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CRICOS #00212K
Thinking systemically in a shrinking world: disease
emergence, global change and human carrying capacity
Visva Bharati University, Shanti Niketan W.B. India, September 3, 2013
Prof Colin Butler, ARC Future Fellow
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“As early as my first years at University I had begun to feel misgivings about the opinion that mankind is constantly developing in the direction of progress.
My impression was that the fire of its ideals was burning low without anyone noticing it or troubling about it.”
Albert Schweitzer (1875-1965)
(Nobel Peace Laureate, advocate of ahimsa)2
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I selected a beautiful place, far away from the
contamination of town life, for I myself, in my young
days, was brought up in that town in the heart of India,
Calcutta, and all the time I had a sort of homesickness
for some distant lane somewhere, where my heart, my
soul, could have its true emancipation...
I knew that the mind had its hunger for the ministrations
of nature, mother-nature … "
3
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“It was always the objective in Santiniketan that
learning would be a part of life's natural growth.
The first step towards this objective was to
establish in the child a sense of oneness with
nature. A child has to be aware of his
surroundings - the trees, birds and animals
around him. The mind is deprived if one is
indifferent to the world outside. From the
beginning, he wanted his students to be aware of
their environment..”4
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Dian Fossey (1932-1985) and young mountain gorilla
Eco-connection
5
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Three examples
1. Infectious Diseases of Poverty (journal article) (2012)
2. Climate Change and Global Health (edited book)
(2014)
3. Human carrying capacity and human health (journal
title) (2004)6
Thinking systemically in a shrinking world: disease emergence, global
change and human carrying capacity
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Acknowledgements
6 “Di TRGIV: “Environment, agriculture and infectious
diseases of poverty”
Prof AJ McMichael (ANU)
Prof Xiao-Nong Zhou (China CDC)
WHO Technical Report
Also Bianca Brijnath, Adrian Sleigh
8
Special Programme for Tropical Diseases Research
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EIDs = emerging infectious diseasesGEC = global environmental change
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A. Global environmental change
B. Nipah virus case study
C. Emerging infectious diseases: a call for deeper
thought
D. What causes a really major epidemic?
E. Thinking systemically – things are connected
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resources climate nutrition governance
11
weakening global health determinants
global environmental change
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0-2013 c.e.
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Borlaug’s warning Nobel prize speech
President Reagan: population problem “vastly exaggerated”
Le Bras: “The problem has become a bit passé” (US Pop Mtg)
1st “check”
2nd “check”
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Last Glaciation
CO2 has not been this high in >half a million years.CO2 from fossil fuel is dominant cause of current warming.
Last interglacial
350
300
250
200
Carbon Dioxide Concentration (ppmv)
600 500 400 300 200 100 0
Thousands of Years Before Present
[Adapted from Figure 6.3, ©IPCC 2007: WG1-AR4]
Carbon Dioxide Concentration in Atmosphere over past 650,000 years
280 ppm (‘pre-industrial’) Modern Homo sapiens
Agriculture begins, 10K BP
Holocene
400 ppm CO2
(2013)
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Most radiation absorbed byEarth, warming it
Most radiation absorbed byEarth, warming it
Some energy is radiated back into space as infrared
waves
Some energy is radiated back into space as infrared
waves
The strength of the sun varies a littleThe strength of the sun varies a little
Aerosols: net cooling effect
Aerosols: net cooling effect
Feedback - additional GHGs
Some outgoing infrared radiation trapped by atmosphere, warming it
Some outgoing infrared radiation trapped by atmosphere, warming it
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CH4 CO2
Green house gases
N2O
Sulfate particles
Radiative forcing
NO2
CH4
O3
CH4
CO2
Slide adapted from one courtesy Prof Steffen Loft, University of Copenhagen,
Denmark
wetlands, rice, tundra, biomass burning,
deforestation
CO2 CH4, black carbon
CO2
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Sea Level: 1993-2012
Rainfall intensity : 1900-2011Land-ocean temperature: 1880-2011
Earth system observations
Greenland ice melt 2013
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“Anthropocene”: the human dominated age (Paul Crutzen)
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integrative
interactive, feedbacks, thresholds
(emergence, phase changes, shocks )
context – milieu – “terrain”
Systems thinking
1818
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EIDs = emerging infectious diseasesGEC = global environmental change
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s
20Apologies to unnamed photographers
Nipah outbreak Malaysia 1997-9
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Pigs (millions)
Mangoes (104 tonnes)
Pulliam et al, 2011
Agricultural intensification in western peninsular Malaysia
response
21
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Emerging diseases – a call for deeper thought
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emerging disease perspective in developed
countries
focus on novel and exotic pathogens
less attention to drug resistance in familiar
pathogens, e.g. TB and malaria
& insecticide resistant vectors, molluscs
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335 Emerging Infectious
Disease “events”
Jones et al. Nature, (2008)
No category for vectorial resistance
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Acinetobacter baumannii resistance:
gentamycin, imipenem, multiple drug, polymixin [4 in total]
Bartonella bacilliformis; + resistance to chloramphenicol ; elizabethae , henselae , quintana [5 in total]
Candida krusei, tropicalis, albicans (1981) + resistance: fluconazole, ketoconazole, micronazole; Candida glabrata (fluconazole-res); [7 in total]
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EIDs: not all equal
Jones et al. Global trends in emerging infectious diseases. Nature, 451, 990-994. (2008) supplement
16/335 Emerging Infectious Disease “events”
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3 needles in the 335 “event” EID haystack
HIV-1
artemisin resistant Plasmodium falciparum
multiple drug resistant Mycobacterium tuberculosis
Nipah?
spilling over .. matter of time .. efficiently spread among
people” NYT 2012
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?
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335 Emerging Infectious
Disease “events”
Jones et al. Nature, (2008)
No reflection of disease burden, now or
potential
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milieu and microbe
captionClaude Bernard (1813-1878)
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“Pathogenic tradeoff”
Pathogens “want” to reproduce
Effect on host not of concern:
Sometimes 1. hurt, don’t kill
2. don’t hurt
3. kill slowly
4. kill quickly
pathogen reproduction chance enhanced
4. In comparison, reproduction harder
trend to co-existence
29Ewald P (2004). Evolution of virulence. Infectious Disease Clinics of North America 18:1–15.
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New milieus: different tradeoff?
pathogens in crowded host milieus that kill quickly have
- numerous other hosts to colonise
- hosts may have high genetic similarity
- LITTLE or No evolutionary penalty from rapid host mortality
might viruses that cause rapid infections (even severe) be favoured? (do slower acting viruses have less opportunity to reproduce?)
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Low Pathogenic H ighly
Pathogenic
Avian Influenza
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Crowded, immobile hosts: new pathogen
opportunities?
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Milieu and the
Adapted from Oxford et al Lancet Inf Diseases 2002; 2:111-4
2.5% global mortality (with bacterial co-infections)
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Future civilisation: a risky milieu
energy, raw materials: emerging scarcity
economic system: archaic
inequality: civil stress, terrorism, fascism, war
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Adapted from Murray & King, Nature. 2012; 481: 433-5.
Apparent production cap
2005: Plateau Oil
Production (million barrels/day)
Oil price (US$ per barrel)
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$1 billion a day, from Europe, Nth America
Third carbon age? Runaway warming, water risk
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Wise TA. The Cost to Developing Countries of U.S. Corn Ethanol Expansion: Tufts University; 2012.
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(nominal prices)
37Butler, 2013
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Russia/Ukraine heat/drought
US droughts
Butler
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rapid public health response*limited antimicrobial resistance, but increasing nutrition ok
public health breakdownnutrition worseliving conditions worseconflict increasing?
Could civilisation failure “breed” a
megapandemic?
* For diseases perceived as major threats to developed countries
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Potential EID categories later this century (by burden of disease)
all connected – a systems view
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Secondary
Tertiary
Tertiary
Primary
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Heat waves, fewer cold waves, injuries, floods, fires
Infectious diseases, especially vector borne, allergies, air pollutants, infrastructure
secondary
primary
tertiary
Health effects of eco-climate stress
famine, conflict, pop’n displacement, refugees, development failure
4343
Men
tal h
ealth
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Waterscarcity
Regions afflicted by problems due to environmental stresses: • population pressure • water shortage• climate change affecting crops • sea level rise • pre-existing hunger• armed conflict, current/recent
From UK Ministry of Defence
[May RM, 2007 Lowy Institute Lecture]
Climate Change: Multiplier of Conflicts and Regional Tensions
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“The dangerous impacts of climate change can only be
discussed in terms of nonlinear behavior.’’
Hans Joachim Schellnhuber
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Butler Climate Change and Global Health, CABI, UK, in press
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“Social vaccine”
“Demand will create a parachute”
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Toxicity
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Placebo
Vaccine spectrum
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Panic, despair, or indifference
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“Polyanna”
“Social vaccine” spectrum
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Not just “natural” capital –But interaction of natural, human, social, built, financial
And some would say moral
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Dian Fossey (1932-1985) and young mountain gorilla
Eco-connection
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Crisis = opportunity53
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Ingenuity in the Year without a summer (1816)54
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Global Energy Assessment, 2012
Solar (1975-20072007-10)
NUCLEAR
US$/kwH(2005
dollars)
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India: planning 455 new coal plants
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Global Energy Assessment, 2012Global Energy Assessment, 2012
Unmet electricity need
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Global Energy Assessment, 2012
Lack of “modern” energy
Most electricity is not clean
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Lock-in of Technological and Social Cultures &Institutions
The QWERTY Phenomenon
SUBSIDIES: fossil fuel /renewables: 6 to 1 (2011 )
10 times more than costs of Hurricane Sandy
59Hurricane Sandy 2012
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He Had a dream
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ÉdouardLe Roy
Paul Crutzen
noösphere(planetary thinking, sharing)
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