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Cirion Foundation

the impact of infectious diseases

Prof. dr. Ab Osterhaus

“Prepare for the worst”

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Virologist and flu expert, professor Ab Osterhaus likes to say it like it is, often to the extent that he advocates far-reaching and unpopular measures. Whether it concerns mad cow disease or bird flu, professor Osterhaus has always been one of the first to call for action. It’s won him few friends in some circles, and on several occasions the reputation of being a prophet of doom. But Osterhaus takes it all in his stride and remains vigilant to the threat of infectious diseases. He had already established the elusiveness of viruses 30 years ago, when his fellow students called him a crackpot for his doctoral research on a variant of a virus found in cats. It was the Seventies – when the world of virology was riding a wave of euphoria as one scientific success followed the other. It seemed at the time that the major infectious diseases, illnesses that had claimed the lives of millions of people over the centuries, had been eradicated for ever by vaccines and antibiotics. Why then would anyone want to conduct doctoral research into a subject that had been relegated to history? Evidently, the young researcher knew something others didn’t.
“We should never underestimate the resilience of viruses. They mutate and adapt and always find new ways back to man,” he said.

Thankless science
He was right too; the lull in the battle against infectious diseases proved to be the calm before the storm. In the Eighties and Nineties viral infectious diseases such as AIDS, dengue, hepatitis C and mad cow disease were to leave their destructive trails. And years later, bird flu would also have cost the lives of many people had professor Osterhaus and his professional colleagues not made a timely intervention. But despite all this, virology remains a thankless science. Even if Osterhaus was able to prevent the outbreak a viral epidemic, there are always those who will maintain that the danger was not a significant one in the first place. Again, making him the prophet of doom.  

Knowledge
“Always prepare for the worst,” says Ab Osterhaus. But how exactly does one do so? How can you protect society against the ever-dormant danger of infectious diseases? According to Osterhaus it’s by acknowledging and taking into account every factor that plays a role in the creation and spread of infectious diseases and by ensuring that everyone who is in a position to help combat their spread is involved in the necessary practical measures. He once compared the response to infectious diseases to the circumstances surrounding the 2004 tsunami. “A lot of expertise was available then too: scientists were aware of the potential consequences of an earthquake below the sea, but the expertise was fragmented and gathering dust in various institutions all over the world. As a result, the necessary precautionary measures were not taken in time. An effective warning system was not in place and the subsequent death of 200,000 people proved that it really should have been.”

Contingency measures
Osterhaus maintains that the threat of an epidemic should always immediately trigger the implementation of a number of contingency measures. “However, in the past we’ve seen that agricultural ministries are likely to behave in a counter-productive manner in such situations.” By way of example he cites the beginning of the BSE crisis, when people were quick to point out that it came from outside the country and didn’t start here. Later, those same people claimed to have everything under control, and that there was no reason for concern because it would be solved by contact research. This proved to be ineffectual. Pavlov-like reactions served only to increase the danger of an epidemic outbreak and eventually resulted in the culling of far more animals than would otherwise have been necessary. “If you don’t take immediate action against new viral infectious diseases you can be faced with things like RSV, respirator syncytial virus, which can lead to serious respiratory-tract infections. This virus keeps on rearing its head and claims the lives of more children every year. You can only respond quickly and adequately when the need arises if you are always optimally prepared for the worst.”   

Disastrous
Most new infectious diseases nowadays originate in the animal world, which makes it all the more important to take great care when it comes to animals. Osterhaus concurs with this standpoint but points out that the safety of people in the current situation is not always conducive to the welfare of animals. “Processing offal and bones into animal feed proved to be disastrous. It sounded like a good idea at the time: you recycle animal protein, limit the need for transporting cattle feed and thus also the likelihood of infectious diseases. But we inadvertently made carnivores out of herbivores. Worse still, we turned cows into cannibals by making them eat their own kind.”

Hugely vulnerable
Osterhaus goes on to explain that when we were suddenly confronted by BSE, it quickly all went very wrong. By accumulating the beef mountain the meat industry had made itself hugely vulnerable. “That’s not to say, however, that a cow grazing in a field is, by definition, infection-free – far from it. From an infection-control perspective, and given our penchant for eating lots of meat, underscoring our safety would entail erecting a few hermetically sealed apartment blocks here on the River Maas and populating then with pigs. Not a very attractive proposition, but that’s what it means if people want to continue eating so much meat and be protected from infectious diseases too.” Realistically, Osterhaus doesn’t see our meat-consumption behavior radically changing any time soon, which is why he feels it’s so important to put in place a system that enables us to react quickly and adequately to new infection threats.

Better collaboration
Professor Osterhaus might be skeptical when it comes to our capacity to change our consumptive patterns, but he does see the potential for better collaboration between the people who are combating infectious diseases. “The fact that infectious diseases spread so quickly all over the world is down to many societal factors, ranging from rising urbanization to our greatly increased mobility. This is why it’s futile to just point the finger at one another when a threat appears. If we do, it only makes it more difficult to act quickly and pragmatically, as we did when we were up against the bird flu threat.” To illustrate this point, he explains that when it seemed as if the SARS virus would spread all over the world, a dozen laboratories and a handful of modern communication media made it possible to prevent such a pandemic. “By bringing the right people together, holding daily teleconferences and continuously uploading all the available data, many lives were saved. But it did require that we made clear agreements with one another. However, in every collaborative initiative you’ll find mechanisms that obstruct the sharing of information and these have to be identified and neutralized. In science, for example, it’s all about names and being published. During our collective offensive against bird flu we agreed up front that any possible intellectual rights would belong to everyone who was involved, and this clearly benefited the exchange of information.”

Cirion
Professor Osterhaus is very much aware that his work greatly depends on the information provided by others and that only the correct information can lead to correct diagnoses. “I support the initiatives of Cirion because this organization advocates a broad approach to tackling a concrete problem. Infectious diseases still have a deadly outcome in parts of the world, while new ones, like hepatitis B and C and dengue, are continually joining their ranks. And let’s not forget AIDS. A mere 20 percent of the world’s population has access to AIDS inhibitors. These inhibitors now make us perceive AIDS here as a chronic ailment, but for 80 percent of the people in the world it’s still a fatal disease, one that claims 2.5 million lives every year.”

Collective responsibility
The burden of disease, Osterhaus maintains – the societal impact of destructive infectious diseases like AIDS – is enormous. And it’s the collective responsibility of all of us, not just scientists, but politicians and people in education and the media too. “Eventually, we’ll have to find a vaccine, but in the meantime we have a duty to limit the damage, which can only be done through a collaborative, integrated approach. Cirion brings together people from different disciplines, which is important, although we shouldn’t expect this foundation to solve all the problems. When it comes to viruses there are no certainties, except that new infectious diseases are bound to manifest themselves in future. The only way to prepare ourselves for the threats that await us is through better collaboration.”