February 2008 Archives

Reps. John Dingell and Bart Stupak sent a letter to CDC Director Dr. Julie Louise Gerberding yesterday, questioning a report on pollution in the Great Lakes suppressed by the Agency for Toxic Substances and Disease Registry (ATSDR) . The Center for Public Integrity published "Great Lakes Danger Zones" detailing how the CDC blocked publication of a study for seven months because it contained "alarming information."

The 400 page report, "Public Health Implications of Hazardous Substances in the Twenty-Six U.S. Great Lakes Areas of Concern", documented elevated rates for cancer mortality, infant mortality, low birth weight, and premature births, concurrent with hazardous waste such as dioxins, polychorinated biphenyls (PCBS), pesticides, lead and mercury (no cause and effect research yet). Nine million people living in "problem areas" around the Great Lakes are potentially affected, including the metropolitan areas around Chicago, Cleveland, Detroit, and Milwaukee.

The International Joint Commission, an independent bilateral organization that advises the U.S. and Canadian governments on the use and quality of the Great Lakes and other "boundary waters" commissioned the report. Dr. Peter Orris, a professor at the University of Illinois School of Public Health participated, and urged the ATSDR not to suppress the report. He talked to the Center for Public Integrity about the rigor of the findings:

"This report, which has taken years in production, was subjected to independent expert review by the IJC's Health Professionals Task Force and other boards, over 20 EPA scientists, state agency scientists from New York and Minnesota, three academics (including myself), and multiple reviews within ATSDR. As such, this is perhaps the most extensively critiqued report, internally and externally, that I have heard of."

Christopher De Rosa, also involved in the production of the report, had headed ATSDR for 15 years as the director of the agency's division of toxicology and environmental medicine. He had a strong international reputation, including commendations from officials at the IJC, specifically for his work on that study. De Rosa had also pressed agency heads to release of the study, and said that delaying the study had the "the appearance of censorship of science and distribution of factual information regarding the health status of vulnerable communities." Senior agency officials first criticized De Rosa on the study, then demoted him -- apparently for his temerity.

The congressmen wrote in their letter "The validity of the findings of this [ADSTR] report deserves a fair and open debate within the scientific community. That cannot occur if this report is withheld from publication; accordingly, the report should be released." The letter asks for specific documents and records relevant to the investigation, provides a definition for "records", and necessarily warns against the destruction of evidence . The full letter is here. A previous member of the IJC had an opinion about why the report was suppressed. The "whole problem with all this kind of work is wrapped up in that word 'injury'", he said governments are aligned with chemical companies and don't want evidence of injury because "If you have injury, that implies liability".

"...Except for Prisoners and Students"

"Grade D Beef, Unfit For Human Consumption (Except for Prisoners and Students)". That's an urban legend -- there is no such label, says Snopes.com. But apparently there's a witness outside the loading zone of every college cafeteria who reports that workers are hauling in boxes labeled with this very dicey standard.¹

It may be a funny story and an urban legend, but reading the news lately you wouldn't necessarily believe that the beef we're being served matches the USDA's quite delicious sounding quality ratings: "prime", "choice", "select", "standard" and "utility". (OK "utility" sounds a little iffy). The USDA bases the ratings on things like marbling and maturity grades, and for all the various grading parameters they employ, you'd hope that whatever ended up on your plate jived with the image you have of the happy cow in the grassy field, mouth full of clover and switchgrass -- an image that's widely dispersed by the beef industry. Unfortunately the Humane Society recently videotaped downed cattle being "urged" to slaughter, which swiftly and cruelly dispossessed us of our happy cow images.

The Humane Society sued the US Department of Agriculture (USDA) yesterday in an attempt to force the agency to close a loophole in beef slaughter guidelines. Last year the USDA loosened a 2004 regulation aimed at preventing diseased cows from entering the food chain. The USDA allows "downer" cows (ones that had fallen down and can't get up) into the food chain , if they have made it through an initial inspection then collapsed, but are subsequently examined and cleared by a veterinarian on call. Iffy. Apparently the veterinarians don't always get called.

Downed cows that can't walk themselves to the slaughter line are often not fit for human consumption because of disease -- especially what's commonly referred to as "mad-cow disease" -- bovine spongiform encephalopathy (BSE). This is worrisome because BSE, the result of a prion infection, is fatal. BSE is infrequently transmitted to humans who eat the infected meat, where it manifests as Creutzfeldt-Jakob disease -- also fatal.

The Humane Society filmed workers abusing cows at the Hallmark slaughter plant and released a video in January. The widely publicized video shows fallen cows being prodded, hosed, rolled and dragged to slaughter with farm equipment. The release of the video prompted the USDA to shut down the plant, which supplies Westland Meat Co. This was no doubt a blow to Westland, a company that in 2005 received USDA's Livestock and Seed Program Industry Recognition Award, for "Outstanding Performance and Commitment in the Production and Delivery of Quality Beef Products". Westland supplies the USDA's Commodity Procurement Branch providing meat to elder homes and schools and other organizations in 36 states. The USDA subsequently recalled 143 million pounds of ground beef.

Common-Sense Provisos

Most of the beef had already been eaten but the USDA assured diners that the health risks to humans were small. In the aftermath of the recall USDA accused the Humane Society of holding back its video evidence, an accusation that some found absurd. Rosa DeLauro, (D-CT) noted: "It is the height of irony that the U.S.D.A. is now trying to blame the whistle-blower for the agency's own irresponsible behavior."

The USDA tightened the rules in 2004 in response to several cases of Creutzfeldt-Jakob, but then last year loosened the rules when the meat industry complained that the mandates condemning non-ambulatory disabled cattle were too broad. Industry advocates wanted the USDA to allow cows downed after the initial inspection to be examined and possibly cleared by a veterinarian. Otherwise they reasoned, an non-diseased cow with a broken leg might be wasted.

A vice president from the American Meat Institute called the industry's request "a proviso founded in common sense." However the New York Times reports that 20/29 cattle in 9 months of USDA inspections had no indications of physical injury that would explain their "downer" status, suggesting that downer cows are less often found to have a sprained ankle, and more often sickly beasts with suspected BSE. (The paper doesn't give the number of total cattle processed.)

The Federal Meat Inspection Act (FMIA) was signed into law in June, 1906 by President Theodore Roosevelt. The USDA recently celebrated its 100 year history of "protecting consumers" -- a perennial challenge.

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¹ I thought it was true until this very moment.

Acronym Required previously published Cow Rendering - Ingenuity Gone Mad", and "The Companions of Mad Cows".

Staffers Warn About Credibility of the Agency

Senator Barbara Boxer (D-CA) called the EPA "an agency in crisis" today, and released memos written by EPA staff to Stephen Johnson last year. Agency staff warned EPA head Johnson not to deny California's request for an EPA waiver allowing the state to set its own mileage standards¹. One memo warned that Johnson and the agency would lose credibility: "this is a choice only you can make, but I ask you to think about the history and the future of the agency in making it", the memo from a deputy director said. Johnson denied the waiver.

Johnson stated last December that California's standard wouldn't be as effective as the federal US Corporate Average Fuel Economy (CAFE) standards. He said that under the California rule greenhouse gases (GHGs) would drop by 33.8%, while the federally set standards would reduce GHGs by 35%.

However California pointed out in their prompt lawsuit against the agency that the EPA's calculations were wrong. The state's program will reduce green house gases (GHGs) 113% more than the new Federal CAFE standards.

State standards would reduce green house gas emissions by 30 million tons in 2020 (PDF accessed 2/26/08). If calculations included twelve states that recently adopted California's standards emissions would drop a total of "74 million metric tons per year in 2020" (PDF)-- 75% more than the Federal law.

It makes sense that the EPA's calculations were incorrect, after all, why would the auto industry be so vehemently opposed to California's proposal and so exuberant about the federal standard if the California proposal was more lenient?

At the time of the denial, the press noted that EPA lawyers had warned Johnson about his decision. Now the details of the internal memos reveal the extent to which EPA staff advised against denying the waiver.

Christopher Grundler, the deputy director of the EPA's Transportation and Air Quality division and chief executive of the agency's National Vehicle and Fuel Emissions Laboratory in Ann Arbor, Michigan, wrote that there was "no legal or technical justification for denying [the waiver]." He said, "If you are asked to deny this waiver [by the White House], I fear the credibility of the agency that we both love will be irreparably damaged."

Another staffer recounted presenting evidence to Johnson on California's "historically demonstrated compelling and extraordinary conditions" that would allow the waiver -- including climate change, limited water resources, wildfires, expansive coastal exposure, large population, and an important agriculture sector.

"Special Interest Governing At It's Worst"

In the past, the EPA routinely granted California waivers, 50 waivers and 40 waiver amendments in the last 40 years. Given the EPA's previous actions, many people saw the denial as unprecedented, unfounded -- worthy of many adjectives. State Attorney General Jerry₁ Brown called the EPA's action "shocking in its incoherence". California's governor Arnold Schwarzenegger called it "unconscionable". New York state Attorney General Andrew Cuomo called the EPA's stance "shameful", and New Jersey's speedster-governor Mark Corzine called the decision "horrendous", and based on "crazy reasoning". Vermont and fourteen other states joined the lawsuit.

Boxer said today that the EPA's denial "is about special interest governing at its worst... It is just a nightmare."²

California requested the waiver back in 2005. For two years it tried to get EPA's approval while the administration stalled, until California finally sued to get the decision. After Johnson's denial, California sued the Environmental Protection Agency (EPA) in the Ninth Circuit Court of Appeals in January for its refusal to grant California permission to set its emissions for new cars and trucks.

Sixteen states have joined California's efforts to require automakers to make vehicles that get 44 miles per gallon by 2020.

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¹Under the Clean Air Act, California can set its legislation as long as the EPA provides a waiver. California is the only state allowed to set stricter standards, under the Federal Clean Air Act, and once California has set standards other states can adopt them.

²We won't quibble about when its at its best.

On the front page of the "Sunday Styles" section of the New York Times Sunday was a grand photo of three of Charlize Theron's stylists and fashion consultants considering long flowing gowns for the Oscars festivities. Also an article about Gardasil vaccinations for boys, titled "Vaccinating Boys For Girl's Sake?" So it's pretty much like this. Your eyes are first drawn to the photo of the women with their leggings and boots and fashionable outfits and hairstyles. Then your eyes automatically drift to the left to read "Protect yourselves against the human papillomavirus, or H.P.V., which causes cervical cancer."

The article explains the idea of extending the vaccine to boys in 2009 which is to "slow the rates of cervical cancer". Some controversy here of course. Says the paper, "Public health folks charmlessly call this 'herd immunity'". Speaking of charm school, and charm is relevant not only to "Sunday Styles" but to vaccinations for sexually transmitted diseases -- taking "science is culture" to heart -- what about that page layout?

Conflict of Interest?

Would you believe a nutrition researcher working for Coca-Cola who said that restricting foods might backfire in preventing obesity because 'birds put on weight when food is scarce'? Would you choose him to be president of "The Obesity Society", if your club's mission was to "be the leader in understanding, preventing and treating obesity and in improving the lives of those affected"?

A recent New York Times article, "Conflict on the Menu", threw light on the "food fight among the nation's obesity experts". The New York State Restaurant Association hired the president-elect of the Obesity Society, Dr. David Allison, to support their suit against New York City's regulation requiring chain restaurants to list the kilocalorie values on menu items.

Allison submitted an affidavit warning that listing calories on menus might encourage overeating. According to the NYT he suggested the regulation would either tempt patrons with "the forbidden-fruit allure of high-calorie foods", or leave them so hungry they'd "later gorge themselves".

Somewhat less creatively, the American Medical Association, the American Academy of Pediatrics, the American Heart Association, the American Diabetes Association, the American Public Health Association, the California Center for Public Health Advocacy, the Medical Society of the State of New York, the Trust for America's Health, and many other organizations back the city's regulation.

Obesity & Personal Freedom

While the New York Times keeps the focus of the story on the skirmish within the Obesity Society, there are other stakeholders. One category of stakeholders are "consumer freedom and choice" advocates, who vehemently object to the city's plan.

The Center for Consumer Freedom (CCF) is a group that lobbies against government regulation. They wrote histrionically about New York City's calorie labeling plan in "Menu Labeling Meltdown", warning that "the food cop campaign will plaster our nation's menus with warning labels." They said that Dr. Allison provided "damning evidence" that labeling "might be harmful". CCF belabored the idea that Allison's affidavit dealt a "major blow" to the city's plan and that Burger King might not have to label their Whopper with its energy value: 670 kilocalories.

CCF claims to fight for Americans' right to "guilt free eating". Their stated mission is "promoting personal responsibility and protecting consumer choice" and they're especially belligerent towards individuals or groups like the Center for Science in the Public Interest (CSPI) -- "the food cops". While CSPI works for the public interest, Sourcewatch says CCF is "a front group for the restaurant, alcohol and tobacco industries". Indeed, Phillip Morris started the organization under the name "Guest Choice Network" years ago for the purpose of organizing restaurants against government smoking bans.

It probably comes as no surprise then, that CCF wields the same arguments that tobacco lobbyists used to oppose government smoking bans, saying the food labelig rules violate the First Amendment. However Sandra Wootan, director of nutrition policy at the Center for Science in the Public Interest (CSPI), says: "The restaurant industry isn't concerned about defending the First Amendment, as its lawsuit laughably claims. It just wants to keep its customers in the dark. People need nutrition information to exercise personal responsibility and to feed their children healthy diets." In other words choice is actually broaden with more information, like calorie labels.

So does "personal freedom" stand for "corporate freedom" in this context? Of course, personal freedom is important, but governments are also obliged to work on behalf of the community. New York city's regulation basically requires chain restaurants that already post caloric information elsewhere, like on websites, post the same information in their restaurants. This is hardly the cumbersome requirement that CCF makes it out to be, since the restaurants already have the information, and it's not too difficult to post a sign above a pastry that says "350 kcal" or "950 kcal".

Science & Policy

Despite the Center for Consumer Freedom's (CCF) approval of Allison's recent position they haven't always been so friendly to Dr. Allison, and in turn, Mr. Allison hasn't always been so friendly to industry positions. For instance, in 2001, CCF contested Dr. Allison's 1999 finding that obesity caused 300,000 deaths a year, calling the research "bogus". The organization accused him of "voicing support for an onerous and unnecessary 'Twinkie Tax'", and having "ties to the weight-loss industry". In 2004 and 2005 the group decried Dr. Allison's research conclusions in articles like "Hypocritical Food Cops Preach 'Integrity'", accusing him of conflict of interest and citing Allison's many industry affiliations to discredit his research.

In 2005 Allison was one of ten authors on a New England Journal of Medicine paper showing that the average lifespan in the US would decrease because of the obesity epidemic. (Olshansky et al, "A Potential Decline in Life Expectancy in the United States in the 21st Century", March 17, 2005 Vol. 352:1138-1145.) The accompanying editorial said the group's assumptions were "excessively gloomy".

Although this was a science research paper, the authors pointed out policy implications. There were possible up-sides to the research, they wrote, for instance: "the U.S. population may be inadvertently saving Social Security by becoming more obese". But policy interventions might reverse the death trends, they wrote: "Unless effective population-level interventions to reduce obesity are developed, the steady rise in life expectancy observed in the modern era may soon come to an end and the youth of today may, on average, live less healthy and possibly even shorter lives than their parents."

An accompanying editorial gave more detail. "Deadweight? --The Influence of Obesity on Longevity", by Samuel Preston, Ph.D., mentioned other research showing that only "30 excess calories a day during an eight-year period for Americans 20 to 40 years of age" produced the obesity epidemic. (NEJM Volume 352:1135-1137). Given the morbidity and mortality implications of small increases in daily calories, Dr. Preston said: "reversing the increase in body mass might be accomplished through small behavioral changes...food and restaurant industries would be valuable allies in this effort..."

The authors recommended that government interventions were important to maintaining current longevity, as well as cooperation from restaurants in trying to influence calorie reduction. Which makes it particularly ironic that co-author Allison now chooses the role of a hired gun fighting calorie labeling on behalf of restaurants.

In contrast to their favorable opinion of Allison a few years ago, CCF now applauds Allison's position, with no mentions of his "conflicts of interest", which served as the meat and potatoes of their previous irate stories about his research.

News of Allison's affidavit supposedly caused a fracas among members of the Obesity Society, who got ''completely mad that a president-elect of [an] organization that cares about obesity and cares about healthy eating, wants to hold back information from people that helps them make healthy choices'', according to the NYT. The current president of The Obesity Society to put out a separate statement opposing Dr. Allison's and supporting the city's labeling rules.

When The "Truth" Pays in Gold

A professor at the University of Alabama, Dr. Allison is an obesity statistician with a background in psychology. He's more than just a statistician with an affidavit that appears to be a conflict of interest. He's has published over 300 papers and 5 books.

For his efforts and accomplishments Dr. Allison was honored by George Bush last year in a White House ceremony for recipients of the Presidential Award for Excellence in Science, Mathematics and Engineering". The award recognizes mentoring of women, minorities, and persons with disabilities.

Dr. Allison noted that the award was not just about mentoring but also about making sure the students "understand the ethical foundation on which science is based." It's a mission he apparently takes seriously, as The Birmingham News reported: ''In science, we are not just doing a job,'' he said. ''I was chosen. I think of it like a calling. It is a special and sacred profession. Our sacred duty is truth.''

When questioned by the New York Times about his support of the restaurant industry Allison said, "I'm happy to be involved in the pursuit for truth....Sometimes, when I'm involved in the pursuit for truth, I'm hired by the Federal Trade Commission. Sometimes I help them. Sometimes I help a group like the restaurant industry."

Speaking his truth, Allison remains agnostic in his choice of client. He has been consulted by government, industry and the media for his expertise in obesity, science and integrity. When University of Vermont obesity professor Eric Poehlman was accused of falsifying data on metabolism and aging in research papers and federal grant applications, Dr. Allison interviewed the media in his defense: "I believe he's innocent, and I believe that he is being broken financially to the point where he's ready to give up the fight because he has no more money to fight with, and that's the way the game works", (Boston Globe, March, 2005). Poehlman served a year in jail, paid fines and recieved penalties.

Dough Boy

The Center for Consumer Freedom historically discredited any research Allison was involved in except when it ran in their favor. They accused Allison repeatedly of conflict of interest especially with companies selling "weight control product and services". CCF's leader may be a "real bottom feeder" as CSPI puts it, but the organization doesn't exaggerate Allison's impressive industry ties. In the 2005 NEJM paper about obesity longevity, nine authors each disclosed zero financial interests or affiliations. Dr. Allison, however, listed 150 organizational affiliations in a three page single spaced PDF, attached to the paper.

Dr. Allison's list of grants, monetary donations, donations of product, payments for consultation, contracts, honoria and commitments include consulting assignments for numerous parties, like lawyers engaged in litigation, pharmaceutical companies including Pfizer, Eli Lily, Wyeth Ayerst, Glaxo, as well as Corning, Frito-Lay, Coca-Cola, the Wheat Council, Kraft Foods, Nabisco, the FDA and ILSI. He has impressive experience doing everything from serving on the United Soybean Panel's Nutrition Advisory Board, to being an expert witness for defendant Lockheed Martin at $350 an hour in a groundwater contamination lawsuit.

Much of this was listed in Allison's resume, which I assume the Obesity Society recieved prior to selecting him to their leadership council. If not it was summarized at the Integrity in Science project at CSPI, or in disclosure documents in his publications. His insouciant transparency, extensive network (I assume), precocious achievement. and ethically unencumbered attitudes to choosing clients no doubt secured him a Obesity Society leadership position.

In this sense, doesn't the indignation from The Obesity Society is fine make you wonder? If Allison's position is so disagreeable, why did the nominating committee and 2,000 members in the society select him to be their future president? His consulting positions were a significant piece of his resume. He has been a paid industry consultant for at least 15 years.

Hungry Scientists, Money

Pharmaceutical companies, lawyers, labs, product companies, insurance companies, NGO's, and governments all have an interest in obesity, which means there's a lot of funding at stake in research. Yet by accident or design, research can be wrong, with resulting policy implications.

Allison co-authored a study published in NEJM, and endorsed policies that are the opposite of the "expertise" he now sells..

Poehlman's false data of age related metabolic depreciation affected policy. Doctors and researchers based study and clinical practice on his results. Grants for Poehlman meant that other scientists were denied funding.

In 2004, the CDC released a study which overestimated the annual deaths from obesity. This created false public perceptions and had policy implications, as various stakeholders eyed the competitive pie of public health money and got nervous that the CDC's results would deprive other public health goal like anti-tobacco funding for the cause of obesity.

Some people think that science should remain separate from policy -- like an old TV dinner, the cut vegetables separate from meat product and the syrupy peaches, each one in its own plastic mold -- compartmentalized, never mixed. Combining "science and policy" confuses the public they say. Others say that science and policy are already mixed up, a big stew.

The news often blends everything together, the science, the policy, the personalities, the business, the lobbyists, but yet affects neutrality. The news is too often drained of color and interesting nutrients and doled out as an equally portioned product of pro and con, like symmetrical gray-brown freeze-dried blocks of frozen vegetable puree. We're fed an easily digested story with the predictable arch of a food fight and a neat two part conflict: "Scientists found this...but others found that".

Unfortunately, one of the largest problems resulting from this information processing by media and various lobbies, politicians, and interest groups, is that many of us -- citizens, reporters, politicians, scientists out of their field... have no clue who's the lobbyist, the "unbiased researcher", the expert, or the apostate. But our confusion not only a conflict of interest problem, or a media problem, scientists' fault, or some government agency's fault. It's a larger more thorny economic conundrum.

Update: The New York Times reported that David Allison resigned as the incomin.g president of the Obesity Society. (Oct. 26, 2009, corrected middle initial) He said in his email statement that "I stand behind the scientific statements I made, my right to make them, and the manner in which I made them", however he apologized for the "distress" he might have caused the Obesity Society. The economic tensions that interfere with frank science presentation and reporting remain.

William Kristol says that "Democrats Should Read Kipling". He bases his recommendation on George Orwell's 1942 essay, "Rudyard Kipling". Kristol responds to the House Democrats' hesitation to sign-off on the Foreign Intelligence Security Act (FISA), by taking a ludicrously bold position and advancing Orwell in support of the surveillance act.

He suggests that Orwell and Kipling would have approved the Bush administration's unfettered surveillance mission -- although more realistic reaction to the juxtaposition of Orwell and the Bush administration might be apoplectic brain stem activity -- 1984!1984! 1984!".

Kristol trots out the director of the Central Intelligence Agency, the Attorney General, a former federal judge, the director of national intelligence, and a retired Vice Admiral, who he says approve of surveillance. But the titles are identical to previous casts of discredited characters -- the ones who slam-dunked the US into Iraq, couldn't remember the facts and never meant to mislead Congress. And they're here to warn us blandly that "surveillance abilities are important to our national security"? Republican, Democrats and citizens agree. That's not the issue.

In Sunday's Los Angeles Times, Andrew P. Napolitano, a former New Jersey Superior Court judge and FOX commentator, wrote in "The Invasion of America", that since 1978, the government has been allowed 99% of its FISA applications. The current provisions would allow unfettered surveillance of phone or e-mail conversations if one of the people was a foreigner. He said:

"Those who believe the Constitution means what it says should tremble at every effort to weaken any of its protections. The Constitution protects all "persons" and all "people" implicated by government behavior....If we lower constitutional protections for foreigners and their American correspondents, for whom will we lower them next?"

FISA was approved by the Senate and the House continues its debate. To address the controversy, Kristol tracked down Orwell's essay on Kipling (a response to T.S. Eliot's essay) "in a used-book store -- in the Milwaukee airport, of all places". Fortunately for readers, they need not venture to a used-book store in Milwaukee as our intrepid columnist did, they can read Orwell's essay on the internet ("the World Wide Web", as it were).

Orwell observed that Kipling was often used for "quotations parroted to and fro without any attempt to look up their context or discover their meaning." Indeed, that seems to be Orwell's own plight as well. Kristol clips sentences from Orwell's essay to cobble together his threadbare argument: Democrats should support FISA because the Republican party has been in power so long that only they understand how to rule the country.

Kristol gets off to a rough start using Orwell's oft-quoted comment that Kipling's writing was '''morally insensitive and aesthetically disgusting'''. He brazenly edits Orwell's sentence, which actually read: "jingo imperialist, he is morally insensitive and aesthetically disgusting" (emphasis mine). Kristol says Democrats should be more like Kipling, who -- and he carefully selects another snippet of text -- "at least tried to imagine what action and responsibility are like".

So does Kristol intend to suggest that Democrats toady the administration with "jingo imperialism" like an early 20th century children's story writer -- or dare we suggest, like some columnists at the New York Times? Should Democrats kowtow to those who like to "think of themselves as the governing party "(emphasis mine)? Or are those in the "ruling power" the "jingo imperialists"? Quoting the sentence out of context as he does, Kristol leaves plenty of room for readers' interpretations, but distorts rather than elucidates Orwell on Kipling, (via T.S. Eliot, the impetus for Orwell's essay).

Kipling can't be scissored and dressed up like a little paper doll in patriotic neoliberal red white and blue trousers. Kipling was not some caricature scribe, but a paradoxical and contradictory writer whose views of England and its empire changed over time.

Edmund Wilson, Sara Suleri, W.H. Auden, Salman Rusdie, Edward Said, TS Eliot, and many more have studied Kipling's contradictions, nationalism, imperialism and racist attitudes. One biographer, David Gilmour wrote in "The Long Recessional: The Imperial Life of Rudyard Kipling, of "his early role as apostle of the empire, the embodiment of imperial aspiration, and his later one as the prophet of national decline." Kristol lauded Kipling for "identif[ying] himself with the ruling power and not with the opposition." But this was not Kipling, who often wrote from the perspective of the non-rulers.

Christopher Hitchens wrote a review of Gilmour's political biography in the June, 2002 issue of The Atlantic, called "A Man of Permanent Contradictions". Hitchens characterized Kipling as a deft marketeer: "his entire success as a bard derived from the ability to shift between Low and High Church, so to speak." Hitchens quotes Kipling's poem "If", which seems to recognize of the need for political versatility:

In keeping with Kipling's literary fate of being widely adapted by all parties, the poem was a favorite of "José Antonio Primo de Rivera, the founder of Spanish fascism, and of President Woodrow Wilson. It was apparently written in honor of Leander Starr Jameson, a British colonial pirate who led an aggressive raid into Boer territory, precipitating the horrible South African war", Hitchens points out. I suppose its a complementary tradition then, that Kristol adopt Kipling as a neoliberal mascot.

But jingo imperialist he may have been, Kipling also embodied a stoicism and sense of military duty that's unfamiliar to much of the ruling elite today. When his son was denied commission into the army, Kipling pulled strings so he could enlist. As Hitchens writes:

"Ultimately, Kipling's two greatest literary and emotional attainments - the ability to evoke childhood and the capacity to ennoble imperialism - contradicted themselves too flatly and painfully, and culminated in the shattering sacrifice of his beloved son, John, on the Western Front in 1915. This was enough inner contradiction for several lifetimes."²

For all the variably scathing and favorable analysis, the pondering, questioning, loathing and admiration, Kipling remains enigmatic. He celebrated the empire, but foresaw its decline. Writes Hitchens; "To those born or brought up in England after 1914, let alone 1945, the sense of a waning day is part of the assumed historical outcome. It was Kipling's achievement to have sounded this sad, admonishing note during the imperial midday, and to have conveyed the premonition among his hearers that dusk was nearer than they had thought." The poem "Recessional", as quoted by Hitchens, warns of the Empire's demise:

Orwell wrote that while Kipling celebrated empire, he chaffed at its failings, saying: "He could not foresee, therefore, that the same motives which brought the Empire into existence would end by destroying it...The modern totalitarians know what they are doing, and the nineteenth-century English did not know what they were doing."

Kristol blurs Orwell's meanings and Kipling's complexities and contradictions. He grasps at Kipling's legacy and crafts a familiar Republican myth for loyalists. Ever the party scribe, Kristol draws Democrats as "refined people who snigger at the sometimes inept and ungraceful ways of the Republicans". Adept himself at fiction, Kristol charges that Democrats, once they controlled the Congress, "ensured that [Bush] couldn't turn those failures [in Iraq] around." This brand of subterfuge masking as patriotism is not Kipling's, nor should any of us continue to embrace it.

Perhaps Kristol attempts to reach beyond 1980's history, the worn cowboy hat and stirrups of the Reagan figurehead, but the plot is the same. Whose nightmare/dream is this? I'm not drawing any parallels between the US and British empires -- an analogy that would be as perilous as Kristol's -- but it's no longer morning in America.

Kristol attempts to sketch, a lovable and omniscient administration, a clan of sometimes bumbling but honest and well meaning folks, bible loving people just like you and me, who know what's best for us and happened upon power by the love of God (and the Supreme Court). They do not exist. What Kristol hails is a cold, organized machine with profiteering corporate intentions for Iraq and frighteningly little regard for the Constitution, you or me.

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¹ Here is the full text of Orwell's book about Big Brother, "1984".

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Acronym Required previously wrote on immunity for telecoms, and FISA. We also wrote on Rikki-Tikki-Tavi and mongooses.

The Importance of Science and Technology

There's a call from scientists and non-scientists to stage presidential debates specifically to address science and technology. This popular rally for a debate draws attention to science issues in politics in a unique way. Signers give excellent reasons for the debate, such as increasing US education and competitiveness in science. We'd gladly watch any debate on science and technology. But in signing on, we're tempted to vote "present". Any idea sweeping from sea to shining sea with such unreserved gusto deserves critiques.

Through the lens of science, the current administration certainly affronts. But the policy stance of the Bush administration thwarts knowledge of many subject areas, not just science. Bush policy looks like a siege on economics, for instance, when you consider the tax cuts, the foreign debt, the money pouring into Iraq, the rising "risk" of recession, the housing debacle, and the foreign tourists swarming Manhattan as if it were the mall of American on a Caribbean island outpost staging a final sale.

The Bush years have also been an assault on ethics, on reason, on common sense, on history, on the Constitution, the environment, egalitarianism, religious freedom, diversity; on human rights, education, foreign policy, healthcare, the English language, on AIDS, other beings, privacy, international diplomacy, and above all, on democracy. I've missed something, I'm sure. Pick your favorite subject -- Bush's foray in Iraq probably seems like a war on war, to military scholars.

But is this really all about the current administration? Can we snap our fingers and make it all change? Or have we over time created a bit of a monster, a system that when followed to its logical apex and aided by a business focused government, is capable of taking everything else hostage, including whatever we happen to remember that we hold dear, be that science or democracy?

Debate -- Dare We Question?

Nature questioned the initiative last week in an editorial ( "Best tests for candidates", p. 603), and an article by David Goldston ("A debatable proposition", p 621). Both pieces brought up good points. Goldston warned against conflating science with policy. He questioned whether a debate would benefit the cause of science and its public understanding, and whether the debate proponents had considered how it might unfold. He pointed out that greater visibility does not necessarily coincide with greater funding, and that more funding in turn doesn't necessarily benefit the science or the public. Goldston expressed concerns about presenting issues to a national audience, and suggested that the whole effort may backfire.

The author of the Nature editorial wrote: "In reality, science and technology are a factor in many issues, sometimes a defining one, but most often not. They can and must inform political debate, but will rarely be at its centre." Nature has many journals and some editors signed the initiative. This author supports science debate but questions the forum. On the issue of climate change for example, this Nature editor wrote:

"Scientific issues - how to deal with the uncertainties of climate sensitivity when deciding goals for emissions, or how far to shift federal research priorities towards near-to-medium-term innovation in alternative-energy systems - would play a key role in such a debate. But they would not be the whole story: tax policy, international trade, treaty law and foreign policy are just as crucial."

Climate science could inform energy policy, but policy also needs to consider many stakeholders and economic and business interests. As much as science plays a role in policy, you could easily justify a completely different focus, say labor. For years the auto industry has blamed layoffs on EPA regulations. Automakers fight tooth and nail to protect the regulatory status quo, and have used jobs as leverage when negotiating desired business results -- short-term profits. In the end, the policies did not in help the industry, labor, or the environment, but framing policy in terms of labor is still legitimate. Any focus, however worthy, can be distorted to an end that doesn't serve the long term interests of society.

The auto industry has also torqued perceptions of technology for business ends. When automakers claim, year after year, that they don't have the technology to improve mileage standards, many legislators latch on to the promise of more efficient technologies just around the corner. In this vein, while calling for attention to science and technology, we should note that the terms "science" and "technology" already have enthusiastic bipartisan support. But "science" and "technology" can be used with patriotic abandon in chest-thumping rhetoric -- while "sound" policy does not always follow.

United We Stand

The debate rally presents a nice show of unity to quash nasty rumors from media that scientists are forever bickering. But what interests does "science" really represent? Many signers cited the importance of specific funding objectives, lending support to Nature's editorial point that "for all that it claims to be a 'grass-roots' phenomenon, the proposed debate can be seen as an attempt by various elite institutions to grab the microphone and set the agenda from the top down."

There's certainly a consistent call for more funding, but the signers express very different ideologies, and it's hard to imagine a debate that could soothe the variety of concerns. For instance a scientist wrote about the Bush tenure: "We have seen what seven years of negligence and disdain for science has done to American pre-eminence". Many scientists noted the importance of a president who understands science and technology. But others saw citizen disinterest or Congress as the problem. One scientist charged Congress in the budget vote last fall: "cynically, ceding science was a brilliant political choice by Congress: With one stroke they diminished the Bush legacy while not affecting election campaigns..." Policy issues cannot be simplified to a "pragmatic challenge" regardless of "political stripe", as the debate proponents propose, especially when money is at stake.

One person's "good" science or technology is different from the next. Nuclear fission was a righteous American science challenge until it was used for bombs on Japan, then many scientists regretted their research roles. Nuclear energy technology was popular until its dangers became apparent. But now some declare nuclear energy the next best answer to the energy crisis. Along the way many scientists have had strong personal convictions about the uses of nuclear fission. But throughout history, society has valued the technology differently from time to time. I believe we elect a president who, with their smart advisers, will guide us to technology related policies that fit the times and their shifting challenges, but who need not be required to delineate the steps of nuclear fission. Although the debate proponents declare that it won't be a "test" some scientists are clamoring for just such a drill. Importantly, the "right" answer for one scientist, I'm sure, would offend others or not necessarily be the best policy for the country.

Since presidential candidates talk freely about "faith", some think they should be equally eager to talk about controversial policy issues. But faith is prudent politics. Speaking about faith is imperative to winning an election, as George W. Bush proved. If you follow polls, 50% of people polled wouldn't vote for an atheist president. Conservatives can whip up very strong emotional reactions to some issues, like stem cell research. With the current presidential pool of McCain, Clinton, and Obama, and with many Christian conservatives at sea without a viable candidate, it's not clear that pushing these issues to the fore would elicit the assurances many scientists want to hear.

Stem Cell Research or Faith?

Public conversation on stem cell research, one of the proposed topics, has been suppressed, politicized, emotionalized, and distorted by all sides. You would have to wear blinders to think that what's called "stem cell research" is only about science. But scientists often imply that this is the case, ignoring other really important questions that the use of the resulting technology brings up -- about ethics, human life, realistic expectations in research, scientific opportunity, disease. Some even want to make it a rhetorical debate to try and circumvent the messier issues.

During the Bush administration, conversations about issues of stem cell research were shunted out of the federal arena. Research still went forward, but it progressed differently so as not to offend those who think any medicine defies nature. This stifled important debate about an science issue. Or did it? Do we want a government that makes embryonic stem cell research a federal issue, as with abortion? If the government wasn't involved would it give researchers more freedom than if a compromise was reached between all parties? -- this is how the fertility industry works. (Before deciding read conservative bioethics literature and understand the range of positions.) Or would a hands off government turn stem cell research into an unregulated free for all, detrimental to patients and consumers? Also not a great prospect. These are tough questions.

Nevertheless all the current contenders have addressed stem cell research to the extent that they can, in their legislative records and in previous presidential debates; Hilary Clinton here, Barack Obama here. John McCain for the moment says he supports federal funding.

"Science integrity", is another hot button topic offered up for the debate. What is it? Is it the science behind mosquito nets for malaria, versus the science behind DTT? Proponents of both approaches, each with a significant voice, backed by science research and at odds with each other, are prominently represented among the signers. My guess is that despite the strong disagreements, candidates would want to satisfy both parties without alienating the DTT/chemical lobbies.

Speaking of lobbying, Exxon Mobil profits extravagantly while advertising its research affiliation with Stanford in full page newspaper ads and funding think-tanks to deny global warming. Does this fit in the category of scientific integrity? What would a candidate say? Many of these issues don't have clear cut answers, but no candidate is going to want to alienate the oil companies (or anyone else). Barack Obama has already said, with an uneasy smile, that corporations shouldn't occupy every chair at the debate. Hilary Clinton has at times indicated her disdain of anti-science positions. McCain has expressed positions on this too.

But do the organizers think that candidates answers will be more detailed and frank during a short Science Debate 2008 Inc., forum than what they've already offered? Consider the breadth of topics: "American economic competitiveness and support for scientific research; policy approaches to climate change; clean energy; the healthcare crisis; science education and technology in schools; scientific integrity; GM agriculture; transportation infrastructure; immigration; the genome; data privacy; intellectual property; pandemic diseases; the health of the oceans; water resources; stem cells; conservation and species loss; population; the space program, and others".

These topics fascinate me -- though admittedly some I find puzzling -- "population?" As in condoms? Malthus? Another century? And not to be pessimistic, but when people are losing jobs and houses, do we think the science and technology aspects of "transportation infrastructure" will hold the attention of voters?

Democratic Republic,or Kingdom?

I'm not one of those people who thinks the president is an insignificant figurehead. The president is a critical leader in the US and in the world and how and where the president leads is vital to the country's progress. But is all this enthusiasm for a presidential science debate in fact an knee-jerk reaction that ironically lends credence to Bush's megalomaniacal attempt to make his an imperial presidency? Science and technology are necessary for economic preeminence, as many signers noted. But if this is so than why are science and technology relegated to a neglected special interest that needs to get down on bended knee before the future king to beg for special favors?

Sticking with the global warming example, the legislation we don't have today on global warming is as much attributable to the representatives and to citizens, as it is any president. For years, Congressman Dingell, Democrat from Michigan, has been highly influential on fighting any regulatory legislation coming out of Congress on automobiles. Look at the voting records of your representatives, many who have been in office longer than Bush, to help you understand how we're moving forward of global warming. Look at your neighbors attitudes towards energy consumption, and your own.

Similarly, it's short-sided to see look back only to the past decade for the root of problems. Bush isn't the first president who wasn't effective on climate change. We could just as easily and incorrectly blame this all on Reagan. Had he decided, for instance, not to put quotas on Japanese auto imports back in 1980, we could wildly speculate that the automobile industry would have been jump-started into competitiveness, sparing the industry, jobs, and the environment.

The Bush administration supported positions that defied and stymied science. But it wasn't because the Bush administration didn't "understand" science. I'm sure Bush could ably debate any science subject if pressed. Remember what many people were thinking about when Bush ran for office? In debates, Bush and Gore actually shared some positions and quite a few people didn't even think they could discern a difference: "Republican, Democrat, they're all the same", some said in 2000. The economy was great, we were fairly peaceful, and we had some significant challenges, like global warming, that we hadn't really come to grips with yet.

A Man With A Plan

When Bush was running for office, lest we forget, people were swayed with illusions of "compassionate conservatism". The US was possessed by nightmares about manufactured scandals like "Whitewater", and spooked by visions of powerful presidents plying young naifs with lascivious antics in White House drawing rooms. People saw Gore as a plodding intellectual and Bush offered that folksy honesty, plus, wow, could he cut brush. Bush wooed folks by promising to keep his pants on. He slyly, faux shyly, revealed that "Jesus" was his favorite philosopher. We sighed in relief (the rhetorical we); no hanky-panky on his watch, and swept to the polls on the winds of morality, our best foot forward.

The fact that Bush administration sided with corporations in the global warming debate, and said the science was unclear means he saw an advantage to taking the business side. Had people paid attention to Bush's history, they would not have been so shocked at what he doled out once elected. Religion was a tool. In February 2000, Joe Conason wrote an excellent disturbing biography for Harper's on George W. Bush and his tenure in Texas politics called Notes on a Native Son: Part I. "The George W. Bush success story: A heartwarming tale about baseball, $1.7 billion, and a lot of swell friends." At the end of the long, detailed (page turning) story of Bush's rise to governorship, Conason concluded:

"This vast agglomeration of monied influence is what has made George W. Bush both a rich man and a potential president. Knowing how he became what he is, it's difficult to imagine Bush cleansing the soiled hem of democracy, as his advertising promises he will do. He professes a compassionate conservatism, but his true ideology, the record suggests, is crony capitalism."

Eight years later, this seems eerily accurate. But as Bob Herbert said, quoting John Keane on Tom Paine; our modern democracy is superior because it "enables citizens to reconsider their judgments about the quality and unintended consequences of those decisions."

Science & Technology: What You Can Do

Everyone and every interest wants to gain the attention of the candidates. An editorial in the Financial Times a couple of days ago tapped one of the presidential candidates for foreign affairs: "Obama Could Help Put Out the Fire in Kenya" cried the title. Science and technology interests are certainly important to the country. However many of the issues that are suggested as topics are spelled out by the candidates elsewhere. As worthwhile as it is to elevate science to the level of the presidency, we should also work to piece together each candidate's history, rhetoric and voting records in context, look at their advisers positions, and elevate our level of thoughtful participation in day to day decisions informed by science and technology.

Goldston pointed out that concerned science advocates should not engage the candidates but should lobby in Congress. I don't think that scientists shouldn't lobby the presidential hopefuls, but they should be equally focused on asking what they can do themselves to make these issues more salient within their communities. It takes work to tediously pick through the positions and histories of the candidates. It can seem thankless without the spotlight of a debate stage highlighting the effort. But it's as critical an exercise.

A collaborative, iterative, and public initiative to accomplish this would clarify what scientists collectively believe is important, besides funding. The effort would also show the candidates the seriousness and unity of the agitators. Finally, the fruits of this labor could serve to sober unreflective enthusiasm born of the same wild disenchantment that boomeranged us into voting for the current administration.

When Media Swooned In the Arms of Tobacco

Cigarette peddlers lethally succeed in convincing people to suck smoke into their lungs non-stop, decade after decade. We have accumulated mountains of evidence, millions of publicly available documents, court proceedings, leaked internal industry documents, movies, journal articles, lawsuits, and books. One in five deaths in the US is smoking-related according to the Center for Disease Control (CDC) - all preventable deaths, tragically wasted lives. Despite the evidence the tobacco is the culprit of a major health problem, however, we are still trying to dissuade people from smoking.

Most of us understand the deceptive business strategies that the cigarette industry uses to reap profits from its killer product, in fact tobacco is the standard by which deception around other science issues is measured. Tobacco industry history informs current discussion on other health concerns such as global warming, diabetes, asbestos and cell phones. Comparisons between the issues are frequent, sometimes pertinent, but too often facile.

Like tobacco, all seem to have a single corporate culprit. But in order to successfully continue profiting from cigarettes, many parties collaborate, including stockholders, scientists, legislators, presidents, and the media. Tobacco captured the media for decades, in movies that romanticized smoking, in prolific cigarette advertising, and in dubious reporting informed by lobbyists that minimized the known health hazards thereby insuring the continued sale and consumption of cigarettes.

"Investigative" Reporting, Wink, Wink

One of many interesting stories in the history of tobacco is how the industry influenced news reports back in the 1990's when reporters started uncovering the "dirty secrets" of the cigarette business. Major TV stations squelched stories when reporters divulged the tobacco companies' knowledge about the health dangers of smoking. Tobacco companies took advantage of the networks' business aspirations and fears about getting sued, while certain media companies, motivated by profit, complied by shutting down controversial investigative reporting. Together, the tobacco industry and the media industry stifled public knowledge about the risks of smoking.

The 1990's was only last decade, just yesterday, but people tend to forget. Pieces of this story can be found on internet, for instance here and here and here. In his recent book The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America (2007).¹, Allan Brandt chronicles the story of how two major television stations capitulated to the tobacco industry.

In 1994 ABC News show Day One, aired a report called "Smoke Screen". One trick was to "spike" cigarettes with extra doses of tobacco, adding reconstituted tobacco plant stems and leaves along with extracted nicotine to its cigarettes. This doctoring effectively controlled the dose of nicotine in cigarettes, and incidentally maintained the level of nicotine in the "low-tar" cigarettes, assuring addiction. Jack E. Henningfield, an expert on addiction from the National Institute on Drug Abuse at the NIH, called cigarettes the "crack cocaine form of nicotine delivery". This wasn't stunning news since the Surgeon General had declared nicotine addictive in 1988.

However Phillip Morris promptly sued ABC for libel and $10 billion dollars in compensatory and punitive damages. Phillip Morris was particularly defensive about ABC's assertion that cigarettes were "spiked". They kept insisting that nicotine was not a drug, rather, as their scientists put it, a "product" that gave people "a pleasing sensory experience with mild pharmacology".

Many experts thought the network would win the case. ABC's report hadn't specifically implicated any company, and Phillip Morris's libel claim was not clear-cut, since the company would have had to prove both intent and malice. ABC defended Day One in court for months, spending millions in legal fees.

Also Taking Tobacco On, CBS

Meanwhile, Lowell Bergman of CBS's 60 Minutes was putting together another story, this one featuring Jeffrey Wigand, a biochemist from Brown & Williamson. Wigand was one of many company whistleblowers who had begun to speak out about the tobacco industry and worked with the FDA on their investigation of the industry.

When Mike Wallace interviewed Wigand for CBS, the CEO's of seven major cigarette companies had just testified before Congressman Henry Waxman's (D-CA) Subcommittee on Health and the Environment. Each had said in almost identical statements: "Nicotine is not addictive". But Wigand knew otherwise. He had headed up various research projects at Brown & Williamson and lobbied within his company, B&W, for safe cigarettes. He told Wallace that the CEO Thomas Sandefur had lied to Waxman's committee. B&W management knew that cigarettes were addictive, Wigand said, and used every opportunity to leverage research data that proved their addictiveness to sell the product. He also described how scientists added ammonia to the cigarettes to assure that the lungs absorbed the nicotine more easily, and how carcinogenic additives like coumarin (one of 700 cigarette additives at the time) were added to cigarettes despite known toxicity.

The Weak-Kneed Fourth Estate

Right before CBS aired its show, ABC shocked its employers, its lawyers, and onlookers by settling its lawsuit with Phillip Morris. The surprise settlement was motivated by ABC's pending business deal with Walt Disney Company. Disney wanted the liability of the lawsuit off the table. Phillip Morris had also threatened to pull advertising worth $100 million dollars a year.

As part of the settlement, ABC apologized to R.J. Reynolds and Phillip Morris and paid 15 million dollars in legal fees. Phillip Morris took out full page ads in national publications to advertise the network's apology.

Shortly after ABC's settlement with Phillip Morris, CBS canceled the 60 Minutes show featuring the interview with Wigand. CBS revealed that they were in the midst of finalizing a $5.4 billion dollar merger with Westinghouse Electric Corporation. Many in and outside the media agreed that the Phillip Morris lawsuit was about intimidation and that it effectively dampened investigative journalism.

Business interests had once again prevailed. Coincidentally or not, Laurence Tisch, the CEO of CBS, was the father of Andrew Tisch, CEO of Lorillard, who testified at the Waxman hearings. In the industry's well established pattern of denying science and math when it was inconvenient, Tisch told the subcommittee that he did not believe that cigarettes caused death, because death rates were generate by computers therefore only statistical".

Tobacco Testifies

The CEO's sworn denials of their knowledge of tobacco's dangers were wearing thin and did not endear them to legislators. When James Johnston, CEO of R.J. Reynolds, compared cigarettes to ordinary sweets like Twinkies, Waxman tersely pointed out the stark difference between the two:"Death". Waxman was not swayed then, and of course today, cigarette company denials elicit aghast indignation across the world, especially in the US and EU. We're wise to deceptive marketing, legislative finagling, and payments to scientists in mid-life/career crises made pliable about science with money. Cigarette companies lie, obviously.

But this doesn't help people who are addicted, or people who aren't educated about tobacco's addictive and dangerous nature, or those who think smoking is fashionable, will bring prosperity, joie de vive, and independence -- don't laugh, this is what cigarette marketing sells. Many people have quit smoking and many people never start, but many more people continue to inhale and die. True, this is a devastating public health problem, but its also an undying, successful business strategy.

Tobacco Industry Solutions for Today's Business Executives: A Case Study

Tobacco's marketing strategies are highly successful, as Harvard Business Review (HBR) highlighted in their February 2008 issue, where Michael Sheehan tutored HBR reading executives on "Understanding Opposition".

Along with other business techniques, he advised: "[s]omewhere between co-option and tug-of-war lies what I call a deflection strategy." The tobacco industry used "deflection strategy", Sheehan wrote, to deal with pressures to reduce second hand smoke in the 1980's. The tobacco industry reframed the issue as a "sick-building" problem, which was caused by energy efficient buildings.

Cigarette companies blamed the energy efficient buildings for trapping indoor pollutants in furniture, office machines and carpets. This was the solution wasn't banning smoking, Sheehan said, describing how the tobacco industry reframed or "deflected" the issue. "The solution was to engineer efficient ways of bringing more fresh air into facilities", and although the "strategy wasn't ultimately successful", he wrote, it successfully "stymied [smoking] bans for several years."

It's all about business, therefore all is fair, the article reasons. "Understanding Opposition" was on page 24 of HBS. Three pages before that article, on page 21, was an article on ethics, titled "How Honest People Cheat", a report on supposedly "honest" people's propensities towards dishonesty. It was nice to have close at hand in HBR because it explained some of the rationale of both the cigarette companies who deceived, and their would be emulators.

"It's clear that we have an incredible ability to rationalize our dishonesty and that justifying it becomes substantially easier when cheating is one step removed from cash. Nonmonetary exchanges allow people greater psychological latitude to cheat -- leading to crimes that go well beyond pilfered pens to backdated stock options, falsified financial reports, and crony deals."

The Harvard Business Review editors ironically and neatly compartmentalize tobacco industry's "deflection" on page 24, from "cheating", on page 21. Your average businessman should now be able to successfully walk this line. It's fine to stymie a ban on smoking; but one should never, ever, backdate stock options.

Worldwide Opportunities

The tobacco story spans a hundred years and is a complex mix of sociology, science, business and politics. While the number of smokers in the United States began to decrease in the 60's, there are still large numbers of addicts, especially among poorer populations and those in inner cities who are especially susceptible to tobacco's marketing. The companies long ago saw the writing on the wall in the US with the rash of lawsuits and public health activism, and adapted to the business challenge by expanding their global strategy.

Companies today market aggressively in foreign countries, skillfully navigating each country's laws and seducing young smokers using the same tools they perfected during the 20th century in the US. Advertisements spin notions of individuality, prosperity, freedom and cool factor. The messages appeal to the poorest populations who are naive to the addiction and health consequences.

At every stage, cigarette makers seem to master all the tricks. Yesterday, the organization Corporate Accountability accused Phillip Morris, British American Tobacco and Japan Tobacco of colluding with smugglers to gain entry into markets.

So, Knowing Tobacco's Record, Fewer People Smoke?

According to The World Health Organization, tobacco use causes more than 5 million deaths per year worldwide. Tobacco use will cause more than 8 million deaths annually by 2030. The increase will occur mostly among lower income people, especially in developing countries. [updated link 11/12]

In moment of enthusiasm in 1996, former Senator Jesse Helms (R-NC) said to a reporter: "I was with some Vietnamese recently, and some of them were smoking two cigarettes at the same time. That's the kind of customers we need!" Then perhaps realizing how that sounded, he added: "Well, not exactly". A Vietnamese official queried by the same reporter said, "We'll smoke for 10 more years, until we are a more developed country." Then, perhaps not realizing the power of addiction he added, "Then we'll quit, just like you." (NYT April 12, 1996) More realistically, one doctor commented a decade ago about China's growing tobacco addiction: "If the Chinese smoke like Americans, then they will die like Americans"

For all the hand-wringing about tobacco's health effects, it remains highly profitable and therefore capable of keeping potential naysayers at bay regardless of the form of of government. China illustrates the economic benefit of this strategy especially well. The state owned tobacco industry in China contributes $30 billion to government coffers a year, tax revenue that comprises 7% of government revenue (a few years ago it was 12-14%). 350 million people smoke in China, and 1 million people a year die. The country racks up $5 billion in medical costs per year. But government officials have balked at tobacco control, noting that it would "destabilize" the country. To drive the point home, a recent WHO study found that "governments around the world collect 500 times more money in tobacco taxes each year than they spend on anti-tobacco efforts."

It's easy to pick a primary culprit to blame problems on. But while society struggles with smoking as a major public health problem, governments simultaneously allow complex business, government, civilian, and not-for profit interactions and infiltrations between industry, the media, entertainment, and policy-making institutions.

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¹ This post is not a review of the book, which is excellent, captivating, and highly recommended. Brandt's analysis and perspectives on the tobacco industry are thorough and insightful. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America (2007)

Acronym Required previously wrote about tobacco industry funding of science research in "My Lab Thanks You For Smoking", and UC Senate Smokes RE-89. Lowell Bergman was one of the producers of last years four part PBS Frontline series called "News War" that we wrote about here.

The FDA, Hanging by Its Fingertips

The Food and Drug Administration is "barely hanging on by its fingertips", said Peter Barton Hutt, former chief counsel of the agency, when he spoke before the Subcommittee of the Committee on Energy and Commerce in the House of Representatives last week. The FDA's problems are not new, they're cumulative. In an interview with The Hill last year, Hutt expressed his frustration with Congress, which continues to pile statutes on top of the 1938 law without providing extra funds. He noted that the Food, Drug and Cosmetic Act "has been amended well over 200 times and now reads something worse than the Internal Revenue Code"

The congressional subcommittee heard dire testimony from the Goverment Accountability Office (GAO) and various members of the FDA's self-assessment committee who conducted a review of the agency in 2007 at a time when product recalls were continuous and frequent. The self-assessment, "FDA Science and Mission at Risk", and an Institute of Medicine (IOM) report, "The Future of Drug Safety", highlighted systemic problems with the FDA that inevitably trickle down to the public as food safety and drug safety risks.

Leadership Unstable

Those who testified said the FDA leadership was politicized and unstable. They pointed out organizational dysfunction, lack of coherent management structure, paucity of vision and competence, and problems with recruitment, retention, and morale. Others spoke out about major gaps in science expertise, nonexistent peer review, and scientists who are disengaged with the broader scientific community. Of course large government agencies inevitably need better information technology capabilities, but one former CDC employee who now works in consulting focused his report exclusively on the FDA's technology needs.

Andrew C. von Eschenbach, the commissioner who heads the agency, didn't think it was all that bad. He noted that the FDA had proven, "state-of-the-art applied sciences", a "commitment to peer review", and that a he had hired a new CIO. He opposed majority opinion by pointing out that the "collaborative relationship among the Agency participants was an excellent model for other government programs".

The FDA ensures the safety of about 80% of the US food supply, according the GAO, $417 billion of domestic food, and $49 billion of imported food. The GAO noted that there were fewer that 100 inspections of 190,000 foreign food firms in 2007, which is half the number of inspections as 2001. Of all the areas that need attention, food inspection is a high priority area that suffers in part from a lack of user fees that fund other areas, like drugs and medical devices, which receive millions of dollars. According to Hutt and others who met with the subcommittee, the agency urgently needs more money from Congress in order to meet its charge of assuring the safety of food and drugs. Hutt recommended that the Congress increase FDA employees by 50 percent and double FDA funding.

This week, the FDA announced the agency's budget request for 2009-- which given the state of the agency seems paltry, a mere 5.7 percent increase over this year's budget. The 2009 budget proposal includes important increases for food safety and medical product safety and development. The one area that the FDA proposed cutting is in Administrative Savings and Management Efficiencies. We hope, as is sometimes the case in larger institutions, that this function title is a euphemism for something else and is somehow part of the larger problem. Otherwise, it's not intuitive, given the state of the agency's organization troubles, that funds directed in this area should be "redirected to higher priority items".

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Acronym Required wrote about von Eschenbach's confirmation hearings in "The FDA'S Medical Ideology"

"Resuscitating The FDA", about the FDA in the wake of various fiascos.

FDA -- Calling Off The Dogs, about Plan B and staff turnover.

Ethics- The NIH and FDA, about conflicts of interests among scientists in these two agencies.

The New York Times has launched what I can only assume is an inadvertent pro-vegetarian campaign. Last week an article featured pictures of cattle, shoulder to shoulder in a pen, up to their cattle knees in "mud", accompanying an article about beef consumption in the US. You could almost smell the repugnant odor, especially if you've ever driven by one of these vast cattle pens. Even at 50mph/80kph, the smell is mind-alteringly revolting, capable of singeing the hair off the inside of your nostrils.

Today the paper provides lurid details from the investigation of a neurological illness that affects workers of hog manufacturing plants, especially one in Austin, Minnesota. (Denise Grady, "A Medical Mystery Unfolds in Minnesota")

The Center for Disease Control (CDC) in Atlanta reports that at least 12 people at the Austin, Minnesota plant have been affected with symptoms ranging from weakness on both sides of the body that gets worse over time, mild pain, numbness, tingling and heaviness in their legs and feet, to acute paralysis. While the illness generally resolves and some workers were affected for only 8 days, others were affected up to 213 days.

Investigators on the case recognize common symptoms between workers, and although they don't yet know the exact cause, they're making progress. The Washington Post described how the translator who accompanied the patients recognized common symptoms between some of her clients. Once several victims were identified, investigators learned that the majority of the affected workers had harvested brains from the swine.This is a stomach churning job that the journalists seem lucky enough to not have actually witnessed, since reporters are not allowed in the plant. We try not to revel in the details that follow, but queasy readers, be forewarned.

When the state epidemiologist toured the plant with the owner, they observed workers at the "head table", whose job was to remove the brain and skeletal muscle from the swine. Brains were removed with an air hose in a process that called "blowing brains". After studying workers from various stations at the plant, the CDC found that 7 of the 10 head table workers in their study were affected by the disease. These workers didn't wear long sleeves or face shields. Possibly as a result they inhaled aerosolized brains or head muscle from the spray that caused their symptoms. Once the plant owners realized that the illness was related to brain blowing, say all the news stories, they stopped the process.

The interesting part of the story to some people may be the gross-out factor, but to doctors and scientists it's the question of what causes the disease. It wasn't clear from the first patients that the symptoms were work related, since many of the symptoms are common to other diseases. Tests for various parasites, viruses and bacteria came back negative. More testing revealed that the patients had what doctor's think is a new disease, progressive inflammatory neuropathy (PIN) ¹. This label distinguished the condition from doctors' original assessment earlier last year of chronic inflammatory demyelinating polyneuropathy (CIDP), a rare, but known disease.

Doctors ran tests for inflammation, and "electrodiagnostic tests" of the nervous system, such as measurements of nerve conductivity. One of the things that showed up is evidence of axonal and peripheral nerve cell demyelination. Myelin covers the axon part of the nerve cell and allows small electric impulses, the action potential, to be conducted very quickly through the nerve cell. Healthy myelinated nerves transmit signals to and from the spine to the periphery of the body.²

Doctors hypothesize that the patients' immune systems became unable to distinguish foreign proteins of the pigs that they inadvertently ingested, from their own body's proteins. In this autoimmune ("auto"- self) response, the immune system attacks the body's own proteins, perhaps in the myelin. When the myelin is damaged, as with different autoimmune disorders such as Multiple Sclerosis (which also effects the central nervous system ³), or in Guillain-Barre Syndrome, the nerve signals don't transmit properly, causing numbness or tingling, numbness, foot droop, or more severe symptoms.

One avenue of research scientists are following according to the NYT is comparing the pig to human myelin DNA sequence to understand the extent of the similarities. Researchers hope to gain knowledge about what exactly happens in the immune system to cause the neuropathy. The goal is to identify agents that trigger the immune response.

The workers respond to treatment differently, as would be expected from the disparate disease pathology. Some workers responded to steroid treatment. Other workers responded to intravenous immunoglobulin (IVIG) treatment. IVIG treatment uses donated IgG immunoglobin products from the plasma of pooled blood from many donors, either to boost the antibodies in an immune compromised individual, or as in these cases, to suppress the autoimmune response and control inflammation. Some have recovered quickly, while others have a longer road ahead.

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¹When news outlets say, "CDC is calling the condition progressive inflammatory neuropathy". The term is not too complicated to understand. Doctors observe that the symptoms get worse over time, progress, "progressive". Tests show evidence of "inflammation"². Disease of the nerves is "neuropathy" -- in this case of the peripheral nerves. Thus, "progressive Inflammatory Neuropathy".

²The nervous system is amazing, an you can see this every time you move by understanding a little bit about the neuromuscular system. Complex and intricate physiology allows you score a goal or dip your toe in the water and recognize it as cool, or warm, as the nervous system communicates that back to the brain. To briefly summarize the process, which you can find in more thorough detail elsewhere, when you kick the ball, the thought originates in the CNS -- through the motor cortex of your brain, then as a nerve impulse transmitted down your spinal cord. At that point the somatic nervous system transmits the signal from the spine to the muscles of your foot and leg. At the muscle, a biochemical reaction at the site where the nerve cell meets the muscle cell triggers muscle contraction. Think of this happening for all the muscles, in the exact right order, when athletes pass a football, or perform an uneven parallel bar routine, or swim.

³ In the body there is the peripheral nervous system (PNS), and the central nervous system (CNS). The CNS is the brain and spinal cord, and the peripheral nervous system consists of the somatic and autonomic nervous systems. The somatic nervous system innervates skeletal muscle, skin, and sense organs.

The Jungle is Upton Sinclair's book about meatpacking conditions in the early 20th century.

Acronym Required wrote other posts about livestock related diseases that were infectious, which PIN is not. We wrote about BSE (mad-cow disease), caused by an infectious agent called a prion, in "Cow Rendering - Ingenuity Gone Mad", and "The Companions of Mad Cows". We've also covered the bacterial infection of Streptoccocus suis in Chinese pigs, and the Coxsackie virus in Britain's Foot-and-Mouth Disease. We wrote several posts on the H5N1 virus known as avian flu.

Art Tries to Imitate Science Tries to Imitate Art Tries to Imitates Science.....

Last year, Acronym Required wrote about the American Film Institute's Catalyst Workshop, which recruits scientists to train them in scriptwriting. "Science's Silver Bullet -- The Silver Screen?" described a Pentagon sponsored workshop that recruited "hard-core", "lab-certified scientists" to write scripts and portray "appealing" science protagonists.

The rational behind recruiting scientists? Back in 2005, the New York Times published a story on the Catalyst Workshop that explained Hollywood's demand for scientists: "They're compensated very minimally, they're going on blind faith that what they're searching for is going to pay off. And film making is exactly the same way". ("Pentagon's New Goal: Put Science Into Scripts", 08/04/05). An unflinching assessment indeed. We venture that "blind faith" is a slur to most scientists, no doubt filmmakers as well. As for the pay, true enough, most "lab-certified" scientists get paid pitifully. When we published the story we could only guess how scriptwriters fared.

Now with the writers strike, we have more information. According to the New York Times, some writers get paid significantly more than your average "lab-certified scientist". A recent article said that the "typical TV series writer may get $30,000 an episode, plus residuals". Movie scriptwriters get a million dollars in advance payment, according to studio executives. ("In Hollywood, a Sacred Cow Lands on the Contract Table", August 5, 2007 ). Of course sometimes the truth is found by reading between words, so we'll take that for the propaganda that it is.

While the top of the pay scale for Hollywood writers does seem like a brighter star than what scientists have to wish for, we know that only a few lucky writers get a stab at these choice positions. The rest of the labor force traipses gig to gig for what many consider menial pay: "More water sir?"

Sure, wink, wink, the writers are gouging the poor executives by asking them for residuals on digital works. The obvious question is: If the projected digital profits are such pittance, than why is the executive side of the contract table so apoplectic?

Is it "Over"?

In the case of the writer's strike, despite weekend rumors originating with a Fox News executive, claiming that the strike is over, we're waiting for the writers to make the call. We know that announcements like "it's over" are sometimes craftily used by those in charge of crisises to make the media go away.

Over or not, there's happy news from an unexpected source. Nature offers a proposal to the strikers. (Nature is a science journal.) The editors tell scientists to "saunter down to your local picket line, gather up a couple of film and television writers, and introduce them to the fascinations of the scientific life..." They add that plying them with drinks might help. ("A Quantum of Solace", Jan. 31, 2008). Who knows how the Hollywood writers will receive the offer, but I can't help thinking of the Anthony Burgess quote: "We all need money, but there are degrees of desperation."

Anyway, until we can truly cheer for the writers, we'll marvel at how the tables have turned. Last year, Hollywood sought out scientist scriptwriters, this year scientists seek out Hollywood scriptwriters.