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AIDS Pandemic Provokes Alarming Reassessments Of Infectious Disease

In 1900, infectious disease was the leading cause of mortality in the United States, accounting for at least 37 percent of deaths. By 1950, this had been mitigated to 6.8 percent and, by 1989, to 2.8 percent, with corresponding improvements in life expectancy. These numbers, of course, must be taken with a grain of salt, given the eventual preemptive role of infection in chronic illness, and many disorders whose infectious etiology is still to be recognized. Further, the relative importance

Joshua Lederberg
In 1900, infectious disease was the leading cause of mortality in the United States, accounting for at least 37 percent of deaths. By 1950, this had been mitigated to 6.8 percent and, by 1989, to 2.8 percent, with corresponding improvements in life expectancy. These numbers, of course, must be taken with a grain of salt, given the eventual preemptive role of infection in chronic illness, and many disorders whose infectious etiology is still to be recognized.

Further, the relative importance of sanitation, health education, and nutrition--in contrast to medical interventions like immunization and antibiotics--has remained in contentious debate. Regardless, this achievement is trumpeted as the conquest of infectious disease--a glorious tribute, indeed, to public health and medical science.

In consequence, health research since 1950 has ever more emphasized chronic constitutional afflictions like cancer, cardiovascular disease, and psychiatric disorders to the relative neglect of infection. Environmental anxieties are focused on radiation...

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