Why New and Resurgent Infectious Diseases Caught Public Health by Surprise and a Strategy to Prevent This

Award Year:
Tamara Awerbuch, Richard Levins
Public Health Strategies
This study investigates why the public health community was caught by surprise by the resurgence of diseases that were in decline such as malaria, TB, cholera and rabies, and the appearance of apparently new diseases including AIDS, legionnaire's disease, hantavirus, and Lyme disease. It looks at the results of: fragmentation of knowledge among disciplines; isolation of evolutionary ecology and social science from public health; the urgency to meet immediate human need; and institutional and philosophical biases in setting research priorities. A review determines the overlap in public health journals with ecology, biogeography, population genetics, veterinary and plant pathology literature. An analysis of health programs identifies major gaps in the epidemiology framework due to the prevailing fragmentation of knowledge. Several integrative case studies are developed for particular diseases, and a research and educational strategy for an integrative epidemiology is proposed.