International collaboration and technology in response to pandemics is essential, argues Professor Barry Marshall AC. Nobel Prize Laureate Professor Marshall is Co-Director of the Marshall Centre for Infectious Diseases Research and Training.
No man is an island, and no country is truly separate from the whole even if water completely surrounds it. Australia is not immune to global health crises because of its geographic position - as events in recent years have proven.
Viruses and flus such as the SARS coronavirus, H5N1 avian influenza, swine influenza virus and Hendra virus are all known to most of us. However around the world there lurk many identified threats that are not necessarily household names yet have the potential to wield a huge social and economic impact. Worse still are the as-yet unknown viruses - the infectious agents that haven't yet reared their heads but, as we know from history, tend to emerge seemingly out of nowhere and spread like wildfire. It is likely that should these viruses become epidemics or pandemics, they will not respect boundaries nor be selective about who they target.
It is difficult to discuss the very real threat of pandemics without sounding alarmist, particularly as virulent disease has the potential to claim millions of lives and drain economies by billions of dollars. However, hysteria has no role in our response to what is undoubtedly one of the biggest challenges of our time. This is a time to be practical: collaboration, preparation, surveillance and a preparedness to commit to and invest in enhancing technology and expertise should be the core facets of our response.
Australia is an island in physical description only; the reality is that we are part of a region and we need to work with others in the region to shore up our collective defences. It could be said that the issue of health transcends all other issues. The wellbeing of mankind is a universal challenge that rises above cultural, political and religious differences. There are many ways in which we can join forces with the international community against the common enemy of the pandemic, among them the sharing of expertise, educational exchanges between institutions, collaborative research and development, and co-operative health and disaster management planning and principles.
Being prepared is not just for boy scouts. In recent years Australia has done much to enhance surveillance of disease potential, particularly in the Asia and Pacific regions, and this work must continue to grow. Vigilance about influenza threats as well as animal-to-people diseases (such as mosquito-borne dengue fever) will help us to keep abreast of changes in the nature of viruses and mutation issues. In turn, this will help us to develop appropriate vaccines and grow our stockpiles of relevant drugs and medical equipment.
The robustness of our response to a potential pandemic is dependent on having the right quality and quantity of health workers who are appropriately educated and trained. We must be prepared to invest in the skill development of health workers and recognise the benefits to be gained from exchanges with international professionals. We must establish strategies for shared resources in biotechnology; we need to work with vaccine producers from around the world to discover the best way to prevent disease spread. It must be remembered that disease plays out in different ways: a virus that might kill people in some countries might tend to resemble a mild cold in others; the same disease that puts one person in intensive care for a month might be brushed off in a day by another. By working across countries and across sectors, we can get the most comprehensive picture of a pandemic.
Co-operative disaster response relationships will help in our response; the International Skills and Training Institute in Health (ISTIH), which was set up in Perth in 2005 following the Indian Ocean tsunami, is one example of how we can leverage expertise and resources for the common good.
Mother Nature is our greatest teacher, but unfortunately she has been overly vigilant about her responsibility to teach in our region in recent times. The Indonesian, Samoan and Philippines disasters have served to highlight the enormity of the need for a strategic and coordinated response to natural disasters. In coming months we have a major responsibility to identify "what worked" in Australia's reactions and share these learnings with others. Similarly, we need to cherry-pick the best of the international actions and assess how they can be applied in our responses.
Pandemics are not just about peoples' lives, although that is the Number One priority. Pandemics have the potential to create huge economic challenges. The resources involved in monitoring, managing and mitigating pandemics are significant. Lost revenue from tourism depletion and decreased worker productivity are just some of the side effects. It is estimated that the SARS outbreak cost the global economy $20 billion.
International collaboration in response to pandemics is essential for the wellbeing of our citizens and our economies.
This opinion piece was published in a special report, "In the Zone: Crisis, Opportunity and the New World Order", The Australian newspaper, November 7 - 8, 2009...