Infectious disease is rife for most of the world's population, showing close correlation with poverty, poor sanitation, poor education, high fertility, poor access to basic health care and hot climates. There is ample evidence of rapid genetic change of existing lethal pathogens, eg new strains of drug-resistant tuberculosis, new influenza variants. HIV has apparently evolved only in the latter half of this century, with the current epidemic centred on sub-Saharan Africa, and continues to change rapidly.
To contain nature's genetic experimentation must be the main objective. This requires attention to the basic requirements of public health and the development of new vaccines which must be effective, cheap and available for use in the parts of the world where they are needed most. Vaccine development is critically dependent on the safe application of recent advances in genetic engineering.
London School of Hygiene and Tropical Medicine
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