BMJ  2004;328:531 (28 February), doi:10.1136/bmj.328.7438.531-a

reviews

SOUNDINGS

Weapons of mass destruction

The agricultural revolution was the first quantum leap in manipulating the environment and the industrial revolution was the second. The medical revolution is the third. Domestication, the harnessing of stored energy, and the eradication of hostile species were necessary before man could invade all niches on earth and multiply. The securement of man's biosphere began with the battle against lion and bear and wolf. Now the biological enemies are microscopic and submicroscopic—and our heroes are Jenner and Pasteur and Fleming rather than Theseus, who slayed the Minotaur, Perseus, the killer of Medusa, or Hercules, the accomplished exterminator of dangerous megafauna.

Our biological, chemical, and physical warfare against multitudes of living things is not only directed against those species that invade humans, but also against their vectors, pathogens to our domestic animals and plants, the vectors of these pathogens, and all living things which compete with us and our stock or cultivars.

A completely germ free world is unattainable, but is it a desirable objective? It entails environmental changes that represent new dangers to man and his chattels. Take antibiotic warfare, for example. Microbes are more resilient than we thought; 50 years of broadcasting poisonous substances has had little impact on the pyramid of life.

A justification for a campaign against infection may sound unnecessary. Of course, we do not want tuberculosis, not even in our cows, and we do not want rabies—even if this means doing away with the bat. The combined use of insecticides, pesticides, and herbicides can make economic sense, but only if economy is interpreted as maximising returns over a given period.

If species diversity is desirable, does the concept afford protection to the mosquito and even pathogens or only to the African violet, the Californian condor, and the panda?

The discovery that fanatical hygiene, antibiotic use in infants, and perhaps even vaccinations are detrimental to the maturing immune system and are associated with allergies, asthma, and autoimmune disease should be a warning: our aggression against the rest of the universe is demonstrably detrimental to our wellbeing.

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Nairobi Hospital Proceedings, Kenya

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