Facing the foe

If it weren't for global warming throwing the seasons into chaos, the annual CPhI Worldwide exhibition could be viewed as the beginning of autumn. And that, in turn, means that the influenza season is almost upon us.

As the world's foremost suppliers of pharmaceutical ingredients, services and equipment get together to present the latest developments and innovations, the World Health Organisation has issued a timely reminder that the threat to public health is greater than ever before: new diseases are emerging at the historically unprecedented rate of one per year.

A decade has passed since the H5N1 avian influenza virus was first isolated in humans and it is four years since SARS caused a worldwide panic. The dire predictions of an epidemic sweeping the globe and wiping out whole civilisations didn't materialise, the media frenzy soon died down and life went back to normal.

But the conditions that could give rise to a global epidemic haven't changed, the WHO warns. A false sense of security in the absence of infectious disease outbreaks results in inadequate investment in public health; unexpected policy changes in immunisation strategy allows diseases to re-emerge; and forced migration caused by conflicts gives rise to overcrowded, unhygienic and impoverished living conditions. These factors combined with microbial evolution and antibiotic resistance; the rapid expansion of air travel; and animal husbandry and food processing threats mean that the world is still highly vulnerable and a major outbreak of an infection disease remains a question of "when" rather than "if".

"In our increasingly interconnected world, new diseases are emerging at an unprecedented rate, often with the ability to cross borders rapidly and spread," says the WHO. Since 1967, at least 39 new pathogens have been identified, including HIV, Ebola haemorrhagic fever, Marburg fever and SARS, while other centuries-old threats, such as pandemic influenza, malaria and tuberculosis, continue to pose a threat.

Sharing of medical data, skills and technology between rich and poor nations is one of the most feasible routes to health security, according to the WHO, requiring international co-operation, collective responsibility and effective action. Without this, it says, there could be devastating impacts on the global economy and international security.

So while we are all in Milan admiring each other's technologies and applauding the winners of the Innovation Awards, let no one lose sight of the fact that there is still a war to be fought against an enemy that is increasing in number and potency.