By: Ben Cobb, Chisom Nwaneri, Andrew McCrary, Deng Madut, Valerie Parker

Polio, Typhus, and AIDS account for several of the worst infectious disease outbreaks in world history. Recently, outbreaks such as Avian Influenza (A/H5NI subtype) and Swine Influenza Virus (A/H1N1 subtype) has caused significant infection globally, creating public concern for diseases similar to these. Zoonotic diseases are an area of concern both in developed countries and in developing countries. In developed countries, agriculture and livestock care are potential zoonotic disease transfer areas, while in developing countries, interaction with livestock is a fairly common, daily activity, increasing the risk for zoonotic disease transfer substantially. For example, China is responsible for 47% of pork production (Gray, 2013) and has been a source for zoonotic disease transfer. In Dr. Gray’s words, he feels “optimistic that in China we can … reduce cross-species zoonotic pathogen transmission.” (Gray, 2013)

Question #1: Comparing before and after Dr. Gray’s readings and lectures, how has your view changed about working with, eating, or being in the proximity of certain animals that have been linked to zoonotic disease, such as birds and pigs?

As a One Health partner, Dr. Gray’s work emphasizes interdisciplinary collaboration between certain entities, such as Duke University and The Center for Disease Control. Interdisciplinary action is so imperative in this regard that Dr. Gray states “[u]ntil we develop interdisciplinary approaches to expand this knowledge, it seems likely that humans will continue to be the unfortunate sentinels for novel SIV detection.” (Gray, 2013) Currently, work is being done between One Health, Duke University, and the US Swine Industry. Global health is a field that permeates many other fields, such as public policy, health and medicine, agriculture, animal care, business, psychology, and many more.

Question #2: In addition to One Health, Duke University, and certain US animal industries, what other areas/organizations do you feel could be partnered with in order to decrease zoonotic transfer disease to improve the current interdisciplinary approach?

While preventing zoonotic disease transfer is the primary goal, necessary and swift steps need to be taken when breakout does occur in order to prevent mitigate the health consequences within each individual already infected and to prevent the spread of the infection person-to-person further. Oftentimes, in order to evaluate the necessary steps to take, understanding the disease at a molecular level is imperative. One topic of much concern is antibiotic resistance. According to the CDC, every year, at least 2 million people in the US are infected with antibiotic-resistant bacteria and at least 23,000 of those people die annually due to the infection of these antibiotic-resistant bacteria. The CDC has created the Antibiotic Resistance Solutions Initiative, a $264 million intervention to slow and combat antibiotic resistance. There are five primary goals in this Initiative:

  1. Slow the Development of Resistant Bacteria and Prevent the Spread of Resistant Infections
  2. Strengthen National One-Health Surveillance Efforts to Combat Resistance
  3. Advance Development and Use of Rapid and Innovative Diagnostic Tests for Identification and Characterization of Resistant Bacteria
  4. Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines
  5. Improve International Collaboration and Capacities for Antibiotic Resistance Prevention, Surveillance, Control, and Antibiotic Research and Development

Question #3: Which of these primary goals do you feel are the most important? Which are the least important? Are there any goals or alternatives to antibiotic resistance that aren’t listed that you feel could play an important role in decreasing or preventing the antibiotic resistance?  

It is clear that antibiotics are key to combating bacterial infection, while other drugs, such as anti-retrovirals, are necessary for combatting viral infection. While the use of these medicines are greatly important, it is not always possible for certain countries to obtain this medication. In many low-income countries, approximately 90% of medication is purchased by individuals instead of a healthcare facility or the government. The prices for these medications are extremely high. For example, the WHO stated in a report that “a low-skilled government employee in Tanzania an entire months’ wages for a course of antibiotics to treat pneumonia”. This extreme inaccessibility to medication creates a very difficult environment to prevent infectious disease. There is currently a fight between the US, developing countries, and drug companies to provide lower cost medication to countries that need them. There is also currently no solution in place and many people in the developing world are sick and dying from infectious disease simply due to the cost of medication.

Question #4: What do you believe the solution for decreasing the cost of medication in the developing world is? Who would need to be involved in this solution?

Infectious diseases are extremely prevalent and life-threatening globally. It is the responsibility of global health professionals to prevent these diseases, educate the public, and attempt to eradicate these infectious diseases that are so harmful.