Plagues of the Past, Present and Future: A Visit from Laurie Garrett

IMG_1279As a way to celebrate 20 years of global engagement and scholarship, the Buffett Institute invited a series of esteemed speakers to address the Northwestern community. The afternoon of May 15th, guests had the opportunity to hear from Laurie Garrett, one of America’s leading voices in the field of global health. Her talk, entitled “From AIDS to Ebola: What Have We Learned?” offered a comprehensive history of plagues throughout human history, deftly linking the epidemics of the past with those that have taken place recently.

Garrett’s familiarity with plagues is well recognized in the global health community at Northwestern; as mentioned by NU lecturer Michael Diamond, her books are frequently assigned to students within the global health curriculum. Garrett has been widely recognized for her writings, as the only individual to win the Pulitzer Prize, the Peabody Award, and the Polk Award.

“I’ve always been fascinated with plagues,” Garrett began her talk, “for the social, historical, economic, and governmental dimensions.” The interdisciplinary paths of her talk emerged early on and provided listeners with a comprehensive understanding of how plagues fit into both the historical and current context.

Garrett began her talk with a chronological description of the great plagues of the world, from the Black Death in Europe to the plague in Surat, India of 1994, to more recent outbreaks of HIV, SARS, MRSA and Ebola. Each time she wove another thread into the patchwork of the global health history, she brought out the commonalities between the devastation behind these epidemics: that of stigma, fear, and misunderstanding.

In the case of the most recent Ebola outbreak in 2014, the 21st known outbreak of the disease, the world “ignored prior outbreaks, warnings of the environment, and the increased probability of outbreaks,” says Garrett. The world had no diagnostic tools, no surveillance, no vaccine, and no known treatment, leaving medical workers and communities horribly underprepared for the outbreak. In fact, from the very beginnings of the most recent strain, a lack of communication between the governments of Sierra Leone and Liberia, as well as delayed action by the WHO, created a precarious delay in response. This lapse in preparedness struck Garrett as a “breakdown in solidarity and collaboration in global health.”

Garrett’s perspective as an active leader in the global health field allows her critical understanding of the factors involved in a large-scale epidemic. As a Senior Fellow for Global Health at the Council on Foreign Relations, Garrett remains active in the field, modestly speaking of her involvement as she told the stories of plagues through past decades. In fact, her work and dedication to the field were clear and invaluable for all in attendance of her talk.

In his remarks following Garrett’s talk, Professor Diamond spoke of his admiration for Garrett, praising her holistic approach to understanding global health, as well as her recognition of the heroism of people on the ground.

In fact, Garrett spoke repeatedly of the power of grassroots action throughout both the Ebola and HIV epidemics. It was the communities’ responses that made massive changes in numbers of cases and diminishing the spread of both epidemics, she said repeatedly, while not undermining the impressive efforts of grossly understaffed and resource-deficient healthcare workers.

As for the question of what we have learned in studying the plagues of the past to the present: Garrett clearly believes it to be the organized and thoughtful preparation for epidemics before they escalate. Her talk highlighted various points during each outbreak that could have been avoided or scaled down by improved methods of communications between political, economic, or social structures. Outbreaks cannot be understood without each piece of the puzzle, and her talk deftly provided a look at both the puzzles and improvements in hindsight with the skill of someone well immersed in the world of global health.

The scripts of outbreaks may be predictable, said Helen Tilley, Director of Science in Human Culture and Associate Professor of History, in her comments following Garrett’s talk. Each time a new disease emerges in full force, society sees the following aspects: confusion of its origin, heightened stigma, intense fear, political divisiveness, and religious explanations. It is preparedness for and education about these scripts that will help the world react to future outbreaks. In fact, said Tilley, “epidemics hold up a mirror to society.”

The lecture, followed by comments from Diamond, Tilley, and Northwestern alumnus Victor Roy, gave attendees a fascinating look into how epidemics have changed, yet stayed the same, over centuries. The recommendations for improvements were realistic, interdisciplinary, and spoke to the immense challenges that face the global health community in the future. “The next epidemic will come,” concluded Garrett, “and it could be worse.”

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