The march of the West Nile virus (illustration on Flickr by A J Cann: Present and future arboviral threats. Antiviral Res. 2010 85[2]: 328–345).

Laurie Garnett, a scientific consultant on Steven Soderbergh’s new film ‘Contagion’, wrote the popular science book The Coming Plague in the 1990s. In a piece on CNN last week, she warns that ‘there is no governing structure for a pandemic, and little more than vague political pressure to ensure limited access to life-sparing tools and medicines for more than half the world population. . . .

‘ . . . [T]he days when epidemics could be tackled locally had long passed. I argued that the movie had to demonstrate that disease threats in the 21st century are global threats, but the world lacks an appropriate system of governance and trade to permit a genuinely equitable response.

‘Without equity, pandemic battles will fail. Viruses will simply recirculate, and perhaps undergo mutations or changes that render vaccines useless, passing through the unprotected populations of the planet.

Those who see ‘Contagion’ will recognize these themes in its plot: Chinese villagers clamor for vaccines, Internet users gravitate to false claims and order anything they think may help, the entire world sees the pandemic unfold on TV and the Internet and grows universally fearful. Fear spreads globally, even as governments fail in their ineptitude and exhaustion, with police, fire, public health and political leaders themselves falling victim to the virus. . . .

‘What audiences see is the best rendition of events likely to unfold in such a pandemic as can be estimated, based on how governments, public health leaders, scientists, drug companies, communities, law enforcement and international agencies have responded to recent outbreaks of less virulent germs. . . .

‘Internationally, mechanisms of global health governance are very weak. The World Health Organization is running a $1 billion budget deficit, laying off more than 20%, or 300, of its employees this year. . . .

‘In the United States, politicians post-2001 grew tired of our Centers for Disease Control and Prevention, long the world’s premier disease-fighter. . . . Under the Obama administration, the CDC is led by the very able Dr. Thomas Frieden, but congressional mandates have shifted its resources and focus from epidemics and outbreaks to obesity management and chronic disease issues. . . .

‘In these recessionary times, public health budgets are falling to budget axes from Maine to Manila. . . .

‘”Contagion” should serve as a wake-up call not only about the germs, but perhaps more importantly about the frailty of governance, nationally and worldwide.’

Read the whole article on CNN: ‘Contagion’ is part reality, part fantasy, totally possible, 14 Sep 2011.