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The emergence of infectious diseases leading to plagues and pandemics occurred regularly throughout history. These events have had an unparalleled impact on human history, shaping societies and cultures in ways that few other phenomena have.  Paradoxically, this ‘reset’ on society has also sparked progress and innovations not only in science, but economic and political systems as well. This is put in perspective with the following review of some plagues and pandemics throughout history:

The Athenian plague is a historically documented event, occurring between 430-26 BC. Originating in Ethiopia and spreading throughout Egypt and Greece. The plague was widely documented by Athenian historian and general Thucydides, who wrote ‘Through knowledge, patience and science we can prevail.’1

The plague of Justinian is thought to have originated in Ethiopia moving through Egypt, or the Central Asian Steppes and quickly spread throughout the Eastern Roman Empire and its neighbours. After the initial outbreak in 541, intermittent plague outbreaks occurred every 8 to 12 years for two centuries and then disappeared for unknown reasons,2 killing an estimated 15-100 million people, representing 25-60% of the population of Europe at the time. The high mortality caused by the disease is said to have contributed to the weakening and eventual decline of the Byzantine Empire.2

The Black Death originated in China in 1334 and swept across Central Asia into Europe through the land and sea trade routes of the Silk Road in 1347. The Black Death is responsible for some 350-400 million deaths, killing as many as 30-60% of the European population and was followed by successive waves.3 It was at this time that Pope Gregory I introduced the blessing, “God bless you,” for those who sneezed in the morning and might be dead by nightfall.4 The black death resulted in fundamental change for the working poor, creating a labour shortage that empowered workers, resulting in better working and living conditions.

The Spanish Flu was the first global pandemic in modern history. The pandemic, which may have originated in the United States, spread in at least three (3) distinct waves within a nine (9) month interval.5 The first wave (Spring/Summer 1918) caused high morbidity and low mortality, but both the second and third waves (Summer/Fall 1918 and Winter 1918–19) caused high mortality, resulting in approximately 500 million infections (25% of the world population) and 50 million deaths worldwide.6  Fifty percent of those killed over two years by the H1N1 influenza A pandemic were 40 years old or younger. The Spanish flu had an immense influence on civilization, with many governments embracing new concepts of preventive and social medicine. Rethinking public health policies, countries like France and Germany introduced centralized healthcare systems and the US adopted employer based insurance plans.7

HIV | AIDS started in the early 1980s in the United States causing significant public concern as HIV inevitably progressed to AIDS and ultimately death. A slowly progressing global pandemic cascading through decades of time, different continents, and different populations. HIV affects about 40 million people globally and has killed almost the same number of people since 1981. The HIV | AIDS pandemic not only led to new models of regulation (NOC/c) but also to the creation of a framework for patient advocacy within the research system that never existed before, allowing people with the disease to have a voice in how the disease is researched and treated.8

COVID19. In early December 2019, atypical pneumonia were reported in a cluster of patients in Wuhan (China) and were shown to be caused by a new coronavirus, called SARS-CoV-2.9 On March 11, 2020, the World Health Organization (WHO) declared this to be a pandemic.10 Within a few months, COVID19 spread globally leading to more than 662 million contaminations and nearly 7 million deaths worldwide as of January 2023.10A The global threat brought on by COVID19 resulted in extensive government interventions, including lockdowns and other sanitary and societal measures, to safeguard public health, impacting economic development worldwide. Calling on science, innovation and technology to provide rapid solutions, at any cost. 

Cancer, in parallel, is a global and deadly disease, and like pandemics, has severe socio economic repercussions. It is expected that the incidence and mortality due to cancer will reach pandemic proportions by 2040. According to the Global Cancer Observatory (GCO), approximately 29.4 million people worldwide will be diagnosed with the disease and an expected 16.2 million cancer related deaths will occur.11 While cancer is a non communicable disease (NCD), both cancer and infectious diseases (like SARS-COV-2) pose a significant threat to public health. Pandemics have received considerable attention and resources, while cancer remains a significant public health issue that needs urgent attention. More efficient and effective medical treatment is only part of the solution. Cancer is no longer just a problem for healthcare systems. To achieve further progress, we need a collective and concerted effort that involves; all levels of government (FPT ministries of health, finance, innovation, science and industry, employment, workforce development and disability inclusion) working together to create supportive policies and regulations, public and private partnerships collaborating to provide resources and expertise, patients and communities participating in decision making and advocacy, innovative technologies and solutions that improve prevention, diagnosis, treatment and care, policies and strategies that address the social determinants of health and reduce health inequalities, and funding and support for cancer research and innovation. 

Cancer is a silent pandemic with no end in sight. To address this ongoing health crisis, we must allocate comparable resources and efforts to cancer as we have to COVID19. 

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