On a recent plane ride, I watched Karate Kid Legends. The latest installment of The Karate Kid saga is focused on a Kung Fu master, who knew Mr. Miyagi, seeking out Daniel LaRusso. Part of the theme of the movie is disseminating the knowledge of one’s mentor, in this case Daniel continuing to teach karate in the Miyagi-do style. It made me think of D.A. Henderson and the principles of infectious disease and epidemiology he instilled in me. He has now been gone for 9 years (this post is regretfully a little late—was intended for August 19) and I try my best to think about how DA would help me think through the problems in infectious disease when I discuss these topics with the media, colleagues, students, and others. I hope I do his mentorship of me justice.
Each year, I think about what guidance he would give me (and the country and the world) on the happening infectious disease. I, for one, would be embarrassed to show him the headlines of 2025 as we have seen a major backslide from 2016, when he died. I have always been puzzled how societies turn away from their scientific and technological achievements, but I am now puzzled any longer because we are seeing it in real time.
So the questions I would pose to D.A. now have en enhanced urgency and his answers are needed more than ever.
Here are 5 questions I would ask him:
1. Are the politics of the anti-vaccine movement too strong to get out of this mess? The anti-vaccine movement — which used to be a creature of the far-left—has now completely infected the leadership of the Republican Party. Do things have to collapse before they get better? Can anything get Republican leaders to disavow this group and stand on principle versus political expediency. How can the originator of Operation Warp Speed stand for this?
2. Do you think the U.S. will lose it’s measles elimination status? The largest outbreak, centered in West Texas, is over but smaller outbreaks are continuing — some of which were seeded by that one. Measles elimination status is depending on no-ongoing transmission lasting for at least a year? It’s unlikely that PAHO retains its elimination status as the Canadian and Mexican outbreaks are much worse than the ones here.
3. I always ask about polio. It seems to be unraveling more and more with increased wild cases in Pakistan and more vaccine-derived cases popping up. Shouldn’t this pivot to being only about wild polio? Or is the ideal solution the one you always advocated — just driving paralytic polio down to level where it is no longer a major health problems for the world and continue polio immunization alongside other routine childhood vaccines.
4. What is going to be the trajectory of the current clade of H5N1 circulating in poultry farms, dairy cattle farms, and in numerous mammalian species. Human cases have been, mostly, mild so it seems that this clade of the virus has serious constraints in causing severe disease in humans (vs. other mammals). Is H7N9 still more concerning or is H5N1’s threat elevated as it is in more places and in more mammals given it the opportunity to mutate or reassort with a seasonal virus?
5. What is the status of biological weapons work? Is our biodefense capacity resilient enough for 2025. It’s likely that Russia, North Korea, and China all have offensive bioweapons program. Is our biodefense apparatus — which must be tightly integrated to our public health systems — up to the task? Is the White House engaged enough or possessing of the expertise to handle these threats? What is the first thing to focus on that could strengthen the US in this regard?
There are many more questions to ask DA. But these are the first five that came to mind.
I’ll leave you with this, just think for a moment if you knew DA or ever heard him speak (or look him up on YouTube): can you imagine his booming, authoritative, and incisive voice addressing the irrational nihilism of RFK, Jr? That image should make you smile (I know it has the effect on me).