Issue link: https://beckershealthcare.uberflip.com/i/717576
88 THOUGHT LEADERSHIP going to have the best, state-of-the-art treat- ment for heart attacks, but we are also going to reduce the number of people who come in with heart attacks. at would force them to get prevention involved. at's the sort of last mile objective that could really change things. e best decisions are based on the best sci- ence, but the best results are based on the best management. It's this combination of science and management that can make a coalition really work. Q: What are one or two healthcare is- sues you feel are absolutely essential for the presidential candidates to ad- dress in the coming months? WF: I would sure like to see them address the issue of prevention. Each day, life expectan- cy for the average American increases by 6-7 hours. at's just an incredible figure, and a big share of that is prevention. Yet prevention is always the last thing funded. We don't seem to learn the lesson. is is true for individuals, cities, states and the nation: We don't truly val- ue health until we lose it. It's hard to get people to speak about prevention ahead of time. e other thing I would like to see them discuss is global health. When I started at the CDC, I was told over and over we had to justify everything we did on the basis of what it meant for the health of an American, and not the health of the world. All you have to do is look at Ebola and Zika and you re- alize how short-sighted that is. It's the same with smallpox eradication. e U.S. saves as much money every three months because of smallpox eradication as its total investment in smallpox eradication. Every year we get four times return on our total investment, and that will continue forever. It becomes almost an infinite figure. We should have more discussion on how re- lated we all are in this world and how import- ant it is to be investing in global health. It's es- pecially important when you see the political discussions now becoming very nationalistic. Einstein said nationalism is an infantile dis- ease. He called it the "measles of mankind." When it comes to health, we have to talk glob- ally. Q: Do you expect the Zika virus to be a major challenge for U.S. healthcare providers this summer? Why or why not? WF: I don't know what's going to happen with Zika. is virus has been known about for decades. It was recovered in Africa and oth- er places, and the vector was in the Americas for a long time, but for some reason it didn't spread. When it did spread, it spread fast. I would expect that's what will happen in part of the U.S., but I can't be sure. I know we have to be ready for the worst-case scenario. One of the good things that Zika has done — it's caused people to do a better job of conveying their research findings. Just [recently] e New York Times talked about how people are putting their findings online before they even publish them. at's a nice step in medical re- search. Q: You mentioned we have to be ready for the worst-case scenario with Zika. What is that? WF: e worst case would be massive spread wherever we have Aedes aegypti mosqui- toes, and we pretty much know where that is. en, it's pregnant women becoming infected and having infected children. One of the hard things about Zika is this is the first virus we've ever known about that is spread by a mosquito that causes birth defects. It isn't as if we have a track record of knowing how this will play out. Q: You recently were named to Ther- anos' board of directors and its sci- entific and medical advisory board and previously served on the compa- ny's board of counselors. What first attracted you to this company and what made you decide to stick with it through its recent troubles? WF: My interest initially was very much around global health. What they have done is what the computer industry has done. at the industry has gone from computers that take up an entire room to desktop computers, to lap- tops, to smartphones. is miniaturization is now being done by eranos in technologies and equipment. is means it is possible to consider using this technology in developing countries, even without electricity. You could hook up this technology to a car battery. Why is that so important in global health? One example: You see a person with tuberculosis in a clinic in Nigeria. You take a sample and it takes three weeks to see if that person has tu- berculosis or not. By the time you get the result back, you may or may not be able to find that person again. But with eranos and this min- iaturization, you can actually make a diagnosis in the clinic the day you see a patient and you can tell whether that organism is resistant to antibiotics. It's a huge leap forward. at's what originally attracted my attention. Having had the opportunity to look at their technology, it's very robust. e problems they have been vilified for have to do with lab oper- ations and the fact that they have not published in peer reviewed journals. ey are correcting the operational problems, and changes are be- ing made. As for the science, they are preparing to send articles to peer reviewed journals. For me, the bottom line is that global health needs this sort of technology and eranos is going to solve the problems to provide it. at's what has me excited. Q: Why didn't they initially choose to publish in peer review journals? WF: eranos was trying to get to a point of development where they had the entire package before they released the specifics of it. Now they realize that did not work so well, and they are going to share their technologies with the scientific community. Q: Are they at the stage now where they have the whole package or are they still working on it? WF: ey have tests now for many entities, but the number of things to be tested contin- ues to increase. In one sense, [eranos has] a platform in which they will be working on new technologies forever. Not only are there so many organisms we don't know about, but one new problem organism emerges every year, like Ebola and Lassa fever, and the other hemorrhagic fevers of the past. n "One of the hard things about Zika is this is the first virus we've ever known about that is spread by a mosquito that causes birth defects. It isn't as if we have a track record of knowing how this will play out."