldn't want to do that if you were trying to keep the world safe from viruses.
So we are having more viruses jump from animals to humans for lots of different reasons related to modernity. And normally our ability to protect the world keeps apace with that, maybe even is a little bit ahead and every year we're a little bit safer. That's not true right now. Right now because of the re-organization and nationalism and re-organization and dislike for the United Nations and its agencies I think we're in a period of grave vulnerability. So it's those two things together.
The greatest global threats to health can be divided into two categories, explains epidemiologist and former head of philanthropy at Google, Dr. Larry Brilliant: there is the biological, and the socio-political. In the last 30 years, there have been at least 30 heretofore unknown viruses that have jumped from animals to humans, for worrying reasons Brilliant attributes to modernity and our increase in animal protein consumption. Still, the socio-political threats are the more immediately dangerous. There are centrifugal forces at play that are pushing society to two extreme camps. The domestic and global division caused President Trump’s ‘America First’ mentality and disregard for public health leaves us vulnerable to new viruses that, if they aren’t detected early enough, could be the next pandemic. "Right now because of the re-organization and nationalism… and dislike for the United Nations and its agencies, I think we're in a period of grave vulnerability," says Brilliant. Larry Brilliant is the author of Sometimes Brilliant: The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History.
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How would the ability to genetically customize children change society? Sci-fi author Eugene Clark explores the future on our horizon in Volume I of the "Genetic Pressure" series.
- A new sci-fi book series called "Genetic Pressure" explores the scientific and moral implications of a world with a burgeoning designer baby industry.
- It's currently illegal to implant genetically edited human embryos in most nations, but designer babies may someday become widespread.
- While gene-editing technology could help humans eliminate genetic diseases, some in the scientific community fear it may also usher in a new era of eugenics.
Tribalism and discrimination<p>One question the "Genetic Pressure" series explores: What would tribalism and discrimination look like in a world with designer babies? As designer babies grow up, they could be noticeably different from other people, potentially being smarter, more attractive and healthier. This could breed resentment between the groups—as it does in the series.</p><p>"[Designer babies] slowly find that 'everyone else,' and even their own parents, becomes less and less tolerable," author Eugene Clark told Big Think. "Meanwhile, everyone else slowly feels threatened by the designer babies."</p><p>For example, one character in the series who was born a designer baby faces discrimination and harassment from "normal people"—they call her "soulless" and say she was "made in a factory," a "consumer product." </p><p>Would such divisions emerge in the real world? The answer may depend on who's able to afford designer baby services. If it's only the ultra-wealthy, then it's easy to imagine how being a designer baby could be seen by society as a kind of hyper-privilege, which designer babies would have to reckon with. </p><p>Even if people from all socioeconomic backgrounds can someday afford designer babies, people born designer babies may struggle with tough existential questions: Can they ever take full credit for things they achieve, or were they born with an unfair advantage? To what extent should they spend their lives helping the less fortunate? </p>
Sexuality dilemmas<p>Sexuality presents another set of thorny questions. If a designer baby industry someday allows people to optimize humans for attractiveness, designer babies could grow up to find themselves surrounded by ultra-attractive people. That may not sound like a big problem.</p><p>But consider that, if designer babies someday become the standard way to have children, there'd necessarily be a years-long gap in which only some people are having designer babies. Meanwhile, the rest of society would be having children the old-fashioned way. So, in terms of attractiveness, society could see increasingly apparent disparities in physical appearances between the two groups. "Normal people" could begin to seem increasingly ugly.</p><p>But ultra-attractive people who were born designer babies could face problems, too. One could be the loss of body image. </p><p>When designer babies grow up in the "Genetic Pressure" series, men look like all the other men, and women look like all the other women. This homogeneity of physical appearance occurs because parents of designer babies start following trends, all choosing similar traits for their children: tall, athletic build, olive skin, etc. </p><p>Sure, facial traits remain relatively unique, but everyone's more or less equally attractive. And this causes strange changes to sexual preferences.</p><p>"In a society of sexual equals, they start looking for other differentiators," he said, noting that violet-colored eyes become a rare trait that genetically engineered humans find especially attractive in the series.</p><p>But what about sexual relationships between genetically engineered humans and "normal" people? In the "Genetic Pressure" series, many "normal" people want to have kids with (or at least have sex with) genetically engineered humans. But a minority of engineered humans oppose breeding with "normal" people, and this leads to an ideology that considers engineered humans to be racially supreme. </p>
Regulating designer babies<p>On a policy level, there are many open questions about how governments might legislate a world with designer babies. But it's not totally new territory, considering the West's dark history of eugenics experiments.</p><p>In the 20th century, the U.S. conducted multiple eugenics programs, including immigration restrictions based on genetic inferiority and forced sterilizations. In 1927, for example, the Supreme Court ruled that forcibly sterilizing the mentally handicapped didn't violate the Constitution. Supreme Court Justice Oliver Wendall Holmes wrote, "… three generations of imbeciles are enough." </p><p>After the Holocaust, eugenics programs became increasingly taboo and regulated in the U.S. (though some states continued forced sterilizations <a href="https://www.uvm.edu/~lkaelber/eugenics/" target="_blank">into the 1970s</a>). In recent years, some policymakers and scientists have expressed concerns about how gene-editing technologies could reanimate the eugenics nightmares of the 20th century. </p><p>Currently, the U.S. doesn't explicitly ban human germline genetic editing on the federal level, but a combination of laws effectively render it <a href="https://academic.oup.com/jlb/advance-article/doi/10.1093/jlb/lsaa006/5841599#204481018" target="_blank" rel="noopener noreferrer">illegal to implant a genetically modified embryo</a>. Part of the reason is that scientists still aren't sure of the unintended consequences of new gene-editing technologies. </p><p>But there are also concerns that these technologies could usher in a new era of eugenics. After all, the function of a designer baby industry, like the one in the "Genetic Pressure" series, wouldn't necessarily be limited to eliminating genetic diseases; it could also work to increase the occurrence of "desirable" traits. </p><p>If the industry did that, it'd effectively signal that the <em>opposites of those traits are undesirable. </em>As the International Bioethics Committee <a href="https://academic.oup.com/jlb/advance-article/doi/10.1093/jlb/lsaa006/5841599#204481018" target="_blank" rel="noopener noreferrer">wrote</a>, this would "jeopardize the inherent and therefore equal dignity of all human beings and renew eugenics, disguised as the fulfillment of the wish for a better, improved life."</p><p><em>"Genetic Pressure Volume I: Baby Steps"</em><em> by Eugene Clark is <a href="http://bigth.ink/38VhJn3" target="_blank">available now.</a></em></p>
A popular and longstanding wave of thought in psychology and psychotherapy is that diagnosis is not relevant for practitioners in those fields.
Scientists regenerate damaged spinal cord nerve fibers with designer protein, helping paralyzed mice walk again.
- Researchers from Germany use a designer protein to treat spinal cord damage in mice.
- The procedure employs gene therapy to regenerate damaged nerve fibers that carry signals to and from the brain.
- The scientists aim to eventually apply the technique to humans.
What is a spinal cord injury?<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="88b8d4e44e46b7d5fe49d1f3bca56078"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/dKtBC2Sg_Bg?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Scientists use new methods to discover what's inside drug containers used by ancient Mayan people.
- Archaeologists used new methods to identify contents of Mayan drug containers.
- They were able to discover a non-tobacco plant that was mixed in by the smoking Mayans.
- The approach promises to open up new frontiers in the knowledge of substances ancient people consumed.
PARME staff archaeologists excavating a burial site at the Tamanache site, Mérida, Yucatan.
Cold hands and feet? Maybe it's your anxiety.
- When we feel anxious, the brain's fight or flight instinct kicks in, and the blood flow is redirected from your extremities towards the torso and vital organs.
- According to the CDC, 7.1% of children between the ages of 3-17 (approximately 4.4 million) have an anxiety diagnosis.
- Anxiety disorders will impact 31% of Americans at some point in their lives.