Wednesday, September 3, 2008

Wiping out the next smallpox

The Internet has had an enormous impact on people's lives around the world in the ten years since Google's founding. It has changed politics, entertainment, culture, business, health care, the environment and just about every other topic you can think of. Which got us to thinking, what's going to happen in the next ten years? How will this phenomenal technology evolve, how will we adapt, and (more importantly) how will it adapt to us? We asked ten of our top experts this very question, and during September (our 10th anniversary month) we are presenting their responses. As computer scientist Alan Kay has famously observed, the best way to predict the future is to invent it, so we will be doing our best to make good on our experts' words every day. - Karen Wickre and Alan Eagle, series editors

It took more than a village: it took the entire world -- people of all races, countries and religions -- to eradicate smallpox. The final naturally occurring cases of "Variola major" in Bangladesh in 1978 and "Variola minor" in Somalia in 1977 marked the end to a chain of suffering and early death dating back to the Biblical plagues, and to Pharoah Ramses, who died from the very same disease. Since then we have continued to face countless pandemics -- the Black Death, cholera, and now bird flu, SARS, HIV/AIDS and a new generation of zoonotic diseases -- diseases that, often because of changes in population or climate, jump from animals to humans. We can't be sure where the next smallpox will emerge, but we can be sure that it will take an effort larger than any single person or organization to defeat it.

Today there are some real heroes working to check off two more diseases from the list. The World Health Organization has led the charge against the highly infectious disease of polio. Along with UNICEF and dozens of NGOs, and millions of national and local health workers, members of Rotary International and volunteers from moms to Mullahs have stepped up to the plate and contained polio so that hundreds, not millions, of kids are paralyzed annually, but we cannot consider the case closed until we erase the last case, in the last country. The Carter Center has also accomplished a tremendous feat by leading the effort to shrink the cases of Guinea worm to the tens of thousands from the millions. Just as it took 150,000 health workers -- the world's unsung heroes -- to make one billion house calls in India searching for hidden cases of smallpox, it will take collaboration on a global scale to track and eliminate the next pandemic.

There is no Nobel Prize for "Preventing a Pandemic," and the hardest part about working in this field is imagining the unimaginable. What will be the next SARS, the next ebola, the next H5N1 bird flu? Epidemiologists try to "out think" the massive numbers of permutations and combinations that may give rise to the newest threat to our lives. Chances are a microbe capable of sweeping the globe will emerge in the next decade or two, and chances are it will cross to humans from an animal host (as did SARS, the Spanish flu, and HIV/AIDS). We need new ways to find these emerging threats earlier in the process, before thousands are infected and the epidemic spirals out of control.

Google.org's Predict and Prevent initiative is working with partners to use digital, genomic and IT technology to identify "hot spots" of emerging threats and provide early warning before they become global crises. When you're fighting a pandemic, early detection and early response can be the difference between dozens and hundreds of millions infected. What better birthday present could we offer the world after our 20th year, than to say we joined hands with a global movement and helped prevent the next smallpox?

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