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Knowledge Systems for Sustainable Development

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    • Broadening vision and disrupting set ideas...
      • Scientific expertise must be given its full status in society - Philippe Kourilsky

Scientific expertise must be given its full status in society - Philippe Kourilsky

Adding further regulations as regards health and the environment very often brings about a parallel increase of the economic cost of operations. This process of regulation is an obstacle for poor countries and prevents them from finding solutions to their own problems. Avoiding these obstacles requires a proper cost-benefit analysis, differentiating according to context. The "contextual" ethics method should therefore be considered. A scientific approach to find a workable solution would be an instrument for progress.

Regulation of the major health and environmental issues raises the whole question of the role of regulating authorities. This role is nowadays the purview of the major international agencies that are invested with considerable power because they draw up and monitor the various standards that operators in the field must comply with.

The standards expand continually, sometimes with good reason, and this entails a similar increase in expenditure. This is a major problem for poor countries that are no longer able to keep up with increasingly demanding standards. Regulatory hurdles may prevent them from solving their own problems.

As an example, the Institut Pasteur in Cambodia has been immunising against rabies free of charge, using a vaccine produced in Viet Nam, but WHO has recommended its suspension. It is true that this old fashioned vaccine is no longer up to standard and can have secondary effects. However, we are at a loss to adapt to this new situation because the new vaccine is 50 times more expensive than the old one!

Also, it is implicitly accepted that raising standards is a way to improve safety and is a universally acceptable ethical activity. But perhaps we ought to adopt another ethical view, describing it as "contextual", in contrast with what is supposed to apply everywhere according to the same pattern. There is fierce controversy on this subject. In this context, I can quote the example of the rotavirus vaccine. In the United States, after 500'000 children had been immunised using this vaccine, about twenty of them suffered from serious intestinal disorders at a level that was apparently only slightly higher than is the case in a non-vaccinated population. As a result, the vaccine was withdrawn, but no one suggested that it could be used in developing countries, where 600'000 children die every year of rotavirus contamination and its complications.

How can we cope with such a predicament? As a minimum, we must go much further down the road of measuring the cost of implementing these regulations, including those on the subject of safety. A proper cost-benefit analysis must be performed for the different situations where problems arise. Academia must take on the responsibility of making sure that this debate makes some progress.

My suggestion would be to consider contextual ethics instead of relying exclusively on universal ethics. Unlike William Dab, I believe that precaution can, in some cases, be a luxury that only developed countries can afford. Substituting precaution for prevention is in fact an "ethical confidence trick"

On the basis of these considerations that relate solutions to local environmental and health challenges, I shall use the support provided by the activities of the Network of Pasteur Institutes. This international network for cooperation, which operates in all five continents, is continuing to expand, particularly in developing countries where the main thrust of efforts to achieve health and sustainable development is in progress. I refer in particular to the curbing of transmissible diseases, sanitary education, epidemiological research, screening activities, preventive medicine, vaccination, hygiene, and of course, action to improve the environment with all the favourable sanitary consequences that are well known.

In pure Pasteurian tradition, we consider that scientific research must play an important role in developmental issues. Scientific innovation is in fact one of the ways for society to attain this "sustainable economy" that we all strive for.

However, I must qualify my statement and say that I am fully aware that science, on its own, cannot solve all the problems we are confronted with. Research has a contribution to make, but this does not mean that it is the only possible way forward.

In the space of ten years, between the summits of Rio and Johannesburg, there has been growing awareness that development models, when they do not take sufficient care to protect the resources of the planet, are dangerous. This is how the corrective concept to market economy typified by the word "sustainable" was coined. The aim is to reconcile the right of each of us to prosperity with the duty to protect collective assets, amongst which are health, the environment, and education. Continuing economic and social progress must be equated with the prevailing natural laws that condition our access to these collective assets.

We may well wonder in today's world if the considerable advances of science, in particular the life sciences, will produce progress of equal importance in the field of health. And how can we ensure that the life sciences generate further knowledge that can help to manage the environment? The fact that the countries of the South are the first to suffer from some of our deficiencies must be continually stressed. How to improve treatment and health care to deal with the scourges that afflict them are matters we are much concerned with. More than half the research done in the Institut Pasteur on infectious diseases is for orphan diseases, i.e. those that affect individuals and populations who have no financial resources. Therefore, prospects of a market or any direct profitability are not encouraging. Progress in the prevention and treatment of these neglected diseases raises a number of problems, in particular as regards clinical and pharmaceutical development.

For development to be sustainable, it must therefore be based on cooperation between all the actors. There are a great number of them. They are in the public, international and private sectors. In this respect, I am glad of our association with Veolia Environnement. It is a symbol of tighter links between a research institute and an industrial concern of impressive international stature. Such partnerships are extremely useful and need amplification by prior reflection and subsequent attention, along the courses of action of both entities.

Precaution is not a luxury reserved for rich countries

Development of precautionary principles also depends on a reinforcement of scientific organisation. However, this does not mean that precaution is a luxury reserved for rich countries. There cannot be durable precautionary principles applied to the countries of the North and laisser-faire in the countries of the South.
William DAB, Director General, French Ministry of Health

Educating to combat obscurantism

We live in a society overrun by well organised obscurantism. It is essential that we extricate children from such situations and lead them towards the use of reason.
Georges CHARPAK, Physics Nobel Prize, member of the Académie des Sciences and of the European Council for Nuclear Research.