The pandemic century: one hundred years of panic, hysteria and hubris

Abstract

Dr Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization (WHO), declared the Ebola outbreak in the Democratic Republic of Congo a Public Health Emergency of International Concern (PHEIC) on 17 July 2019. This announcement came after months of discussion about when and if he should call a PHEIC for this outbreak. What was interesting about the debate was the apparent disconnect between the political and economic purposes of declaring an emergency, which were in complete contradiction to the medical and scientific view that declaring a PHEIC would not serve to enhance the medical and public health response. Of course, now that the PHEIC has been declared, it will be interesting to see whether its presumed levers work, especially in terms of increased donor and political support to halt the spread of the disease. What is certain, however, is that this Ebola outbreak, like west Africa's in 2014, is challenging the medical and scientific community's conventional understanding of the conditions conducive to the spread of the disease. The virus itself is well understood; the social, environmental and political factors that fuel the outbreak are harder to grasp. The pandemic century reveals the necessity for the scientific community to come to terms with the interplay between social, environmental and political factors and infectious disease aetiology—and the difficulties they will face in attempting to do so.