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Geoff Gratwick of Bangor is a retired doctor and former state senator.
The year after I finished my medical training, I worked at a remote hospital in a poverty-stricken country. One evening when I was covering the ER, I admitted a powerfully built young farmer — he was probably in his early thirties — because he had been acting strangely. I did all the proper tests but couldn’t decide what was wrong. He got worse and developed a rash. His young wife, small children and extended family were a constant, worried presence at his bedside.
I eventually got hold of an experienced local doctor who almost immediately diagnosed measles encephalitis, or brain fever. I had heard of it in medical school but never seen it. Two days later, my patient died.
Measles is caused by an airborne virus and is extremely infectious. Usually, it is benign but complications can include blindness, pneumonia and encephalitis. Before the vaccine there were 3 million to 4 million measles cases each year in the U.S. and 400 to 500 people died. Two doses of the vaccine provide immunity. Sadly, an estimated 22 million children worldwide have missed a first dose of the vaccine.
Were it not for vaccine skeptics we might well have no cases now in the U.S. My young patient and his family had not been vaccinated because they were poor and lived far away.
The Trump administration recently announced that it wants the U.S. to pull out of the World Health Organization. Currently, every country in the world except Liechtenstein belongs.
WHO brings experience, personnel, research, and resources to where they are needed. It helps those in impoverished countries and also benefits us.
Smallpox is no more. Polio has been almost eliminated. HIV, malaria and tuberculosis are diminishing. An Ebola outbreak in West Africa killed more than 11,000 people in 2014-2016 before it was contained. In 2014, a traveler with Ebola entered the U.S. The traveler died while being treated at a hospital in Texas. He was the first person to die of Ebola in the U.S. Dozens of people who were in contact with the patient, including two nurses, were closely monitored; none of them became ill. Prevention, the focus of the WHO, works.
But we must not become complacent. Infections are a treacherous foe. COVID likely appeared in a small market in Wuhan, China, transmitted from wild animals to people. It spread worldwide with vast human and economic consequences. More than a million people died in the U.S. Despite the remarkably rapid development of a vaccine, COVID is still with us.
Health care workers are now seeing the first cases of bird flu in humans. It started by decimating flocks of chickens (the price of eggs has risen nearly 40 percent over the past year), spread to cows and now 67 cases have been reported in humans. Epidemic diseases will keep appearing. To think that we can make them disappear by wishing is folly.
Infectious diseases don’t recognize national boundaries. The WHO knows that dealing with them and their causes where and when they first appear is much better than dealing with their consequences later. The relationships that the U.S. has developed with public health agencies throughout the world are an important part of this equation. We learn about problems while they are still in their infancy and work with local health workers to contain them. We run controlled trials both here and abroad to develop new medicines and vaccines. Eighty percent of our pharmaceutical supply chain depends on ingredients from foreign countries, particularly from India and China. These connections keep us safer here at home.
It is estimated that nearly 100 million Americans travel abroad each year with the military, on business, as tourists or as a family; more than 66 million foreigners come here. Wealth alone will not protect us. Building border walls will not deter nasty bugs from finding their way into our lives.
Why does Donald Trump want to withdraw from the WHO? He argues that it is a bureaucracy, inefficient and controlled by foreigners. Because we pay too much, about $700 million per year (although most of this comes from private contributions, not the U.S. government). Because the WHO didn’t investigate China sufficiently for being the original host country for COVID. If the U.S. withdraws from the WHO, who will fill our place? Likely China. Is this a desired outcome?
There is a supreme arrogance to the idea that we in the U.S. can isolate ourselves from the modern world, that we are fortress America, that what occurs abroad will not affect us physically, morally or spiritually. We are part of the world whether Trump likes it or not. My young patient so many years ago need not have died. His right to life was just as powerful as yours or mine. The WHO is one of the ways we can work together to prevent tragedy. To threaten to withdraw our support is short-sighted and plain wrong.
