John Crump is McKinlay Professor of Global Health and Co-Director, Otago Global Health Institute, University of Otago, Dunedin; Adjunct Professor of Medicine, Pathology, and Global Health at Duke University; and a Guest Researcher with the US Centers for Disease Control and Prevention. He graduated from the University of Otago Medical School in 1993 and trained as both an internist in infectious diseases and as a pathologist in medical microbiology, training at Christchurch Hospital, New Zealand; the Royal Free Hospital, London; the Canberra Hospital, Australia; Duke University Medical Center; and with the US Centers for Disease Control and Prevention. He is a Fellow of the Royal Australasian College of Physicians, a Fellow of the Royal College of Pathologists of Australasia, a Fellow of the Royal College of Physicians of the United Kingdom, and a diplomate of the London School of Hygiene and Tropical Medicine. His main interests are in the prevention, diagnosis, and treatment of infectious diseases in developing countries, with particular focus on febrile illness; invasive bacterial diseases especially the salmonelloses; bacterial zoonoses; and enteric infections.
Plagues Of The past, Pandemics Of Tomorrow
History suggests that infectious diseases pose the greatest future risk for causing ‘mortality shocks,’ events with the potential to kill millions of humans, disrupt the global economic system, and change history. The influenza pandemic of 1918-20 was estimated to have killed 50 to 100 million people worldwide, or 3-5 percent of the human population. The 2002-3 Severe Acute Respiratory Distress Syndrome (SARS) epidemic uncovered problems with the global approach to managing infectious diseases emergencies, leading to revision of the International Health Regulations (IHR) in 2005. However, subsequent outbreaks culminating in the 2014-16 West Africa Ebola virus disease epidemic showed that changes to the IHR alone were not sufficient for countries and the international community to identify and respond adequately to such events. The risk for future pandemics will be explored by describing the diversity of mammalian viruses capable of infecting humans and understanding the drivers of emergence of human infectious diseases. To illustrate the impact of epidemics on communities and health systems, the New Zealand experience responding to the 1918 influenza pandemic will be described. Improvements in global health epidemic preparedness following the 2014-16 West Africa Ebola virus disease outbreak will be reviewed.