Diseases do not stop at frontiers-hence, the need for international co-operation between large pharmaceutical laboratories and governing agencies. A case in point is the urban outbreak of the swine flu, which began in Mexico and then spread quickly to North American cities and other metropolises around the world. The Mexican and American cities, which largely escaped the fear and economic repercussions of the SARS outbreak, are among the most affected populations. Unlike other 20th-century 'flu outbreaks, the H1N1 virus did not emerge from South Asia, nor did it impact their cities in the same way as the SARS virus, which had rapidly infiltrated the cities of developing countries such as Beijing. Information flows, managed by the World Health Organization and national agencies, monitored the spread of the virus: to and from research laboratories, hospitals, public health agencies, government organizations and pharmaceutical companies, back to the general public.
Dealing with such epidemics is a matter of urban security and has consequences for urban and spatial planning in terms of biomedical infrastructures (health care, laboratories, research). In Europe and North America, there is a growing trend to bring these infrastructures nearer to the populations to be treated. Many private laboratories prefer to set up in the cities and towns rather than in suburban business parks, as in the case of the East River Science Park in Manhattan and the MaRS project in Toronto (Canada), with its art galleries and direct access to the transportation network. The Academic Medical Centre in Amsterdam, whose buildings are all connected internally, is attracting many biotech companies. The Asian cities that have been the epicentre for recent viruses (SARS and avian 'flu), have begun to develop different logics for medical urban planning. The fear of contagion now means that they have relocated medical centres from city centres to suburban campuses such as Biopolis in Singapour and the biotech science park of Hsin-Chu in Taïwan. Health centres are thus shifting in line with the diseases themselves and with societal representations of the most effective way of tackling them.
H1N1: urban superspreaders