Public Health: Slow Motion Disaster (John Michael Greer)

  John Michael Greer -- The Archdruid Report

  Oct. 18, 2006 -- Of the four aspects of our deindustrial predicament I outlined in a previous post -– fossil fuel depletion, economic contraction, declining public health, and political dysfunction –- public health has received far and away the least attention from the peak oil community. This is ironic, to use no stronger word. I’ve argued at length elsewhere that the energy shortages and economic breakdowns sometimes claimed as causes of imminent industrial collapse will play out instead over decades of unsteady decline, and taken a certain amount of heat from apocalyptically minded peak oil theorists for that. Here, though, the shoe is on the other foot. Though it’s all but unnoticed outside of a small cadre of worried professionals, the disintegration of public health in coming decades promises a disaster in slow motion.

  It’s not surprising that this particular crisis has gotten so little air time. Public health is one of the least regarded, though among the most necessary, of the basic services industrial society provides its citizens. It’s not exciting stuff. Sanitation, pest control, water treatment, food safety regulations, and the like are exactly the sort of humdrum bureaucratic activities that today’s popular culture ignores most readily. Even infectious disease control rarely achieves the level of intensity chronicled, say, in Randy Shilts’ history of the AIDS epidemic, And The Band Played On; more often it’s a matter of collecting statistics, tracing contacts, and sending emails to local officials and hospitals in the certain knowledge that most of the recipients will just hit the delete button. On these pedestrian activities, though, rests the industrial world’s relative freedom from the plagues that visited previous societies so regularly and killed so many of our ancestors.

  The impending collapse of public health, like most aspects of our current predicament, has an abundance of causes. One is the failure of government at all levels to maintain even the very modest support public health once received. Lacking an influential constituency in the political class, public health departments far more often than not came out the losers in the tax and budget struggles that dominated American state and local politics in the last quarter of the 20th century. Worse, food safety regulations were among the consumer protections gutted by business-friendly politicians, with results that make the headlines tolerably often these days.

  A second factor in collapsing public health is the end of the antibiotic age. Starting in the early years of the 20th century, when penicillin revolutionized the treatment of bacterial infections, antibiotics transformed medical practice. Dozens of once-lethal diseases -– diphtheria, tuberculosis, bubonic plague, and many others -– became treatable conditions. A few prescient researchers cautioned that microbes could evolve resistance to the new “wonder drugs” if the latter were used too indiscriminately, but their warnings went unheard amid the cheerleading of a pharmaceutical industry concerned only with increasing sales and profits, and a medical system that became little more than the pharmaceutical industry’s marketing arm. The result has been an explosion of antibiotic-resistant microbes. The media not long ago announced the emergence of XDR (extreme drug resistant) tuberculosis in Africa and Asia, adding to the list of microbes even the best modern antibiotics won’t treat.

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