Four current or former presidents of the Alumni Council (l to r): Barry Levy, current president, Gail Price, 2001-03, Hugh Fulmer, 1972-74, and Joan Altekruse, 1990-2001. Not pictured is J. Jacques Carter, president-elect.

The annual two-day Alumni Weekend kicked off on June 10 with a reception to honor recipients of the School's Awards of Merit and on June 11 with a panel discussion and a keynote address.

The panel discussion, "21st Century Solutions to 20th Century Diseases," was moderated by Marc Lipsitch, associate professor of epidemiology in the Department of Epidemiology, who provided an overview of immunology and vaccinations.

One of the biggest hurdles facing the public health community today is the rapid development, production, and stockpiling of vaccines to deal with emerging diseases, as well as the refinement of an effective delivery system. With growing concern about a possible flu pandemic, he said, preventive interventions such as vaccines will be essential.

Panelist David Sinclair is the director of the Paul F. Glenn Laboratories for the Molecular Biology of Aging at HMS. In 1997, Sinclair's research at MIT identified the discovery of the cause of aging in yeast, a first for any species. Today, his lab works to unravel the secrets of a long, healthy lifespan by studying the aging process in nematode worms, fruit flies, mice, and baker's yeast.

Not so long ago, researchers believed that humans, like automobiles, had parts that wore down until they eventually died. Now, researchers know that there are mechanisms that repair damage throughout the lifetime in order to prolong life.

"The pace of aging is regulated by genes, and diet regulates those genes," Sinclair said. "When you put rat cells under biological stress, such as calorie restriction or heat shock, they go into a defensive mode and activate longevity regulation genes." Those genes, in turn, protect against the effects of diseases associated with aging, such as heart disease and osteoporosis. Sinclair is working toward a better understanding of those protective effects.

Panelist Alan Woodward, president of the Massachusetts Medical Society and chief of emergency services for Emerson Hospital in Concord, MA, warned of an impending crisis in health care in this state and in others.

"Our current health care system will be unable to meet the demands of tomorrow without making radical changes today," he said. "We need a safe, effective, patient-centered health care delivery system, dramatically different from what we have today."

There is no capacity to react to massive casualties resulting from a major flu pandemic, terrorist act, or natural disaster, he said. "Our hospitals are operating beyond safe limits, norms are stressed, and seasonal peaks are beyond our capability," he said.

Woodward outlined several remedies he sees as crucial at local and federal levels:

• Base health care on universal coverage.

• Eliminate overused or underused resources.

• Encourage patients to follow healthy lifestyles.

• Follow evidence-based guidelines.

• Reform medical liability.

• Support the public health infrastructure.

Alumnus Armin Fidler, MPH '89, SM '90, health sector manager for the Europe-Central Asia Region for the World Bank, echoed Woodward's concern, adding that challenges for the developing world are even greater than those facing developed countries.

The breakup of the former Soviet Union at the end of the 20th century set off widespread change in Eastern Europe and Central Asia. The transition from totalitarian to democratic regimes in the region has posed "far-reaching implications for the continuation of health care and social systems," said Fidler.

"In the European Union, many of the changes in health care are driven by EU legislation," he said, and so Eastern Europe will see fast increasing health and social expenditures, which Fidler predicts will cause strains on fiscal performance.

Poverty, weak health infrastructure, few health resources, and burgeoning populations stress health care delivery in the Central Asian countries of Uzbekistan and Tajikistan.

Fidler cited some success with introducing co-payments, supplementary insurance systems, new financing models, drug-cost containment through managed-care models, evidence-based medicine and public health, and proactive policies to optimize hospital capacity in some areas.

Luncheon keynote speaker and Harvard alumnus David Blumenthal, AB '70, MD '74, MPP '75, described a new book he is writing about the involvement of American presidents in health care reform, particularly in the Medicare and Medicaid programs. July 31 marks the 40th anniversary of the establishment of Medicare.

The day's events were introduced by Elsbeth Kalenderian, DDS, MPH '89, chair of the Alumni Weekend Committee. HSPH Alumni Association President Barry Levy, MD, MPH '70, offered closing comments.

The program was organized by the Alumni Programs Office.

--PHC