Positive developments in public health must be viewed against a backdrop of missed opportunities and scientific contradictions.The scientific contradictions are many. As invasive medical procedures become more sophisticated and complex, public health faces a lengthening list of nosocomial infectious disease problems. When a familiar diseasecausing organism is well understood, its penchant for survival makes it resistant to drugs designed to combat it. Most recently, dapsone-resistant Mycobacterium leprae and strains of Neisseria gonorrhoeae resistant to both penicillin and spectinomycin have been reported.1-3Industrial progress means new health problems traced to chemical exposures at work or in other settings— another contradiction.Missed opportunities that continue to plague public health practitioners include unnecessary premature deaths around the globe. They result from malaria and other parasitic diseases, tuberculosis, diarrheal diseases, vaccine-preventable diseases of children, and other preventable causes. The toll of preventable illness is staggering, and for hundreds of millions
Foege WH. Public Health. JAMA. 1982;247(21):2979–2980. doi:10.1001/jama.1982.03320460079033
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