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  • 1 U.S. Naval Medical Research Center Detachment
 American Embassy Lima
 APO AA 34031
 Telephone: 51-1-562-3848
 Fax: 51-1-561-3042

Dear Sir:

Our colleague Dr. Meshnick has proposed that our Society change its name.1 He expresses the view that “Hygiene” may not represent the membership and the work we conduct. He suggests, “The American Society of Tropical Medicine and Global Health.” I don’t know what “Global Health” means, but I do understand “Hygiene” and argue its relevance to diseases of the tropics and our Society.

Maintaining health in the tropics requires more than medical intervention after disease strikes. It requires more than drugs and vaccines to prevent disease. It requires something else, hygiene. Next year will be the 100th anniversary of the commencement of the work of Dr. William Gorgas in Panama. That 10-year effort was not accomplished with medicine or global health, it was hygiene: spraying insecticides, eliminating breeding sites, creating efficient drainage, building homes that keep mosquitoes at bay, and many other measures unrelated to clinical or laboratory medicine. Today many of the tropical infectious agents our Society investigates creep out of the conditions created by ignorance of hygiene.

The neglect of hygiene as a tool of disease prevention is lamentable. A simple hygienic practice that could prevent endemic disease often doesn’t happen because no one thought of it. We fly into areas of endemic disease bearing rapid diagnostics and effective therapies, but we neglect to bring the idea for a simple measure of hygiene that could prevent most of the infections being diagnosed and treated. Hygiene has no cache. No one funds research aimed at improving hygiene, and that’s too bad. Hygiene comes with no microsatellite arrays, ELISA wells, or dramatic recoveries in the clinic. Sound hygiene quietly creates communities of healthy people.

I propose the Society retain “Hygiene” in its name, and more actively promote the relationship between sound hygiene and human health in the tropics.



Meshnick SR, 2003. Letter to the editor. Am J Trop Med Hyg 68 :507.

Author Notes

E-mail: baird@nmrcd.med.navy.mil