School of Public Health marks 75th anniversary

By William J. Cromie

Gazette Staff

The School of Public Health celebrated its 75th birthday this week. Some 700 professionals from academia, government, and industry gathered in Boston to attend a three-day symposium called "Gateway to World Health: New Science and Strategy in Public Health."

At the opening session on Sunday, Harvey Fineberg, Dean of SPH, called the meeting "a feast of nostalgia to honor past achievements, and of opportunity to probe pressing scientific, practical, and policy issues. It is a gateway from the current state of public health . . . to a future being built upon a foundation of the past."

Sunday's presentations focused on control of infectious diseases and environmental threats. Monday's discussions explored health-delivery systems, social policies, and global health. On Tuesday, speakers addressed the social and individual aspects of aging.

Participants took a break from the lectures and discussions to dine and dance at a gala evening on Sunday. The festivities were highlighted by remarks from President Neil L. Rudenstine and Gro Harlem Brundtland, MPH '65, a member of the Norwegian parliament.

"Since the School's early decades, it has adapted itself to public health challenges that have become increasingly complicated and that can be effectively addressed only through combining knowledge across many fields," Rudenstine said. "The School has led the way in enabling us to understand, far more deeply than before, the interconnections among a wide range of social and environmental conditions and their probable effects on the health of different human populations."

Keynotes and Killers

Symposium sessions were televised and fed to various sites around the country. Live audio on the SPH Web page made the words of speakers available to everyone in the world with access to the Internet.

The symposium followed Alumni Day events on April 25 and 26. The events included an International Night on Friday, which featured performances and foods from around the world. On Saturday, the alums enjoyed lunch with Dean Fineberg, followed by presentations and roundtable discussions on a variety of topics from AIDS to women's health. The day ended with a cocktail reception and a musical satire on health care today.

In a keynote speech on Sunday, Barry Bloom of the Albert Einstein College of Medicine in New York City noted that infectious diseases, such as AIDS, tuberculosis, and malaria, are the major causes of poor health around the world. He cited TB as the planet's prime cause of sickness and death.

That will change by the year 2020, Bloom predicted. "Infectious diseases will give way to chronic diseases such as heart disease, cancer, depression, and road accidents," he said.

Bloom noted that more money, by itself, won't solve any of the world's pressing health problems. "But," he added, "they can't solve them without it either. Small decreases in poverty levels result in surprisingly large increases in life expectancy."

Max Essex, chairman of the Harvard AIDS Institute, described the difficult battle to develop vaccines against "the endless generation of new strains of HIV," the virus that causes AIDS.

He warned that "new epidemics must be anticipated." A new strain known as HIV-1C, which is transmitted by heterosexual activity, is now ravaging India. More than 98 percent of new infections in Thailand are blamed on HIV-1E, also spread by heterosexual activity.

Essex called this part of "a second AIDS epidemic," replacing the first, which involved mostly homosexuals and drug users.

Researchers tracking another virus, HIV-2, among prostitutes in Africa, have been surprised by the number of infectees who do not develop full-blown AIDS. Essex noted that infection with HIV-2 may provide "significant protection" from the deadlier HIV-1, the prime source of AIDS in North America and Europe. He noted that scientists at Harvard and elsewhere have started studies to determine if the biology of HIV-2 can somehow be used to defeat its more lethal cousin.

In a session devoted to genes and the environment, Leona Samson, professor of toxicology at SPH, described how DNA that repairs itself can protect against genetic damage caused by sunlight. Those whose genes cannot carry out this repair work are two thousand times more prone to skin cancer than normal people.

"It appears that even moderate decreases in DNA repair capacity are associated with increased risk of skin and other types of cancer," Samson concluded. She then discussed prospects for screening everyone for repair capacity, and the ethical considerations that this would involve.

For three days, more than 45 researchers described hard-won new findings and frustrating unknowns, failures to develop new vaccines and hopes of eliminating present scourges the way smallpox and polio were eradicated.

Fineberg noted that many participants in the SPH's 75th birthday celebration would play key roles in realizing those hopes. "Much of the work that might be presented in an SPH 100th anniversary symposium," he said, "has not yet begun, and each of us has the opportunity to contribute to that work."