Prevention is better than cure

Abstract

The history of the control of infectious disease reflects the balance between our understanding of the nature of infection, the mechanisms of host resistance and the available technology to deliver an intervention. However, behind this 'biomedical' construct lies a deeper set of issues which embody serendipity, public understanding, and population-based intervention and its acceptability by the wider community, often complicated by the decisions and subsequent vacillations of policy makers.

Fig 1.

The impact of tuberculosis as seen in the average mortality from infectious diseases in London between 1847 and 1850 (data from the Royal Statistical Society). During this period (1851 census) the population of London was 2.6 million and the average all cause mortality was 16,300 per annum.

Fig 2a, b.

Mortality from tuberculosis per 100,000 of the population by country (a) and major city (b). Data from Ref 22.

Fig 3.

The generation of HPV-specific, CD8+ cytotoxic T cells after vaccination with a vaccinia recombinant expressing modified HPV type 16 and 18, E6 and E7. CITATION Bor96 l 2057.⁶⁵ E = effector; T = target.

Fig 4.

The establishment of the Global Alliance for Non-Communicable Diseases. NHMRC = National Health and Medical Research Council of Australia; MRC = Medical Research Council; CIHR = Canadian Institute of Health Research; NIH = National Institutes of Health; MoH = Ministry of Health/Chinese Academy of Medical Sciences.