Writer says health
woes threaten
world security

The noted journalist urges
health officials to remember
public health is about people

---

By Helen Altonn
haltonn@starbulletin.com

An award-winning medical and science writer who has studied worldwide health and medical conditions says worsening public health problems pose serious security threats.

"Health is a national and global security issue," Newsday writer Laurie Garrett said in a key address yesterday at a Global Public Health conference at the Hawai'i Convention Center.

Garrett, winner of the prestigious Peabody, Polk and Pulitzer journalism awards and author of two major books, said widening gaps in wealth distribution in and between nations, in life expectancy rates and needs vs. capabilities of public health systems in poor nations are issues that breed hatred, resentment and instability, she said.

Garrett said that after the Sept. 11 terrorist attack and following anthrax scare, every lab in the country was overwhelmed.

"The American public expects you in this room to protect them from all microbial threats," she told the Pacific-wide delegates at the Hawaii Public Health Association's conference.

But "it's unreasonable," she said. "They want the kind of security they expected the FBI to give them. Public health cannot do that."

However, she said, over the next six months, terrorism will be driving the largest infusion of money ever into public health. Congress has appropriated $5.6 billion to battle bioterrorism next year, with $1.6 billion going to local public health developments. Also, $2 billion was authorized for infectious disease research, she said.

But public health officials must deliver the message to policy-makers that "public health is about people, not technology and quick fixes."

She said the United States has committed $1.3 billion over the next four years to fight HIV/AIDS, tuberculosis and malaria, but an estimated $7 billion to $10 billion a year is needed just to deal with HIV/AIDS.

She said "security folks are really freaked out" about the HIV/AIDS epidemics in Africa and other poor regions.

"Imagine, with a 44 percent current adult infectious rate in Botswana, if no vaccine is developed, what would be the distribution of society?"

The family structure in Africa has eroded, Garrett said. The number of senior citizens remains about the same, but the whole middle group of people supporting seniors and raising children is gone, she said.

There is no productive labor force and no supervisors for adolescents, a situation that "translates into civil war, the rise of wild dictatorships and economic collapse," she said. "The social order is gone with the demise of the middle-age population."

The traditional clan system is collapsing in some parts of Africa, resulting in increasing AIDS orphans, she said.

"Whole cultures are collapsing while we are living in the U.S.A. alive and well. The scale of it is astounding."

Fast-spreading HIV/AIDS in India is the next big concern; China has a high level of infection; Indonesia's rate is climbing; and the epidemic is "completely out of control" in Russia, Garrett said.

Concern in the United States about HIV/AIDS has diminished, but trends indicate a resurgence of sexually transmitted diseases in the gay community, she said.

Other worries in the United States concern the increasingly drug-resistant HIV strains, drug companies going for profits instead of meeting the need for new medicines and vaccine supplies, and the correlation between human diseases and antibodies used in chickens, livestock and aquaculture-grown seafood, Garrett said.

The national nurses shortage also presents dangers, since an overworked nurse is more likely to make errors, she said.