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November 30, 2018

Book Talk with Dr. Jonathan Quick: The End of Epidemics

By Hana Burkly

On November 9, 2018, Jonathan D. Quick, M.D., MPH, came to Georgetown to discuss his new book, The End of Epidemics: The Looming Threat to Humanity and How to Stop It. Dr. Quick’s book is concerned primarily with modern epidemics and how future epidemics can be prevented, treated, and controlled before they become global pandemics. During his talk, Dr. Quick reviewed past pandemics, from the 1918 Influenza pandemic which killed 50 to 100 million people globally to the 2002 SARS epidemic in Hong Kong which spread to 27 countries within a matter of weeks.

When asked if he believed it was likely that we would experience another 1918 Influenza-level pandemic in the future, Dr. Quick replied, “I would argue we’re just as likely, but for different reasons.” He explained that a number of factors — growing populations, increasing urbanization, climate change, conflict, deforestation, and food demand — increase the risk of new infectious diseases quickly spreading and going global.

“It’s really a story of hope in the end,” said Dr. Quick of his book. “We know how to stop local outbreaks from spreading. The question is, will we?” This question turns out to be a tricky one. According to some calculations, the cost of another 1918 Influenza-level pandemic in the present day would have a death toll that rivals that of a nuclear war. However, as Dr. Quick has learned throughout his work with world leaders, it often takes more than just numbers to convince a person to make a change.

He referenced former president George W. Bush’s President's Emergency Plan for AIDS Relief, a program which has had dramatic success since its inception in 2003. Dr. Quick believes that President Bush’s primary motivations for the program were not political but rather moral. As a result, more emphasis should be placed on moral conviction when working to convince global leaders to invest in disease control and prevention.

The financial cost of prevention is not astronomical. Combining World Bank and other estimates, Dr. Quick calculates it would take an additional $7.5 billion per year to combat the problem of a potential future pandemic. But it will take more than money to solve the problem. Dr. Quick outlined seven principles that all global leaders should follow as they make decisions related to their countries’ health systems:

1. Lead like the house is on fire — act with urgency, decisiveness, and courage.
2. Build resilient systems and global security — invest in strong public-health systems.
3. Engage in active prevention — such as vaccination, personal prevention habits, and vector control.
4. Listen to timely truths — trusted sources, local engagement.
5. Invest in innovation — breakthrough to prevent, control, and eliminate threats.
6. Invest wisely — an extra $7.5 billion annually.
7. Ring the alarm — citizen activists and social movements.

The work is not limited to world leaders. Equally important is disrupting the last mile of disease transmission, which would include training dispensers of medicine, who are often pharmacists, in giving correct advice, dispensing medication safely, referring patients appropriately, and being alert and aware of outbreaks.

The bottom line, according to Dr. Quick, is simple: we are hurtling into a century of potentially devastating epidemics. We can make the world safer from epidemic and pandemic threats. The question is, will we?

Dr. Quick is the senior fellow emeritus and former president and CEO of Management Sciences for Health (MSH), a global non-profit health organization. MSH works to develop and spread supply chains for essential medicines, working closely with health systems leaders worldwide to expand access to these medicines and treatments worldwide.

Hana Burkly (NHS'19, G'20), a GHI student fellow, is pursuing a joint B.S./M.S. degree in global health.