Emergent diseases and multidisciplinarity (MSE Speaker Series, 11 November 15, 2009)

At the McGill School of Environment Speaker Series on November 11, Holly Dressel presented a hypothetical paper in which she argued the necessity of a multidisciplinary approach in detecting, responding to, and avoiding emergent diseases, using H1N1 as a case study. While I agree with her thesis, I wonder if perhaps those of us who work and study in the area of environment are so entrenched in this Paradigm of Multidisciplinarity that at times we fall into the trap of simply paying lip service to the approach without fully appreciating the power, and the challenges, that accompany it. Working with academics outside our fields, government and community members and experts in other sectors of society can be challenging: we speak different “languages,” come at the problem with different underlying assumptions, have different expectations for what a “good solution” is, and prefer different approaches to decision making and problem solving. And yet we continue to try to work collaboratively because it provides us with fresh perspectives and analytical tools outside our personal toolboxes. Ms. Dressel outlined a number of ways in which a multidisciplinary approach is important in dealing with the problem of an emergent disease. I would like to expand upon them here.

Detection of emergent diseases: In both H1N1 and BSE before it, Ms. Dressel pointed out that it was not the epidemiologists and virologists who first identified the emergence of these diseases and their sources, but rather frontline health workers and members of the communities themselves.

Responding to emergent diseases: In the crisis situations that emerge during a pandemic, frontline healthcare workers are again necessary in responding to emergent diseases. However, other disciplines and sectors of society play important roles in providing care, slowing spread of the disease and disseminating information to the public. Sociologists, anthropologists and psychologists can help us to understand the social dynamics during these periods, and can inform how and what information is given to the public. The media is important in disseminating this information and coordinating medical interventions through announcements of vaccination and quarantine programs. Religious leaders are also important sources of information for billions of people worldwide, particularly during times of distress and uncertainty like those seen during a pandemic. The role these community leaders play can be a positive one, as has been shown by the pandemic plans many church groups have developed, or a negative one, as seen in the response of many conservative Christian clergy to HIV/AIDS. The scientific community needs to take seriously the important role religious leaders play in the daily lives and information gathering of many people, and equip them with appropriate information.

Avoiding emergent diseases: Avoidance has been perhaps the most difficult step, and also perhaps the step most in need of a multidisciplinary approach. Ms. Dressel pointed to a number of disciplines with valuable tools to help society avoid the conditions in which viruses are able to jump the species barrier and cause pandemics in human populations, such as is the case with H1N1. She suggested that we need to engage political economists to help us understand the economies of scale and political pressures that make intensive industrialized meat production plants (the source of many of these diseases) so dominant in meat production. She also suggested that we consult with ethicists and philosophers to help us understand our relationship with and responsibility to the animals we eat, which will help us make better collective decisions about appropriate, ethical methods of producing meat products. I think we must also engage farmers themselves, and other agricultural experts, to find out what is feasible for farmers, and what kind of support (financial, legal, or otherwise) they need in order to make viable the methods of animal husbandry that will not lead to the emergence of new diseases. The government, business and banking sectors will then need to be engaged, to ensure these conditions are met.

A multidisciplinary approach will be necessary for avoiding and dealing with future emergent diseases. Currently, collaboration between experts in a variety of disciplines is a commonly accepted approach in addressing environmental problems. Viewing emergent diseases as environmental problems, rather than simply health problems for medical workers to address, may increase the extent to which experts outside the field of medicine engage in finding solutions to the conditions that lead to the emergence of new diseases.

2 Responses to “Emergent diseases and multidisciplinarity (MSE Speaker Series, 11 November 15, 2009)”

  1. natalie says:

    Rachel, I enjoyed reading your views on the Paradigm of Multidisciplinarity and agree in practice, engaging a variety of partners is a challenging task.

    It is, however, your comment on diseases as an environmental problem that really caught my interest. When we think in an ecological sense, are disease vectors such as bacteria or viruses a problem, or a solution?

    Disease is just one of the many mechanisms of checks and balances operating to release physical and biological systems from the stresses imposed by an over-populated species. We understand this phenomenon when it concerns other species, but have difficulty applying it to humanity. How do we reconcile a view of disease as an environmental problem, in light of our moral and ethical obligations to heal the sick?

  2. rachel says:

    Natalie, you’re absolutely right about the place of disease-causing organisms in nature – as one of my Master’s supervisors, David Marcogliese at Environment Canada, likes to point out, healthy ecosystems have healthy parasites. However, disease organisms such as parasites, viruses and bacteria become a problem when human interventions in the environment, such as the careless use and release of antibiotics, cause them to rapidly evolve.