After first noting some hard-won progress on the measles / polio / HIV / malaria net / and pandemic preparedness fronts (all of which is fragile), CDC director and conference keynoter Julie Gerberding, reeled off a much longer list of what still needs work. “Many of the things challenging us now aren’t going to get better. We are missing capacity and investment… We need to get real and realistic about what it’s going to take,” she said. “There are two major problems: We don’t know what to do for some of these problems. And we don’t do what we know.”

One Medicine / One Health

In the face of such a frank and dark assessment, the rallying cry of “One Medicine / One Health”  – a movement recognizing the links between human, animal and environmental health – provided a rare ray of hope. Over half of all known human infectious diseases and more than 75% of emerging diseases are zoonotic, meaning animals can get them, too, or can serve as symptom-free pathogen “reservoirs.” Bottom line: healthier animals mean healthier people, and vice-versa. Whether as sentinels (dead crows for West Nile) or as routes of transmission (wobbly “downer” livestock for Mad Cow), it pays to pay attention to the other passengers on the ark.

"We're not a population of humans living among a population of dogs, cats, and iguanas, We're a population of animals,” as Scott Weese, vet from the University of Guelph, put it, starting off a talk on the multi-species conquest of MRSA.

A One Health approach means also worrying about diseases that don’t affect humans directly, such as Colony Collapse Disorder in bees, which, over the last few years has decimated honeybee populations critical for food crop pollination. This more wholistic view that disease as an outcome takes environmental factors into account. Shifts in weather and climate patterns, for example, can trigger or worsen outbreaks of vector-borne diseases (malaria, Rift Valley fever, borreliosis). It calls for studying how all the branches of the tree of life connect. If E.coli can travel effortlessly between cow gut, stream, soil, plant and into a salad-loving human, then researchers should be able to make the journey just as easily. Follow the microbes...

One Health also means taking a smarter, leveraged approach to research. Tracey McNamara, the veterinary pathologist whose determined sleuthing played a critical role identifying West Nile virus as the culprit behind the initial U.S. outbreak in 1999, sees lots of “low hanging fruit” opportunities. She points out that samples from 30,000 wild birds tested for WNV could also have been used to test for avian influenza and other pathogens of interest.

Technology offered a second glimmer of optimism, providing a better way to do just that.  Columbia University’s Ian Lipkin wow’ed the crowd with a lecture on rapid diagnostic tests capable of determining whether a pathogen is a previously unknown germ and, if so, to what it is related.

And it was SRO to hear Google.org director Larry Brilliant speak on the potential of real time interactive mapping, modeling and data analysis for improved surveillance, which included a brief overview of some of the work being done by “dot.org” and InSTEDD* (Innovative Support To Emergencies, Diseases and Disasters), an independent non-profit spun off from the foundation.

Humanitarian Technology Review

Most of InSTEDD’s efforts are focused on developing software, adapting hardware and testing out systems for better disease surveillance, data collection, connectivity and field communications. I have been asked, however, to work on a project for that is bit different: to develop a plan for a weekly online newsletter / website journal covering technology for global heath and humanitarian action. (see posts Humanitarian Technology Review and Technology for the Greater Good)

Disease and disaster – the twin foci of the Humanitarian Technology Review (working title) – are typically viewed as separate issues, handled by different agencies and specialists. Yet there is no humanitarian crisis without a health component, or a serious outbreak of disease without a humanitarian dimension.

Just as “One Medicine / One Health” is an approach to integrate different fields of research and create links between health disciplines, HTR is a medium designed to make connections between those with needs and those with ideas, products and funding. HTR is a tool for helping find those much-needed better answers.

The Humanitarian Technology Review is an “idea-in-progress.” Please send any thoughts, ideas or questions to: htr@instedd.org or jaginsburg@gmail.com.

1. *“Innovative Support To Emergencies, Diseases and Disasters” is a retrofit for an acronym introduced in a speech at a TED conference by epidemiologist-turned-Google.org director Larry Brilliant. It was originally a double pun on TED and EDD – Early Disease Detection.

by Janet A. Ginsburg