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Politically Incorrect

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Enlightened self-interest is "one" reason to support the One Campaign

The band on my wrist is simple: some type of white rubber material stamped on the outside with the word “one.”

            One person. One voice. One vote at a time. That’s part of the mission statement for one.org, an ambitious, worldwide project to seek funding for health, education, clean water and food to “transform the futures and hopes of an entire generation of the poorest countries.” The estimated cost to do this? One percent of our gross national product.

            Many will read this and dismiss the One project as yet another misguided, liberal attempt to save the world. They’ll argue, either to themselves or to others, that a “welfare mentality” is destroying our country. They’ll say it’s somehow morally wrong for a nation to help those in need. They’ll argue that people should “pull themselves up by their bootstraps” and “make it on their own.” The “haves” will wonder why in the world they should use the fruit of their labor to help those who “have not.”

            Let me give just one reason why everyone should support this effort, no matter which side of the political spectrum their inclinations lead them to: enlightened self-interest. People should support this project because it’s in their own best interest to do so.

            The provision of health, education, clean water and food, and the elimination of the poverty that leads to the lack of these, is the backbone of a functioning public health system, and if you don’t know why a functioning public health system is important for your future well-being, if you didn’t know that public health is floundering, you should.

            The simple truth is that infectious disease does not recognize the artificial boundaries we use to separate ourselves from our fellow Homo sapiens on this planet Earth. Cholera doesn’t care what race you are. Influenza travels freely through continents, countries, states and cities. Tuberculosis will take up residence in the lungs of Christians, Muslims, Buddhists and atheists. Staphylococcus will strike both rich and poor. And every single one of us are threatened by these infectious diseases (and a host of others) in ways not seen since the 1940s ushered in the age of antibiotics – an age now drawing to a close thanks, in large part, to an ignorance of the value of public health.

            Our founding fathers and mothers faced health crises we can only imagine today. Smallpox, plague, cholera, measles and the fevers – malaria, yellow and dengue – left our ancestors with an average life span that wouldn’t qualify a one of them to run for President today. And that was assuming they even made it to adulthood, which wasn’t a good bet to place – Americans had a fifty percent chance of dying before they reached the age of five.

Then, in 1743, Dr. Cadwallader Colden recognized a crucial connection between homes located around filthy, standing water and a higher incidence of yellow fever. In 1796 New York City passed the nation’s first comprehensive public health law.

            Although Americans of the time recognized a sense of duty to the public at large, it was enlightened self-interest that helped to drive public health expenditures. J.L. Pomeroy, first health commissioner of Los Angeles County, put it succinctly, when he stated a fact we seem to have lost sight of today. “It must be clearly recognized that diseases recognize no boundary lines…” he said.

            That support for public health means that Americans today can expect to live more than twice as long as our ancestors did 250 years ago, and there is less than one half of a one-percent chance that a child will die before the age of five. An unexpected result of that has been a sense of complacency on the part of Americans that the risks are over, and focus can move away from traditional public health issues to the diseases of aging – cancer, heart disease and the like.

            Unfortunately, the signs are obvious that we neglect public health at our own peril; what we chose not to learn from information may well be learned from first-hand experience.

            Consider these facts:

            -The CDC reported in 2002 that 90,000 Americans die annually from hospital-acquired infections. That is more than the combined total number of deaths attributed to AIDS, breast cancer and motor vehicle accidents.

            -Ten percent of all hospital patients (50 percent of those in ICU) will contract a hospital-acquired infection. (And a serious blood infection, for example, adds $60,000 to the average hospital bill.)

            -Antibiotic resistance is labeled by the U.S. FDA as “a growing threat,” and “an increasing public health problem.” Currently, tuberculosis, gonorrhea, malaria and childhood ear infections are just a few of the diseases that have become hard to treat with antibiotic drugs.

            -Staph bacteria, the leading cause of hospital infections in the United States and itself the cause of 60,000 to 80,000 deaths annually, is now “armed to the teeth with resistance genes against virtually all available antibacterial agents, including penicillin,” according to the Laboratory of Microbiology at The Rockefeller University. There are strains of staphylococcus that are now resistant even to vancomyacin, the “last resort” in our arsenal of antibiotics.

            As frightening as a return to a world without the protection of antibiotics may be, it is only one of the threats an under-funded public health system is facing.

            Emerging infectious diseases (SARS, HIV, Ebola-type hemorrhagic fevers) and re-emerging diseases (flu, tuberculosis, malaria, etc…) worldwide continue to kill. Many of the most frightening diseases are, luckily, relatively hard to catch, but there is no guarantee that will always be true. In fact, the guarantee is that it won’t always be true – because bacteria continually adapt. In today’s global society, the health of the people on the African continent - or the Asian one, given the drastic public health situation in the former Russian republics - can rapidly impact the health of those of us at home.

            In addition, the aftermath of rampant public health failures worldwide can result in security issues at home. A report for the CIA by the National Intelligence Council states that infectious disease has major implications for U.S. national security and “The severe social and economic impact of infectious diseases is likely to intensify the struggle for political power to control scarce state resources.”

            Dealing with the threats facing the continued health of every person in the world today, which more than ever is in our own best interest to do, will mean dealing with the poverty that amplifies our health threats, turning infections into epidemics and epidemics into pandemics. Study after study has shown that the poor are less healthy in almost every disease and disability category, regardless of their particular habits and behaviors.

            Pulitzer prize-winning journalist Laurie Garrett, in The Coming Plague: Newly Emerging Diseases in a World Out of Balance, sounded the warning a decade ago. “While the human race battles itself ... the advantage moves to the microbes' court. They are our predators and they will be victorious if we, Homo sapiens, do not learn how to live in a rational global village that affords the microbes few opportunities.”

            We haven’t done much to win that war – in America, we haven’t even declared it yet. And ignorance may yet win the day. But that can change… with one person. One voice. One vote at a time.

            To learn more about the One campaign, visit here.  Laurie Garrett’s novels, The Coming Plague and Betrayal of Trust (which chronicles the rise, and fall, of public health) may be ordered locally at Vanderford’s Books and Office Products in downtown Sandpoint. You can visit her website here. The Global Infectious Disease Threat and Its Implications for the United States, a report prepared by the National Intelligence Council, can be read here.

 

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Landon Otis

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one, poverty, public health, Laurie Garrett

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