September 2006 Archives

Scientists & Engineers for America (SEA) might have underestimated the enthusiasm for their cause when they aimed to sign-up "1000 new members by the end of the day on Friday". They reached their goal of 1000 members yesterday, and now are hoping for 5000 by Friday (today).

The group is dedicated to promoting politicians and government policy that includes and respects science. Their mission statment states that "SEA is the only national organization dedicated exclusively to electing leaders who share this vision." Their "Bill of Rights for Scientists and Engineers" lists their main goals for fostering strong science in government. The group is a 527 organization.

From the site XKCD, for the cool kids...

Webcomic Randall Munroe posts cartoons about math, science, romance...

"Beliefs" was posted on XKCD while back. It is licensed under a the Commercial Commons 2.5 License (Attribution, Non-Commercial)

Part I of this article appeared earlier.

Is This The Document?"

The journal Nature reported yesterday that a NOAA document was "quashed" by the Department of Commerce. However representatives from NOAA vehemantly denied Nature's account and no document was available to support one side or the other. Now "versions" of a document titled "NOAA Fact Sheet: Atlantic Hurricanes and Climate" have been "leaked" to safeties in the field. Roger Pielke Jr., a political scientist at University of Colorado's Center for Science and Technology Policy Research, generously tracked down and presented a stripped down version of the "fact sheet" in the form of plain text on his blog.

The Nature article said that the suppressed NOAA information was a "consensus statement. They draft they saw "stated that global warming may be contributing to hurricane intensity and that further research is needed to clarify the issue." The text of the "draft" posted on Pielke's site did say that, (basically) but it wasn't the focus of the text (if there was one). The posted text posed five "questions", let's say, with their "answers", I suppose. The drift of the whole thing can be summarized by a brief word count. Number of times the word "decadal" is used: 9. Number of times "anthropogenic" is used: 1. "Global warming": 2. For instance:

• Q: "Has there been increased hurricane activity?

  A:"Seasons since 1995 have been more active...strong decadal variations...earlier periods were as active."

• Q: "How have ocean temperatures varied?

  A: "[..] They have warmed...this warming is attributed to the Atlantic multi-decadal oscillation..."

• Q:"What factors influence seasonal to multi-decadal hurricane activity?"

  A: "The tropical multi-decadal phenomenon, [..] El Nino/La Nina determine the multi-decadal extremes"

• Q:"How long will the current active period last?"

  A: "Scientists disagree...there is a limited understanding of natural decadal variability...of irregular temporal behavior...the previous active period lasted 25 years".

The "fact-sheet" is titled "Atlantic Hurricanes and Climate", but "climate" is only mentioned twice, under "Key Problems NOAA is working on". The agency is working on "Understanding...climate variability"...and decadal prediction, and decadal hurricane variability. The phase "climate change" doesn't appear in the document. NOAA acknowledges anthropogenic forcing only to say they are working on "[u]nderstanding whether or not and to what degree anthropogenic forcing is having an influence on hurricanes".

"Global warming" is mentioned, but the term is spliced somewhat unscrutably into the other 600 words in the text, to limited affect. For instance here's one sentence lodged into multi-decadal causation verbiage: "Because of global warming the active period could persist." Here is another sentence:

"Strong natural decadal variations, as well as changes in data quality, density, sources, and methodologies for estimating hurricane strengths, lie at the heart of arguments whether or not a global warming contribution to a trend in tropical cyclone intensities can be detected."

The Nature article refers to a "consensus", but the text we viewed hardly strikes us as a consensus, nor would we call it a "fact" sheet. But the text we viewed was stripped of references, charts and data, so its hard to discern what it might have been or is now. It's more like a "position" statement, but perhaps there's something actually more substantive and worth suppressing in the unstripped document.

This may be the mysterious document, but if it is NOAA, the Commerce Department and others would like the Natureit to fade away as "an interesting piece of fiction". But the media focus on the NOAA report is only part of the story.

Transparency in Government?

The appearance of the fact sheet can be interpreted to support NOAA's defense of their May actions. But the news of the Nature article was pre-released en masse largely by the Associated Press. The AP article drew attention to the suppression of the NOAA report, but not to Nature's whole story.

The second half of Nature's article looked at a separate issue involving more emails, this time between the Department of Commerce, NOAA, and CNBC television. This was reported fairly extensively on the internet, it was Salon's story. The emails (several available here on Senator Waxman's site) reveal maneuverings around potential NOAA representation on a CNBC show about hurricanes and climate change. Tom Knutson is a NOAA research meterologist who uses models to simulate storms under different environmental conditions. He is one of the researchers who has shown that hurricanes formed under higher CO2 conditions tend to be more intense with higher precipitation. The emails turned on the politics of his stance and whether he should represent NOAA or whether a different scientist with views that the favored multi-decadal variation influence of hurricanes should represent NOAA in the CNBC interview. In the end, NOAA declined the interview.

Nature's story is not solely about one NOAA document that can be dismissed, it looks at several incidences of apparent obfuscation of pertinent NOAA research by the Department of Commerce, and strongly reinforces the case that there is a pattern of suppression of scientific data key to understanding the threat of hurricanes. This fact is not lost on many scientists, journalists, civilians, businesses and politicians.

However, the contentious presentation of the issue has motivated some observers to dismiss the issue as an election year tiff, for instance the Lompoc Record tells us to relax because the election is almost over. (where is Lompoc?). The New York Times barely summoned the energy to write three and a half sentences about the issue before concluding wearily that "scientists do not agree".

This is unfortunate. Moreover, it's unclear why NOAA doesn't just release their version of the whole document (references, data, charts, color and all). Why hide documents? Why hide science? After all, NOAA's "climate goal is to: "Understand and describe climate variability and change to enhance society's ability to plan and respond".

The Bush Administration continues to fervently hope, against all scientific evidence, that global warming isn't happening. Today, perhaps a nod to industry or media, or fellow politicians, Bushe pressured NOAA to suppress climate science that gives more evidence of the effects of humans on climate.

With media fanfare, the Bush administration declassified conclusions from a report on the state of flourishing terrorism. Media leaks about the report were not flattering to the administration's Iraq actions, so apparently the White House was compelled to release the actual conclusions. Consistent with this candor_only_under_intense_pressure approach, news from Washington Post says that last spring, the Bush administration tried to suppress a National Oceanographic and Atmospheric Association (NOAA) report that global warming tied to stronger hurricanes. Actually, reports Nature, the White House "quashed" the review.

The ubiquitous associated press report about the science journal's article says that Ants Leetmaa, who headed the panel reviewing hurricanes and global warming data for NOAA, was advised in May by e-mail from the Department of Commerce that the language in the panel's conclusions was too technical and should not be released to the public. NOAA's pre-hurricane season press release last May detailed the cause hurricanes and how it related to climate change:

"Warmer ocean water combined with lower wind shear, weaker easterly trade winds, and a more favorable wind pattern in the mid-levels of the atmosphere are the factors that collectively will favor the development of storms in greater numbers and to greater intensity. Warm water is the energy source for storms while favorable wind patterns limit the wind shear that can tear apart a storm's building cloud structure."

But then, strangely, concluded: "This confluence of conditions in the ocean and atmosphere is strongly related to a climate pattern known as the multi-decadal signal, which has been in place since 1995...". Their conclusion that cyclical climate patterns were responsible contradicted scientific evidence. Notably, two studies published at the time of the press release strengthened the link between anthropogenic warming, ocean temperatures and hurricanes. Matthew Huber et al published a paper in Geophysical Research Letters showing that the intensity and frequency of storms had doubled with a one-quarter degree increase in global temperature. Emanuel Mann et al reported in a study in Eos that warming ocean temperatures, not cyclical warming, were responsible for increased hurricane intensity.

But while climate scientists are publishing studies weekly, if not daily, The New York Times reported at the time that a meteorologist with the Hurricane Research Division of the National Oceanic and Atmospheric Administration, Stanley B. Goldenberg was unimpressed by the new research:

'[he] expressed skepticism about any connection between global warming and hurricane intensity, [and] said he had not seen the new papers but had read nothing in other recent research to change his view...."There's going to be an endless series of articles from this circle that is embracing this new theology built on very flimsy interpretation"'

It's alarming that a NOAA spokesperson doesn't admit science done by it's own agency. But today NOAA is denying the influence of politics and White House manipulations. NOAA is refuting Nature's report saying that the product of the panel was not a "document" but a "two-page fact sheet". Referring to the May hurricane report, a spokesman said that the fact sheet wasn't complete by the time the pre-hurricane press kit went out. Other news reports on the event say that the report was "merely an internal document", and the agency could not take a position on the science. What is true? Was it a report? A two page fact sheet? Insignificant? For internal use only? Was NOAA really challenged to get the two page fact sheet out in time for the press release? Isn't it NOAA's job to report science?

The evidence for global warming is well established, and the link to hurricane intensity has been growing since at least 1987 with Kerry Emanuel's work The evidence has grown in the past two decades, and researchers continually refine their understanding of growing amounts of global data that spans decades, centuries or longer. Emanuel says that the power of tropical cyclones in the North Atlantic and Pacific has doubled since 1950. Webster et al (Science, Sept. 16, 2005) provided evidence showing that the number of category 4 and 5 hurricanes has increased globally in the past three decades. Researchers are still refining the details, since this type of analysis is difficult. But they don't argue over the ever more solid connection C02, global warming and hurricanes. Even NOAA says somewhat obliquely on its website:

"An implication of these studies [the review doesn't include recent studies] is that if the frequency of tropical cyclones remains the same over the coming century, a greenhouse-gas induced warming may lead to an increasing risk in the occurrence of highly destructive category-5 storms."

What to do? Insist that your government provide you the most up to date "technical details" of global warming available, and that to do otherwise is pedantic at best. Or criminal. Follow current research on global warming. Search for information, it's bountiful. Real Climate, has thorough, detailed analyses of the research.

This story is continued in our article "Tell Me About the Multi-Decadal Variations"

The World Wildlife Fund lost seven members of their organization in a helicopter crash near the Kangchenjunga Conservation Area (KCA) last weekend. 24 people were killed in the crash including group including members of the WWF, and conservationists, scientists and scholars from Nepal, the U.S. Canada and Finland. The group had traveled to the area last week to hand over management of the Kanchenchunga Conservation Area to local groups. Our condolences to all involved, who collectively and individually accomplished tremendous work for our environment and communities.

Waddling Through The Ages

The Institute of Medicine (IOM) released a report on the ever growing problem of obesity in kids this week. One in five kids will be obese by 2010. Despite the horrified reaction by commentators to the press, this is not a new concern. Fitness and sports goals for kids have long been promoted but obesity has only grown more prevalent despite a sharp increase in attention to the problem over the last couple of decades. The attitude was different in 1981 when a Washington Post headline claimed "Fat children found to have higher IQs than their leaner peers". The article reported on a study done from 1959 through the 1970's, on over 20,000 children whose IQ's and bodyweight were measured. We're not sure of the reliability of this report (the original or the WP one) , but we don't think the same headline would be published today.

By the late 1980's doctors worried loudly about obesity in kids, heightening public awareness. But the concern didn't compare to today's outcry, because the problem was still a bit obscure. For instance a New York Times article from 1989 titled "Eat Well" opened by observing that obese kids suffer from image problems, even though they no longer need to go to a "chubby" department to buy clothes. Obesity was viewed as someone else's issue -- those poor kids who had to spend their summers at those camps that are listed one after another in the grim black and white classifieds at the back of the New York Times Magazine. But this opening paragraph belied the more serious problem. The article went on to review a study on obesity in 22,000 children done at Harvard by Dr. Dietz and Steven Gortmaker:

"'The study, published in the American Journal of Diseases of Children in May 1987, showed that since the 1960's, obesity had increased by 54 percent among children age 6 to 11 years old and by 39 percent among children age 12 to 17. Of all the nation's children, about 23 percent are obese, Dr. Dietz said."

Other studies conducted in the 1980's, including ones by the Department of Agriculture and a National Health and Nutrition Examination Survey from the National Center for Health Statistics from 1988 to 1994, found that one in five children in the United States could be considered overweight. People uniformly blamed the problem on television, fast food, and sedentary lifestyles.

The latest report says that one in five children will be "obese" by 2010. These children will be over the 95th percentile of Body Mass Index (BMI) for their age. The CDC defines obese and overweight for adults differently then children. For adults, overweight means being having a BMI of 25-29.9, and obese means having a BMI of greater than or equal to 30. Children are categorized according to their percentile weight for their age group. They are considered "at risk of overweight" at between 85th-95th percentile of their ideal weight according to Body Mass Index (BMI), and "overweight" when they fall into the 95th percentile of greater. The current report uses the terms "obese" and "risk of obese" instead of "overweight" and "risk of overweight". Some reports used the adult definitions for children¹.

Over the past 20 years the redundancy of these studies and their alarming tenor has become almost monotonous. While the adrenaline rush stimulated by the headlines may cause people to throw their arms up in the air, it hasn't stimulated the flight response necessary to burn calories. Apparently there's no distress that can't be soothed with a nice snack.

The Recommended Solutions

So Americans get fatter. Kids spend hours watching TV or sitting at the computer. They drink soda, they eat junk food. They don't walk to school, in fact many communities don't even build sidewalks anymore. Phys-ed classes fall victim to budget restrictions and after school recreation programs ask parents for donations. Optimistically, we recognize that for each of these problems, scores of public health organizations and legislators are acting to counter with solution. Last May the beverage industry agreed to voluntary limits on sodas in schools. Non-profits givegrants to communities for building sidewalks to "promote physical activity". Budget cuts tend to spare core subjects like math but decimate health, art, phys-ed, and music, so Congress introduced bills S.1276 and H.R.4359 to amend No Child Left Behind to include physical education as a core subject.

However change does not come easily. S.1276 was introduced in June in 2005, and now, millions of pops later, it's still in committee. S.799, which targets childhood obesity is also in process. Industries have tenaciously fought all measures to limit kids' access to junk food, as we mentioned in a June 2005 post. Organizations like Consumer Freedom", funded by the soda and fast food industries, distort and mock the science and motivations of public health advocates.

In Mississippi, where 1 in 3 adults is obese and 25% of the children are overweight, competing interests fight about soda pop. State Senate Bill 2602 introduced a proposal that the Department of Education to set the "vending machine policy". Some school board members oppose the bill because they say it will decrease profits used to support expenses and activities. Milk companies don't buy scoreboards they say, but soda companies are good stewards. Meanwhile another paper reports that parents' back-to-school shopping lists now include candy and snacks and suggest sending children to school with some sugary "rewards".

Efforts to regulate fitness and health become fiery debates with no lack of irony. Vending machines didn't used to exist in schools. Over the last year, the Mississippi School Board has debated what the vending machines will sell, has defended the sale of soda in schools, has voted against an outright ban, has asked for public comment, and will vote again on the "vending machine policy" in October. A school board that spends its time debating the virtues of pop seems like a school board that has lost its way.

Sidewalks used to be built so that people more easily avoid the mud and horse manure, then so they wouldn't be hit by cars walking in the street. They were a safety feature to accommodate bipedal transportation. Now the funding of sidewalk building is relegated to foundations like the Robert Wood Johnson foundation in hopes that the presence of sidewalks will encourage our obese, sedentary society to walk.

The Systemwide, So-Called Solutions

The IOM report, while critical of the lack of progress, acknowledges that there has been a lot of work done to try to improve kid's diets and exercise. "Given the numerous changes being implemented throughout the nation to improve the dietary quality and extent of physical activity for children and youth, an overarching assessment [is complicated]"

The subliminal suggestion of fast food ("overarching") is no-doubt coincidental, but marketing seems to be key to both the obesity problem and its solution. How is fast food faring? Perhaps the *uproar* against fast foods will have hurt sales? No, apparently "systemwide sales for McDonald's restaurants worldwide increased 8.6% in August, or 7.1% in constant currencies". It's common parlance but "systemwide", used here, conjures up images of global "systems" rapidly spitting out greasy little beef patties. Sales are up on all continents.

The company's revenues were $20,460,000,000 in 2005. In 1995 revenues were half that, $9,795,000,000. An extraordinary increase in salad revenues no doubt. Clearly, the industry is recognizing the windfalls of its advertising campaigns. This IOM report recommends some familiar measures that the fast food industry should take to promote healthy fast-food eating:

• Make sure that nutrition information is "clear and useful"
• "Expand healthier food options"
• "Strictly adhere to marketing guidelines that minimize the risk of obesity in children and youth."

The food industry naturally stalls or complies begrudgingly with these pleas while putting up a good false front for health.McDonald's, for example, routinely issues press releases about adding healthier choices as well as nutritional information to its products. However when its first nutritional labels appeared they were in small print on the back of the food trays; nice if you want to tip your food onto the floor after buying it, but hardly useful for choosing a "healthy" option before your purchase. The company announced in 2002 that they were cutting the fat in their fries in half, in 2003 they announced delays to their plans. In 2006 studies found that the U.S. McDonald's fries contain more fat than anywhere in the world. Furthermore the company had been underreporting the grams of trans-fats in its fries.

The fast food industry spent 10 billion dollars marketing food beverages and meals to children and youth in 2004, according to the IOM report. Their profits show that they reap the reward of this investment. You wouldn't guess how sedentary McDonald's customers are though, given the maniacal action oriented verbiage on their investment page:

"In each of the Plan's five areas of focus - people, products, place, price and promotion - we're energized and in a constant state of motion, innovating for our customers. That's why the Plan to Win is vibrant and alive. That's why the plan to Win is working. That's why the Plan to Win is Forever Young."

Seems like this clown pillaged the medicine cabinet and is high on amphetamines. $5 billion of the $10 billion dollars spent advertising snacks, soda and food to children was spent on television advertising. The audience is children who watch up to 4 hours of TV a day. The fast-food and soda industries often defend their high calorie offerings by saying that exercise is the problem, not soda or burgers and fries. But the more TV kids watch, the more fast food ads they see, the more they eat, and the less they walk on sidewalks. McDonald's high octane pitch seems oriented to sell a wind-up action figure that orbits the living room seventy-five times before shooting off to the moon --but it's selling chocolate milk shakes and fries, and the target audience is sedentary.

The success of this advertising points to a possible solution however. The Center for Disease Control CDC's VERB: It's What You Do" campaign, uses social marketing to promote activity in 21 million "tweens", aged 9-13. This successful (CDC) program used "smart marketing and branding techniques that speak directly to tweens' motivating factors". While the benefits of many programs are unmeasured, this one had documented benefits. The IOM report stressed the success of this report, however the government cut funding for the VERB campaign. This is discouraging.

However the success of VERB proved that children do learn and adapt healthy behaviors -- we apparently needed to be reminded of this. VERB may have seemed like an expensive campaign -- it's budget was $125 million, plus an additional $75 million in custom programming and events donated from key media partners". But it leveraged the same dynamic motivators (cool, fun) that fast-food companies do with their far more enormous 10 billion dollar budgets. We can predict where this leads. Promo Magazine, an online publication for the advertising industry, juxtaposes the competing agendas. In one article, "Food Marketers Rally to Avoid Kids' Marketing Bans", (July, 2005), the magazine writes about advertisers protesting Senator Tom Harkin's bill to regulate junk-food advertising through the FTC -- banning advertising is "unconstitutional", executives cry. In other headlines, the magazine touts awards received by CDC's VERB program. It seems incongruous to me that what used to be plain old fun (playing with the neighborhood kids outside), needs a multi-million dollar ad campaign to promote. Moreover, while a 10 billion dollar market aimed at getting kids to consume fast-food and soda is a revenue bonanza for some, it is also an obesity problem that cost an estimated $11,000,000,000 in medical expenditures in 2003. These two multi-billion dollar industries, a 10 billion dollar investment for an 11 billion dollar problem seem to be opposing, unless the goal is simply to pour money into the economy. The effort to ameliorate health costs of obesity and to compete with the immense fast-food marketing budgets that promote high calorie food, will need to employ both innovative and inevitably expensive means to turn around the obesity trend --or "epidemic"-- as they say. But whatever the risk may be of promoting an arms race between the opposing forces, obesity can't be taken lightly.

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¹ The interchange of the two terms makes it seem like this 20% overweight/obesity problem has been looming for the last decades. In reality different studies use different terms, then the media amplifies this ambiguity by interchanging the terms overweight, obese, heavy. (updated 091906)

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South Africa's Wealth/Health Paradox

South Africa, where approximately 1 in 9 people are afflicted with AIDS, has a paradoxical economic development profile. It is considered an upper middle income country based on its healthy Gross Domestic Product (GDP). The World Bank ranked South Africa's GDP 27th of 177 countries in 2005, putting it in about the 85th percentile for GDP. The International Marketing Council of South Africa, with the slogan "South Africa, Alive With Possibility", describes the country as the "economic powerhouse of Africa".

Yet about 800 people a day die from AIDS in this country. Life expectancy in South Africa has decreased by four years and deaths from AIDS continue to decimate populations of young women under age 35 and men in their 30's and 40's, people who are in their prime and who -- from an economic perspective -- are in the most productive years of their life.

Now more bad news. An alarming study from Statistics South Africa's shows yet another dramatic increase in deaths from AIDS in South Africa. The report analyzed death rates from unnatural and natural causes and found that the death rate from communicable diseases of South African women aged 30-45 had increased by about three times, from 500 per 100,000, to 1500 per 100,000 between 1997 and 2004. Male deaths from communicable diseases had also increased and had even doubled in some areas. Some of this bad news was predicted. Since there is a lag between infection and full blown AIDS, it was assumed that the death rates would not decrease until 2008. However the figures are still stunning - as they were last year, and the year before...

The expectations of economists and politicians was that post-apartheid Africa would rebound and that the health of South Africans would improve. Indeed according to economic measures Africa is doing better and foreign investment has skyrocketed. But even compared to Russia, where life expectancy decreased as a result of political upheaval and economic downturn, the current patterns in South Africa indicate a dire state of affairs. For scientists and doctors, the increases in deaths are distressing since there are few signs that action is being taken to stem the epidemic.

South Africa AIDS Policies

With full knowledge of the toll of South Africa's AIDS policies, international public health officials, scientists and doctors are taking South Africa to task and rightly so. Historically, the government has denied that the HIV virus caused AIDS, and it has been slow to implement treatment programs for AIDS afflicted patients. Despite pleading from world leaders, South Africa's AIDS policy remains one of obfuscation and denial. Health minister Dr. Tshabalala-Msimang often insists that nutrition will beat AIDS, and regularly pushes garlic, beets and lemon, and African potatoes as effective cures. Since patient treatment via antiretrovirals now costs less that $130 dollars a year. South Africa's health policies are out of step with the modernity and prosperity that it claims.

The country was condemned at the AIDS conference in Montreal this year for displaying a basket of this produce in its booth, initially without antiretroviral drugs. Earlier this year the country banned two non-governmental organizations (NGO's) from a UN AIDS conference because they were particularly critical of Mbeki's policies.

In the most recent international public plea for policy change, a group of 81 doctors wrote a letter to President Mbeki asking the president to replace the ineffectual health minister, Dr Tshabalala-Msimang. In response to the recent letter, the health minister complained that the international community was undermining the country's efforts. She has long defended her nutrition advice as "the truth", and allegedly doesn't mind her moniker- Dr. Beetroot".

In response to the outcry against him, the president has assigned a new committee to oversee the AIDS program, according to an associated press article (South Africa Scales Back Health Minister's AIDS Role). But the health minister denies that she has been demoted, and in typical sidestepping form, a government spokesperson, Themba Maseko, said: we need to shift the focus from saying the problem is the Minister of Health".

Effective AIDS Policies

AIDS programs succeed in countries because of many deliberate actions by leaders. It is imperative that there is strong leadership to combat AIDS at the very, very top levels of a government. So in South Africa's case, if the problem is not with the minister of health then it is with the president.

People have said that effective AIDS policies will be pushed to the fore by governments who realize that deaths impede economic progress. It's hard to imagine that South Africa, where 1 in 9 people on average are affected by the deadly disease and only a small fraction receive drugs, has not come to terms with this economic reality. Any government which claims that beetroot is as effective as antiretrovirals is, as Stephen Lewis put it: "obtuse, dilatory and negligent."

Once it seemed intuitive that a higher GDP could be linked to greater general welfare of a country's citizens. Economists now recognize that GDP doesn't always correlate with overall broader measures of prosperity. South Africa is a telling example of this phenomenon. The United Nations' Human Development Index (HDI) rates quality of life factors such as education, the status of women, morbidity, and mortality. South Africa's comes in at 121sh out of 178 countries. This puts it in about the 33rd percentile of all countries, in the company of many countries who have far fewer resources. Therefore in terms of HDI, as opposed to GDP, South Africa's is in the same band of countries that its pro-business groups lord over with their "economic powerhouse" status.

In this "post-apartheid" era, we would not expect this chasm between the HDI (where it lies in the 33rd percentile) and GDP (where it is the 85th percentile). We would not expect the travesty of preventable AIDS deaths. We only wish that such a sorry state of affairs would convince those at the top levels of the government that only an active AIDS program will assure that South Africa truly is, as its marketing campaign says: "alive with possibility".

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Acronym Required previously wrote about AIDS in Not in Paradise Anymore - AIDS in Africa - Reason for Optimism?" - in response to a David Brooks column and optimistic prognosis for the AIDS epidemic in South Africa. We also wrote about AIDS in Zimbawe, in Burma, as well as in other articles.