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Pandemic threats: what is to be done

As yet another wave of fear is triggered around the world by the threat of pandemic flu, this time prefixed ‘swine’ rather than ‘avian,’ it is time to consider whether animals are ganging up against humans — or if humans are creating conditions that imperil all forms of life.

It is common to think of infections as diseases caused by dangerous ‘bugs’ that are inimical to our health and must be prevented from entering our bodies by sanitary measures, blocked when they do by protective vaccines and aggressively combated through antibiotics or anti-viral drugs if signs of infection develop. We do not usually pause to enquire why these bacteria or viruses suddenly spring forth to spread rapidly across countries and continents. We simply assume that these villains must be lurking around us all the time and suddenly turn malevolent when seasonal changes enable them to erupt and increased human-to-human contact allows them to spread.

This biomedical view of infections, although backed by laboratory diagnostics and medical therapeutics, presents a narrow perspective that must be supplemented by a broader social perspective. For this, we must return to the 19th century to read the words of Rudolf Virchow, a remarkably accomplished German pathologist, anthropologist, statesman, and social activist.

Sent by the King of Prussia in 1848 to investigate an outbreak of typhus in Upper Silesia, Virchow returned with much more than a medical report. In a damning indictment of the appalling living conditions, which created the epidemic, he called for self-government, unlimited democracy, tax reform, and the abolition of feudal duties and privileges. Virchow wrote: “Do we not always find the diseases of the populace traceable to defects in Society? If disease is an expression of individual life under unfavourable circumstances, then epidemics must be indicative of mass disturbances.”

We have certainly come a long way from those dismal conditions in Silesia. With improved social conditions, infections declined over most of the twentieth century. Yet the situation has changed in recent decades. The Institute of Medicine (IOM), one of the three U.S. National Academies of Science, says that new infectious diseases are now emerging at a historically unprecedented rate of one per year. Even as we scamper around to produce vaccines and find drugs for one infectious onslaught, another breaks out, precipitating further panic. An article in the science journal Nature, published in 2008, states that while infectious disease outbreaks have significantly increased over the past 50 years, over 60 per cent of them are related to zoonoses, which are diseases transmitted to humans from animals. Such infections include the West Nile virus and Avian influenza (from birds), Ebola hemorrhagic fever and SARS (from bats), and the H1N1 ‘Swine’ flu (from pigs).

Reviewing evidence from several sources, the IOM concludes that zoonotic diseases arise from an expanding convergence of several factors, prominent among which are climate change, population growth, and consumer demand for foods of animal origin. Climate change creates conditions for some insect vectors, like mosquitoes, to breed in larger numbers. Flood, famine, and drought, resulting from climate change, create insanitary conditions and break down immunity but also cause large-scale human migration, leading to the spread of disease. Population growth leads to overcrowding, permitting greater spread of infection within communities. But it is also a stimulus for migration, which carries the risk to other communities.

The dramatic rise in the consumption of animal-origin foods is not merely the result of self-indulgent consumer behaviour in affluent countries. It is driven by a vast and growing global commercial enterprise in animal and poultry farming and meat export. This requires industrial scale breeding of cattle, pigs, and poultry in crowded conditions. Global production of meat is expected to double from 229 million tonnes in 2000 to 465 million tonnes in 2050. Even now, livestock production occupies 30 per cent of the land area of the planet. While we may not expect the whole world to turn vegetarian, we certainly need to reduce the unacceptably high levels of meat production and consumption through concerted global actions.

When we add deforestation to this commercial incubator, we permit insect vectors and wild animals to carry infectious agents into human-bred livestock and then on to humans. This conveyor belt created by humans enables fast-track transmission of infections.

When viruses and bacteria have large host reservoirs of livestock or humans to replicate themselves, they tend to mutate to more virulent forms, for there is now no danger of eliminating themselves through extermination of a limited host population. Amazing as it seems, such impeccable evolutionary logic of survival and propagation drives the manner in which these minuscule microbial life forms behave.

Livestock production contributes 18 per cent of greenhouse gas emissions, arising both from deforestation to accommodate livestock and from animal emissions of methane and nitrous oxide. Deforestation is also caused by the increased agricultural activity needed to support grain feeding of large livestocks. Industrial production of animal feed and livestock breeding are also major causes of depleted water supply.

Environment and health have other convergent concerns too. An increase in the consumption of red meat increases the risk of heart disease and several cancers. Increased vehicular density in urban areas not only contributes to increased fossil fuel consumption and exhaust emissions, contributing to global warming, but also dumps toxic pollutants into the air we breathe, leading to respiratory diseases and cancers. Automated transport also reduces physical activity, contributing to hypertension, heart disease, diabetes, obesity, and some cancers. Yet we do not pause to ponder why our city planners only build more flyovers to accommodate many more cars, while pedestrian pathways shrink and protected cycle lanes disappear.

Industrial scale animal food production not only increases the amount of meat consumed but also makes the quality of meat unhealthier. The Policy And Action For Cancer Prevention Report (2009) published by the World Cancer Research Fund points out that wild meat is lean, low in saturated fatty acids, and high in n-3 fatty acids. In contrast, intensive systems involving rapid weight gain in cattle, pigs, and poultry produce meat with higher fat content, increased ratios of saturated to unsaturated fatty acids, and lower stores of vitamin A and beta-carotene. This increases the risk of heart and blood vessel disease as well as certain cancers.

Tobacco too poses threats to both health and environment. While tobacco-related diseases now claim 5.5 million lives a year globally and are likely to kill over 9 million by 2030, tobacco farming also leads to large-scale deforestation, since wood is burnt for ‘curing’ the tobacco leaf for some forms of tobacco production. It has been estimated that for every 300 cigarettes smoked anywhere, someone somewhere has killed a tree. Second-hand smoke is also an environmental pollutant. Tobacco cultivation depletes subsoil water while product packaging consumes huge quantities of paper.

It is clear that we can no longer afford to continue our non-sustainable patterns of consumption, whether of animal foods or fossil fuels or our forest reserves. The convergence of concerns, related to both environment and human health, leads us to this common and irrefutable conclusion. It is time to seek social solutions to these pressing problems that arise from our present actions and pose a grave threat to our future survival. We have to think beyond culling chickens or slaughtering pigs, as a post-facto response to an epidemic outbreak. As Virchow wisely observed: “Medicine has imperceptibly led us into the social field and placed us in a position of confronting directly the great problems of our time.”

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