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From 1932 to 1972, the United States Public Health Service conducted a non-therapeutic experiment involving over 400 black male sharecroppers infected with syphilis. The Tuskegee Study had nothing to do with treatment. It purpose was to trace the spontaneous evolution of the disease in order to learn how syphilis affected black subjects. The men were not told they had syphilis; they were not warned about what the disease might do to them; and, with the exception of a smattering of medication during the first few months, they were not given health care. Instead of the powerful drugs they required, they were given aspirin for their aches and pains. Health officials systematically deceived the men into believing they were patients in a government study of bad blood, a catch-all phrase black sharecroppers used to describe a host of illnesses. At the end of this 40 year deathwatch, more than 100 men had died from syphilis or related complications.

“Bad Blood” provides compelling answers to the question of how such a tragedy could have been allowed to occur. Tracing the evolution of medical ethics and the nature of decision making in bureaucracies, Jones attempted to show that the Tuskegee Study was not, in fact, an aberration, but a logical outgrowth of race relations and medical practice in the United States.

The tension between public health and individual rights raises key questions in the face of public health crises such as tuberculosis (TB) and Ebola: What are the circumstances that warrant the obligatory detention of individuals with an infectious disease as a measure of protecting the general public? What are the implications for the protection of privacy while managing and controlling the spread of diseases such as HIV? What must be done to obtain informed consent for research and epidemiological studies that benefit public health? Recent handling of TB and Ebola patients in West Africa captures the tensions inherent in the attempt to balance public health and individual rights. In this Perspective, we outline our experiences in handling Petition 329 of 2014, a constitutional petition filed in the High Court of Kenya in 2010, which sought to challenge the arrest and detention of two TB patients for interrupting their TB treatment.

Since the first cases of a then-unidentified pneumonia were reported in late December, hoaxes, half-truths and flat-out lies have proliferated, mostly through social media.

Most cases are not life-threatening, which is also what makes the virus a historic challenge to contain.

The 2020 outbreak of coronavirus has terrified the world--and revealed how unprepared we are for the next outbreak of an infectious disease. Somewhere in nature, a killer virus is boiling up in the bloodstream of a bird, bat, monkey, or pig, preparing to jump to a human being. This not-yet-detected germ has the potential to wipe out millions of lives over a matter of weeks or months. That risk makes the threat posed by ISIS, a ground war, a massive climate event, or even the dropping of a nuclear bomb on a major city pale in comparison.

In The End of Epidemics, Duke Global Health Institute faculty member and past Chair of the Global Health Council Dr. Jonathan D. Quick examines the eradication of smallpox and devastating effects of influenza, AIDS, SARS, Ebola, and other viral diseases . Analyzing local and global efforts to contain these diseases and citing firsthand accounts of failure and success, Dr. Quick proposes a new set of actions which he has coined The Power of Seven, to end epidemics before they can begin. These actions include:

• Spending prudently to prevent disease before an epidemic strikes, rather than spending too little, too late 
• Ensuring prompt, open, and accurate communication between nations and aid agencies, instead of secrecy and territorial disputes 
• Fighting disease and preventing panic with innovation and good science