The growing global health crisis

In 1969, when addressing the American Congress, Surgeon General William Stewart is believed to have said that “it is time to close the book on infectious diseases, and declare the war against pestilence won”. This came at a time of great euphoria around the recent strides made in the field of antibiotics and encapsulates a contemporary feeling that science was winning the battle against disease. And yet, the 21st century has seen diseases like smallpox and polio, almost eradicated in the 1970’s, become increasingly common, and future of global health looks yet bleaker.

“Antimicrobial resistance in a ticking time bomb…for the UK”, says Sally Davies, Chief Medical Officer for the UK. As she states, a major part of the growing health crisis is the problem of increasing bacterial resistance to current antibiotic treatment. This can be attributed to the natural evolutionary process, but also the misuse of drugs by the common person. People are consistently being given a course of medication and stopping the course prematurely, once their symptoms have died down. Already we, as a society, are experiencing some of the effects of this resistance. Dr Ibrahim Hassan, a consultant microbiologist from Manchester, reported to the BBC that “we’re beginning to see that in some hospitals, patients coming in with this infection with no antibiotic that can be used to treat them”. A further factor in the problem of drug resistance is the effect of the increasing privatization of drug production. This has greatly incentivised the production and development of drugs that can act as palliatives to chronic diseases, where the drug will be used for decades, whilst deterring research into new antibiotics which have a short-term use. The fact that no new class of antibiotics has been developed since the 1980’s is a clear indication of the dire current state of antibiotic production, and consequently the dire state of the future of antibiotic treatment.

“The effect of projected climate change indicates that a prolonged transmission season is as important as geographical expansion in correct assessment of the effect of changes in transmission patterns” of infectious disease. As highlighted here by a recent article from The Lancet, global warming is another significant factor in the growing prevalence and effects of disease on the world’s population. For instance, a recent BBC report from Nairobi found that this city, previously protected by its altitude, is now suffering from malaria for the first time. In addition, diseases like malaria are anticipated to spread to higher latitudes, with southern European countries potentially at risk by the end of this century.

A final complicating factor in the fight against disease this century is the fast rates of urbanisation taking place globally. This has had a particular effect on the transmission of infectious diseases as more concentrated human settlement has allowed for easier transmission of disease. Rural to urban migration is a trend only set to continue during this century, making this an ever-growing problem. Moreover, the prevalence of slums with poor sanitation and living conditions in the major cities of LIC’s (Low Income Countries) provides perfect breeding conditions for many vectors, such as mosquitoes, increasing the risk of vector-borne diseases like malaria.

Therefore, it is clear that, along with climate change, terrorism and population growth, global health is one of the biggest issues we must tackle in the 21st century. Unless we act upon the failings of the current global health movement, it is possible that, as Dame Sally Davies reports, “if you get an infection in your bloodstream, in about 10, 20 years it might be untreatable”.

Contributed by Ben Williamson

Recent flooding is just a taste of what is to come for the UK

“Let’s hope this isn’t the sign of things to come,”1. In the aftermath of the severe flooding which has hit both the UK’s coastlines and rivers in the past few weeks, Margaret Young, a resident at Chesil Beach in Dorset, hinted at the extent of Britain’s coming flooding problem.

Currently, flooding poses a very serious annual threat to the UK. Over 110 flood alerts were issued last week 2, whilst the Environment Agency has reported that flooding cost the UK “between about £260 and £620 million”3 in the period of April 2012 and April 2013. Global warming is widely predicted to greatly increase the risk and severity of flooding in the UK, making this one of the most important economic and social issues for the UK in the 21st Century. The European Environment Agency predicts that climate change will “increase the occurrence and frequency of flood events…in particular flash floods”, whilst the Government’s own report expects “2 or 4 times” as much river flooding as now by 20803.

Reports like these, as well as the devastation caused by recent flooding, has led to widespread questioning of the government’s plans to cut another £300 million from DEFRA’s budget – the body responsible for flood defence – at a time when it should be increasing it. This is not a new issue either, as the 2004 Foresight Future Flooding report stated a need for yearly increases of £10 – £30 million above inflation to the flood defence budget, until the 2080’s. Although the Environment Secretary, Owen Paterson, has defended his government’s cuts as necessary for overall deficit reduction, the flood defence budget should surely be ring fenced given that “every £1 currently invested…reduces the long-term cost of flooding… by around £8”3.

However, it is not just increased spending that is needed on flood management, but more effective spending. A recent Guardian article revealed the complete mismatch of flood prevention and farming policy in river drainage basins where vast sums of money are being spent on subsidies for upland farmers to create additional farmland by removing vegetation, increasing flood risk4. Bare land has no or little vegetation to intercept rainfall, significantly increasing the risk of flooding downstream. A recent study of small-scale reforestation at Pontbren, near the source of the River Severn, showed that if 5% more land in the river’s catchment was reforested, there would be a 29% reduction in flooding peaks5 downstream.

Flood defence is, of course, only a small part of the work of Owen Paterson and DEFRA (Department for the Environment, Food and Rural Affairs) but it is also just one example of their continued incompetence in managing environmental affairs. The ongoing badger culls vociferously pursued by the Government in Western England present another obvious example. 2,081 badgers are scheduled to be killed in the pilot scheme alone, yet DEFRA’s own figures predict a measly 16% reduction in TB cases in cattle as a result of the badger cull. However, a recent analysis of the Randomised Badger Culling Trial which ran from 1998 to 2005 has shown even this figure to be an overestimate, since in the areas studied only 6% of cows received TB directly from badgers6.

All this goes to show that a government policy of cutting and misspending the flood defence budget is no effective policy at all in mitigating against the increased flooding that will be brought about by global warming. Though this damage may not affect the PM or his colleagues living in the Home Counties, it will bring devastation to 900,000 other homes in the UK by 20503.

While Margaret Young and thousands of others continue the cleanup operation after the recent flooding, the threat of severe flooding to their and others’ properties will be getting ever worse, thanks in large part to the incompetence of our coalition government.

Contributed by Ben Williamson

1. The Guardian, http://www.theguardian.com/uk-news/2014/jan/07/uk-floods-chesil-beach-sirens

2. Met Office, flood alert chart for 08/01/14.

3. Environment Agency, http://a0768b4a8a31e106d8b0-50dc802554eb38a24458b98ff72d550b.r19.cf3.rackcdn.com/LIT_8443_200ddd.pdf

4. The Guardian, http://www.theguardian.com/commentisfree/2014/jan/13/flooding-public-spending-britain-europe-policies-homes

5. Howard Wheater et al 2008, http://nora.nerc.ac.uk/5890/1/ur16_impacts_upland_land_management_wp2_2_v1_0.pdf

6. PLOS, http://currents.plos.org/outbreaks/article/the-contribution-of-badger-to-cattle-tb-incidence-in-high-cattle-incidence-areas/

‘Six Degrees’ by Mark Lynas – A review

In its 2001 Third Assessment Report, the Intergovernmental Panel on Climate Change (IPCC), predicted an average global temperature rise of between 1.4o and 5.8o by the end of the century. In ‘Six Degrees’, Mark Lynas draws together half a century of scientific research to present a comprehensive, degree-by-degree study of the effects of global warming on the planet. The IPCC’s prediction becomes far more worrying when it is considered they state 2o degrees as the limit of manageable global warming. As Lynas himself points out, ‘climate change is the canvas on which the history of the twenty-first century will be painted’.

We begin with 1o – a level no longer deemed achievable by the IPCC, therefore making this chapter’s events all inevitable: a scary proposition. The “dustbowl” of the American mid-west in the 1930’s will return to even greater effect, creating a Nebraskan desert as the fertile top soil of this area is stripped away exposing the sand beneath. Though the state’s people may not be missed, Nebraska is the highest producer of red meat in the USA, selling over 3 billion kilos annually. Meanwhile, across the pond in Europe, the Alpine skiing industry will collapse quite literally as melting snow triggers huge avalanches every year. The Great Barrier Reef is also likely to become extinct, with 70% of all corals already dead or dying. Lynas pulls no punches, stating in his final chapter that ‘the Alpine glaciers, the Nebraskan grazing lands and the resplendent coral reefs are already condemned by events which lie in the past.’

2o signals irrevocable damage to Earth’s biodiversity. A 2004 study published in Nature predicted that ‘over a third of all species would be ‘committed to extinction’ by the time global temperatures reached two degrees’. Like much of the effects of climate change, this is not due to the level of warming, but its unprecedented speed, a key argument lost on those, like the Environment Secretary Owen Paterson, who play down the dangers of global warming. Such speed prevents evolution saving many species as they are unable to adjust their range fast enough towards the poles (‘In Holland, populations of pied flycatchers have declined by 90 per cent… because their chicks hatching is currently mistimed with the advancing spring’). This is compounded by human’s already catastrophic impact on the natural world – ‘species are already becoming extinct at a rate of 100-1,000 times greater than the normal background rate’ – trapping many species in ever decreasing pockets of habitat.

The book’s remaining chapters continue in a similarly chilling fashion, revealing how humanity will become ever more confined to the poles, as nature is systematically annihilated. These chapters also reveal the worst of our fate: an unstoppable positive feedback cycle taking global warming out of our control. The release of methane hydrates, a gas 20 times more effective than carbon dioxide at trapping heat; the end of the albedo effect as all Arctic sea ice is melted; wildfires in the Amazon releasing carbon dioxide trapped in plants – these will all create an unimaginable ‘vicious cycle’ of warming, irreversibly changing the planet. 5o and 6o begin to call into question the survival of the human species itself, as we herd ourselves into ever smaller fragments of the planet. The assault on the ozone layer would leave the sun’s rays strong enough to trigger ‘outbreaks of cancer amongst anyone who survived’ whilst the new coastal areas created by massive sea level rise would become virtually uninhabitable given the upwelling of toxic hydrogen sulphide from the ocean’s depth. However, though Lynas concludes that human extinction would be ‘unlikely’ given humans’ ‘unique combination of intelligence and a strong survival instinct’, billions of people would inevitably die as we run out of habitable space.

The books ends with a chapter entitled ‘Choosing our future’: Lynas’ plea to us all to act now to stop an almost incomprehensible murder of human and natural population alike. Sadly, Lynas’ assertion that we cannot let atmospheric levels pass 400ppm is now outdated as in April this year readings of 400ppm were recorded at Mauna Loa, Hawaii for the first time in the history of the planet. This only serves to strengthen Lynas’ message that our ‘path lies not in passively accepting our destructive role, but in actively resisting such a horrendous fate. ‘Six Degrees’ is a landmark achievement, assimilating the work of thousands of scientists, and equipping our generation for potentially the hardest fight in the short history of humanity: stopping climate change.

Contributed by Ben Williamson