Home ›› 06 Mar 2022 ›› Opinion
Public health is by no means just about the outbreak of infectious diseases or health emergencies; it represents the population or holistic view of medicine. It originated from the initial intent of society to protect and improve the health of the public, and there is thus a great deal of altruism in it. Hygiene as the means to achieve this goal is the crystallization of human ingenuity in preventing infectious diseases and has made undeniable contributions to improving the public’s health. There are too many population- or society-level problems in modern medicine that limit health services’ quality, efficiency, and equity in all countries. These problems are not simply medical issues and cannot be left to health workers alone; their resolutions must be based on social, political, legal, economic, moral, and many other considerations, and require the support and participation of the whole society. It must be stressed that the inability to see and resolve major medical and health issues at the community or societal level is the real weak link in the public health system. The Covid-19 pandemic provides us with a rare opportunity to closely examine the validity of the construction of modern medicine, which is armed by science, and focus more on technologies than on people’s values and more on new ideas than on conventional wisdom.
The world’s responses to the Covid-19 emergency have revealed a badly weakened public health system. A hundred years ago, public health was the only effective measure for combating infectious diseases, which were then the leading cause of human death. It is still a decisive weapon against Covid-19 and other contagious diseases alike but was barely recognized and trusted at the beginning of the pandemic by the general public and even some international strategists. Public health aims to improve the entire population’s health by using societal methods. It is not simply a medical issue, and building a robust public health system requires broad participation from various sections of society. While the Covid-19 pandemic has placed unprecedented demands on modern healthcare systems, the industry’s response has vividly demonstrated its resilience and ability to bring innovations to market quickly. The sector’s innovation capabilities must continue to rise to the challenges presented by Covid-19 and the economic fallout from its spread. While many industries are facing unprecedented disruption, medicine and healthcare are uniquely affected, given the nature of this crisis. For example, pharmaceutical companies racing to develop vaccines must also manage complex supply chains, new models for engagement with healthcare professionals, a largely remote workforce, and disruption to many clinical trials.
Similarly, hospitals are caring for Covid-19 patients with evolving protocols while maintaining continuity of care for others, often against the backdrop of vulnerable staff, supply and equipment shortages, and, for some, accelerating financial headwinds. The pandemic sparked an unprecedented drive to control a lethal disease whose outbreak led to a near-global shutdown to contain its spread. Billions in public and private money were pumped into research like never before in such a short space of time. It’s not something the medical world would have chosen, but the developments of the past two years could not have happened without Covid-19. The pathogen has served as a significant catalyst ushering in different technologies, data, and research that offer insights into other diseases. The lessons learned and the new norms that have solidified will change medical science forever. The world now sits on the verge of several potentially significant breakthroughs, primarily thanks to the growing research into hi-tech vaccines, which could benefit patients with cancer and a whole raft of infectious diseases.
Meanwhile, new studies into long Covid-19 could shine a light on blood clotting, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and other conditions associated with the stubborn virus. Obesity and vitamin levels are under the microscope; while digitisation and increased cross-border collaboration could soon reap the rewards. Covid-19 has stimulated the rapid translation of previous knowledge into practice. Developing science takes many years and needs an opportunity to be implemented.
Covid-19 has provided an easier regulatory environment with fast-tracked trials, so vaccine developments, for example, have been rapid. Until Covid-19, it could take a decade or more for a new vaccine or drug to go through all the development and regulatory stages, he adds. Still, now they have been rolled out within 12 months of the first description of the disease. Our expectations are now for a much more rapid translation, and implementation of scientific advances, The caveat to this is the continuing need for equity of access to these advances, which is yet to be seen with vaccines and drugs. Just five years ago, there was widespread hesitation to invest in experimental drugs that use synthetic molecules to guide human cells into making specific proteins that can defend against diseases. No product based on mRNA (which stands for messenger ribonucleic acid, and provides recipes to create proteins) technology had ever been approved, but within two years, there have been rapid development and success of Pfizer/BioNTech and Moderna’s jabs against Covid-19. Relative public acceptance of an unusual hi-tech approach has also been key, and approval by a diverse range of regulatory bodies has given both investors and the industry confidence. This could open the floodgates to further approvals if the new jabs impress in trials. If we want a different vaccine, we add the last bit, and then we’re ready to go, Professor Sarah Gilbert, architect of the Oxford Vaccine. They already have their sights set on another killer disease, malaria, which is estimated to have killed almost half of all people since the Stone Age. It remained a leading cause of global infectious disease death last year: more than 600,000 people, usually young children, died from it.
Digital health has also come to the fore as a result of pandemic responses. The use of smartphone applications and the public understanding of data and knowledge of disease prevalence are now widespread; People are increasingly accustomed to getting clinical advice at a distance, through virtual consultations, while other information collected on apps is sent to medical professionals. Home testing is also a significant advance, as it allows people to effectively self-diagnose and thus limit their exposure to others. This has come alongside rapid clinical evaluation. Covid has provided a vision for how best to apply science to health problems in the future. If there’s one area of optimism, this move towards scientific collaboration and the impressive advances that have emerged in such a relatively short space of time. “It’s been such a horrific time for so many people”, agrees David Braun, an oncologist and scientist focusing on cancer immunotherapies at the Yale Cancer Centre in New Haven, whose team is working to transfer the RNA technology to a cancer jab. “I hope that some of the scientific advances made during this period might help us to treat other diseases, so that at least there can be one glimmer of hope that comes out of this tremendously difficult situation. The Covid-19 pandemic tells us that the ‘high technology from a century ago is still the most powerful instrument for controlling newly emerged infectious diseases today.’
All our experts are authoritative in their own fields, but might not see the whole picture. We need specialists, but also need to bridge the gaps between different disciplines. To do that, we need generalists who can see things from a higher plane. The experts’ task is mainly to provide facts and truth. In the capital-driven commercialist world, truth and profit are inextricably linked. Because of this, the version of reality we hear may often be incomplete or distorted. Unfortunately, people are often confused and might not trust the reliable information. Science is not the same as belief; it is a tool. Even though we know the facts that do not mean that we can always make good decisions. We seek truth, but the truth is not equal to dreams. We must get the relationship between science and faith right on major issues. History has taught us that the transformation of a nation’s healthcare system is not based on the calculations of science and efficiency but on the construction of great ideas. At the turning points in the history of public health stand lawyers, sociologists, economists, philosophers, educators, physicians, and many more. They have given public health a broad vision and tremendous vitality and transformed its development trajectory with their faith, commitment, and hard work. Today, many more people are starting to pay attention to public health, which is truly encouraging.
The writer is a researcher based in the UK. He can be contacted at raihan567@yahoo.com
