Recently in Science and Development Category

Do The Inuit Know Something That North Carolinians Don't?

Part I: Our Way of Life

When scientists predicted that the sea-level would rise 39 inches along the East Coast by 2100, North Carolina lawmakers promptly drafted legislation instructing state coastal development planners to ignore that science. The legislators said climate change was a "phobia" of scientists that would "quite frankly kill development on the coast". As one lawmaker put it, "nothing proved to me that they can prove those astronomical sea-level rises".

The audacious denial of science caused an uproar from aghast researchers and citizens. So North Carolina lawmakers revised the bill slightly, asking for further study, very slow study, with a report due in 2015. In 2016 they will consider the report, and until then North Carolina towns can act as if there's no tomorrow, as if the seas aren't rising. North Carolina Governor Bev Perdue commented that she thought each town should be free to draw from their own science studies. She allowed the new law, AB 819, to pass without her signature.

This year scientists also studied the effects of climate change in two vast Inuit regions, Nunavik, in northern Quebec, and Nunatsiavut, in Newfoundland and Labrador. They published their findings in a 300 page report: "Time For Action To Deal With Climate Change In Nunavik and Nunatsiavut". The report, aimed at Inuit policy makers and citizens, was featured in the region's Nunatsiaq News, where the summary of findings and recommendations filled the entire front page of its online edition.

Inuit Regions Map
Inuit Regions Map (by Statistics, Canada 2007 w/ permission)

The Inuit Way Of Life

The Inuit seem to take a different approach to dealing with climate change than the North Carolinians - for one, they don't doubt it. The report describes how scientists work with Inuit of all ages to exchange knowledge and plan for climate change, although for years, while other nations argued the reality of global warming, the Inuit were busy adapting, because they had to.

They've been living through global warming changes since the 1990s, so the results of climate change are a fact of life. Spring arrives earlier each year, fall later. Berries that the Inuit harvest are being crowded out by other shrubbery. Caribou herds shrink as the once abundant animals migrate north or starve. Glaciers have lost significant mass, and the ice that the Inuit traveled over safely for generations is melting in unexpected places, sometimes killing unsuspecting hunters. The Inuit believe the climate scientists' predictions, that precipitation will increase 10-25% and temperatures will rise of 3-4 degrees Celsius.


For generations, the Inuit hunted and fished - caribou, seal, Arctic Charr, narwhal, and game birds. Children were taught to read and understand the clouds, the snow, the ice floes, the glaciers, and the animals. Through to the mid-20th century, the Inuit were nomadic, as this 1959 piece dryly depicts, and as one man recounts in the film "Inuit Knowledge and Climate Change": "As we were traveling my mother went into labor, and my father quickly built an igloo...that was the way of life".

Their way of life changed in the mid-20th century, when they established permanent communities. They still hunt, know their ice floes and live close to the environment, but they're no longer nomads, building igloos of frozen snow blocks in the winter and erecting tents in the summer. Instead they build homes in towns, often on permafrost. Permafrost was once a sound foundation, but it's now affected by climate change, as residents of Pangnirtung, Nunavut were abruptly reminded one spring.

A river runs through Pangnirtung, and one morning residents awoke to thunderous rushing water that tossed boulders ahead of it, raucously carving channels through the permafrost down to bedrock, causing river banks to cave in, and taking out two bridges that connected the town. As one person described the chaos:

"Every single night there was a new event. There was a new crack opening, stuff collapsing. It was amazing to see, just fascinating. It looked like an earthquake. There were a lot of elders down there, and they were really upset. There is a lot of history in pieces of the river for them. They would clean sealskins there and polar bear skins, and they would remember people being at those places, and those places don't exist anymore. There were elders in tears."

Kids in Pangnirtung wrote about that event, the melting glaciers, the falling bridges, the sewage that had to be dumped into the ocean.... The kids don't wonder why it happened, don't ask whether this particular event is from global warming, they write: "This is what happened in Pangnirtung...because of climate change. We really need to stop what we are doing to this planet."

The Royal We...Who Suck It Up

In the US, climate change seemed to sneak up on us more slowly. Many people live and work inside and only glance occasionally at the weather out their windows. We've always had storms, so it was hard to say whether any one was a harbinger of climate change or not. Hurricane Andrew in 1992? Hurricane Katrina 2005? Irene, 2011? Sandy, 2012? The fires in the West, the floods in the Midwest, the tornadoes in the Southeast?


Mother with Baby Carriage
Cape Dorset (2002) by Ansgar Walk (WikiMedia Commons)

Although we've had plenty of warnings from scientists as well as obvious weather changes and events, the US has been disastrously slow in acknowledging climate change. Maybe this is why the extreme weather of the past few years has seemed abrupt and shocking to citizens as well as to politicians surveying the damage with pathos. When North Carolina was hit by 92 tornadoes one Saturday afternoon in April, 2011, devastating towns and communities, Governor Bev Perdue told the New York Times that she was "nearly in tears touring damaged areas".

Legislators like those who lead North Carolina argue their right to ignore science. They help constituents ignore science too, by facilitating efficient mop-up and rebuilding in the wake of ever more severe disasters. After the tornadoes Governor Perdue assured people via the New York Times that, "she had been in contact with President Obama and anticipated that a federal state of emergency would be declared by week's end"...and had also "met with the director of the Federal Emergency Management Agency (FEMA)..." Many farmers lost their crops and machinery and buildings and may not have had insurance; many families' lost their homes when tornadoes blew them to bits. But North Carolinians were stoic, Perdue said: "We understand how to face adversity and suck it up".

The Inuit may be in an even more precarious position, sucking-it-up-wise, than North Carolinians. As one Inuit said: "We cannot exist purely by making money, if we do not have our environment we do not survive...." The Inuit cannot control the carbon emissions of Canada and the US, or those of burgeoning emitters like China. They must muster whatever mitigation measures they can, such as those suggested in one government pamphlet: "The Homeowner's Guide to Permafrost".

They can also cajole and plead, as they did at Doha, for reduced carbon emissions and compensation from emitters to help with mitigation. Inuit leader Mary Simon has said: "If we think small, our actions will be small, like decisions made by children. But now, our world has to think like adults. We must act more intelligently. Our world leaders must do the same."


(To Be Continued...)

World AIDS Day, 2012

Today is 25th World AIDS Day, so more people than usual spent time last week reading about the world's progress conquering AIDS. In good news, deaths from AIDS have declined. In Sub-Saharan Africa they have declined by 32% in the last 5 years, continuing an excellent trend. But how do we perceive the progress? We wrote on World AIDS Day, 2009 about how Google tried to correct our search "HIV infections decrease", to "HIV infections increase".

The first search phrase, ending with "decrease", yielded only 1,940,000 results in .22 seconds, whereas the second, ending with "increase", gave 3,550,000 results in .18 seconds.

If Google was tracking a trend, they were wrong, because by 2009 HIV infections had decreased by 15% in 10 years. But we in the world were very accustomed to bad news about HIV infections and AIDS, as Google documented. Today, three years later, there's even better news for HIV/AIDS - on the drug development front, as well as on detection, treatment, and prevention fronts. That was an example in 2009 of how false bad news overwhelmed positive news (via a Google algorithm)

Today, the bad news is that people still die of AIDS all over the world - in Russia, China, Asia, Africa, and the US, where public health officials recently recommended that people ages 15-64 be tested for HIV. African countries, especially in Sub-Saharan countries, still have the most cases of HIV infected people, and many of people aren't being treated for what is basically affordably treatable. But how should we talk about this bad news? That is the subject of this post.

But the Bad News, How Shall We Put It? Shalll We Ignore It?

In the past few years an interesting conflict has arisen about news in Africa. Critics complain that Western media can't take its eyes off the cliched, ailing, and violent aspects of the African continent, thus giving an inaccurate, un-nuanced and harmful view of its many countries. Nicholas Kristof is a popular target.

The group Radi-Aid released a parody video urging Africans to give money to send radiators to Norway ("frostbite kills too"). Produced by Norwegian students, it mocks this so-called "poverty porn" in the style of the 1984 Band-Aid fund raiser. It's a charming video and relays a potent message. But realize that the Radi-Aid video mocks something that's 25 years old - as in, what can't you mock from 1984?

But beside that minor quibble, of course, I see their point, I think anyone can. If you've ever traveled, you've probably run into inaccurate media portrayals of your country that are just crazy. I remember reading an English paper in Asia that had only bizarre stories about the US, things like - Woman in Tennessee Found Herself In Closet Stomping Beetles. What? You had no idea where they found it -- could they have just made it up? Based on American TV shows, little kids would ask me if I ever got shot in a gunfight - NOO?

Cultural misconceptions are legion and universally perpetuated. I'm sure small towns in the Mid-West that occasionally get besieged by floods and tornadoes feel betrayed by the mainstream media too - Hey wait! we have great potlucks here and there's the most amazing other stuff too! New Orleans must have felt that way during and after Katrina. C'mon! Shot after shot of all those people in the stadium? It's not only Africa that's the subject of inaccurate, negative media portrayals, it's every other country, town and borough, and all subjects too - science, math, economics, election polling, women...they all have their bad day via the media and press.

Aid Solicitations, In the Eyes of The Beholder?

For African countries, a lot of so-called poverty-porn starts with international non-governmental organizations (INGOs). INGOs do use sympathy for fund-raising -- large-eyed children dragging teddy bears, or gathered around looking up at the camera pathetically, or forlorn in barren, monochromatic surroundings. To me it gets a little gross, but they use what works, what gets people to reach into their pockets and give money. These images get picked up or pushed upon the media and used as news. Here's a clear example of how deceptive this imagery can be. But these stories don't comprise all the news of any country.

Some commentators have pointed to what they say are "better" portrayals of Africa that could be used to fundraise. In one, a cute kid in a video acts out an Arnold Schwarzenegger movie, interspersed with the movie's gunfight where "2000" people get killed. The video describes him as smart and articulate, without mentioning or questioning as far as I could tell the especially violent part of American culture that the ~5 year old is copying so very, very accurately. So clearly, different people find different solicitations using kids appealing. Some people take offense to a small child holding a bowl up, but have no problem with a small child acting out extreme violence with a pretend gun followed by a plea for donations. Personally, I have as much problem with the second as the first, and would also ask while we're at it -- shouldn't we question the ethics of using a child for fund-raising at all? Or is it ok as long as the child is wearing a shirt and not holding a bowl? (Then there are whole factions of international development that abhor aid altogether and they also have some good points that I'm not going to talk about here.)

Maybe News About Malaria Shouldn't Focus on Africa, Where 90% of All Cases Occur?

To their point, many other countries, India, the US, China, have crushing poverty, but aren't necessarily defined by it, as critics claim Africa is by Western media. That may be true, but when it comes to preventable infectious disease, 99% of people who die from AIDS, malaria, and tuberculosis (TB) live in the developing world, and the center of the HIV/AIDS epidemic is still in sub-Saharan Africa, where 70% of all new infections among adults and 91% of new infections among children occur. Malaria kills about 780,000 people each year, and 90% of malaria cases are in Africa.

Such illness and death devastate families, workers, and economies. When mining companies in South Africa started treating workers for AIDS and malaria, they had a business goal, stop lost productivity. Similarly, in our global economy, Asia's and Africa's problems and successes affect the world. That means that how African nations attend to public health influences our own public health and impacts our companies that invest in Africa.

Reporting on Africa is not just about Africa, it's about us in the West too. Reporting is not a selfless endeavor. We absolutely should be reporting on Africa's "bad" news (not exclusively of course). Our public health problems (e.g. infectious disease, antibiotic resistance) derive from and are dependent on not only our own public health systems, but also those of developing nations. Our health depends on the policies, laws and regulations all nations produce and uphold for preventing and treating disease, and for drugs and pharmaceutical companies.

We understand that Africa knows investors want stable countries to invest in. African nations naturally want to discourage negative foreign media. But is it the job of responsible media to protect the image of nations? Or is it the job of responsible media, say American or European media, to report on issues that might impact (or interest) its citizens - like public health environments in countries like Africa or Asia or wherever that might promote pharmaceutical regimes that foster antibiotic resistance for instance, or public health environments that allow pandemics to spread for example?

Progress of International Development

For close to a century, international development has sought to raise basic standard of living the world over, not just Africa, but South America, Asia, Central America and parts of North America. Driven by various agendas and business interests and research, we've compiled a long history of what has worked and not worked. For many reasons, what seemed to work in Asia, South America, Central America, etc. didn't work well in Africa. In addition, various national tragedies bogged down progress there. No sooner was apartheid defeated in South Africa, for instance, then AIDS struck. Journalists weren't wrong to cover these events.

Journalists reporting these stories have also sometimes brought needed attention that often benefits the subjects. For instance media outlets reported on the 39 pharmaceutical countries that sued South Africa when it tried to import affordable AIDS drugs at the height of the AIDS epidemic. The companies eventually dropped the suit. When President Mbeki refused to acknowledge that HIV caused AIDS, the media was there. The media now has more opportunity to report positive AIDS news.

Prosperity To Spare

Recent prosperity in the west gave people the means to donate money and ideas for aid organizations. Take the Gates Foundation, founded in 1994. This 2001 Seattle Post Intelligencer article writes about how Bill Gates started slowly learning about international development and health needs in 1998:

"I had no idea," the Microsoft co-founder said. "I learned a lot about the whole vaccine miracle, about how effective they are and yet millions were still dying from these diseases.

"So we decided, jeez, the impact we could have by getting vaccines to these children and getting more funding for research into new vaccines could be just incredible."

That was only about fifteen years ago. A world business leader "had no idea" about preventable diseases in Africa. It's easy not to realize how many advances have been made in the past few decades, in part because what was unheard of in 2000 has now became common knowledge to everyone. Globalization of business has brought increasing attention to development issues that are no longer "a world away". But make not mistake, most of these ideas have been around for decades, like the fact that women's education is key to development. Vaccines have long been (albeit controversially) considered the ideal solution to diseases.

What's new is that foundations like the Gates Foundation are increasingly media savvy, and the media is increasingly in tune with the goals of development. This environment made it possible for Kristof to start writing what he did, and in many ways his articles were in synch with US development goals and rhetoric. (Part of the rational for invading Afghanistan, for instance was women's education.) But many of the most popular articles, for instance Kristof's, also opened readers' eyes to both positive as well as alarming stories outside of their mostly elite, privileged self-indulgent New York Times world view. Not a bad thing. Increasingly, global connections have eased people's ability to travel to different countries, increased curiosity about different cultures, and along with that, encouraged inclinations to want to help (I'm not going to argue whether the burgeoning aid industry is good or bad, but some of the 'wanting to help' inclinations, are selfless).

So Does Media Portray Africa Too Negatively?

A recent BBC program asked the question at a conference in Kampala, Uganda: Is media propagating negative stereotypes of Africa? The opinions were very interesting, ranging from a couple of people who that said African leaders themselves inflate problems in order to get foreign aid, to those who said that Africa was seen not as a problem but as an investment opportunity for many countries.

Of course there should be positive stories about African countries. But don't ignore the good that comes publicizing problems. While South Africa struggled with its AIDS crisis with the world advocating for its citizens, countries like China for years suppressed news of its AIDS epidemic. Other alternatives exist also, reporters and columnists who ignore and glaze over tragedy, and focus only on business that privileges the elite, and ignore those who are not in the elite. You can find those stories anywhere, if you would prefer them.

Malaria Vaccine Data - Release then Patch?

Does International Public Health News Compel Us to Cheer Enthusiastically?

Everyone wants drugs to cure diseases. Everyone wants vaccines to prevent them. And in a world of urgent international public health problems, what is more publicly urgent then developing solutions for AIDS or malaria? Positive news on this front is always welcome, and in line with that, you don't win popularity points by sticking pins in up-beat public health reports, results, or clinical trial data. MarianaRuiz Villarreal'sWikiMosquito.jpg Popular science journalists generally talk about cool, politically neutral science, or slick technology, or brilliant research successfully advanced to save lives; they write about winning clinical trials that will end scourges, any scourge - cancer, AIDS, Hepatitis, obesity... Good news!

Cheerful news, like recent headlines highlighting research showing a vaccine for malaria that may be 55.1% effective. NPR headlines enthused "Vaccine Slashes Infection Risk By Half", whereas a more cautions USA Today said: "Malaria Vaccine May Have Potential to Save Millions".

The RTS,S/AS01 vaccine is a decades long effort, now a collaboration between The Gates Foundation funded PATH Malaria Vaccine Inititive (MVI) and GlaxoSmithKline (GSK). The partners recently published interim results in the New England Journal of Medicine (NEJM)2 and presented their results to the media. By all accounts, the Phase III trials delivered very good news.

The Mosquito Drawing by M. R. Villarreal can be found at Wikipedia 1

But What Does "May" Mean, in "May Save Millions"?

No one could say that Bill and Melinda Gates haven't changed the face of international public health. Mr. Gates leads a relentless campaign pushing the power of vaccines; he berates governments that don't vaccinate enough people; and he effectively leverages the media to deliver his messages. Last year the Gates Foundation held a fund-raiser hoping to collect $3.7 billion from governments and instead received $4.3 billion. As Global Alliance for Vaccination & Immunization's (GAVI) chief executive put it, "Bill was a little like a poker player who put a lot of chips on the table and scared everyone else off." Perhaps Gates is more a bridge guy, but point taken.

Given this, who would write-up the newest Gates Foundation news as, "a vaccine shown to be at best 44.9% ineffective in a half-done clinical trial"? No one. With the intense drive for upbeat news, I credit USA Today for their cautious "may save millions". But if you look more closely, for instance read the editorial accompanying the NEJM report3, or listen to scientists around the web and in journals like The Lancet 4, or pay attention the malaria researchers interviewed by "Nature News5, the caveats of this recent malaria study grab your attention:

  1. First, there's the announcement itself. The data released is interim data; the full results of the malaria trial will be released in three years. Interim data releases are not unprecedented but past experiences, for instance with an AIDS vaccine, caution us against overly enthusiastic receptions for incomplete trials.
  2. The interim results were reported for children aged 5-17 months, but the target age group is infants aged 6-12 weeks. In other words, these results don't address efficacy of the vaccine for the target group.
  3. NEJM reported that at 12 months, the vaccine reduced episodes of malaria by 55.1%. However a US military scientist working with Sanaria, a competing vaccine maker, told Nature News that RTS,S actually offered only 35-36% protection 12 months after the vaccine. It appears that the efficacy of the vaccine might wane over time.
  4. Although the reports noted reduced mortality, another scientist emphasized to Nature News that the data didn't support that announcement. Scientists hypothesize that the vaccine may just delay infection.
  5. Although the vaccine reportedly cut severe disease in older kids by 47%, combining that data with the available data of the younger kids gave only a 34.8% decrease. This suggests the data for the target group of younger kids might turn out lower than reported in these interim results.
  6. In addition, incidents like convulsions and meningitis might be more frequent in the vaccinated group.

These might not be showstoppers. For instance researchers hope that booster shots will improve efficacy. But what if in the end the much touted vaccine turns out not to be a vaccine but just another shot? Scientists and public health workers concern themselves with such non-trivial caveats. What's behind the apparently waning efficacy? How is the adjuvant effecting immunity? Science is exacting even when media reports are not. People also have underlying concerns about what's driving policy, science or the press releases?

Is Marginal Progress, "Success"?

Two of the people interviewed by Nature News are affiliated with Sanaria, a company that is also developing a malaria vaccine. Sanaria just released their own news of a Phase I malaria vaccine study testing the safety of a live attenuated virus. Nature interviewed the first author on the Sanaria study published by Science, as well as the CEO and last author on the Science study. They were complementary of the RTS,S effort, if somewhat critical on some points.6

It's worth noting the history of the Sanaria vaccine, to give context to the executives' comments and perspective. Like the RTS,S vaccine, Sanaria's vaccine is an extremely expensive, tricky, and laborious endeavor. The underlying idea for seems promising, but for starters technicians must painstakingly dissect out the salivary glands of mosquitoes in order to develop the vaccine.7 It's unclear how this can scale.

On top of the laboriousness of vaccine development, once the vaccine was made it didn't seem to work. In their first clinical trial, Sanaria injected 44 subjects. 42 people got malaria and 2 didn't, a 4.5% "success" rate. These subjects might have been better protected from malaria lounging in a malaria endemic region in mosquito-infested huts, but the Sanaria execs quickly pointed out that it wasn't the stunning failure it looked like, rather, it was a trial that "yielded positive results" -- as their press release put it (without including relevant numbers). The company is buoyed by such "success" and primed for the next controversial7 phase.

Because vaccines promise a silver bullet solution to disease, at the moment, every possible vaccine holds promise, since we have no viable one.

Sanaria's position as competitors doesn't invalidate their commentary on RTS,S (complementary as well as critical), since Sanaria executives voiced reservations shared by many others. An editorial in last week's "The Lancet indicated that the release of unorthodox partial results seemed to be more politically than scientifically driven. Diplomatically, The Lancet editors wrote: "although the latest findings are encouraging, we look forward to the full results of the RTS,S/AS01 trial in 3 years time."5

When There is No Treatment, What Does A More Effective "Treatment" Look Like?

Will the upcoming younger cohort data meet World Health Organization (WHO) goals of 'Protective efficacy of more than 50% against severe disease and death lasting longer than one year'? 5 This is an important question. Vaccine experts usually aim for 80% or more efficacy, and representatives for PATH say they hope to get there eventually. So then, does that make this vaccine a beta version?

Is all this media hoopla deserved for a beta version vaccine? A physician working in Africa distributing bed-nets warned against statements that might mislead people "to overestimate the impact of any single new intervention", in a comment at NEJM. Acknowledging this commenter also has vested interests doesn't detract from his message. 75% of the MVI/GSK study participants used bed-nets. But would people in real-life discontinue the more cumbersome bed-net efforts with a vaccine on the horizon? Will bed-nets still be funded with a 50% effective vaccine? A 30% effective vaccine? If you're a mom and your kid gets a vaccine that is 50% effective, what precautions do you then take to prevent infection? Does a 50-50 vaccine make your life better?

The tremendous investment in vaccines, both in terms of money and expectations, shouldn't slow other prevention and treatment efforts. But realistically, we don't have unlimited resources. It would be naive to think that the prolonged difficulty of vaccine development, the immense investment, and lack of a viable alternative don't influence funding and policy decisions.

Some of the problems scientists identified with this vaccine trial have persisted for years. In this 2006 book chapter recently released online, an economist analyzes RTS,S vaccine data of previous trials (PDF) (HT Nature News5). He reports on waning efficacy; and questions how the public health community decides which vaccine candidates merit further investment. 5 years later, as the latest trial barely noses over the 50% bar, we grapple with the same issues and questions he raised back then, but billions more dollars have been invested.

Which leads us to wonder whether mid-trial fanfare primes us react to whatever future malaria vaccine news comes along with knee-jerk positive determinism? What if the younger data shows only (say, hypothetically) 30% efficacy? Would we ever abandon the effort? As more and more money gets invested, do decision makers begin to act less rationally?

Media reports may boost stocks, may raise money and may discourage competitors, but in the end, the science behind the vaccine, the science that's supposed to underpin public health decisions, is fussy and complicated -- caveats matter. After all, you're asking people and governments to donate tens of billions of dollars, and you're promising 7 billion people that your vaccine will keep millions safe.

Tough Economy for an IPO?

Can we push for an end to malaria as if we were trying to put a computer on every desktop? Does this big money, big marketing, big media approach to public health that some find so jarring actually work? I'm not saying it doesn't. Perhaps it will become a more accepted way of developing medicines and vaccines. Maybe public health needs exactly this kind of paradigm shift.

But even if a 40% or 50% effective vaccine is acceptable from a public health perspective, once this vaccine is developed, governments will still need to consider costs. In this economy, some ask, how much will governments shell out for a vaccine with a 50% efficacy rate? Can you and should we market vaccine with lots of pre-release fanfare to push governments towards buying the vaccine?

Asked about cost per vaccine, GSK wouldn't answer directly, but stressed how the company will reinvest all the proceeds to improve the vaccine. Shares of GSK rose slightly on the RTS,S vaccine news, and shares of biotech company Agenus which makes the RTS,S vaccine adjuvant rose from $.48 prior to the announcement, to $2.80 (which got Agenus re-listed by the SEC). All things that may influence decisions. However when questioned about the unconventional data release, PATH's MVI director didn't mention politics, billions of invested dollars, stakeholder expectations, or the saved Massachusetts biotech companies. He said: "we felt it was our scientific and ethical duty to make the results public when they become available."5


1 The mosquito drawing is by Mariana Ruiz Villarreal. It is the anatomy of a Culex pipiens, a vector for malaria. This image was selected as Wikipedia's Picture of The Day for 10 September 2010.

2 The RTS,S Clinical Trials Partnership; First Results of Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African Children, October 18, 2011 10.1056/NEJMoa1102287

3White, N. F.R.S.; A Vaccine for Malaria October 18, 2011 10.1056/NEJMe1111777

4Editorial: The Lancet, Volume 378, Issue 9802, Page 1528, 29 October 2011, doi:10.1016/S0140-6736(11)61659-0

5Butler, D.; Malaria Vaccine Results Face Scrutiny: Published online 26 October 2011, Nature 478, 439-440 2011, doi:10.1038/478439a

6Epstein et al: "Live Attenuated Malaria Vaccine Designed to Protect Through Hepatic CD8+ T Cell Immunity": September 8 2011 Science 28 October 2011: Vol. 334 no. 6055 pp. 475-480 DOI: 10.1126/science.1211548

7 Kappe1, S., and Mikolajczak1, S.; "Another Shot at a Malaria Vaccine". Science 28 October 2011: Vol. 334 no. 6055 pp. 460-461 DOI: 10.1126/science.1213934

8 Farlow, Andrew.; "A Review of Malaria Vaccine Candidate RTS,S/AS02A", Chapter Three of The Science, Economics, and Politics of Malaria Vaccine Policy, a report written in 2005 and 2006 and published 14 April 2006 and January 2010. Department of Economics, and Oriel College, University of Oxford.


We previously wrote about Phase II Clinical Trials of the RTS,S vaccine here. We wrote about US funding for malaria here and here; vaccine strategy here; malaria prevention here and here. We've also written frequently on international public health, including the development of a AIDS vaccine, here and here.

South Africa's Media Crackdown

Note: Unfortunately, all The Times of South Africa links in this article have been paywalled.

South Africa's award winning journalist, Mzilikazi wa Afrika had been doggedly investigating government corruption, when he was arrested on August 4th by police outside the offices of his employer the Sunday Times. wa Africa1 had recently written a story about a shady real estate deal arranged by National Police Commissioner General Bheki Cele, a deal Cele vehemently denied was shady. A few weeks later, because of its shadiness, the deal was put on hold.

The journalist had also been investigating a story about some murders of public officials that took place in the Mpumalanga province, that police were failing to investigate.

Kidnapping and Treason Accusations for South African Journalists

He was held for 48 hours as police drove him from place to place. They stopped at his house and ransacked it, confiscating his computer and his eight year old son's, and taking his journalist notebooks - some 10 years old. He hoped they didn't bring him to the province of Mpumalanga where all the murders had taken place, and where those who were murdered appeared on a hit list that perhaps had his name on it. But they did. At one point the police dropped him at the Waterval Boven, Mpumalanga police station, where:

"one of the officers warned me that I was being left in this tiny town for my own safety. 'Don't eat or drink anything, we know they are going to try and poison you. These people want you dead' he said...."

Mzilikazi wa Africa tells his story of being shuttled about by police here.

After 18 hours of being "carted about in fear of his life", as the headline put it, he was read his rights.

"At 1:40am, I was taken back to Mapiyane's office, where the general introduced himself as the lead investigator in the case and read me my rights. He said I would be charged with fraud and defeating the ends of justice...He asked me to make a statement, 'to make things easier' for me. I told him I could not do that without my lawyer present. Mapiyane was irritated and a colleague of his told me I was giving them problems by writing stories about Mpumalanga [a province]."

"Five-and-a-half hours after I first got there, I was taken to the Nelspruit, Mpumalanga police station. It was 3:20am."

"At 8am my legal team finally had access to me...One of the questions the police asked was: "Have you either directly or indirectly been discrediting senior office bearers of the ANC in Mpumalanga?"

They asked him: "Are you destroying the image and integrity of the ANC in Mpumalanga?" The police grilled him on a story he had not published.

wa Africa charged with fraud, forgery and uttering (passing forged documents - because he had been faxed a fake resignation of a Mpumalanga government official). People believe wa Africa's harassment is retribution for his investigative journalism, or a concerted police attempt to ferret out his sources, perhaps potential whistleblowers in the Mpumalanga province .

The police intimidation of the journalist has sent chills through South Africa and the world, especially in light of two initiatives sought by the African National Congress -- the Protection of Information Bill and the proposed Media Appeals Tribunals (MAT).

"The Sword is Mightier Than The Pen"

That the sword is mightier then the pen is the joke passed among journalists, as the South African government brims with ideas about how to curb the still vibrant press -- unruly by government standards. Thus the detention of wa Africa, not too mention scarier trends like calls by a youth league of the ANC to convict the journalist of "high treason" hint at the draconian potential of these moves.

The government proposes media appeals tribunals (MAT), yet admits excellent ombudsmen system already in place. As well, a bill being discussed in parliament called unconstitutional by the national lawyers bar would impose 15-25 years jail time for journalists who fail to support vague notions of "national interest".

As former journalist Sej Motau, from the opposition Democratic Alliance, wrote

"It's not about journalists; it's about every one of us in this country, and I'd like to appeal to the people of this country. If we fall asleep on this one, and we think, 'Oh no, it's only about the journalists', we're making a big, big mistake."

Indeed, if people can't ask why they don't have electricity and why the government isn't following through on promises, then all South Africans suffer. And if the ANC government can classify information willy-nilly, imprisoning journalists and newspapers who don't pen their line, businesses are in trouble too. As the Independent Online writes:

"If passed, the bill would also restrict access to information from regulators and state-owned enterprises, which critics say could cut investors off from information affecting equity, treasury and foreign exchange markets."

Business Speaks Out

Foreign companies like ArcelorMittal (steel, Luxembourg), and Lonmin (mining, UK) are also rightly concerned. Both have already been subjected to the corrupt business practices that benefited President Zuma and his associates. Domestic businesses are likewise worried, policies that favor ANC sycophants undermine their profitability too.

The business press gets it. Michael Skapinker, commenting for the Financial Times, and R.W. Johnson, writing in the Wall Street Journal, led the (rather anemic) international outcry earlier this week. Unfortunately, Johnson's column in the WSJ (it's worth noting) introduced some confusion about what South African bill was at issue.2 Johnson wrote:

"the government plans a "Protection of Personal Information Bill," which would only allow reporting about people's personal lives with their consent. Heavy penalties would thus prevent any more reporting of Mr. Nizimande's wine-bibbing or of illegitimate children born to President Zuma's mistresses. This is accompanied by a new "Information Bill" proposal, which would impose penalties of up to 25 years in jail for reporting about anything the government declares to be a matter of national interest, itself defined broadly to include anything which may be for the advancement of the public good..."

WSJ has confused two bills. The "Protection of Personal Information Bill" can be found here at KPMG, Africa, and there's more information here at Deloitte. This bill deals with how organizations deal with private personal information, and the need for standards in the public and private sectors guiding how some information needs to be protected while other information needs to be accessible. KPMG writes: "Over the years, the principles contained in the Bill have become recognized as the leading practice baseline for effective data privacy around the world..."

The WSJ is the only place I've read Johnson's unique interpretation of the Protection of Personal Information. The bill has been heralded by some human rights advocates because it will protect victims. Could be abused by government? I'm sure anything could happen, but it would also be highly unusual for WSJ (and the FT) to oppose KPMG and Deloitte. Security of personal information is important to democracy, and security is also a growing business sector. Condyn, an IT security contractor, recently issued a press release seeking to clear up just this type of confusion between the two similarly named bills.

No, the bill that worries everyone is the "Protection of (State) Information Bill", the ANC controlled government's wild grab to redefine how government officials classify and release information. It basically gives government officials free reign to classify any secrets as they wish into "classified", "secret", and "top-secret". The media appeals tribunal would impose the government's view.

Don't Go Hysterical About Tribunals Zuma Says -- Russia is Sharing Their Media Strategy With Us?

Of course President Zuma and members of government insist that the African National Congress,(ANC), is not trying to muzzle journalists, and will not impose "draconian apartheid laws to gag the freedom of the press".

Of course Zuma says that while complaining extensively that media is a consolidated institution destroying the good of the nation on the other. According to him: "South Africans rebelled against the media in June-July this year, united in their diversity" during FIFA. They defied the "media fraternity" and its "chorus of division and negativity", he said, peddling the notion that South Africa would be a Disneyland of green grass, ball playing, vuvuzelas, and international celebration if not for the negative media.

The discussion document accompanying the paper gets to the meat of the ANC media crackdown and exudes an anti-liberal (in the economics sense) view, although there's some blatant hypocrisy underlying the pronouncement:

"Our objectives therefore are to vigorously communicate the ANC's outlook and values (developmental state, collective rights, values of caring and sharing community, solidarity, ubuntu, non sexism, working together) versus the current mainstream media's ideological outlook (neo-liberalism, a weak and passive state, and overemphasis on individual rights, market fundamentalism, etc)."

For journalists who resist being state messengers? Perhaps like the World Cup, it'll be loud droning vuvuzelas, kicks to the ribs, and shots to the heads. Zuma explains the tribunals:

"The media has put itself on the pedestal of being the guardian. We therefore have the right to ask, who is guarding the guardian?....During our State visit to Russia a week ago, Russian television was running a promotional jingle saying: 'How dependent is the independent media? Who pays for the news'?

Newspapers are profit motivated says Zuma, the the news isn't "independent". Therefore, why shouldn't the news be the megaphone of the ANC party? And what better example to reassure your countrymen of your intentions for the press -- than Russia? Reporters Without Borders ranked Russia 153rd of 175 countries in the Press Freedom Index last year. As the International Press Institute reports, Russia remains one of the most dangerous places for reporters, a place where journalists are murdered with impunity. What a puzzling PR move. Is this a twisted way to get western investment? Or are public announcements about lessons from Russia on dealing with the media, just...governance as usual?

"Freedom" of the Press

With recent actions, the Zuma government has been compared to the oppressive states of Gambia and Zimbabwe. 37 of the country's editors signed a petition protesting the government's intentions to curtail freedom of the press. The international response, including that from top US media, is an unanimous call to drop the contentious bill and media appeals tribunals.

But the crackdown has been brewing for a while, and is not the first step the ANC has taken to sweep in some censorship. And the government has long derided newspapers and journalists who unveil information that doesn't paint the government in a favorable light. In 2007 we wrote about Africa's AIDS and public health crisis in hospitals, which the media persistently exposed. In response to the press attention, Mbeki pounded back in his own newspaper columns, including one Acronym Required dubbed "the mini-skirt memo". But Mbeki never did address the critical and deadly public health issues -- never in his whole term.

Mbeki's ANC consistently labeled anyone who criticized him as being unfaithful to the revolution, and Zuma seems to have picked up the same defense. This move to muffle the media more would be a blow for democracy, human rights, and business. But unfortunately, some countries have proven, like China and Russia and many others, that with the help of greed enabled complacency from US and Europe, freedom of information and freedom of press aren't necessarily requirements for state enrichment.

President Zuma urges people to "move away from hysteria dwelling on individual experiences". And he concludes: "We will use our right to express what we think. And we should not be silenced by claims of 'threats to press freedom'".

Acronym Required writes frequently about South Africa, especially issues involved the state's public health policies, HIV/AIDS progress, and media.


1a name he adopted meaning "of Africa"

2 No one would accuse these authors of being dedicated to politically liberal causes. Concurring with China, Skapinker this spring urged a ban on comment anonymity 'to promote civility', a trending meme that would slap a lid on many important forms of speech. While some people took exception to Skapinker's tedious idea, in one published letter to the FT editor, the writer agreed with Skapinker, and added that we should also identify motorists' identities via their license plates to promote highway civility, because as he noted absurdly, perhaps fooled by randomness or his own mind's machinations, people who drove cars with vanity plates were more polite.

RW Johnson for his part, recently outraged writers, academics, and civilians with a racist piece he wrote for the London Book Review. 73 signatories complained in a letter to LBR that his work was "often stacked with the superficial and the racist".

AIDS Denier Architects His "Day In Court", Owns the "Judge"

The University of California, Berkeley always amazes. It has an ultra-liberal reputation, yet it defies its label by harboring some of the most controversial figures and protects them under the auspices of academic freedom, which is obviously an excellent institution, but stretched at Berkeley to fit many circumstances. The law school dean used it to protect John Yoo, the law professor who crafted the Bush administration's torture policy, for instance. Now the school has invoked the useful catch-all to clear scientist Peter Duesberg of wrong-doing over a paper he wrote denying the HIV viral link to AIDS. The University said there was "insufficient evidence" to do anything else.

Berkeley Did Not Judge the "Accuracy or Validity of the Article"

Although UC Berkeley didn't judge the "accuracy or validity of the article", those issues lie at the heart the ongoing Duesberg controversy. Dueberg initiated his latest foray by publishing a paper in a non-peer review journal called "Medical Hypotheses". He claimed in his paper that the HIV virus didn't cause AIDS, something he's been promoting for years. The paper did not undergo peer-review. Scientists refuted his false theories in a collective uproar, but the journal retracted the paper. The journal editor was then fired, and the publisher Elsevier promised to rethink the journal format.

Then the University received two letters, one from Treatment Action Coalition (TAC) in South Africa, criticizing Duesberg's paper for conflict of interest and for "making false claims". The letters asked the University to investigate. The school did so, however yesterday's action clearing Duesberg of wrongdoing indicates that the UC Berkeley mission, policy and conduct documents don't contain anything that's applicable to Duesberg's situation.

Duesberg's Legacy In South Africa

The main problem is not necessarily the statements Duesberg published last year, but the fact that for years he's been publishing them and they've significantly influenced policy and beliefs about AIDS and science in general. It's his actions outside the University, like Yoo's, that cause the most distress. Duesberg sat on former South African President Mbeki's advisory panel on AIDS back in 1999-2000, and the South African government frequently cited his AIDS ideas to support their policies. Mbeki didn't treat AIDS in his country, letting hundreds of thousands of people die.

Whether Duesberg was a handy foil for Mbeki's pre-determined policy -- whether Mbeki's countrymen died because the president was more driven to toe conservative economic and social policy the procure available AIDS drugs -- is unclear. What is clear is that the country had the highest death rate from AIDS in history, while wielding the most mendacious policies that Mbeki backed-up with "science" created by Duesberg.

Yet there's nothing in Berkeley policy that specifically calls this a crime.

Peer-Review? Whatever. Duesberg = UC Berkeley= AIDS Denial = Mbeki's AIDS Policy = Death

A Berkeley spokesman told Nature: "The university relies on the scholarly peer-review process, rather than disciplinary procedures, for evaluating the value of scientific work." There. Very official. However AIDS denialists don't rely on peer-review. They revel in non-peer-review.

And unlike the University and scientists who care about peer-review, for Duesberg's purposes, getting a paper retracted by some flaky non-peer-reviewed tabloid called "Medical Hypotheses" doesn't matter. He has his audience. For years he's had a self-promoting website up, and his ideas have gained an audience. Next they'll go after "my parking permits" he says. His audience laps this stuff up -- the underdog, taking on the big evil science establishment.

UC Berkeley has their policies and official responses. Academic freedom, the concept, is unarguably beneficial, the heart of academia. But the fact remains, one of the most renowned research universities in the world supports a scientist largely responsible for some of the most deadly anti-science claims in history.

"Official" HIV/AIDS "research" from the University of California, Berkeley.

UC Berkeley policy has nothing to say. Peer-review? Here's what the world sees: Duesberg = UC Berkeley= AIDS Denial = Mbeki's AIDS Policy = Death. Somewhere deep in the heart of hearts of some university bureaucrat, under all the official, vague missions, purposes, and policies, doesn't this cause angst? Or is the thick overgrowth of bureaucracy muffle the death cries?


Interestingly, it's Duesberg himself whose been spear-heading the reporting on the investigation. Apparently Duesberg has enough confidence in the support of anti-science, AIDS denialist community, to know the outcome would work for his purposes. And since now Duesberg is claiming that he was "exonerated", it's like free marketing for his theories. How tragic.


1PLoS One, the audience reviewed journal, is also tangentially affiliated with UC Berkeley via PLoS co-founder and esteemed scientist Michael Eisen.

Acronym Required has written frequently on South Africa and AIDS, occasionally about HIV/AIDS deniers, and once in a while about UC Berkeley.

BP's Spill - A Black Duck Event?

The BP spill in the gulf remains an unrelenting environmental and economic disaster. Oil industry technology lets us pierce deep holes in the ocean floor and extract oil for energy and profit for companies. That know-how is obviously way ahead of the know-how to avert and fix oil rig failures that impact people and the economy more frequently than they should.

Flimsy Tech, Strong Marketing

John Gapper wrote over a month ago in the Financial Times that the BP disaster could have been worse, for instance if the larger Thunder Horse rig failed. He quoted BP's website: "Everything about Thunder Horse is at or beyond the limits of the offshore industry's experience", and noted: "What once sounded impressively high-tech now sounds positively scary."

Of course, lack of "industry experience" sounds less scary today, a month and a half later, because we understand the enormity of the Deepwater Horizon mishap. Our fear has been removed by experience. Can we fathom anything worse, now that the estimated volume of gushing oil has been adjusted upward; now that plugs, top-kills, and various domes and caps have failed to stop the damage?

We don't even have a word for it. "Spill"? As in a sippy-cup of milk? Perhaps we need a new word for ~60,000 gallons a day gushing into the Gulf? Gusher's not quite right. Sound's almost celebratory, like champagne. Trivialities aside, don't we need a new system to assure that technology to contain spills doesn't extend "beyond the limits of offshore industry's experience"?

Tech Failure as Entertainment Staple?

Technological failures happen every day, we don't have blind faith in technology, despite what some say. Buildings collapse, brakes fail, cars crash. We live with this, we wear seatbelts, mandate airbags, set values on body parts. And when worse comes to worse, we get cathartic pleasure from accidents. It's true. Why is the traffic stopped on the highway for five miles back? The accident is cleared, the bodies are gone, but people need to gawk at the damage on the cars. What can't be gotten in person we get on TV. Any botoxed, pancake make-up plastered announcer who manages to contort their face into an emotion while describing an airplane crash, a fire, or a kitten with two faces steals our attention.

A little hormone surge, then back to the routine until the next catastrophic high. We depend on those hormone surges like some probably depend on prayer, to get us through the mundane day. A little spilt milk souring someone else's life is great entertainment. The difference with this spill is that we're usually free, after a few minutes of rubbernecking, to drive away from the scene, catecholamine rush satisfied.

We crave that. And so the media finally goaded President Obama to say "kick-ass" on TV -- to pretend-put BP in it's place and give us a little surge. True, talking about ass-kicking will never prevent the next catastrophe, but the grinding negotiations of lawmaking never provides an adrenaline boost. We champion people talking about change, but that's it. Unfortunately, Obama's presidential version of "kick-ass" didn't satisfy. Fortunately Congress can always step up to some ass-kick rhetoric theatre for America.

Weak Oversight of Inevitable Failure?

The company face-off with congress suits business too. Companies seem used to enduring public lashings, as long as their business goes on as usual. CEO's probably have it written into their contracts: "You will appear before Congress for reprimanding should the business of risking lives for profits be revealed, and your job is to exhibit the full range of arrogance and chagrin:" (Salary: $27.2 million).

Dragging bank CEOs before Congress served this purpose earlier this year. And notice how quick we lost interest in the "regulatory loopholes", ensconced as we are in the current crisis.

The hearings also give oil company executives a chance to argue for less regulation right off the bat. The BP technology failure, as inevitable as it was, sent shudders through all the regulation-allergic oil companies. This week executives energetically backstroked away from the flaming BP rig oil gusher. Rex Tillerson (Exxon) described it as an "unprecedented" event, due to a "level of risk...beyond industry norms." that "should not occur". John Watson (Chevron) called it a "single incident" and a "preventable tragedy", due to "failure to operate with high standards".

The Exxon and Chevron CEOs offered lawmakers all sorts of reasons why the BP accident wouldn't happen in their companies, because of "documented standards", "best practices", "proprietary technology", "stop-work authority", and "time to do things right or not at all". Watson said "safe" or "safety" no less than 25 times in his brief.

Of Walruses...and Little People

And about those "documented standards"? We saw how companies share in their contingency plans the phone numbers of the same dead experts, and descriptions of how to clean walruses not seen in the Gulf since the Ice Age. Kudos to Congress for pointing all this out with great theatre. But shouldn't someone be reading these plans before the failure? That walrus thing would be pretty easy to spot. Demonstrating how little relevance these showdowns have, even that embarrassing fact didn't move Exxon's CEO, who said: "It's unfortunate that walruses were included". Because...if they hadn't been included nobody would have noticed that there was no plan at all? Accchhh...the insouciance.

Once impressive technology always looks fatally flimsy after failure, like the feebly blinking red 12:00. We're used to technology achievements -- they yield tremendous bragging rights. We're also used to technology failures. Cars crashes happen and when they do we know how to mop up. Spills occur, as in the Niger Delta and frequent gushers across the world. So shouldn't the standards and contingency plans be evaluated as part and parcel with the technology -- ahead of time? There's more to technology then a deep a hole we can dig for ourselves.

Gateway Drug News

In our break from blogging we learned about an unexplored benefit of writing about news. When we spend free time writing or interpreting news we care about, we interrupt a habit of seeking substantive news amongst the addictive trifle of mainstream media. Trash news is the bread and butter of media companies because apparently readers are addicted to piffle.


Case in point: At Reuters, often a fine outlet, readers devoured the piece "The Hills Are Alive With Haggis". Haggis, you ask? Indeed. Scots consume Haggis a dish made from the lung, liver and heart of a sheep, on Burns night - of course, with lots of whiskey.

An aside: The US banned haggis in 1989 because of the threat of bovine spongiform encephalopathy (BSE), but for some reason unexplored by Reuters, the US recently relaxed the ban. Richard Lochhead, the Scottish environmental secretary waxed ecstatic that Americans can now "sample our world-renowned national dish."

But Reuters did not cover the American ban of sheep innards because of BSE. Readers can only learn that "renowned" as it may be, many Scots don't know what haggis is and Brits are even more uninformed. As the report goes, one in five Brits thinks haggis is "an animal that roams the Highlands", another 18% think it's a Scottish instrument, and 4% think its a character from Harry Potter.

Circuses and More

Like the empty calories of cotton candy, apparently, the haggis story leaves readers hungry for more drivel. Because from "The Hills Are Alive With Haggis", they're unlikely to click on a story about the environmental crisis off the Louisiana coast or the implications of Greek financial crisis. No, says Reuters "after reading this article people will most likely read": "Police barred from penis enlargement", about Indonesian police candidate screening, that even I refuse to link to. Rather that exploring the BSE ban, they'll more likely read: "Circus comes to Turkmenistan again after long ban."

Just like any perilous addiction, it seems that reading banal news leads to reading even more rotten gibberish. Of course, as we've just inadvertently demonstrated, bloggers, once heralded as the saviors of news, are JUST AS PRONE to courting readers with the most scurrilous news they can drum up. But we do try to do better. (This post not included). We try to write about science.

Notes in a New Year, 2010


Help, donate: Partners in Health, or Medecins Sans Frontiers, or the Clinton Foundation, or the International Red Cross or text-to-give.

  • PLoS and Elsevier: On the Same Page?

    One of our favorite things, in the Obama era, is to see would be foes band together. So we look fondly upon the unlikely albeit fragile "alliance" that PLoS and Elsevier ended up in at a recent open access publishing roundtable. The occasion was a meeting around the report issued by the Scholarly Publishing Roundtable. The U.S. House Committee on Science and Technology and the White House Office of Science and Technology Policy (OSTP) convened the meeting of a group of fourteen publishers, university leaders, librarians, and other experts at the round table, who drafted basic agreements about how public access to journal publications. They emphasized:

    "the need to preserve peer review, the necessity of adaptable publishing business models, the benefits of broader public access, the importance of archiving, and the interoperability of online content"

    However, the Elsevier and PLoS representatives refused to join the other 12 members in signing the consensus agreement, although both agreed that points of the agreement were "positive". PLoS and Elsevier apparently both have a lot a stake, since they each sent extra representatives to the panel. Elsevier sent their General Counsel/Senior Vice President, and PLoS sent their Managing Editor as well as their CEO.

    Predictably, YS Chi, speaking for Elsevier, stated that he couldn't sign the agreement because it "supports an overly expansive role of government and advocates approaches to the business of scholarly publishing that I believe are overly prescriptive." No question about where giant, monopolistic, Elsevier ever stands.

    PLoS representative Mark Patterson's statement was a little more difficult to unpack. He said that the agreement "stops far short of recognizing and endorsing the opportunities to unleash the full potential of online communication to transform access to and use of scholarly literature." What did he mean? He didn't include "the need to preserve peer review" as one of his "positive" points of agreement....But does PLoS want more Federal support for PLoS? Explicit endorsement of pay to publish? A more "expansive role for government"? Who knows.

    For more information on open access and this agreement in general, there's a great public access policy forum here at the Office of Science and Technology Policy, and the "ever-enthusiastic public access policy team" at OSTP has extended the comment period. So you can comment, and there's lots to read.

  • H1N1

    The World Health Organization (WHO), has hit back at accusers who say that the organization, along with pharma companies, created a "fake epidemic" in H1N1. WHO reiterated its role to balance urgency and expediency with the uncertain nature of the epidemic. In an editorial generally praising the organization's response, Nature wrote this week:

    "The danger now is that last year's relatively mild pandemic will create a false sense of security and complacency. The reality is that next time we might not be so lucky -- especially given that this time most of the world's population, living as they do in developing countries, had no access to either vaccines or antiviral drugs."

    It's apparently easy for otherwise smart people to be cynical about the H1N1 pandemic. It is truly a challenge to explain risks and uncertainty of pandemics and the fact that the scientists and public health organizations are actually doing a great job.

  • Judge Overrules FDA on Electronic Cigarettes, Whatever They Are

    Some people believe that a president's most lasting legacy is in the judges he appoints; George W. Bush appointed judge Richard Leon of the Federal District Court in Washington. Leon recently moved to stop the FDA from regulating e-cigarettes, on grounds that they aren't tobacco. In fact, e-cigarettes are battery-powered tubes that vaporize nicotine with tobacco flavoring, that simulate cigarette smoking for the user. I can't make that sound good. Seems like the next best thing to sex robots. But anyway, these devices deliver addictive nicotine to the body, but the judge says the FDA can't regulate e-cigarettes as devices anymore.

    In other tobacco regulation news, an article in the New England Journal of Medicine (NEJM) discusses opposition to the Family Smoking Prevention and Tobacco Control Act on First Amendment grounds. Even the ACLU objects to the Act, which prohibits the use of certain words by cigarette advertisers, saying that

    "regulating commercial speech for lawful products only because those products are widely disliked -- even for cause -- sets us on the path of regulating such speech for other products that may only be disfavored by a select few in a position to impose their personal preferences."

    Instead advised the ACLU, "the antidote to harmful speech can be found in the wisdom of countervailing speech -- not in the outright ban of the speech perceived as harmful." But as the NEJM authors wrote:

    "How did we come to believe that the exchange of commercial appeals in the marketplace of goods and services should be equated with free exchange in the marketplace of ideas? Are our freedoms really secured by a constitutional doctrine that would limit our capacity to inhibit the promotion of toxic goods? This is an opportune moment to reflect on these questions and their implications for the relationship between public health goals and the rules that should be foundational in a democracy."
  • EPA's Updated Smog, Ozone Standard

    The EPA proposed new standards for smog last week, which would update the Bush Administration standards. The agency will set the "primary" standard, which protects public health, at a level between 0.060 and 0.070 parts per million (ppm), measured over eight hours, and will also propose a new secondary standard. These standards were recommended by scientists years ago to decrease deaths and smog levels dangerous to children, the elderly, and those with asthma and respiratory disease. As we wrote earlier, the Bush's EPA pushed the weaker standard of .075 ppm. We also wrote about the Obama EPA's stated intention to change the standard last fall.

  • Airport Screening to Double as Healthcare?

    "We are headed toward the moment when screeners will watch watch-listers sashay through while we have to come to the airport in hospital gowns, flapping open in the back", wrote Maureen Dowd recently, commenting on holes in airport security processes. But I think she's seeing a cup half empty. We may well be headed for a moment when airport screening, reviled as a breach of privacy to some, is the closest thing to healthcare people can get.

    The public option has fallen "off the table" again, by now "fallen off the table" so many times that even when it intermittently appears back "on the table", it's obviously shopworn, if not smashed to bits.

    But the glass could still be half full. Think of the savings, if airport screening could double as healthcare screening : "You're cleared for flight sir, and don't worry about that lump..."

  • What to Call It? Science Terminology

    For various reasons, political, scientific, logical (or not) or historical, people refer to the same thing using different terms. Here are two examples.

    Canada does not call the tar sands "tar sands", anymore, they're "oil sands". Of course "tar sands" is more descriptive of the energy-intensive process, of extracting oil, but "oil sands" sounds like something that you would naturally siphon some oil out of, it sounds better.

    In 2005, physicist Lisa Randall urged that "global climate change" was the appropriate phrase to use, because "global warming" would lead people to argue that their winter was actually very cold. Others argued that "climate change" sounded less dangerous, so therefore would be used to manipulate people who would be fearful enough about "global warming" to urge policy changes, whereas "climate change" seemed benign. But it gets even more complicated for some agencies. NASA differentiates between "global warming", which is surface climate change, and "climate change", and "global change", and "global climate change", which deems the most accurate term. I think everyone pretty much knows what everyone's talking about now, though I dare not make conclusions about that.

  • Oh, and Happy Not-So-New Year

    Did you travel over your break? Have fun?

    In the US, marketing aimed at tourists is off the rails. Perhaps marketers have learned that people who travel in a heightened state of orange level stress will sooth themselves by buying absurd products. You may argue that it's a global trend, and indeed, the badminton set peddled to me by a man on the muddy backroad of a major city in Asia seemed ridiculous, until I flipped through Sky Mall Magazine and spied the "King Tut Life Sized Sarcophagus Cabinet" that can be "delivered curbside" (to impress your neighbors). Personally, I would rather pay to bat around a little white badminton birdie in a mud puddle, while talking baksheesh with kids who speak, at will, touristica French, German, English or Japanese. By comparison, traveler oriented products in the US seem conceived by desperate marketing departments who've lost their wits. Case in point -- the sarcophagus cabinet. Or:

    • If you were assigned to seating group 2 or above recently, on my least favorite airline I still fly on, you heard this announcement: "Board now. Enter via aisle closest to the wall, NOT THE RED CARPET." Because "the red carpet", actually a two foot doormat, is reserved for first class customers.

      Some people bemoan the lot of the economy passenger, the so-called "poverty parade", and the herd animal like treatment. But as a first class customer you pay an extra few thousand dollars to traipse across a red mat with bars on each side to keep you in bounds. Sure the legroom's nice, I won't argue, but you have to walk "the red carpet" to get there, and once there in that bigger, comfier seat, you're subjected to complimentary cheesefood snacks. Supposedly smart people actually buy this privilege.

    • At your hotel, you will be sold the usual-- rooms, room service, laundry services, shoe shines and upgrades, not to mention the mini-bar. But what if the five dollar peanuts in the mini-bar are too devilish a temptation for you and your New Year's resolutions? No worries, there's a market-based solution. Pay $50 to have the mini-bar hauled away at one hotel I was recently at.

    • Want to use the hotel refrigerator for your water? $50 fine at another hotel. And the same people who stay at these hotels complain that the EPA's bureaucracy confines their business style.

    • Maybe you actually love business travel and want to bring home a bit of the experience, like the "pulsating" showerhead that your can actually buy from one hotel's glossy catalogue. The catalogue carried other mundane household hardware and dog cushions stamped with the hotel's logo. Pretty special.

    Couldn't we just travel unsolicited sometimes? Definitely not in 2010. Happy New Year.

Notes in December - Development and Evolving Attitudes

  • Copenhagen: Despite walking past sculptures of skeletons and eerie melting ice polar bears and mermaids daily, the climate change delegates collectively refused to come up with anything substantial in Copenhagen. President Obama curtailed his much awaited visit, altogether minimizing his association with what was by most accounts a failure, but also known as an accord, in order to fly home early and beat a snowstorm. If we are one world we are also many countries with our own economic interests in mind.

    Is there a better way? The Economist suggested in an article last week that the talks may have gone better if different regions and pollutants were considered separately. While the idea is interesting, this sort of regime is also how fishing interests repeatedly fail to establish effective ecological safeguards and effective quotas.

    Although the talks weren't considered fruitful, an interesting sidenote is the inability of very tenacious climate change deniers to convince delegates or the thousands of protestors in Copenhagen that climate change is a hoax, and that nothing's at stake.

  • The Ice Floe Debate: Last month, in our Notes on Science Dust-Ups and Dirty Laundry, under "Curly-haired Science Populizers Spar" we wrote about what we'll call the IQ nurture:nature debate between two science popularizer giants, Steven Pinker and Malcolm Gladwell. Pinker had criticized Gladwell for what he cuttingly labeled the "Igon Value Problem", defined as, "when a writer's education on a topic consists in interviewing an expert, he is apt to offer generalizations that are banal, obtuse or flat wrong."

    In return, Gladwell wrote that Pinker might be "unhappy" with him for not joining him on the "lonely ice floe of IQ fundamentalism", and criticized him for quoting bloggers. (Although if not for bloggers there might not be people in science of lower regard in the research hierarchy than some of Gladwell's mashable social scientists -- just saying.)

    After we left off, Pinker responded to Gladwell that IQ was related to "many important educational, economic and social outcomes" according to "52 signatories" and "a unanimous blue-ribbon panel". Gladwell then raked over Pinkers' sources, detailing how 15 of those 52 signatories belonged to a group founded by a eugenicist -- whose members are racists, eugenicists and sexists. After substantiating his response at length, he concludes:

    "The fact that ideas are sometimes supported by people with unsavory connections does not make them invalid. An ice floe is not necessarily a bad place to be. It's just that if you are plainly floating on one, it doesn't make much sense to insist that you are standing on solid ground."

    Although both science popularizers are getting more popular via the dispute, there are important issues at stake here. (Acronym Required previously wrote "Watson Uncut: Surprising? Boring? Racist?)

  • Racism Persists: Psychology researchers at Yale University found that racism persists, despite US society's more tolerant overt attitudes. The psychologists studied nonverbal interactions between white and black characters on television shows, then surveyed study participants for their responses to the actors attitudes (complicated methodology). They concluded that nonverbal behavior towards minorities on television influence the attitudes of millions of viewers.(Dovidio et al Science(326) 1641 - 1642 DOI: 10.1126/science.1184231)

  • Larry Summers Summons the Economy to Man-Up: Larry Summers is overly optimistic on jobs says a guest blogger on Naked Capitalism in the article titled: "Larry Summers Is Like a Guy Who Yells That the Sun Really DOES Revolve Around the Earth and that the Current Orbit is Just a Temporary Aberration . . . and That If We Just Wait a Little While, Everything Will Return to Normal". We last reviewed Summers's history of unfailing optimism in Mission Accomplished: Summers Ends Economy's Free Fall.

  • Coaxing The GOP To Eat Arugula: Michael J. Petrilli questions the GOP vote getting strategy in Wall Street Journal. The Hoover Institute Fellow observes that "with the white working class shrinking and the educated 'creative class' growing", Republicans such as Sarah Palin, "whose entire brand is anti-intellectual", and GOPers who brand themselves for "working-class families", "Sam's Club Republicans", and "your co-worker not your boss", might be miscalculating. Petrilli's assessment of those who criticize "Eastern Elites"? "Playing the populism card looks like a strategy of subtraction rather than addition". Instead he suggests: "What is needed is a full-fledged effort to cultivate "Whole Foods Republicans" - independent minded voters who embrace a progressive lifestyle but not progressive politics."

  • South Africa's Ex-Health Minister Dies: South Africa's Dr. Manto Tshabalala-Msimang died of complications from a liver transplant she had two years ago. As Health Minister during the Thabo Mbeki administration, she was known as "Dr. Beetroot" for her suggestions that lemon, beetroot and garlic would protect AIDS patients against the deadly effects of the disease in lieu of antiretrovirals. Mbeki's administration oversaw the fraught handling of the AIDS crisis in South Africa, and the former president went to great lengths to protect his comrade Tshabalala-Msimang, who attracted international attention for her positions.

    Even the Minister's liver transplant was controversial. The Times wrote in Manto: A Drunk and a Thief, of a Health Minister who was an alcoholic with liver cirrhosis -- a kleptomaniac on bad behavior while in hospital. One hospital employee told the paper that Tshabalala-Msimang's "antics were common knowledge among staff.'Everyone here thinks its hilarious that she is today a health minister in South Africa'". The story questioned whether favoritism and power enabled her to receive a liver transplant ahead of others.

  • Sickle Cell Anemia Not the Only Genetic Mutation to Protect Against Malaria: We learned in our biology courses that the genetic mutation that causes sickle cell anemia is an adaptation to the malaria causing parasite Plasmodium falciparum. Recently, scientists at the Pasteur Institute in Paris have shown that a less common malaria causing strain, Plasmodium vivax, has also caused adaptive pressure on the genome. The scientists found a gene variant associated with an enzyme deficiency which seems to protect against infection by P. vivax in Southeast Asian populations. The variant causes a deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD), associated with neonatal jaundice and hemolytic anemia after exposure to certain infections, foods, or medications. (Sakuntabhai et al Science 326, 1546-1549 (2009)DOI: 10.1126/science.1178849)

  • Cookstove Technology: Indoor pollution causes 1.6 million deaths per year. Cookstoves contribute significantly to indoor pollution, especially in developing countries where morbidity and mortality from cookstoves disproportionately affects women and children. The New Yorker recently published an article about an Oregon company (one of many) working on cookstove technology for developing countries. An efficient cookstove will vent smoke out of the dwelling and will also burn fuel effectively, saving both lives and forests. But as the article shows, it's about more than technology -- there's many ways a cookstove can not work in developing countries.

Tricky Science-Speak


Scientists sometimes confuse people with inscrutable acronyms -- BPA, NIEHS, NTP, EPA (bisphenol A, National Institute of Environmental Health Sciences, National Toxicology Program, Environmental Protection Agency), words that are difficult to pronounce -- "phthalates", or words that are difficult to get to the end of -- "Pneumonoultramicroscopicsilicovolcanoconiosis". But lately, we've been stumping people with words everyone thought they knew, like "trick". People went wild over the idea that East Anglia scientists had used a "trick" to manipulate raw data.

"Trick", previously associated with annuals "treats" and six year olds in fairy costumes, was suddenly linked to nefarious acts. Yes, there is that "trick", but it's not often used1. And did the media mayhem over "trick" top the media mayhem over the breast-baring "wardrobe malfunction" during Super Bowl half-time a couple of years ago? Hard to say -- but global warming is actually serious.

Scientists explained over and over that "trick" can be a good thing, like mathematics, logical thinking, transparency, pragmatism, maybe even dignity for life -- but their insistence only increased suspicion and talk. "Trick" dominated the news cycle longer than any five letter word should be allowed to and even wormed its way into events like the US legislature, where senators leveraged the word in committee meetings to veer away from very important topics like the Toxic Substances Control Act (TSCA)2.

Now we see the word all over the place. And like the original East Anglia "trick", it's often used to rationalize why climate change, the reality, isn't being translated into climate change policy. The Financial Times reported on the tension between China and the US in Copenhagen and quoted China's on its changing stance:

"'China will not be an obstacle [to a deal]. The obstacle now is from developed countries,' he said. 'I know people will say if there is no deal that China is to blame. This is a trick played by the developed countries. They have to look at their own position and can't use China as an excuse...'"

John Tierney recently used the word to propose a temperature based carbon-tax -- a joke perhaps, or to scoff at science?

"[U]se the temperature readings as the basis for a carbon tax instead of a cap-and-trade system...the carbon tax would be more effective at reducing emissions because it is simpler, more transparent, easier to enforce and less vulnerable to accounting tricks and political favoritism."

Up to his usual tricks, that Tierney.

Talking about the challenge the US Senate presents for Obama in Copenhagan, Jason Grumet, president of the Bipartisan Policy Center described Obama's challenge as a "Goldilocks Problem":

''The trick is finding something just right in balancing the importance of demonstrating international leadership while not undermining the legislative dynamic here at home.''

Moving away from climate change, the word "trick" can morph from a bad thing or a challenge, to a good thing. An author recently mused in an essay in the New York Times about the "tricks" to maintaining a marriage.3


The confusion over "trick" is not entirely unjustified. Merriam Webster has seven possible uses of "trick". And another word that's ambiguous for some people, again, reasonably so, because it has nine uses in Merriam Webster, is "hack", as in, they hacked into the email server in East Anglia and stole a thousand emails.

During the December 2, 2009 hearing on the pressing imperative of revising the "Federal Toxic Substances Control Act" (TSCA), climate denier Senator Inhofe (R-OK) hijacked the meeting to windbag on about "tricks" in emails necessitating a halt to EPA emissions rulemaking.

Senator Boxer (D-CA) responded eloquently and forcefully, noting that although she was concerned about criminal acts of "hacking", she was more concerned about anthropogenic carbon emissions, about global warming, and about the repercussions for human health -- that's where her duty was, to the people effected by global warming. About the email break-in she said:

We're dealing with a criminal act of hacking into a computer...It seems to me they must have been hacking this for years. And just before Copenhagen they came out with it...That's what it seems to be...because, these emails, they go many are there? Over a thousand emails? So I don't know how long a thousand emails...

This may be a silly example, but it shows how people with expertise in a particular area assume common understanding of simple words. Here it seems like "hacking" into a computer is visualized as George Washington trying to "hack" down a giant redwood tree in the Muir Woods National Park.

Hack can mean to chop at roughly. It can also mean to tolerate or bear something, for instance, I don't know how Senator Boxer can hack Senator Inofe's perennial global-warming-is-a-hoax B.S. so gracefully. Used as a noun, hack can also be a cough, a horse, a worker, or (derogatorily) someone who misconstrues or butchers something -- for example, Senator Inofe is a real hack when it comes to science and global warming.

But when someone hacks into a computer as they did in East Anglia, they exploit a vulnerability in order to access data owned by someone else. Different than hacking at a tree. It can take a computer hacker a while to find the vulnerability and locate the data, but then they most often swoop in, get it, in this case a bunch of emails, and go. Sometimes they lurk about, poised to commit further crimes, or leave an opening to come back, obviously there's no rules, but generally they're not hewing emails out of the server one at a time over many years 465 -- hack, hack hack, 466 -- chop, chop, 467 -- hack, hack -- that's a different use of the word.

The Trick for Scientists, If They Can Hack It

So "trick" can not so intuitively mean find a solution, as well as to deceive, and "hack" can mean deceptively break into a computer in order to plunder or pillage, as well as to chop at something. And confusingly, computer scientists, sometimes known as "hacks" but in a good way, will "hack" a solution to a very tricky programming problem, just as scientists use a "trick" to help analyze and make sense of data.

And that's the challenge for scientists -- a trivial one, but another one. In addition doing science, teaching, writing grants, motivating grad students, negotiating politics and budget cuts, actually physically looking out for hackers and those who would break into scientists offices and steal computers as part of a global effort to undermine climate science; in addition to assessing threats of bodily harm, scientists need to simplify concepts, avoid acronyms and watch their use of simple seeming words whose meaning they take for granted.

All that work because even people with the best intentions don't always have a grip on either science or its lexicon. And once scientists sort out "trick" and "hack" for everyone, they'll then face the greater challenge of explaining the risks of doing nothing about global warming, with the risks of doing something. After all, probability and risk are orders more challenging for people to grasp than "tricks" and "hacks".


1 See, "Do Names Portend Profession?", in AR's Science Dust-Ups and Dirty Laundry


We wrote about TSCA here. Of 80,000 chemicals produced, there's little information about which ones are on the market, and only 5 are regulated by the EPA.

3 In the NYT on marriage: "Recently one of my wife's college students kept pressing us, with baffled curiosity, for our secret, as if there had to be some trick to it..."

follow us on twitter!