Uppsala Health Summit

Is it Possible to Turn the Tide, Professor Björn Olsen?

2017-09-05

Professor Björn Olsen is well known for his ardent descriptions of how our way of life has increased the risks for pandemics, including the expansion of crowded urban areas and industrialized production of food.

At Uppsala Health Summit, he will help us understand the main drivers behind infectious disease threats and the urgency to take action before these threats turn into pandemics.

In this interview Björn Olsen discusses why it is so critical to implement a One Health perspective, and whether it is still time to turn the tide of pandemics.

– I believe that one of the most difficult things for us to understand today, is our own role as drivers behind the threats, including the rapid emergence of antibiotic resistance, says Professor Olsen. For example, our enormous meat consumption, which by the way is an anomaly from an evolutionary point, has created enormous, uniform, eco-systems developing adverse mono-cultures, while we are well aware that biodiversity and natural ecosystems are necessary for a sustainable protection against emerging infections. Globally, at any given moment, we have 75 – 100 billion poultry, to satisfy our urge for meat.

– When mono-cultures, e.g. humans, poultry or pigs, live side by side, the risk that a pathogen jump over from one species to another is extremely high. In most cases, this happens without any consequences. But, in other cases we see how an influenza virus jumps over from a poultry or a pig farm, and then over to humans, If the virus mutates, adapting to its new human reservoir, it quickly starts circulating among humans. That's a kind of flame that can spark off a pandemic.

During the 20th century we experienced three influenza pandemics, the Spanish flu was the most disastrous and killed about 50 million people worldwide. The most recent pandemic was the Swine flu in 2010, which fortunately turned out to be less dangerous than expected.

– The likelihood for a pandemic to spark off is in fact much higher today. And it is us, the human species, that is the main driver. We must ask ourselves “Should we let it happen, or not?”. – During Uppsala Health Summit, it is extremely important to discuss which preventive measures we can take to counter-act, to prevent.

– We will continue to live with pandemics. Outbreaks, epidemics and pandemics have been part of our lives for 10 – 12 000 years, and will continue to be so. The first microorganisms with pandemic potential were introduced to humans with domestic animals.

– The different pathogens are part of our eco-systems today, but we must build strategies to prevent new infections from emerging and strategies to handle outbreaks.

What can we learn from how pandemics, or epidemics, have been handled previously?

– Surveillance and prevention with a One Health perspective is of utmost importance, Björn Olsen emphasizes. Therefore, we need our authorities to understand and take these questions seriously,  and address these threats continuously, not only when we have an outbreak. At the end of the day, surveillance and prevention is less costly than taking care of the consequences of a pandemic.

– In the event of an outbreak, we must have clear-cut strategies for all links in our healthcare system for what measures to take. Vaccination is extremely important: When should we vaccinate, who and how should we vaccinate, where should we produce the vaccine? We need clear-cut plans for supply-chain management of both vaccine and anti-viral pharmaceuticals and contingency plans for who should get the vaccine first, and who should get the anti-virals that are available and effective.

 – In a situation of a new and dangerous pandemic spreading, like a new Spanish flu situation, healthcare would not have the capacity to handle all sick people, not even in countries like Sweden where healthcare is well developed. The most important take-home message from recent outbreaks is probably that our social construct, our social make-up, is thin. We can’t be too sure that we are altruistic when it really counts.

– We must understand that our behaviour is a prime driver behind the infectious threats, and that sustainable strategy building must start there. What I hope is that Uppsala Health Summit can be a forum for an extremely frank and open discussion, so that we can identify achievable intermediate targets, without losing track of the vision, and where we dare say that yes, the situation is bad.

– When discussing emerging infections and pandemic threats, we need to go outside ourselves, our separate fields of activities, and talk with other disciplines – ecologist, veterinarians, social scientists… If we can’t discuss this together, we are lost from the start.

– We cannot turn the tide, but can stop it for a while, until we have the next generation running the world, hopefully wiser than we are.