Who should be responsible for the world’s health?

A contagious disease posing a health problem in a small village in India one Wednesday morning can spread to Seattle by midnight as a passenger steps off a plane along with 100 other contaminated passengers. The disease can span the state by the next morning, the West Coast by Thursday night, and can become a national emergency before the weekend.

Though this may sound like a Michael Creighton thriller, the transmission of disease is now a very real global problem.

In 1997, a potential world pandemic known as the bird flu virus first appeared in Asia, then Europe and Africa. Though the bird flu virus lacked an efficient way to transmit from person to person, the speed and extent of its range immediately raised concerns about the transmission of disease in today’s globally connected world.

Contrary to previous predictions, Donald G. McNeil, Jr., science reporter for the New York Times, reported in May 2006 that the mobility of people rather than migrating birds spread the avian flu. Now scientists around the world are scrambling to prevent mutations that would allow the virus to spread quickly enough to cause a global flu pandemic. These scientists are employed by private companies, governments and global organizations such as the World Health Organization, each with various motivations for finding a vaccine to protect against dangerous mutations of the virus.

But whose responsibility is it? And when progress is made, who will have access to the necessary drugs? Who will foot the bill? And who will cash in?

These questions are not only pertinent to the prevention of a global flu pandemic. Today many deadly diseases, such as tuberculosis (TB), still exist, despite vaccines that could eradicate them. A standard case of TB in the developing world costs only $16 per patient to treat. Unfortunately, the jury is still out on who is responsible for investing in such endeavors, and those who need treatment cannot afford it themselves.

The dominant perspective has been that world health will handle itself through the privatization of the pharmaceutical industry. Free-trade economists preach reducing barriers to trade so that everyone has access to the world’s resources. However, pharmaceuticals present a unique case of a resource that will not reach everyone who needs it if pricing is determined by supply and demand.

First of all, because research and development of pharmaceuticals is so risky, patent laws permitting the right to control supply, and therefore the pricing of drugs, are necessary in order for private enterprises to be willing to invest in their development at all. Unfortunately, this disempowers the effect of demand on pricing and ignores the ethical implications of pricing a drug out of reach of someone who needs it.

Because of these problems, privatization of the pharmaceutical market inadequately serves the world’s health needs.

So attention turns to government agencies, such as the Centers for Disease Control in the United States. The CDC is funded by taxpayers to ward off disease in the United States. Their interests lie only in their own country. However, the avian flu severely threatens the comfort of that notion. As long as people are traveling around the world, so is disease. Government agencies can no longer afford to ignore disease occurring outside of their country’s borders.

However, it will take more than one nation to organize this effort. In fact, it will take the collaboration of many nations.

And so begins the argument for global organizations such as the World Health Organization. Ideally, a global committee is best positioned to coordinate the efforts of the world in detecting, preventing and eradicating the world of disease.

Unfortunately, all nations will not be able to contribute equally to such organizations. For example, as long as poverty levels of developing nations are such that people are dying of disease and hunger, their attention will not be focused on investing in endeavors to improve the world’s health. They are consumed with creating their own political and economic stability. Until each nation is represented in these global committees, their interests will not be weighted as heavily as the more active players.

What this means for now is simply this: Budgets of global health committees will continue to be biased toward developing nations. For example, only 662 people died from TB in the United States in 2004, while more than 2.4 million cases of TB occur in sub-Saharan Africa each year. This reality is reflected in where money goes. In 2005 the World Bank spent less than 1 percent of its health-sector budget on treating TB in Africa. So for now, 1.6 million people will continue to die each year of preventable and treatable TB.

However, no nation is free from the threat of transmissible disease in today’s ever-connected world. Even developed nations can no longer afford to ignore health problems in other parts of the world. TB is mutating such that some strains are resistant to treatments currently available. If TB is not eradicated, it could pose a global threat as it becomes immune to treatment and spreads around the world. And TB is just one example.

This new global reality does not allow for people to only look out for their own when it comes to health, whether through private enterprise, government funding or representation on global committees. In today’s connected world, only collaborative world-wide efforts will prevent the spread of disease.

Meghan McCourt of Lake Stevens is a graduate student in organizational psychology at Seattle Pacific University.