Intended for healthcare professionals


Prevention is better than cure for emerging infectious diseases

BMJ 2014; 348 doi: (Published 21 February 2014) Cite this as: BMJ 2014;348:g1499
  1. David L Heymann, professor of infectious disease epidemiology123,
  2. Osman A Dar, locum consultant global health 13
  1. 1Public Health England, London SE1 8UG, UK
  2. 2London School of Hygiene and Tropical Medicine, London, UK
  3. 3Chatham House Centre on Global Health Security, Chatham House, London, UK
  1. Correspondence to: D L Heymann david.heymann{at}

Emerging infectious diseases have the potential to cause considerable morbidity, mortality, and economic damage. David Heymann and Osman Dar explain why we need to shift the emphasis from responding to emerging infections once they are detected to preventing them from occurring in the first place and describe one initiative that is working to achieve this

Emerging infectious diseases (emerging infections) have caused tens of billions of dollars worth of damage in the past 20 years and the costs are continuing to rise.1 2 Emerging infections can be new infections, such as HIV (when first discovered), which is thought to have emerged in human populations from a non-human primate; or existing infections that are becoming more common or spreading in geographically new areas as a result of changes in the micro-organisms or changing climate and include West Nile fever, Dengue fever, and chikungunya.3

Many people assume that emerging infections are a matter for tropical disease specialists, but they are important to doctors and policy makers, vets, farmers, traders, and economies globally. Although some emerging infections are specific to tropical areas, such as Ebola and Marburg haemorrhagic fevers, infections that emerge there can spread to other parts of the world, as seen with HIV. There are also many examples of diseases originating in non-tropical settings, including severe acute respiratory syndrome (SARS), influenza A (H5N1), variant Creutzfeldt-Jakob disease/bovine spongiform encephalopathy (BSE), and foodborne Escherichia coli O157 infections.4 5 Another problem is infections that have emerged in new forms—for example, multidrug resistant Staphylococcal and Mycobacterial species.

Over the past decades there has been increasing recognition that the way we deal with infectious disease is often reactive and too late. New diseases are often identified only after they have transferred to humans and sometimes many years after the breach in the species …

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