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Cirion Foundation

the impact of infectious diseases

Prof. dr. ir. Louise O. Fresco

”Sustainable development calls for an integral approach”

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If a child takes an interest in Immanuel Kant’s categorical imperative at the age of ten, what field of study is she likely to choose? Philosophy perhaps? Louise Fresco opted for agricultural science. “The only thing that can be said to be good, without qualification, is goodwill,” wrote Kant. So was it an ethical duty that steered Louise Fresco’s choice of study? And, if so, why did she choose agriculture and not medicine? Fresco: “I thought long and hard whether to study medicine or agriculture, and then I saw those images of starving children during the Biafra war. That confrontation with the horrendous injustice and the disparate division of food in the world made me question the point of curing people of diseases if they didn’t have enough to eat.”

First outbreak of AIDS
At the Wageningen University Fresco learned that sustainable development is only possible if it is stimulated in an integral and interdisciplinary manner. Aspects such as medical aid, the development of agricultural technology, stimulating the economy and policy improvements are all equally important. After finishing her education she had the opportunity to work in New Guinea. She knew that there would be few medical facilities there, so she decided to spend some time there as an understudy to a doctor. Later, she came into contact with doctors in many of the regions where she worked as an agricultural scientist. While she was engaged in research in 1981 in Zaire (now Congo), the local population was affected by the first outbreak of AIDS, but back then, nobody knew what it was. “In the Mama Yemo Hospital in Kinshasa, where I myself was treated for malaria, more than 40 percent of the patients were infected with the HIV virus. I was lucky; a colleague of mine died after receiving a blood transfusion.” The province that she was working in was three times the size of the Netherlands but there were only a few, Swedish, doctors there and the local authorities had little interest in cooperation. Following a long period of drought and living in poverty (the result of years of misrule by the Mobutu administration), the people of Zaire were in very poor health. It was alarming to see the extent to which society had broken down.

Vicious circle
According to Fresco, many African countries have to contend with the preconceived idea that African people are incapable of taking care of themselves. In her opinion this is completely unjust. Many African countries enjoy higher economic growth rates than Europe. But it also has to be said that there are African countries that lack the conditions necessary for normal economic development, such as a transparent market and decent transport facilities. These countries can end up in a vicious circle, where farmers produce food only for their own consumption, investments dry up, hyperinflation is rife and people just decide to leave. In a marginalized society like this, medical aid will also be lacking and people will be more vulnerable to diseases. “But as soon as you create the right conditions for sustainable development this very vulnerability can turn into a strength. Once the vicious circle has been reversed, it immediately becomes clear just how resilient and innovative these people really are.”

Counterproductive
Fresco maintains that the importance of tackling sustainable development in an integral manner cannot be over emphasized and should be done at all levels. At the United Nations she is committed to realizing a better level of cooperation with the WHO. This will facilitate extensive research into the correlation between nutrition and chronic illnesses, such as cancer and heart and vascular diseases. From the perspective of someone suffering from an illness, the availability and consumption of food and the health benefits of nutrition should be seen in a holistic context, she explains. Policy makers must stop thinking in terms of separate boxes: one for agriculture, one for food and one for the economy. This in-the-box way of thinking is counterproductive, partly because it can lead to conflicting messages. One expert can insist that irrigation is necessary to increase agricultural efficiency, for example, while another will want to decrease the amount of open water to prevent the spread of infectious diseases. “While the UN is not in a position to get involved at all levels, it should, none the less, ensure that we appreciate the interdependence of different projects. And the best way to do so is by setting a good example.”  

Balanced situation
Many development projects fail because they start off at community level before the necessary preconditions are in place. Where’s the point, she asks, in equipping farmers with mosquito nets if their paddy fields are infested with larvae and their houses are built on open sewers? “The people behind Cirion understand that an integral working method is essential for the success of a project and they strive to combine social and scientific objectives. Ideally, this creates a balanced situation between scientific advancement and practical relevance.”

Pushing the boundaries
Self improvement is also a motivation for the people at Cirion to participate in certain projects, says Fresco. “In my opinion an approach that’s not purely idealistic is fully legitimate, because without a sound scientific basis an integrated approach in itself will not be effective. If you take groundbreaking technology to the people and involve the local experts, it will serve as a fantastic stimulant and spur the enthusiasm of many people. Besides, to create better solutions we need to push the boundaries of science much further.” The great thing about Cirion, she continues, is that it permits a broad approach to dealing with subjects, leading to new perspectives and thus new methods of improvement. “The people at Cirion don’t shy away from the notion that an integral approach would be too complex because ‘everything depends on everything else’. It’s actually not that complicated. We just have to look closely at all the specific factors that play a role in a given situation.”

Cooperation
Fresco feels that cooperation with local experts is crucial if sustainable development is to be stimulated. Nowadays more and more countries, like China and India, have highly educated specialists. Their expertise is relevant and can be more effectively applied, and, if it falls short, complemented. Experts trained in the Netherlands often posses the necessary creativity to cross disciplinary borders. This is of immeasurable value because the success of projects depends on extensive knowledge and an ability to take a broad view of the big picture. Moreover, all stakeholders must be reading from the same page so that effective solutions, based upon a broad base of social acceptance, can be explicitly implemented. “Modern science is something we can all practice together. It’s time for the scientific elite to start acknowledging the capabilities of local experts and actively involving them in international research projects.”  

Education
Education is close to Fresco’s heart because she sees it as one of the most important ways to stimulate sustainable development. Practically speaking, you have to ascertain what can and cannot be done in a specific situation, taking into account the economic circumstances at the same time. To reduce the risk of infection from animals, for example, they could be housed in separate accommodation. But this is only possible if there’s sufficient funding to construct that accommodation. Similarly, a vaccination program calls for a certain degree of organization. But education is more straightforward to realize and it has a direct impact on people’s behavior. “I am a strong advocate of integrated education that links health, nutrition, agriculture and the environment. In elementary schools children can be taught to wash their hands before eating, but infections can occur in countless ways, from salmonella poisoning from a contaminated wooden chopping board, to a tuberculosis infection from contact with animals.”

Adapting lifestyles
Education can make invisible hazards visible and bring about changes in behavior that can prevent many infections. And while it’s true that cultural customs can pose an obstacle, culture is not necessarily inflexible – people can change, and quickly when Necessary. For example, hundreds of millions of people are migrating from rural areas to cities and people in developing countries are eating more bread and less rice. People are adapting their lifestyles and assuming responsibility for themselves all over the world. “By informing as many people as possible about the dangers of infectious diseases, we are helping them to stay healthy, which has to be a good thing, for everyone.”