From AIDS to COVID-19 to Measles, Why do Infectious Disease Public Health Crises Keep Occurring?

This year marks the 45th anniversary of the Centers for Disease Control and Prevention's (CDC) first Morbidity and Mortality Weekly Report (MMWR) publication describing AIDS. As a way to mark this anniversary as well as discuss other aspects of the disease such as how far treatments have come, The American Journal of Managed Care’s Lead Editor Maggie Shaw and Contagion’s Assistant Managing Editor John Parkinson spoke with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, on a variety of topics around AIDS/HIV.

In his book, Humanizing Public Health: How Disease-Centered Approaches Have Failed Us, author Perry N. Halkitis, PhD, MS, MPH, discusses how human behavior remains a significant factor in their continuation.

“Human beings make decisions that are not always in their best interest,” said Halkitis “People seek pleasure, right? They want to be happy. They don't want to wear a mask. They don't want to get a vaccine, right? They want to go to a party in the middle of COVID. I mean, this is human beings, and we somehow think that human beings are going to be like the mouse in the maze that's going to run to the cheese and learn how to do it, right?”

Halkitis contends societal structures, and flawed public health approaches also continue to fuel the spread of infectious diseases.

“Behavioral approaches are not quite right, and unfortunately, in public health, we have been teaching our students for a very long time using models that assume this rationality, and I think that rationality doesn't exist.”

Halkitis has been familiar with these issues through his work as an epidemiologist and public health psychologist as well as serving as the dean of Rutgers School of Public Health.

As we learned with the COVID-19 pandemic, high consequence infectious disease is just a plane ride away, and he points to the isolationist mentality the US has right now, including leaving the WHO, fighting with former allied countries, and even potentially reducing collaborative, international research.

Lastly, he points to the distrust of medical science.

“We have the majority of people, regardless of party affiliation, not trusting the CDC,” Halkitis said. “Before it was people on the far right not trusting the CDC. Now we have people on the left also not trusting the CDC. And so now you've got a majority of Americans who don't know where to seek information and they're not getting the information that they need to be able to make decisions.”

In the fourth and final episode, Halkitis provides insights around the reduction in public health initiatives and the toll they take on infectious diseases.