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Laurie Garrett, Pulitzer-Prize Winning Science Writer, Speaks on Zika and the Collapse of Global Public Health

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Don Milton and Pulitzer Prize Winner
Laurie Garrett, Senior Fellow for Global Health at the Council on Foreign Relations, with Dr. Don Milton, professor in the Maryland Institute for Applied Environmental Health.

Pulitzer Prize-winning science writer Laurie Garrett, author of several bestselling books and Senior Fellow for Global Health at the Council on Foreign Relations, warned about the consequences of a collapsing global public health infrastructure and the continued threat of Zika during her Grand Rounds lecture at the University of Maryland on October 17, 2016.

Sponsored by the Maryland Institute for Applied Environmental Health (MIAEH), the School of Public Health, the School of Public Policy and the Merrill College of Journalism, Garrett's lecture, "Zika and the Collapse of Global Public Health," examined the rise and fall of epidemic trends throughout history and discussed the ongoing public health impact of the Zika virus.

The World Health Organization (WHO), whose leadership the world must rely on in an age of increasingly complex public health challenges, is crippled by political conflicts, poorly funded, and overwhelmed by the scope of its responsibilities, Garrett said. Extreme poverty undermines the ability to set up global health systems, while globalized travel means that any outbreak could be worldwide within 24 hours.

And yet, "outbreak after outbreak, we see the same shopping list of problems and they never seem to get answered," Garrett said.

"We approach outbreaks, even though we're a high-tech world, with no tools in the tool kit. Along comes Ebola -- the first truly urbanized outbreak the world has ever seen -- and still the world was doing almost nothing ... in the U.S., our epidemic was one of fear and not of Ebola. But because of fear, we are reluctant to come to aid, and the whole world was late to the game. We could have stopped the epidemic. We had the toolkit: we knew enough. And yet the resources were not committed or mobilized."

By the time the U.S. Congress had approved funding for Ebola aid, Garrett pointed out, thousands of people had died. In the case of Zika, Congress responded to President Obama's request for $1.9 billion by instead offering "leftover" Ebola money -- all of which had already been committed to Ebola recovery. 

"If every time we have an outbreak we have to go to Congress and beg, then every outbreak is going to find its resources locked in partisan bickering," she said.

There are many questions about Zika we should have answered by now, said Garrett, but didn't have the resources to do so: How do we test a pregnant woman and reliably give her some sense of the status of her fetus? What does the future look like for these babies? What repellant and pesticides work, and how will we overcome the political challenges of using pesticides? Will Zika adapt to a vaccine, turning it into a permanent feature of our landscape like dengue and chikungunya? 

Simply treating these epidemics, Garrett stressed, is not acceptable. We need a new set of tools and an emergency reserve that is depoliticized. 

And yet, however, dim the prospects, it's important to remember how far we've come since the 40-year life expectancy of the 1800s, she said. 

"We've gone from a pretty grim picture to a world of centurions ... we're headed toward a world where children can be expected to live into adulthood." 

The difference in the most recent era is of course money, she said, adding that the U.S. has been the single biggest donor to global health efforts worldwide.

Dr. Donald Milton, professor at MIAEH who organized the event and introduced Garrett, said her talk was a sobering reminder of how gridlock impacts health.

"Delayed response to Zika will result in babies with a life-long disability and enormous costs for a generation to come," Dr. Milton said. "Garrett indicated that it's not just the U.S. that is suffering from the effect of political gridlock -- the entire global public health infrastructure is experiencing a similar problem, resulting in woefully inadequate financing and lack of ability to anticipate problems and mount timely responses to public health emergencies."

Garrett is the only writer ever to have been awarded all three of the Big "Ps" of journalism: the Peabody, the Polk, and the Pulitzer. Her expertise includes global health systems, chronic and infectious diseases, and bioterrorism. The Public Health Grand Rounds lecture series, launched at the School of Public Health in 2011, hosts distinguished public health leaders to speak on current topics and trends in public health research and practice.

Dr. Elisabeth Maring, director of Global Health Initiatives at MIAEH and director of SPH's Global Public Health Scholars program, said that Garrett’s talk--along with her books, articles, and international work -- compels everyone to pay attention to holes in public health infrastructure.

"I was thrilled for our undergraduate Global Public Health Scholars to hear a well-known figure in the field, who engaged with our own faculty and graduate students by asking questions about infectious disease outbreaks like Zika and Ebola," Dr. Maring said. "Maybe most importantly, Laurie Garrett's presentation pushed students to think critically about a career in global health and how they can make an impact."

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