newly emergent virus, we can at least be vigilant; we can be well-prepared and quick to respond; we can be ingenious and scientifically sophisticated in the forms of our response.
To a considerable degree, such things are already being done on our behalf by some foresighted institutions and individuals in the realm of disease science and public health. Ambitious networks and programs have been created, by the World Health Organization, the Centers for Disease Control and Prevention, the United States Agency for International Development, the European Center for Disease Prevention and Control, the World Organization for Animal Health, and other national and international agencies, to address the danger of emerging zoonotic diseases. Because of concern over the potential of “bioterrorism,” even the US Department of Homeland Security and the Defense Advanced Research Projects Agency (aka Darkest DARPA, whose motto is “Creating & Preventing Strategic Surprise”) of the US Department of Defense have their hands in the mix. (Since the United States foreswore offensive bioweapons research back in 1969, presumably DARPA’s disease program is now aimed at preventing, not creating, strategic surprise of the epidemiological sort.) These efforts carry names and acronyms such as the Global Outbreak Alert and Response Network (GOARN, of WHO), Prophecy (of DARPA), the Emerging Pandemic Threats program (EPT, of USAID), and the Special Pathogens Branch (SPB, of the CDC), all of which sound like programmatic boilerplate but which harbor some dedicated people working in field sites where spillovers happen and secure labs where new pathogens can be quickly studied. Private organizations, such as EcoHealth Alliance (led by a former parasitologist named Peter Daszak and now employing Jon Epstein for his Nipah work in Bangladesh and elsewhere, Aleksei Chmura for his bat research in China, Billy Karesh for his continuing wildlife-health studies around the world, and others), have also tackled the problem. There is an intriguing effort called the Global Viral Forecasting Initiative (GVFI), financed in part by Google and created by a bright, enterprising scientist named Nathan Wolfe, one of whose mentors was Don Burke. GVFI gathers blood samples on small patches of filter paper from bushmeat hunters and other people across tropical Africa and Asia, and screens those samples for new viruses, in a systematic effort to detect spillovers and stop the next pandemic before it begins to spread. Wolfe learned the filter-paper technique from Balbir Singh and Janet Cox-Singh (the malaria researchers who study Plasmodium knowlesi in humans, remember?), during field time he spent with them as a graduate student in the 1990s. At the Mailman School of Public Health, part of Columbia University, Ian Lipkin’s laboratory is a whiz-bang center of efforts to develop new molecular diagnostic tools. Lipkin, trained as a physician as well as a molecular biologist, calls his métier “pathogen discovery” and uses techniques such as high-throughput sequencing (which can sequence thousands of DNA samples quickly and cheaply), MassTag PCR (identifying amplified genome segments by mass spectrometry), and the GreeneChip diagnostic system, which can simultaneously screen for thousands of different pathogens. When Jon Epstein takes serum from flying foxes in Bangladesh, when Aleksei Chmura bleeds bats in southern China, some of those samples go straight to Ian Lipkin.
These scientists are on alert. They are our sentries. They watch the boundaries across which pathogens spill. And they are productively interconnected with one another. When the next novel virus makes its way from a chimpanzee, a bat, a mouse, a duck, or a macaque into a human, and maybe from that human into another human, and thereupon begins causing a small cluster of lethal illnesses, they will see it—we hope they will, anyway—and raise the alarm.
Whatever happens after that will depend on science, politics, social mores, public opinion, public will, and other forms of human behavior. It will depend on how we citizens respond.
So before we respond, either calmly or hysterically, either intelligently or doltishly, we should understand in some measure the basic outlines and dynamics of the situation. We should appreciate that these recent outbreaks of new zoonotic diseases, as well as the recurrence and spread of old ones, are part of a larger pattern, and that humanity is responsible for generating that pattern. We should recognize that they reflect things that we’re doing, not just things that are happening to us. We should understand that, although some of the human-caused factors may seem virtually inexorable, others are within our control.
The experts have alerted us to these factors and it’s easy enough to make a list. We have increased our population to