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Predicting Infectious Disease Outcomes: Could We Do Better?

The benefits of combining the social and natural sciences to create better models for disease outbreaks, including pandemic flu in the UK and emerging diseases in Africa, were emphasised by a leading academic at LIDC. Professor Joyce Tait, of the Edinburgh-based Innogen Centre (funded by the Economic and Social Research Council), which conducts social and economic research on innovation in genomics, discussed the non-linear complexity and feedback loops associated with the progression of diseases. She highlighted the importance for policymakers of understanding the interaction between governance and regulation, science and industry, and public opinion.  Tait added: “We have not approached problems from disciplinary perspectives, but from what do I need to know. We need cross-discipline, cross-function modelling.” The presentation on 28 January was the latest event in the Social Science of Infectious Disease seminar series run by LIDC and the London School of Economics and Political Science (LSE).

Tait began by explaining how unreliable predictions have been in the past. Technological foresight regarded laser applications as dangerous (yet they are used in everyday machines, including CD and DVD players) and social/political predictions did not fare better as the fall of the Berlin Wall caught many by surprise. She said the type of foresight which she prefers concerns managing the future by identifying what is desirable and taking action to make it happen.

GM crops
Tait referred to her own work regarding GM crops to illustrate the downsides of constructing policy without appreciating the interactions between regulators, scientists and the public. She predicted in 1992 in a submission to the House of Lords Select Committee on Science and Technology that the Government’s attitude towards GM crops was going to hand the initiative to environmental groups to frame the debate about new technology for the European public. Tait asserted that the EU imposes the most demanding regulatory system upon GM crops which have not damaged anyone or the environment, and said such policies have led to a “GM crops disaster in Europe.”

Healthcare
The future development of healthcare is also likely to be constrained, according to an Innogen Centre study commissioned by the Organisation for Economic Co-operation and Development on the impact of biotechnology upon healthcare in Europe by 2030. The research showed that high regulatory barriers restrict the innovative potential of small companies. Tait said it is “inconceivable” that  a company like Google, which started from small beginnings in a garage, could fundamentally change healthcare systems. She also said that it is in the interest of large pharmaceutical firms to manage change in the regulatory structure.

Infectious diseases
The characteristics of plant, animal and human diseases in the UK and in sub-Saharan Africa until 2030 were also explored. Tait worked on this research, part of the UK Foresight Programme, with LIDC members, including Professor Jeff Waage, Director of LIDC, Professor Joe Brownlie, of the Royal Veterinary College. The drivers of infectious disease included climate change, governance systems, law, and conflict, and zoonoses (animal diseases which can be transmitted to humans) were identified as a possible source. Although many more moderate and high risks are likely to materialise in Africa, the African respondents surveyed in the project were optimistic about changes in governance systems on the continent. However, Tait acknowledged some of the limitations of the scope of the research and emphasised how the world is much more complex and less linear than a diagram charting the progress of a disease.

Pandemic flu
Tait also discussed her work with Professor Tony Barnett, of the LSE and London School of Hygiene and Tropical Medicine, on conceptual modelling of pandemic flu in the UK. She showed the importance of understanding the social and economic feedback loops which would develop and influence the progression of the epidemic. For example, people could start to panic about getting sick and this would lead to an excessive demand for drugs, which the drug centres may not be able to meet, thereby heightening panic and creating a vicious circle. She drew attention to inconsistencies in some aspects of UK's preparedness for a flu pandemic, noting that "We should be thinking about the unexpected in the advice we give to the public."

By Guy Collender, Communications Officer, LIDC
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