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www.iiasa.ac.at summer 2017 ◼ options 17 directly address health issues. “When planning work in this field we can combine established IIASA work with that of invited scholars who are better linked within the health community—and so define a niche where we can have an impact,” says Lutz. The obesity pandemic is a case in point. Lifestyle, unhealthy nutrition, and obesity are big health challenges and Lutz says these are related to the population factors, such as education, which IIASA is currently studying. He gives the example of Austria, where there is a difference of seven or more years in life expectancy between the highest and the lowest education groups. This is partly related to lifestyle and behaviors like smoking. “In the past, infectious diseases killed the poor as well as the wealthy,” says Lutz, but today, education and behavior are now strong determining factors in life expectancy. IIASA research is also well positioned to integrate existing insights into disease emergence, transmission, and adaptation, with research not only on climate and land use, but also human demography and behavior. Then there is the broader question of systems analysis and its application to health systems. “A full and comprehensive systems view on public health is required where we not only look at singular risks but all risks in combination,” says Lutz, who believes that IIASA is in a position to develop its role in studying these health dimensions in a systemic way. Eradication meets evolution – how disease fights back Health science must tackle the disease as well as treat the diseased populations. However, the history of disease eradication is a brief one. In only two cases have scientists found success; with smallpox and rinderpest. For many others, including malaria and polio, success has sometimes seemed near but in the end has proven elusive. Now, a new study could reinvigorate eradication campaigns by showing how evolution, population factors, and economics can interact to hamper eradication efforts. “It’s a model-based perspective of disease eradication which can provide useful information for public health institutions aiming to eradicate diseases,” says IIASA Evolution and Ecology Program Director and coauthor Ulf Dieckmann. Quite often an eradication campaign will meet with initial encouraging success and then encounter what Dieckmann and colleagues call the “eradication tail” where returns diminish and the disease persists. It’s then that scientists and policymakers have to be prepared for the long haul, perhaps involving decades of financial commitment. “The disease itself can evolve, the pathogens can become resistant to treatment; the patients can evolve, changing their immune system, changing their resistance; and the carriers such as insects, can evolve.” This adaptive capacity has to be taken into account, says Dieckmann and cites integrative modeling as a way to achieve this when assessing the timescales and resources required for eradication campaigns. In fact it’s the “eradication tail” of the campaign which can bite, as Dieckmann and colleagues discovered when factoring costs into their modeling. “So you keep investing but there is no strong pressure from the society anymore because the disease is almost gone, but it’s not quite gone, and if you release the pressure it jumps back,” he says. While the study shows that a model-based perspective can be useful for public health institutions aiming to eradicate diseases, Dieckmann is hoping that a sharper focus on health will bring other benefits. In particular IIASA can help develop data-driven integrated models, “that would enable us to look at multiple diseases, regions, transmission routes, environmental drivers, and intervention options. In this way, we can better understand and manage the synergies, trade-offs, and complex relationships among these components.” In the long term it’s the perfect challenge for an institute like IIASA to tackle. KS “When we consider the spectrum of research areas covered at IIASA that are relevant to the Sustainable Development Goals—then health really comes up as the one field where IIASA must strengthen its standing.” Wolfgang Lutz Further info § Klimek P, Aichberger S, & Thurner S (2016). Disentangling genetic and environmental risk factors for individual diseases from multiplex comorbidity networks. Scientific Reports 6: art.no.39658. [pure.iiasa.ac.at/14251] § Mazzucco R, Dieckmann U, & Metz JAJ (2016). Epidemiological, evolutionary, and economic determinants of eradication tails. Journal of Theoretical Biology 405, 58-65. [pure.iiasa.ac.at/12816] Stefan Thurner thurner@iiasa.ac.at Wolfgang Lutz lutz@iiasa.ac.at Ulf Dieckmann dieckmann@iiasa.ac.at