April 9, 1999

Biomedical tools alone won’t improve world health: speaker

Biomedical tools alone won't improve world health: speaker


World Health Week speaker Dr. David Fraser. (photo by Donna Jones Bailey)

Vanderbilt University School of Medicine students were taken on an investigational journey of sorts last week as the executive director of the International Clinical Epidemiology Network (INCLEN) spoke about his work in studying Lassa Fever in West Africa.

Dr. David W. Fraser, a world health expert who led the investigation of the first outbreak of Legionnaires Disease in 1976, was the keynote speaker for the School of Medicine's World Health Week.

The annual World Health Week lecture series, which began in 1986, is intended to provide exposure to international health issues to students, faculty and the general public. It is also designed to demonstrate to students the opportunities for using a medical degree in an international setting.

Lassa Fever, a viral infection found in the world's tropical regions, is a highly contagious disease that can cause a serious and often fatal illness. The Lassa virus, which spreads rapidly, has been found in one rodent species but the exact mode of transmission to humans is not known.

Fraser and colleagues studied an epidemic of Lassa Fever in Sierra Leone for five months in 1972.

Investigating a world health epidemic has its strengths and in this case led to a productive two decades of researching the virus and similar diseases, Fraser said. But it also has its limitations.

"Five Americans coming in for a month can't understand everything they need to know about the eastern province of Sierra Leone. You end up with a very superficial understanding of the setting."

Besides the investigational route, there are two other paths to improving world health, Fraser said.

The second path is developmental. Fraser used Northern Pakistan as an example. In this remote mountain desert area Prince Karim Aga Khan, internationally known as the religious leader of the Ismaili group of Muslims, has helped the people better develop themselves. It's an area with strong men's and women's organizations, a water sedimentation system, and good schools.

"They want their children well educated. They see this as a way to become economically stronger and more advanced," Fraser said.

"Sustainable improvement in health depends at least as much on strengthening of a population's economic, educational, cultural and organizational fabric as on epidemiological knowledge and biomedical tools," he said.

The third path is using resources wisely to improve health, an example of which is Fraser's organization, INCLEN.

INCLEN is an independent, non-profit organization that helps clinicians and other scientists obtain the knowledge and tools to improve the health of people in the developing world. It was created in 1980 as a project of the Rockefeller Foundation.

"Limited resources have the greatest effect in improving health if they are applied wisely where the need is the greatest and for interventions that are maximally effective," Fraser said.

INCLEN is in charge of 54 clinical epidemiology units in 24 countries.

Fraser said there are obviously more than the three highlighted paths to world health.

"Each of these tools compliments each other. People can use one to make the other better. There's not a single, easy path to world health. Partners can join hands to make a difference."