The increasing prevalence of non-communicable diseases and billions of dollars spent each year point to the ineffectiveness of the germ theory of disease alone. Medical curriculum, which is presently based on the germ theory of disease, needs to be responsive to modern times, and should include rigorous training in physical activities, fasting and nutrition.


Last Sunday, I received a WhatsApp message from my cousin, encouraging me to send a short bio to a budding organisation whose core commitment is to promoting Africa. This came to me in the middle of an online church service that was teaching about a character called Naaman, who had gone all the way from Syria to Israel with significant valuables, searching for a cure for his leprosy. However, the Prophet he went to see did not have a face-to-face contact with him but sent his servant, telling Naaman to go dip himself in a local river for seven times. Certainly, “go dip yourself in the river” did not only come off as too simple but was humiliating to a man of power and great wealth, who had traveled to the dstination over several miles. For sure, he was upset with the silliness and simplicity of the Prophet’s instruction and was quoted as saying, “I thought that he would surely come out to me… wave his hand over the spot and cure me of my leprosy.” As against simplicity, greater value is placed on complexity and abracadabra.

As I was hoping to write a condensed bio of my interest in physical activity and health, admittedly with a drifting mind in the middle of church service, the connection between the simplicity of the Prophet’s instruction to leprous Naaman and the simplicity of regular physical activity in preventing at least 35 modern chronic diseases dawned on me like a fresh revelation. Man has overcome the three biggest threats of infection, predation, and starvation but he is reaping the (three) whirlwinds of heart disease, diabetes, and cancer, in exchange for civilisation, and in the process has built multi-billion dollar pharmaceutical and high tech medical diagnostic industries, with underwhelming outcomes.

John Snow, an English physician, who grew up in the poorest part of the city and whose street was regularly flooded with contaminated water, solved the problem of London’s recurrent cholera epidemic in 1854. In an era of the “miasma” theory of disease, otherwise called the “bad air” origin of disease, his recommendation that water be “filtered and boiled before it is used”, coupled with his keen observation of a “cesspit” leakage into the public water tap in the then Broad Street, ushered in the era of sanitation and hygiene. Alexander Fleming, an Army Doctor in World War I, who was dissatisfied with the use of antiseptic for treating soldiers’ wounds, surreptitiously discovered penicillin in 1928. Fleming’s discovery firmly set the pace for modern medicine’s germ theory of disease, which complemented the public health’s sanitation and good hygiene practices.

I understand that we are in the middle of the COVID-19 pandemic and as I write this, more than six million cases of infection have been reported, with 397,388 deaths worldwide. Admittedly this new infectious disease poses serious threats, but modern medicine was founded on germ disease theory and has an excellent history of finding effective vaccines and appropriate drug therapies in combating all kind of infections.

…the germ disease theory has miserably failed to prevent the continuing prevalence of non-communicable diseases, such as heart disease, diabetes and hypertension. This shortcoming is subtly acknowledged in the medical community through expressions such as “chronic diseases”, as drug therapy does not cure but only attempts to “control” and “manage” these diseases…


However, in the last 40 years, the germ disease theory has miserably failed to prevent the continuing prevalence of non-communicable diseases, such as heart disease, diabetes and hypertension. This shortcoming is subtly acknowledged in the medical community through expressions such as “chronic diseases”, as drug therapy does not cure but only attempts to “control” and “manage” these diseases toward terminal or end-stage, in what has been described as “treat to failure” approach.

While not totally admitting the limited effect of the germ theory of disease on chronic diseases, the saturated fat, an old food, is blamed in part on the new disease of heart attacks, with the claim that it causes “clogged arteries”. This totally ignores the fact that decades of chronic physical inactivity are the main roots of abnormal structural changes in blood vessels, which provide the enabling environment for the clogging of arteries.

To fill the space of the discredited saturated fat, the food industry successfully pushed industrial inflammatory vegetable oils, produced under intense pressure from cottonseed, corn and soybean. To replace butter, vegetable oils are solidified to make margarine and shamelessly pitched to the unsuspecting population as, “I can’t believe it’s not butter”, which makes one to think that butter was worth something, after all. Just like any rural dweller in the West can easily make butter from cow milk, as a rural African child could, I can still make palm oil from palm fruits, and if you don’t believe that vegetable oil is a processed product, try to extract oil from corn or cottonseed in your kitchen. In fact, vegetable oils were traditionally used for candle and soap making, until the late 19th century when these became easier to produce cheaply and vegetable oil was adapted for cooking.

Before COVID-19, examples of silent pandemics and the limitation of the germ theory of disease abounded in the West and all urban centres in developing countries. In the United States alone, about 18.2 million adults have coronary artery disease and close to 647,000 of them die from this disease every year. Furthermore, 88 million adults American have prediabetes, a condition that raises the risk of type 2 diabetes, heart disease, and stroke. Worse yet, 34.2 million U.S. citizens have diabetes, which is the number one cause of kidney failure, leg amputations and adult blindness.

Just as the simplicity of sanitation solved water contamination and cholera epidemics, even before the discovery of penicillin, in the same way the simplicity of regular physical activity, intermittent fasting and infrequent food consumption are combinations of the potent lifestyle that can prevent the onset of chronic diseases.


Against the aforementioned grim statistics, the Tsimane people who live in the Amazon rainforest in Bolivia are credited to have the healthiest hearts in the world. Sanjay Gupta, a neurosurgeon and CNN’s chief medical correspondent, reported during his trip to Tsimane that “intermittent fasting was part of the culture, not because it is fashionable, but because of food scarcity”. According to his on-the-ground observation, for “nearly all of their waking hours, the Tsimane are standing or walking” and if I may add, not with continously overfilled stomachs.

Just as the simplicity of sanitation solved water contamination and cholera epidemics, even before the discovery of penicillin, in the same way the simplicity of regular physical activity, intermittent fasting and infrequent food consumption are combinations of the potent lifestyle that can prevent the onset of chronic diseases. This would more so lead to the less need for multiple medications that do not cure but only manage these conditions, which often get worse and result in end-stage kidney failure and heart disease, amputations, heart attacks, stroke with paralysis and other debilitating medical/physical issues.

According to the Centers for Disease Control and Prevention, the combined cost of diabetes and heart disease in America is $546 billion per year! The increasing prevalence of non-communicable diseases and billions of dollars spent each year point to the ineffectiveness of the germ theory of disease alone. Medical curriculum, which is presently based on the germ theory of disease, needs to be responsive to modern times, and should include rigorous training in physical activities, fasting and nutrition. Certainly, no developing countries can afford billions of dollars in managing the silent pandemics and as Dr. Sanjay Gupta stated, “Tsimane (people) remind us that wealth doesn’t necessarily buy health”.

Mukaila Kareem, a doctor of physiotherapy and physical activity advocate, writes from the U.S.A and can be reached through makkareem5@gmail.com