Published on Investing in Health

Crying wolf? Contagion is a real threat!

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If you accept my 5 cents of wisdom, you should rush to see the new movie “Contagion.” It is a well done, spooky public health mystery, with great acting. Why you may ask? Simply because it is a timely reminder about the public health risks but also the potential benefits of a globalized world.

Watching the movie brought back vivid memories of passionate discussions we had in the fall of 2005 when we—a Europe and Central Asia and East Asia and the Pacific agriculture and public health team—prepared in a few days what became the $500 million Global Program for Avian Influenza and Human Pandemic Preparedness and Response. Some colleagues argued with merit that we were “crying wolf” and that it was going to be a waste of precious resources. Our counter argument was “this is a wonderful opportunity to shine a light and revamp health surveillance systems, basic public health laboratory networks, and update the epidemiological intelligence capacity as these basic public health services and functions usually tend to be the most deteriorated, underfunded, and often underdeveloped, elements of a health system.” Ditto in the veterinary sector.

The movie clearly portrays the interconnection of the animal and human health dimensions of communicable diseases, and how in the new phase of globalization—large-scale movements of people, goods, and services, and shortened geographical distances due to the dramatic growth and improvement of air transportation—the rapid spread of viruses and bacteria is a clear and present danger. The movie also shows that to be vigilant and to be able to mount a rapid and effective response, both locally and globally, countries need to have well-developed, adequately staffed and funded public health agencies such as the U.S. Centers for Disease Control and Prevention (a big role in the movie) to serve as the “intelligence centers” that guide multisectoral responses by collecting, analyzing, and disseminating data and information for decision-making, communicating, and educating the general population, and sharing evidence across countries.

And, as the movie also shows, strong public health infrastructures and networks are needed to galvanize the power of evidence and scientific knowledge to come up with tools (e.g., vaccines or drugs) to control the spread of infectious pathogens that cause disease. In doing so, the movie brings to the fore with great cinematic eloquence one of the main benefits of globalization: the sharing of knowledge and expertise to deal collectively with common public health threats that do not need passports to move with impunity across national borders and cause havoc.

In retrospect, while the avian influenza and human pandemic of the mid-2000s did not become another global disaster as the 1918-1919 Spanish flu pandemic that caused millions of deaths worldwide, it alerted us, just as the movie does, that strong public health structures and essential functions are critical to help member countries build resilience and respond to crises in an ever more interconnected and integrated global village.


Patricio V. Marquez

Former World Bank Group (WBG) Lead Public Health Specialist

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