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Vol 22, No. 11, November 2018   |   Issue PDF view/purchase
100 years after the Spanish Flu: Are we ready for the next epidemic?
In 1918, a deadly flu pandemic swept across the globe. It occurred during World War I where close quarters and massive troop movements helped fuel the spread of disease. It was estimated that 500 million people or one-third of the world’s population became infected with the virus, and 50 to 100 million lives were wiped out. Now 100 years later, the Spanish Flu remains one of the deadliest disease outbreaks in history, and scientists are learning to prepare for future threats.

Professor Peter Piot is the Director of London School of Hygiene & Tropical Medicine, a world centre for research and postgraduate education in public and global health. In this interview, Prof Piot presents on the need for innovations to build resilient health systems that leave no one behind and the lessons Asia can draw upon after being hit before by epidemics such as SARS and Bird Flu, as well as the future health threats that Asia need to be wary of.

What are some lessons we can learn from the Spanish Flu?

One of the biggest lessons learned from the Spanish Flu, and from the many outbreaks that followed, is that we need to be better prepared, planning for every eventuality. Systems need to be in place before an outbreak hits so that it can be quickly contained before spiralling out of control. The second key lesson is that we need new tools. While we are better prepared today with antibiotics and seasonal flu vaccines, we need to accelerate research and development for a universal flu vaccine.

From SARS to bird flu, Asia has been hit before by epidemic and pandemic. What other future health threats would Asia need to be wary of?

While infectious diseases are certainly a big concern in Asia, particularly the so-called ‘zoonotic diseases’ that jump from animals to humans, what is even more worrying right now is the growing rate of chronic conditions, which are also spreading like pandemics.

In 2016 alone, around 75 percent of all deaths in Asia were due to non-communicable diseases, according to the Global Burden of Disease Study. Spreading antimicrobial resistance is another threat to watch in the region and we all need to be thinking about the health impacts of climate change.

Is Asia particularly vulnerable?

These health threats affect us all, but some factors do make Asia particularly vulnerable. To name a few, an ageing population, rapid urbanisation, expanding middle classes, and close human-animal interactions (e.g. extensive livestock production) create a perfect breeding ground for epidemics of both communicable and non-communicable diseases. Weak regulation is also a concern, particularly in the context of growing rates of antibiotic resistance.

Of the future health threats mentioned, would they be of global threats?

Certainly. The reality is that in our increasingly interconnected world, with unprecedented mobility of people, products, and food, all of these health threats are now global.

Are the health systems across Asia on par with the developed world to tackle health threats?

Several Asian countries have made great progress in health systems strengthening, but it would be fair to say that none are fully equipped to manage the growing epidemics of diabetes, cardiovascular disease, obesity, and lung cancer.

In addition, many countries are also lagging in their epidemic preparedness levels. At the same time, the rest of the world also has a lot to learn from Asia, particularly in terms of harnessing innovation and the role of the private sector in health systems strengthening.

What are some of the innovations available today to build resilient health systems to tackle with future health threats?

I think Asia is really leading on innovation in health. I recently learned of IDS Medical and of WeDoctor, an online healthcare solution that is really having a big impact in China, connecting people with the health services they need. I think this kind of innovation is particularly important in the context of chronic shortages of human resources in many places, where digital technologies are filling critical gaps.

For example, social enterprises in low-resource settings like Peek Vision can use smart-phone based technology to enable health care providers to deliver cost-effective and targeted treatment to people with eyesight problems.

At the same time, while there is a wealth of innovation going on in health, there is not enough evaluation and validation as to whether these new technologies actually improve health and this should certainly be a priority as well.

In terms of epidemic and flu outbreak, the closest we have experienced on a major scale was the SARS outbreak in Hong Kong and Singapore. If there was a similar outbreak in the future, what control measures and role can the government play?

I think the key will be strengthening surveillance efforts, acting early, and mobilising a coordinated cross-government response. As ever, preparedness and emergency plans will be critical. So too will be working with the public to reduce panic and to ensure that evidence-based health information is shared and that the spreading of false information or ‘fake news’ is mitigated as much as possible.

Professor Peter Piot is the Director of London School of Hygiene & Tropical Medicine and Handa Professor of Global Health

This article is derived from the Asian Healthcare Leadership Summit (AHLS) 2018 held from 21 to 22 September at Resorts World Sentosa, Singapore. Organised by the idsMED Group.

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