EMBL/EMBO Joint Conference 2002
Helena Maekelae, National Public Health Institute, Helsinki, Finland
Helena Maekelae obtained her MD in 1955 and PhD in 1961 in Helsinki University. She has extensive research experience in USA and UK. On the basis of her work to elucidate the genetic determination of complex polysaccharides she received the German Robert Koch Prize in 1969 and was appointed a member of EMBO in 1984. For most of her professional life Helena MSkelS has been the Director of Bacteriology/Infectious Diseases in the National Public Health Institute in Finland. In this position she was confronted in 1974 with an epidemic of meningococcal meningitis in Finland. This led to a series of large clinical trials with bacterial polysaccharide and conjugate vaccines under development. On this basis she has served in numerous advisory positions to WHO, EU etc. She was the president of the International Union of Microbiological Societies (IUMS) (1994-99) and the chairperson of Physicians for Social Responsibility in Finland (1982-97).
Knowledge: A prime weapon of defense against infectious diseases
From the point of view of biological science, we should be in an excellent position to respond to the challenge of infectious disease. There is an identified enemy to fight, biologically very different from our own body, thereby offering specific targets for attack. Several strategies are available: preventing transmission of the infectious agents, preventing establishment of their infection in our body, and finally killing those that have started a disease. We also have a variety of specific tools to implement these strategies. Thus we are now used to seeing around us in the Western World the success of these strategies: no more worries of epidemics of the big killers of the past, practically no more whooping cough, measles, mumps in our children, and childhood death in infectious disease a rarity. However, infectious disease is still there, partly as the milder but frequent respiratory infections, otitis media of children and pneumonia of the elderly, partly as underlying causes of common chronic diseases, and finally as the real threat of new or re-emerging severe disease epidemics. These are the worries of the industrialized world, to which the wonderful possibilities of present-day molecular biology promise new tools – maybe not immediately but in a not-so-distant future. This is the natural response of science, and very fine as such. However, the resulting improvement in health and wellbeing may be only marginal because of increasing costs. The prime value of this science response is the knowledge that can be applied to respond to future, novel challenges brought about by the evolution continuing in the microbial world.
A global look tells a quite different story. In developing countries – where most of the world's population live – the old-fashioned infectious diseases are far from conquered. Why is this so? The same technologies that have changed the infectious disease profile in the West work irrespective of geography. These technologies are simple and inexpensive: clean water, use of toilets, safe sex, vaccines and antimicrobials properly used. Why are the technologies not implemented adequately more widely, inspite of demonstrated examples of success? The key word may turn out to be ignorance of what can be done and what accomplished. If so, then the real effective response to the burden of infectious disease would be improved knowledge at all levels of actors – families, communities, health care providers, health services administration, health system planners, politicians. How could this be achieved?