Global health in an open world requires an open mind: Conference paper for the Niels Bohr 2013 An Open Mind Conference, parallel session on New Global Threats and Possibilities

Why global health? Health has never been more clearly global than now. Social media have reorganized our way of talking, discussing and interacting globally by spreading happiness, hate speech, obesity and knowledge at the same time. Diseases have never had respect for border control. Polio has suddenly re-emerged in Syria, measles is popping up all over Europe, West Nile fever came from Uganda to USA and is raging in Texas, Dengue and yellow fever threatens to spread to new areas of Europe and the southern states of USA, patients with extremely drug resistant TB have been travelling freely across Europe and the Atlantic ocean within 8 hours, epidemics of diabetes are seen in China, India, Africa and among the poor in Europe and the US and antibiotic resistance is caused by the food industry and spread by humans and food. Science does not exist in vacuum and science does not have a life of its own. Science has a history and has always been part of history. Science does not believe in creationism. Or does it? Global health science seems to be wondering about in its own echo chamber biting its own tail repeatedly trying to recreate itself regardless of its own history and ignoring the real world context of global health. It took 186 years from the discovery of the Smallpox vaccine to the eradication of the disease; it took only 20 years from the onset of the global HIV epidemic to create a global HIV disaster caused by ignorance, negligence, political correctness, religious considerations and lobbying, epidemic stigma and counterproductive politically governed control measures. Governments have had to interpose themselves into controversies of sex, injected drugs, and other taboos in public media. Even the WHO has had trouble confronting such realities. The slow and inadequate international response to HIV/AIDS may have accelerated the epidemic and made it more severe. Some are waiting for the vaccine “fix” or the wonder drug for HIV – but given the history of Smallpox it will probably take 186 years from now if the world doesn’t open its mind both to history and to reality. AIDS is not a fashionable subject anymore but the story of HIV/AIDS is a lesson to global health decision makers. Rephrasing Elisabeth Pisani: whores have wisdom, and we had better open our minds and face it