PBS program on global health starts Nov. 1

[Roland98]

Originally Posted by viscousmemories

Law & Order: SUV?

What, did Benson and Stabler buy an Explorer or something?

[Roland98]

Originally Posted by TomJoe

Well, things have evened out a bit lately, but when HIV research was the "Big Thing", NIH was giving out plenty of money to researchers who probably had no business receiving it ... merely because they proposed to work on HIV and AIDS related research. At least that's what I was told from two of my ex-committee members. Same thing happened (is happening) with bioterrorism and on a smaller scale it happened with genomics, though TIGR managed to practically monopolize that corner of funding, at least for bacterial genomes. I doubt any of us can say that NIH funding isn't, at least in part, granted with a "you help me, I'll help you" attitude because academic buddies/friends are often on grant review committees and it's not a blind/unbiased process. There is plenty of politics in science. Unfortunately.

Overall, I would say that if you're working with one of the "hot topics" there are more opportunities for funding. Doubt that translates into pate and champagne at meetings though.

In summary, at least in US research efforts, some money has been wasted by sub-par researchers, but in the long run I do not think it has made a significantly detrimental impact on the way HIV and AIDS treatment has occured worldwide.

Oh, I definitely agree. Right now I have a grant in on influenza, which has a much better chance of getting funded than it would have, say, 5 years ago, just because there's $$$ for influenza. (Still, with the paylines being so ridiculous, it's unlikely to get funded this round). And certainly, funding isn't equitably distributed: a disease that kills 4,000 a year may get significantly less funding than one that kills 5000. But to suggest that researchers are livin' the high life or something just because they work in an area that happens to currently be well-funded is simply absurd.

[cappuccino]

I watched the program last night and I liked it! That was an interesting bit about Ali contracting smallpox in spite of having been vaccinated and that he survived and became the last known smallpox patient was a nice touch of history. Imagine being the last one in the chain of disease transmission stretching back thousands of years.

The part about polio was pretty cool. The part where they showed the affluent families of a Seattle suburban island being against vaccination was interesting too. They kept on prattling about how they didn't want to burden their children's immune system and that the children were perfectly healthy in spite of having never been vaccinated, hence their natural immunity was better than vaccination. They seemed to have neglected to consider that the reason their kids were so healthy was because they've never been exposed to anything nasty outside the island. I'd be curious to see how quickly those parents change their tune if somebody introduced measles, chicken pox, or even polio on that island.

[viscousmemories]

Originally Posted by Roland98

What, did Benson and Stabler buy an Explorer or something?

Actually Stabler contracted avian flu and Benson had to kill him before it could spread.

[Roland98]

Originally Posted by Demosthenes

I watched the program last night and I liked it! That was an interesting bit about Ali contracting smallpox in spite of having been vaccinated and that he survived and became the last known smallpox patient was a nice touch of history. Imagine being the last one in the chain of disease transmission stretching back thousands of years.

Yeah, I hadn't realized that previously. I knew Somalia was the last frontier as far as smallpox vaccination, but didn't realize one of "their own" was the final case.

The part about polio was pretty cool. The part where they showed the affluent families of a Seattle suburban island being against vaccination was interesting too. They kept on prattling about how they didn't want to burden their children's immune system and that the children were perfectly healthy in spite of having never been vaccinated, hence their natural immunity was better than vaccination. They seemed to have neglected to consider that the reason their kids were so healthy was because they've never been exposed to anything nasty outside the island. I'd be curious to see how quickly those parents change their tune if somebody introduced measles, chicken pox, or even polio on that island.

Yeah, I think I was yelling at my TV for that portion. What they also don't realize is how many hundreds of antigens their kids are exposed to every day of their lives---and yet they handle them just fine. Definitely not a place I'd want to raise my kids. Heck, here in Iowa we had a whooping cough outbreak a few years back, and that was in a fairly highly vaccinated population. I don't know the percentage on that island that refused to vaccinate their kids, but it looked like a pretty good-sized group. One of those "a little bit of knowledge is dangerous" situations.

[Roland98]

Originally Posted by viscousmemories

Actually Stabler contracted avian flu and Benson had to kill him before it could spread.

Oh man!! And I kept hoping they'd hook up...guess I'll root for Olivia and Munch now.

[alphamale]

She's the Asst. Administrator in the bureau of global health in the US agency for international development (appointed to that position by Bush). And while AIDS programs falls under her jurisdiction in Africa, so do about a dozen other disease programs. Additionally, she's not a scientist and has no research experience involving HIV--her experience is as a public health consultant. Finally, note that alpha quoted only one snippet from, again I'll emphasize, a freakin' newspaper article. Even from Dr. Peterson, other published remarks show that she indeed thinks condoms are important in controlling the disease

She's a physician, and everyone who makes or administers AIDS policy and does it well doesn't have to be an AIDS researcher. (I like the "appointed by Bush" snippet - like that ipso facto makes her qualifications suspect ) And it doesn't matter if the snippet came from the National Enquirer, only whether it's a true quote. Do you dispute the quote? AND whether she thinks condoms are important or not is distorting the issue here it is again - read carefully it's whether or not the international AIDS elite caused more deaths in africa by emphasizing condoms over other strategies that demonstrably work better.

[Roland98]

Originally Posted by alphamale

She's a physician, and everyone who makes or administers AIDS policy and does it well doesn't have to be an AIDS researcher.

Agreed, but that's why I asked you about peer-reviewed research--because there *are* people who study these exact questions for a living. I trust them more than I trust a simple policy-maker.

(I like the "appointed by Bush" snippet - like that ipso facto makes her qualifications suspect )

*shrug* It does. He's appointed people who are not only unqualified, but who should never in a million years be doing the job they do--wolves guarding the henhouse. I don't know much about Peterson (and based on her CV, I ain't impressed), but other apointees do indeed make her appointment suspect.

And it doesn't matter if the snippet came from the National Enquirer, only whether it's a true quote. Do you dispute the quote?

That's the thing, buddy boy--it does matter. Peer-reviewed research is certain to present the author's own views. Snippets from an interview with a journalist might, but they might not. Things can be left out, quotes may be out of context. I don't know about the veracity of the quote, but as I linked above, it seems to me there's little doubt that she believes condoms are indeed effective.

AND whether she thinks condoms are important or not is distorting the issue here it is again - read carefully it's whether or not the international AIDS elite caused more deaths in africa by emphasizing condoms over other strategies that demonstrably work better.

That last part is your problem. Read carefully--you've not given any evidence to back your assertion that "other strategies demonstrably work better." That was why you brought the WT article into the mix--supposedly, to prove that assertion. So it IS indeed an issue, because you made it one. Get it?

...and with that, I think I've wasted more than enough time on you. Infectious disease policy is actually a topic I love to discuss, but I prefer to do it at a level of discourse higher than, apparently, you're able to provide. Adieu.

[alphamale]

OK, check this out. More questionable Bush appointees?

http://www.pacha.gov/meetings/minutes/m0304.html

[alphamale]

My post having been unanswered, I hereby declare

TOTAL AND UTTER VICTORY

in this thread!

[wei yau]

[fragment]

You declare victory after half an hour? It would probably take that long to read that last link you posted. The bits I've skimmed through make interesting reading - however, I can't seem to find anything about a "politically correct AIDS elite", or that suggests condoms have no effect in AIDS prevention. Perhaps you could point it out for me.

I assume you don't mean this bit:

Abstinence effectively eliminates risk, Dr. McIlhaney said. Condoms are, if used correctly and consistently, about 90 percent effective. A vaccine, according to UNAIDS, will not exist for another 10 years. The question is not whether you are conservative or liberal or rich or poor, he said, or whether we have a stake other than ending or limiting the epidemic. The question, Dr. McIlhaney said, is, “Is there a place that has reversed this? If there is, we have an obligation to support it.”

Dr. McIlhaney said the Ugandan HIV prevention approach succeeds because of communication about HIV/AIDS and people with AIDS through, in part, social networks.

[Dingfod]

Originally Posted by Roland98

...and with that, I think I've wasted more than enough time on you.

Ignore with the post placeholders disabled is working wonderfully for me. Try it.

[viscousmemories]

Okay Roland, I just finished watching this show and it was really fascinating. I probably should've taken notes for points of discussion, but unfortunately I didn't think of it.

What do you think of the Carter Center guy's insistence that they need to deploy DDT in Africa?

And can I just say that River Blindness is some seriously fucked up shit?

[Roland98]

Originally Posted by viscousmemories

Okay Roland, I just finished watching this show and it was really fascinating. I probably should've taken notes for points of discussion, but unfortunately I didn't think of it.

What do you think of the Carter Center guy's insistence that they need to deploy DDT in Africa?

I think using it inside houses is a good idea. It's fairly cheap and effective, and as mentioned, the environmental effects were from spraying it far and wide--something I don't think many people would support.

And can I just say that River Blindness is some seriously fucked up shit?

No kidding. I was wondering if they'd talk about Guinea worms (WARNING--graphic pics on the site, not for the faint of heart).

The life cycle of D. medinensis is unusual in many respects. The female worms (which can measure up to 1 meter in length, but are only about 2 mm in diameter) are found in (or just under) the skin of the human host, most often in the legs, ankles, or feet. As the female becomes gravid, her body fills with developing embryos. Eventually, the female's body wall ruptures, and the juvenile worms are released into the human's skin. This causes an intense allergic reaction, extreme discomfort (hence the name, the fiery serpent), and finally a papule forms on the skin. The papule eventually ulcerates (breaks open), exposing the female worm and providing a means of escape for the juvenile worms. As one might expect, humans infected with this parasite often seek out water to alleviate the symptoms of the allergic reaction and to wash the ulcer, and the juvenile worms are liberated into the water. The juveniles are eaten by an intermediate host, a copepod, and humans are infected when they drink water containing infected copepods. Once in the human, the juvenile worms migrate from the intestinal tract, through the abdominal cavity, and into the subcutaneous connective tissues. At this point the females are fertilized by the males, and the males die. The females then migrate to the skin, reach sexual maturity, and produce juveniles. In the human host, complete development of the parasite requires about one year.

Several drugs are used to treat dracunculiasis, but most infections are treated by simply removing the female worm once the blister breaks open and she is visible. Typically, the female worm is attached to a small stick and removed by slowly winding the worm on to the stick. Although this is an effective treatment, it does not prevent much of the damage caused by the worms nor reinfection.

Tonight's show should be good as well; I assume they'll spend a decent chunk of time talking about avian flu, and general pandemic preparedness.

[viscousmemories]

Originally Posted by Roland98

I think using it inside houses is a good idea. It's fairly cheap and effective, and as mentioned, the environmental effects were from spraying it far and wide--something I don't think many people would support.

Ah, okay. When the guy said they wanted to use it on houses I didn't catch that the idea was to use it inside houses, so I didn't understand why spraying houses would be so much different from spraying fields. I should read more about DDT. All I've heard my whole life is that it's bad bad bad without any detail, and if some applications of it aren't really all that bad it sucks that people are dying from something that it could be used to prevent.

No kidding. I was wondering if they'd talk about Guinea worms (WARNING--graphic pics on the site, not for the faint of heart).

Tonight's show should be good as well; I assume they'll spend a decent chunk of time talking about avian flu, and general pandemic preparedness.

I'm looking forward to it.

Oh, California's use of sentinel chickens to forewarn about West Nile was cool, too.

[Roland98]

Originally Posted by viscousmemories

Ah, okay. When the guy said they wanted to use it on houses I didn't catch that the idea was to use it inside houses, so I didn't understand why spraying houses would be so much different from spraying fields. I should read more about DDT. All I've heard my whole life is that it's bad bad bad without any detail, and if some applications of it aren't really all that bad it sucks that people are dying from something that it could be used to prevent.

Yeah, it has (mostly deservedly) gotten a bad rap, but a lot of that was due to misapplication and simply piss-poor planning--not looking at (or overlooking) any possible long-term effects of its use. From wikipedia:

Most of the prior use of DDT was in agriculture. Current use for disease control requires only a small fraction of the amounts used previously and is much less likely to cause environmental problems. Residual house spraying involves the treating of all interior walls and ceilings with an insecticide, and is effective against mosquitoes that favour indoor resting before or after feeding. Advocated as the mainstay of malaria eradication programmes in the late 1950s and 1960s, it remains a major component of control programmes in southern African states, though many countries have abandoned or curtailed their spraying activities due to disillusionment over the failure to achieve eradication, concerns over the safety and environmental impact, and administrative, managerial and financial constraints on implementation. Such limited use of DDT has not become ineffective due to resistance in areas where it is used inside homes. Swaziland, Mozambique and Ecuador are examples of countries that have very successfully reduced malaria incidence with DDT. However, its use has been greatly limited in many other countries due to reluctance by aid agencies in the developed world to fund DDT spraying and opposition from Western environmental groups. (Africa fighting malaria FAQ, 2005).

It's not a cure-all and mosquitoes still may develop resistance to it (more on that in the article), but in some places, it could make a real difference.

Oh, California's use of sentinel chickens to forewarn about West Nile was cool, too.

Heh. Yeah, lots of states do that (including here in Iowa). It's just one part of surveillance--mosquitoes are also routinely trapped and mashed to look for WNV. Other animals that are susceptible--such as horses--are also watched closely for signs of disease. And, of course, the dead crow thing.

[livius drusus]

Okay, I think this is probably a really stupid question and just an issue of phrasing, but when they were covering SAARS last night, the Vietnamese nurse mentioned how agonizingly painful it was (like a wild animal devouring your lungs piece by piece) and Brad Pitt said that new diseases are often more painful and more deadly because we have no immunity at all to them. I get the more deadly, but I was surprised to hear that these diseases would also be more painful. Is that true, or am I misinterpreting Brad?

[Dingfod]

Originally Posted by Roland98

It's just one part of surveillance--mosquitoes are also routinely trapped and mashed to look for WNV. Other animals that are susceptible--such as horses--are also watched closely for signs of disease.

The most frequent sign of West Nile in horses is a dead horse. It's almost 100% fatal in horses. There is a vaccine for them though which seems to be working quite well. Costs a couple hundred dollars a year per horse though. Better than a dead horse.

[Roland98]

Originally Posted by livius drusus

Okay, I think this is probably a really stupid question and just an issue of phrasing, but when they were covering SAARS last night, the Vietnamese nurse mentioned how agonizingly painful it was (like a wild animal devouring your lungs piece by piece) and Brad Pitt said that new diseases are often more painful and more deadly because we have no immunity at all to them. I get the more deadly, but I was surprised to hear that these diseases would also be more painful. Is that true, or am I misinterpreting Brad?

Yeah, I think that's a bit of liberty on their part. There's no reason to assume they'd be more painful. Really, there's no evidence they're necessarily more deadly, either--it's just that when they're recognized, it's usually due to an outbreak that has high mortality (which therefore gets our attention).

[viscousmemories]

That was a fascinating show. I'll never again take clean drinking water and public sanitation services for granted. I can't believe the water those Ugandan villagers were drinking. That was messed up.

What's the scoop on the Vitamin A, Ro? Is there really hard data that two drops twice annually can have such a dramatic impact on people's health and welfare? Vitamins are something I've always taken for granted too. I really had no idea they were so important.

[Roland98]

Originally Posted by Warren

The most frequent sign of West Nile in horses is a dead horse. It's almost 100% fatal in horses. There is a vaccine for them though which seems to be working quite well. Costs a couple hundred dollars a year per horse though. Better than a dead horse.

Yeah, several of those mosquito-borne encephalitis viruses are highly deadly to horses. Western and Eastern equine encephalitis viruses can also be human pathogens, but were first recognized in horses, hence the names.

[Dingfod]

Originally Posted by viscousmemories

That was a fascinating show. I'll never again take clean drinking water and public sanitation services for granted. I can't believe the water those Ugandan villagers were drinking. That was messed up.

What's the scoop on the Vitamin A, Ro? Is there really hard data that two drops twice annually can have such a dramatic impact on people's health and welfare? Vitamins are something I've always taken for granted too. I really had no idea they were so important.

Vitamin A plays such a vital role in things such as eyesight.

Originally Posted by Wikipedia

Approximately 250,000 to 500,000 malnourished children in the developing world go blind each year from a deficiency of vitamin A. Night blindness is one of the first signs of vitamin A deficiency. Vitamin A deficiency contributes to blindness by making the cornea very dry and damaging the retina and cornea.

A few drops of it can make a significant difference.

On the flip side, excess Vitamin A can be fatal.

[Roland98]

Originally Posted by viscousmemories

That was a fascinating show. I'll never again take clean drinking water and public sanitation services for granted. I can't believe the water those Ugandan villagers were drinking. That was messed up.

Crazy, isn't it? I wrote a post on that earlier this month. Quoting from the article I was discussing:

Unsafe water is a global public health threat, placing persons at risk for a host of diarrheal and other diseases as well as chemical intoxication. Unsanitary water has particularly devastating effects on young children in the developing world. Each year, >2 million persons, mostly children <5 years of age, die of diarrheal disease. For children in this age group, diarrheal disease accounted for 17% of all deaths from 2000 to 2003, ranking third among causes of death, after neonatal causes and acute respiratory infections. Severe, prolonged diarrheal disease can also lead to malnutrition and impaired physical and cognitive development. Nearly 90% of diarrhea-related deaths have been attributed to unsafe or inadequate water supplies and sanitation —conditions affecting a large part of the world's population. An estimated 1.1 billion persons (one sixth of the world's population) lack access to clean water and 2.6 billion to adequate sanitation.

It's just nuts, and most people in countries like the US have no clue about the magnitude of the situation. And it's something that's often (relatively) cheap and easy to fix. this site says we've spent over 200 billion dollars on the Iraq war. Imagine how many sewer and clean drinking water systems we could have provided for impoverished areas of Africa for that amount of money.

What's the scoop on the Vitamin A, Ro? Is there really hard data that two drops twice annually can have such a dramatic impact on people's health and welfare? Vitamins are something I've always taken for granted too. I really had no idea they were so important.

Oh, yeah, that's been well-established now. Note that his first Lancet paper was in the mid-80's, and the link has been seen in many studies since then. Vitamins aren't really something we have to worry about here (as mentioned, our foods are supplemented with pretty much everything we need if we eat a decently balanced diet), but it's a case where just missing one micronutrient can have a huge effect on health (as they very nicely showed, IMO). Even here in the US, the advice to pregnant women (or really, all women of child-bearing age) to make sure to take enough folic acid has drastically reduced a certain type of birth defects.

[And yes, as Warren adds, too much of vitamin A can kill you. That's one reason they train people to only give a few drops every 6 months. Vitamin A is fat-soluble, so excesses are not excreted in your urine like water-soluble vitamins (such as C).]

That actually brings me to one thing I didn't like about the series. I know it makes for a great story, "David vs. Goliath" type of stuff, but the skeptical reactions to many of those published studies (vitamin A, pellegra, cholera, etc.) are, IMO, the right ones. There are too many examples out there where one pilot study showed magnificent data, but it couldn't be repeated. And while the examples they mentioned were proven to be real associations and the population has benefited immensely from their observations, we can't take those few examples and just brush off our skepticism when the next study with amazing (but not yet repeated) results comes along. Science is all about confirming results; it's too easy for something to happen once and just be a fluke. Other than that minor quibble, I thought it was a great series.

[livius drusus]

I was shocked to hear about how limited vaccine production is these days. I haven't read Bush's full proposal for dealing with an avian flu outbreak, but I hope there's something in there about widening the production base instead of just giving money to the purchase from the tiny existing base, because otherwise it seems to me there'll be a huge bottleneck.