Three Views on the Track Record of Epidemiology
• View 3: Neil Pearce
Director, Centre for Public Health Research
Massey University, Wellington Campus, Wellington, New Zealand

TIME FOR A GLOBAL DIALOGUE

There are three reasons why the World Congress of Epidemiology in Porto Alegre, Brazil, represents an important opportunity for global dialogue.

Firstly, there is a great deal that epidemiologists from “the West” can learn from their Latin American colleagues. Epidemiology in Latin America has a rich and relatively recent history, with impressive and rapid developments in epidemiology both as a scientific discipline, and as a branch of public health with a firm commitment towards transforming the health of the population. This development has involved parallel and integrated developments in both the theory and practice of epidemiology, with an emphasis on the social determination of disease, while incorporating recent technical and theoretical advances at the cellular and molecular levels in an interdisciplinary manner. This does not mean that there is nothing that non-Western epidemiologists can learn from the West; clearly there is a great deal, but what is needed is a dialogue rather than a monologue. With increasing globalisation, we are all in it together. Secondly, it is increasingly recognised that “Western” epidemiologists now have global responsibilities. Just as “the West” represents a minority of the world’s population, but uses the majority of the resources, only about 10% of the world’s health research funding is allocated to the 90% of the world’s health problems which occur in non-Western populations. Thirdly, there are some scientific questions that can best be answered by genuine international collaborations that benefit all of the countries concerned. For example, studies of westernisation and asthma, and the associated “hygiene hypothesis’, cannot be addressed only by studies in Western countries where virtually everyone is exposed to a relatively “clean environment”. It requires global comparisons to clearly show that the hygiene hypothesis is not an adequate or complete explanation for current asthma prevalence patterns and time trends.

For these reasons, the globalization of epidemiology is going to occur as inevitably as economic globalization is occurring, and in both instances the issue is what form that globalization will take. Porto Alegre represents an important opportunity to continue the dialogue.

Job title: Professor and Director, Centre for Public Health Research, Massey University, Wellington, New Zealand

Main qualifications: PhD, DSc 

Research interests: Since the completion of my PhD in epidemiology in 1985 I have been engaged in a wide range of epidemiological research with a particular emphasis on epidemiological methods. During 1980-1988 my main substantive research interests were in occupational epidemiology, and during this time I co-authored a textbook of occupational epidemiology, published by Oxford University Press in 1989. During 1988-2000 my main interests were in asthma epidemiology, including the identification of the role of the asthma drug fenoterol in the New Zealand asthma mortality epidemic, studies of the management of asthma in the community, and more recently studies of the causes of the increases in asthma prevalence in New Zealand and worldwide. I authored a textbook of asthma epidemiology which was published by Oxford University Press in 1998. In 2000 I established the Massey University Centre for Public Health Research which is conducting a wide range of public health research including respiratory disease, cancer, diabetes, Maori health, Pacific health and occupational and environmental health research.