The Body Covers: The 38th Annual Meeting of the Infectious Diseases Society of America
September 7, 2000
I have not attended an ISDA meeting since the ICAAC and IDSA meetings split apart several years ago. I wanted to see what IDSA was like and to talk to many practicing infectious disease doctors to see how they were doing in practice and what HIV issues are most pressing for them. I didn't necessarily have the highest hopes that I would get a lot of HIV buzz from this meeting but I can honestly say that the opening plenary session was inspiring.
William Foege, who is a legendary public health figure now based at the Carter Center at Emory University, gave the first talk. He was instrumental in leading the effort eradicating smallpox, which stands as one of the great achievements of the 20th century. He spoke about the lessons of history as they related to mankind and germs. Both humans and germs are influenced by their genetic make-up, which reflects the influence of evolution over a long period of time. A new concept he spoke of was social DNA, which is the societal milieu that can influence the course of history. A non-infectious disease example he gave was the effect that Abraham Lincoln had on the social DNA of mankind -- an influence that is still felt today.
A major point of his talk was that rugged individualism is a lie and that we are all interdependent. To vaccinate a child in Africa against measles represents the cumulative work of literally thousands of individuals over decades of time to accomplish the social/health good of preventing disease. A single individual can make a difference (e.g. the discovery of penicillin or the small pox vaccine) but groups need to work on how to improve society worldwide.
He gave another example of how fatalism can paralyze a society's ability to work constructively on a problem (AIDS in Africa, for example). Yet certain countries (Uganda) can make a significant dent in the scope of the problem when the will is there. He spoke of the importance of science to have a moral compass and urged the IDSA to take a leadership role in improving the social DNA of the world (looking beyond the borders of the US). The audience took his remarks well for they are aware of the global nature of infectious disease. He quoted Einstein who said, "nationalism is an infantile disease" and left the podium to a loud heartfelt round of applause.
That was a tough act to follow but Dr. Anthony Fauci took the gauntlet and then built on the themes begun by Dr. Foege. His task was to look into the future of infectious diseases and the 21st century. He had been warned not to focus too much on HIV/AIDS and it was refreshing to hear him speak on broad subjects (malaria, TB, pneumonia), but he wove a theme of AIDS as a model for the future into the talk. He personalized the issue with several stories. One involved a radio report he heard in 1967 wherein the U.S. Surgeon General reported to Congress that funding should be slashed for infectious disease programs since the problem was rapidly fading. Since Dr. Fauci was on his way to start an infectious disease fellowship at the NIH, he had a moment of panic about his career choice.
He then made a compelling case for the exciting potential for scientific developments to greatly impact the toll infections have on the world's population. Perhaps the most visible area of change will involve spin-offs from the sequencing of the genomes of both humans and many pathogens. He focused on the same inequities as the previous speaker and emphasized that the feeling he came out of Durban with was that good HIV care MUST and can be made available to most of the world. The inequities of rich and poor must be addressed with global health being a high priority for all countries. He told of a meeting with Clinton and Gore where these issues were frankly discussed. Now, AIDS and other infectious diseases in other countries are increasingly viewed as important health/security/economic problems that impact the U.S. A striking vision of the 21st century was presented where the problems of the 20th century (involving the physical sciences = nuclear weapons and the cold war) will be replaced by a focus on infectious diseases and global health (the biological sciences). Although I have heard Dr. Fauci speak many times this talk seemed to come from the heart as well as from his mind and was very moving and insightful. This opening session was already worth the price of admission!
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