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  Epic Predictions

Illustration by Naomi Shea Will the world be a better place for human health in five years? Ten? Twenty-five? Experts from Johns Hopkins' Bloomberg School of Public Health weigh in with their own informed predictions. From the book Saving Lives, Millions at a Time, produced to celebrate the rededication of the Bloomberg School last spring.

Vaccinate, Eradicate
By 2008, the Guinea worm, which as recently as two decades ago infected millions of Africans annually with ulcers, fever, and sometimes crippling infections, will be eradicated. By 2009, polio will be certified as eradicated. And by 2010, an AIDS vaccine will be deployed globally.
—Donald S. Burke, professor of international health

Prescriptive Profiles
Within the next 25 years, a person's whole genome sequence will be routinely considered as part of his or her health profile, just as age, cholesterol level, and blood pressure are now. Individuals will be able to use their genomic profiles to guide their personal behavior, while health care providers will consider them when prescribing treatment.
—M. Daniele Fallin, assistant professor of epidemiology

Information Overload
In the next few years, the constant harangue of infomercials, "expert" talking heads on "news" channels, and other self-serving sources of "information" will create a spate of bad decisions by the public about health risks. But within the quarter-century, renewed respect for objective science means we will see balanced and safe diets that control the obesity epidemic; basic health care for all; and investments in safe food, clean air, and potable water.
—Scott L. Zeger, professor of biostatistics

Cleaner Water
The proportion of the world's population that has daily access to clean water will increase, largely due to new, simple, rugged field technologies. These technologies will include reusable micro-filters and solar-powered systems that purify water with ultraviolet light.
—Robert S. Lawrence, professor of environmental health sciences

Dirtier Air
In the developed world, we will continue to reduce urban air pollution by closing heavy industry — but that industry will continue to move to, and pollute, the developing world. Emerging "mega-cities" pose unprecedented air pollution problems. My worst fears are for the global atmosphere; we are doing far too little to rein in emissions of greenhouse gases. Without immediate global action, which seems far too unlikely, concentrations of these gases will still be increasing in 2025.
—Jonathan M. Samet, professor of epidemiology

Fear Not
Because the needless fear of negligible risks can interfere with enjoyment of life — while lack of fear of true dangers can lead to tragedy — fear management will be recognized as a significant public health issue. With enhanced risk assessment, risk communication, and pharmaceuticals, the beginnings of such management will be accomplished.
—Stephen P. Teret, professor of health policy and management

Peer Pressure
Instead of chiefly targeting individuals to influence behavior, science will move to understanding how organizations, neighborhoods, laws, and social norms can be changed in ways that improve public health.
—Thomas A. Glass, associate professor of epidemiology

Weighty Issues
By the year 2025, the biodiversity of indigenous foods in the world will plummet by one-third. New classes of "essential nutrients" will be discovered. China's rising economic might will drive up world demand for grain, pushing prices higher and setting off a crisis in food aid for the poorest countries. And America will start losing weight while today's developing economic "tigers" will be putting on pounds: In sum, the world will be no lighter.
—Keith P. West Jr., professor of international health

Crowd Control
By 2050, the global population will increase by almost 3 billion. In nearly all societies in the world, fertility rates will be at replacement levels — 2.1 births per reproductive-aged woman — and average longevity will increase by 10 years.
—Amy O. Tsui, professor of population and family health services

Health and Happiness
In 25 years, screening for depression will be as common as taking blood pressure. As a result, treatment in the primary care setting will increase — and, because depression increases the risk of heart disease, diabetes, and stroke, the incidence of those diseases can be expected to decline.
—William W. Eaton, professor of mental health

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