Columbia International Affairs Online: Working Papers

CIAO DATE: 05/2009

Global Public Health and Biosecurity: Managing Twenty-First Century Risks

Margaret Kruk

July 2007

International Peace Institute


In this first decade of the twenty-first century,we have reason both to commend and to decry the state of human health and our ability to improve it.We have achieved a maximum life expectancy of eighty-six years and have found a way to manage, though not cure, the most deadly epidemic since the Black Plague, AIDS. We can keep up with mutating viruses to produce a new flu vaccine every year and we can save babies born only twenty-three weeks into a pregnancy.Yet that is only half the picture.We also live in a world where a Nigerian newborn has a nearly one in five chance of dying before reaching age five and her mother a one in sixteen chance of dying in one of her pregnancies. Life expectancy in parts of sub-Saharan Africa has fallen below forty years.We have experienced remarkable scientific advances over the past fifty years, although we have not been able to apply many of these to the bedside or to public health policy.And so we have powerful genetic tools to study the components of viral RNA but cannot predict when or even if the bird flu will spread to humans.