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Global Threats to Public Health: Dr. Peter Hotez on Climate Change, Conflicts, Poverty and Antiscience

An illustration of a doctor holding a shield, protecting from virus, germs and bacteria.

We inhabit a paradoxical reality: anti-vaccination movements are increasing while the public clamors for vaccines against new diseases like Ebola and the present coronavirus. In this year’s Hopkins Medicine Distinguished Speakers Series, Peter Hotez of the Baylor College of Medicine began untangling these issues in his talk “Vaccines in an Age of Conflict, Global Instability, Climate Change, and Antiscience.” In his lecture, he first tackled “the forces driving us in the wrong direction,” the four categories in the talk’s title. He then moved into “progresses in the laboratory,” how we are moving against those forces.

Hotez’s career spans from the scientific to the political realms. He has a Ph.D. in biochemistry and an M.D., a dual degree that has enabled him to move between academia and the clinic since he formally began his career in 1987. He began working with neglected tropical diseases (NTDs) after initial research into the impact of schistosomiasis — an NTD caused by parasitic worms particularly affecting reproductive systems — on women’s gynecology in Africa. Yet his first two publications on the subject garnered little funding; no one, including the U.S. government, seemed to find this a worthwhile disease to fight. Hotez realized that schistosomiasis was not the only NTD receiving little attention from large funders. He thus became a political lobbyist for NTD research. At this point in the talk, he gazed around the lecture hall and said, “Never underestimate your power to care about what you’re working on. It’s more a matter of willing to take the time to do it.” His persistence and time certainly paid off — he claimed that 1 billion people are now treated annually for schistosomiasis and other NTDs thanks to his political work.

It is this persistence and time that we need to fend off the “forces driving us in the wrong direction.” He framed these forces using the anthropocene era, the new geological age our world has entered because of human activity. According to Hotez, we are seeing an “unraveling” of developments against such diseases as measles and hookworm due to the anthropocene. Climate change, in conjunction with social issues, has introduced a host of problems that are encouraging the spread of disease. War and political collapse are disintegrating stable health systems, leaving people vulnerable to disease and death. Urbanization and deforestation are bringing us into contact with new disease carriers and occupational hazards. Rapidly rising poverty levels in the 20 wealthiest countries in the world are introducing, or even reintroducing, diseases as a result of insanitary living conditions and inability to afford health care.

However, Hotez spent the most time considering antiscience movements. The World Health Organization has recently declared vaccine hesitancy — people choosing not to vaccinate despite vaccine availability — one of the top 10 global threats. The anti-vaccination movement has served as the primary powerhouse behind the epidemic spreads of measles and mumps, among others. Hotez highlighted four major components of the movement:

  1. The media: Anti-vaccine websites circulate through social media and search engines to inflame fears surrounding vaccine use on children.
  2. The political machine: Most states have anti-vaxxer committees such as Texans for Vaccine Choice and Oregonians for Medical Freedoms lobbying state legislatures against advocates like Hotez.
  3. Deliberate predation: These committees target minority populations to evangelize the supposedly harmful nature of vaccines. They even compare mandated vaccination to historical events like the Holocaust and the Tuskegee Syphilis Experiments.
  4. The War on Women: Anti-vaccination has lately shifted focus from the MMR vaccine to the HPV vaccine, which means less protection against cervical cancer for young women especially.

In response to these components, Hotez and his colleagues have demonstrated the safety of vaccines through scientific fact and personal narrative. Hotez notably published his book Vaccines Did Not Cause Rachel’s Autism, which discussed his daughter’s autistic development, to assuage vaccine fears. Above all, he argued, scientists need to make science more accessible to ordinary people. “The American public has absolutely no idea what we do,” he stated, an issue that only intensifies distrust of the scientific community.

The last third of the lecture focused on laboratory developments, many of which directly respond to these problems. Hotez noted how diplomacy with scientists and governments in the Middle East and South Asia have allowed us to better fight NTDs. The hookworm vaccine that he and his colleagues are developing at Baylor will help the body block hookworms before they can latch onto the skin. Finally, a coronavirus vaccine is in the works, but scientists have to determine its safety before deploying it publicly.

In conclusion, Hotez claimed we are embroiled in an epic struggle. Technology will, and does, help us make strides, but we need to hone our writing and communication skills to include the public in conversations.

As perhaps the sole humanities scholar in the hall, I reflected on the superficial divide between liberal arts and STEM that has emerged in the past decade and the resources that exist to combat this issue. Many of my students in the History of Medicine survey course are science majors, yet they develop key argumentative, discussion and writing skills through the course as well as nuanced understandings of race, gender and class in medicine. Then there are blogs like Biomedical Odyssey, where medical and graduate students sharpen their communicative and investigative abilities for future professional work.

Thus, at Hopkins, we already have the tools to contest these “destructive forces” Hotez discussed — we now need to consider how we employ them.

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