Harvard School of Public Health - Yearbook (Cambridge, MA)

Page 28 text:

Robert Chang, Edward Murray, John Snyder, William Vinson, Herbert Ley, John Peters, and Samuel Bell. ... What is the next horizon... ? nphe prediction made in 1965 that infectious dis- eases would retain their importance has rung true. It is now 1975. Having demonstrated the viral etiology of leukemia and developed a specific vac¬ cine the old question of cost-benefit has arisen. Will the cost of vaccination be worth the benefit achieved? This question can be faced with some assurance now that five years of experience with broad spectrum vaccines against the common en¬ teric and respiratory viruses is behind us. The con¬ cept of geographical vaccination is well established. For instance, this year the 200 members of the 1976 class of the school of Public Health each re¬ ceived sufficient Boston Mix” vaccine for them¬ selves and families in the summer. They arrive here protected from faculty and employees. An attempt is being made to determine wild (that is non- Boston) strains they carry in order to protect the faculty from them. The School of Public Health has now been using its new building for five years. The place of the Microbiology department has been permanently established. No one enters the building without an awareness of this importance. This stems from an event in 1971 which occurred during the trial of vaccines against one of the so-called atypical” mycobacteria. A large aerosol of viable organisms was inadvertently exhausted into the recirculating heating-cooling system. Despite every effort to filter W. Paul Reagan them out or kill them with ultra-violet a few of these hardy organisms still persist. Therefore no one can enter the building without specific chemo¬ therapy or prior vaccination using the new non- cellular hypersensitivity transfer antigen. So it goes. Although man has reached the moon and looks beyond he is still constrained by the tiniest of organisms here at home. What is the next horizon? There is some evidence that the homely amoeba produces a substance protecting arteries from the aging process. Who can predict the future anyway? W. Paul Reagan 24

Page 27 text:

Emphasis on infectious diseases has other justi¬ fications. The public pronouncements by eminent people to the effect that infectious diseases have been conquered are, unfortunately, quite inaccurate and misleading. The process of evolution has not stopped. The generation times of microorganisms are measured in minutes not in decades. The rapid emergence of genetically altered drug-resistant strains of microbial pathogens and of pesticide- resistant disease-transmitting arthropods can be cited to illustrate this important point. More than one hundred viruses hitherto unknown have been recognized in the past few years as pathogenic for man. Furthermore, the Cleveland family study strik¬ ingly emphasizes the importance of infectious dis¬ ease in technologically advanced urban societies to¬ day. . . . Infectious disease accounted for more than half of the considerable amount of illness that took place in this cross section of American city dwellers receiving medical care of high quality by contem¬ porary standards . . . A further reason for renewing the emphasis on prevention of infectious diseases lies in the fact that as a consequence of the flood of new knowledge, the responsibility for preparing skilled people in this field is shifting from the professional schools of medicine, veterinary medicine and nursing to the graduate schools of public health. While stu¬ dents in the basic courses of the professional schools are being familiarized with more and more of the newer subjects such as molecular biology and bio¬ physics, they are receiving less and less instruction in diagnosis, treatment and prevention of infectious diseases. Our nation must increasingly depend on its schools of public health to provide the post¬ graduate instruction to physicians and other mem¬ bers of the health professions so that they will acquire a thorough understanding of infectious dis¬ ease in man and will be able to deal intelligently with community and national programs for reduc¬ ing this major cause of human suffering, disability and death.” John C. Snyder The Education of Health Experts for the 197O ' s by John C. Snyder, M.D., LL.D., F.A.P.H.A. American Journal of Public Health, Part II, Vol. 56, Number 1, 67-73, January 1966. John C. Snyder, A.B., M.D., LL.D. Dr. Herbert Ley and friend 23

Page 29 text:

... The Image of “Prevention .. nphe major challenge for the worker in public health in the next decade is to crystallize the image of prevention” and by so doing to compel the reasoned acceptance of public health as an in¬ tegral component of programs designed to better the welfare of man. That health often is not recog¬ nized as an essential component in economic and social development must in part be attributed to the failure of the health professions to provide a dynamic and informative leadership. While the curative image is sharply defined, that of preven¬ tion remains a nebulous concept in comparison. A visionary leadership in the health field, possessing multidisciplinary human ecology, will, by logic, and deeds, channel a major proportion of limited health resources into preventive services. The time is particularly propitious for the as¬ sumption of leadership. In the affluent as well as in the developing areas of the world, good health is ever more regarded as an inherent right of each citizen. Natural aspirations in the health field are in receipt of increasing political and financial sup¬ port. Plans and programs—or schemes, in the British terminology—appear in profusion and are funded with more enthusiasm than critical assess¬ ment. Consciously or subconsciously, society, like a Ponce de Leon, seeks the objective so aptly labelled by Rene Dubos as the mirage of health.” The pro¬ fessional worker in the health field appreciates that Thomas H. Weller, A.B., S.M., M.D., LL.D. man, a biological entity, will be ever plagued with the problem of disease as modified by a constantly changing human ecology. The health professional must direct the social forces that are groping for the unrealistic goal of total health, into realistic channels that will permit the maximum improve¬ ment in the general health status of the society of man. Further, he must selectively seek new knowl¬ edge pertinent to the solution of the changing problems of human health. Political support for health can be expected to increase. Your challenge in the next decade, there¬ fore, is to provide the leadership that will crystal¬ lize the image of prevention,” so that public health will become an accepted component of programs designed to better the welfare of man. Thomas H. Weller 25