Zika marches on: lessons not learnt

In the case of the USA most Zika infections have been brought back by travellers infected elsewhere. Recently efforts have been made to dissuade people from visiting the Olympic Games in Brazil as well as recommendations that the Games be postponed. While the risk of infection may be low there is no doubting the mosquito population in and around Rio.

One of the great ironies of world public health is that until an outbreak of infectious disease occurs and large numbers of people begin to die the world shows little interest in spending money in trying to contain it.

There seems little doubt that we know what is required to contest our battle with infectious disease. We require the capability and infrastructure to quickly indentify and respond to disease outbreaks and not take refuge in the belief that they are taking place in "remote" locations in parts of Africa or Asia and thus offer little threat to us. Further, we still tend to take refuge in the belief that such disease outbreaks will eventually burn themselves out and offer little threat to developed countries.

As SARS, Ebola and Zika have demonstrated nothing could be further from the truth. There is little doubt that we are desperately still in need of a sophisticated surveillance and response system involving case detection and diagnosis, contact tracing, clinical care and isolation and community engagement. We need a world health authority with the means and power to quickly intervene in disease outbreaks wherever they occur.

Will we ever achieve all this particularly when many countries place emphasis on border security and disengagement from international agreements? While the jury is still out it remains somewhat doubtful. Yet all of the above must be timely and not left until there is a strong fear that the infection will spread to the USA or Europe.

To my mind there is little doubt that with respect to epidemic/pandemic preparedness and response we have learnt very little over the last century. To me such things are an absolutely critical part of human security and lie at the very heart of a nation's and the world's responsibility to protect the social, economic and health circumstances of all their citizens.

The human cost of failing to do this should instil in us the necessity of achieving this. Almost 100 million people died in the flu pandemic of 1918-18 and the HIV/AIDS epidemic and it has been estimated that today the annual losses from pandemics could easily exceed $US60 Billion. Over the last 16 or so years we have been confronted by innumerable global health crises and Zika is only the most recent. Some would say that the era of infectious disease is not over.