ARTIGO ARTICLE 765 The next millennium and epidemiology: searching for information Próximo milênio e epidemiologia: em busca da informação Luis David Castiel 1 1 Departamento de Abstract On the eve of the new millennium, it has become ‘natural’ to admit the emergence of Epidemiologia e Métodos tendencies to perform evaluations and inventories of the past and attempts to forecast future Quantitativos em Saúde. Escola Nacional scenarios. While recognizing the ensuing uncertainties, the current paper takes this point of view de Saúde Pública, as the point of departure for proposing a discussion on the future directions and prospects of Fundação Oswaldo Cruz. epidemiology. Based on the pertinent analyses performed by the Sussers (father and son), I ap- Rua Leopoldo Bulhões 1480, sala 828, Rio de Janeiro, RJ proach and discuss the scope and limits of new aspects assumed by the field, especially to the ex- 21041-210, Brasil. tent that it has included techniques and instruments from bioinformatics and molecular biolo- [email protected]. gy. In the latter areas (amongst many others), the notion of information has gained enormous fiocruz.br importance. I then proceed to analyze the conceptual origins and shifts in this notion, in addi- tion to possible repercussions and effects on the field of biological sciences in general and their research practices in particular. Key words Epidemiology; Molecular Biology; Information Resumo Diante da expectativa de um novo milênio, torna-se “natural” admitir o surgimento de inclinações para procederem-se a avaliações e balanços do passado e a tentativas de prever-se cenários futuros. Este texto parte deste ponto de vista – reconhecendo suas incertezas – para pro- por uma discussão dos rumos e perspectivas da epidemiologia. A partir das análises nesta di- reção pelos Sussers (pai e filho), são abordadas e discutidas o alcance e os limites de novos aspec- tos assumidos pela disciplina, especialmente, ao incluir técnicas e instrumentos da bioinfor- mática e da biologia molecular. Nestas áreas (entre muitas outras), é notável o fato da noção de informação possuir enorme importância. São, então, analisadas origens e deslocamentos con- ceituais desta noção e possíveis repercussões e efeitos no campo das ciências biológicas, em geral, e de suas práticas de pesquisa, em particular. Palavras-chave Epidemiologia; Biologia Molecular; Informação Cad. Saúde Pública, Rio de Janeiro, 14(4):765-778, out-dez, 1998 766 CASTIEL, L. D. “We learn to build discourses on reality that are chronological time is usually seen as a move- highly abstract, but which we know how to rec- ment, allowing for two cases: ognize as true or false. It is a generalization, a 1) time as the movement of objects in con- fantastic extrapolation of our immediate expe- tinuous, linear fashion, with the future moving rience with error or lie. In fact, this is a concrete, in our direction and the past being left behind. unique experience by which we learn simulta- 2) time as movement across a landscape. In neously and concurrently a unique thing and a this case, time can also be seen as “stopped”, discourse on this thing that is different from while we are the ones that move through it what we learned about it.” (e.g., “we are getting to the end of the year, or Henri Atlan close to Christmas”). In a word, the metaphori- cal structure presents “time” passing us from front to back, whether we are standing still and Introduction: turn-of-the-century, “it” is moving towards us or we are moving to- inventories and forecasts wards it, while “it” remains static. That is, some- thing or someone must be moving... There is no It is known that “ends of periods” exercise curi- other way, since as the poet once said, “Time ous effects on human beings. They may be never stops.” weekends (here, specifically, there is an obvi- According to Lakoff (1992), such descrip- ous, strong link to leisure, by opposition to so- tions of time in terms of movement, objects, called “workdays”), ends of the month (pay- and places have a biological basis, since our checks and bills...), ends of the year, decades, sight specifically detects these phenomena, quinquecentennials (a fascination with num- while we have no specific sensors for the pas- bers ending in fives and zeros), turns of cen- sage of time. In order to perceive time, we must turies, and so on... When such periods end, we use references obtained from our available vi- join in acts of celebration, joint remembrance sual sensors. Yet we are unaware of this in our (co-memmoration), weddings, birthdays, quin- daily lives. In fact, this does not even matter in quecentennials, centennials (of births and solving everyday problems (and it may be more deaths of both persons and human creations)... convenient to ignore it). As Lakoff & Johnson An “end of period” is obviously an arbitrary, say: conventional temporal category (human groups “(...) All this detailed and consistent culturally define the ways by which they mark metaphorical structure is part of our daily lit- the passage of time) created by these peculiar eral language for time, so familiar that we nor- beings that produce things which recursively mally do not realize that it is a metaphorical affect them in what is often an unpredictable construction” (Lakoff & Johnson, 1980:82). way. Regardless of the metaphorical configura- In the face of presumed “chronological ter- tion of time that comes into play, this prelimi- minations”, there emerges the task of produc- nary comment requires identifying the “topo- ing evaluations, inventories, and value judg- graphical” perspective adopted by this com- ments. To what ends? In very simplified terms, mentator, situated as I am below the Equator, several can be identified: with all the possible sins this may entail, espe- a) more explicit ends: to monitor and ob- cially the geographical and sociocultural gaps jectively identify trajectories and processes un- (with unavoidable biases and prejudices) vis-à- der way over the course of a given period of vis the players in the Anglo-Saxon scenario, time; where most epidemiological work and futuris- b) less explicit ends: to (re)describe for our- tic speculation is produced. I refer to this line selves (by redescribing to ourselves) “what of work because of its undeniable influence on happened” in terms of ordered narratives, full the field of epidemiology worldwide. Sooner or of symbolic components, seeking meanings in later we feel the repercussions of what happens the “subjective” happenings that accompany in epidemiology above the Equator. the events of chronological time. Although such a speculative undertaking There appears to be a particular need to might spark criticism due to the risk of a mis- prepare for the vicissitudes of the “fate” that taken reading, I should highlight the perti- “awaits us”... We need periodic structures to al- nence of such an exercise, since it creates pos- low for the ordered narratives of our (re)de- sibilities for reflection and perhaps organiza- scriptions of ourselves and our surroundings. tion vis-à-vis overwhelming and adverse situ- A brief comment is in order on our metaphor- ations (after all, there are always “priorities” ical constructions with regard to the notion of defined according to the respective interest passing of time. In this sense, the passing of groups involved). This paper thus discusses an Cad. Saúde Pública, Rio de Janeiro, 14(4):765-778, out-dez, 1998 THE NEXT MILLENIUM AND EPIDEMIOLOGY 767 outline for epidemiology “in the next millenni- by sociocultural practices in contemporary so- um”. In other words, my goal is to call attention cieties, along the lines previously hinted at by to the description of future scenarios (even ad- the genre known as “science fiction”. mitting the decline of futurology, a discipline in vogue in the 1970s) in order to orient what could (or should) be “the best” (insofar as pos- Predicting the future: sible) prospects for Sub-Equatorial epidemi- a jigsaw puzzle without all the pieces ology. While there is an underlying “evaluative When we were kids, we used to have fun play- furor” in this exercise, justified by the spirit of ing with kaleidoscopes, which would assume expectation surrounding this period of “new various abstract shapes, with symmetrical times”, on the other hand it is necessary to planes [kali- comes from the Greek kállos, or adopt a certain degree of complacency based “beautiful” (hence calligraphy) (Ferreira, 1986)]. on the obvious reasons for the fallibility of any The designs changed their appearance based current forecast: in addition to the usual “ob- on the mechanical movement of the object, servation biases”, there is also a great lack of maintaining the same elements, through a play precision resulting from the instability and on mirrors. We could control the speed of the rapid pace of today’s technoscientific and so- changes and even carefully stop the toy and ciocultural changes. show the resulting designs to our friends. Outside the walls of academe, astrologers, Along the lines of this playful metaphor, the “wizards”, “prophets”, “soothsayers”, and various new “kaleidoscopes” are built with electronic crystal-ball “experts” are in great demand. Espe- microcircuits linked to screens (LCDs or tradi- cially (et pour cause?) at a moment when the tional videos or kinescopes) and/or internet natural sciences in general have begun to view networks, with extensively multiplied elements most of the systems surrounding us as complex that shift cinematically, whereby the images and dynamic, thus highlighting their stochastic can be animated, in script form, and anthropo- character and resulting unpredictability (in de- morphic, allowing for control (or so-called “in- terministic terms). Worse yet, some researchers teractivity”) with objectives, phases, or (for at “state-of-the-art” research centers, like the those who so desire) heavy doses of competi- Santa Fé Institute in the United States, have be- tion and scoring (videogames) or even “hu- gun to doubt the possibility of reaching a uni- manoid” demands (see Tamagotchi, the egg- fied theory for complex systems.