Polio Plus a lot More

Polio Plus a lot More

PolioPlusPolio may have been eliminated from Africa.

Although the context is Africa, this is an uniquely American story. It’s a hero’s tale of misplaced generosity: More than 30 years ago a generous group of American middle class business leaders decided they would eradicate polio.

Last week the Global Polio Eradication (GPE) Initiative announced that it had been one year since any new case of polio had been identified in Africa.

(Qualification: a handful of new cases caused by the vaccine itself persist in Nigeria and Madagascar, but these are not infectious.)

The GPE began in 1988 after a 1985 Rotary Club project inspired when a Rotarian visited the Philippines and was moved by efforts there to eradicate the disease.

Within three years individual Rotarians had donated almost $200 million dollars. (To date they have contributed more than $1.3 billion.)

Reluctantly United Nations organizations joined the effort. I say reluctantly because the science of public health was most developed within the United Nations community, and it was understood by them that “a few years” was not a realistic goal.

The UN and its agencies get beaten to death when they set goals they don’t achieve. But UNESCO (the United Nations Educational Scientific and Cultural Organization) agreed to partner in the effort when convinced by the less political World Health Organization (WHO), which also joined the effort in 1988 after America’s CDC came on board.

But none of these three public health organizations – attracted by the enormous amount of the Rotary contributions – wanted to be the lead organization.

It was understood that if public health organizations’ assessment of the enormous amount of time and money the project really needed were honestly conveyed to Rotarians the project might be abandoned. More puerilely, they might not get use of the funds. So the GPE was formed as an umbrella organization.

I was a Rotarian at the time, and I was extraordinarily humbled by my suburban club’s generosity towards projects I was developing in Africa. So I was roundly criticized as hypocritical and selfish when I opposed the polio campaign.

I knew the goals were unrealistic. Everyone was treating polio as if it were smallpox. The eradication of smallpox worldwide in 1978 (officially announced in 1980) still had enormous resonance in 1985 as a successful worldwide public health initiative.

WHO suggested, designed and led the effort to eradicate smallpox, a decade-long effort that began in 1958. The world – particularly America in 1958 – was considerably more socialistic than it is, today, and the successful eradication of smallpox in the U.S. and Europe inspired wonderful governmental generosity to take this know-how into the undeveloped world.

It was expensive, and it was paid for by increased taxes on westerners.

America’s psyche changed radically in the late 1970s and 1980s. Private initiative was displacing government initiatives.

Rotary is a private, capitalist club. To its lasting credit in this troubling period of change in America it was also developing thousands if not tens of thousands of small projects that were working better than the bluster of aid that was flowing for crony reasons during the Cold War.

It seemed to make sense. Private initiative. Less bureaucratic operations. Strictly altruistic.

But Rotary was not accountable to the body of science which governments and world political organizations were.

I knew that eradication of polio would take more than “a few years” and more importantly, that the quarter billion dollars raised for a few-year effort would have to become substantially more if the ultimate goal of the project was to be realized.

I knew because I had watched polio immunization in Africa fail, first-hand.

The problem is that a single immunization as was used to eradicate smallpox won’t work with polio. Polio eradication then required at least two immunizations per child and they needed to be spaced months apart.

That is a concept near impossible to convey to an illiterate peasant and particularly to skeptical ones. It’s also a regime that requires meticulous accounting and reporting. Who is immunized when is not an easy task to record when so many millions of young, undernourished and illiterate children are involved.

So it’s taken a little bit more than a “few years” and by the way, Rotary’s goal of worldwide eradication has not occurred. The infectious polio virus persists in Pakistan and Afghanistan.

It’s unclear how much has been spent to date. The New York Times reports the effort costs $1 billion/year.

Last February the Rotarian who inspired the program celebrated the 30-year effort by explaining why he felt the project could be done by Rotary:

“We didn’t need medical people, we could do it ourselves.”

Do it yourself is an American concept that is horribly immature. There is very little in the world today that can be successfully accomplished “by one’s self.”

Teams of very different kinds of people, spanning enormous disciplines and representing high science and lengthy specific experience, are required for almost everything even something as simple as counting children when the context is global.

What we need to do is tap into the incredible generosity of an individual Rotarian, which I can absolutely attest to. We need to develop that twinkling morality into a complete understanding that no Rotary – no homogenous organization – can work alone in a global context. Only massive efforts coordinated by governments can achieve global success.

And equally importantly, we must accept the facts, however daunting they may seem. Inspiration is great. Science is, too.

#1 : Ebola

#1 : Ebola

EbolaNbr12015The ebola epidemic is the Number 1 story in Africa for 2014, and for a slew of reasons.

(To see a list of all my Top Ten stories in Africa for 2014, click here.)

The epidemic started in March and will likely continue well into this year, but the spread is slowing and increased public understandings have reduced global fears and improved people’s sensitivities to poverty and war.

Today just under 7,900 people have died of ebola from a known 20,000+ cases in seven countries: Liberia, Guinea, Sierra Leone, Nigeria, the US, Mali and the UK.

The UK’s case occurred just this weekend as a health worker in Glasgow became sick after returning home as a volunteer in West Africa.

Of the nine people who became sick with ebola in the United States, one died; more than 3,400 have died in Liberia and 2,700 in neighboring Sierra Leone; 1,700 in Guinea and eight in neighboring Nigeria.

That makes the U.S. the only country where this specific outbreak has caused a death outside of West Africa. Not Kenya, not Tanzania, not South Africa. Just the U.S.

The public’s control of its initial panic comes from a growing understanding that the disease while extremely serious is not uniquely so.

Had polio, HIV, SARS, MERS or even the current flu epidemic in the U.S. broken out in this part of Africa at this same time, it is likely an epidemic would have occurred just as it did with ebola.

The control of the disease is relatively simple where hardly more than a basic public health infrastructure exists, as was demonstrated in Nigeria. Similarly so in the U.S., where another lesson was learned:

Health care in the U.S. – at least at one hospital in Texas – is not what it’s ranked up to be.

A month ago I wrote ebola’s “Epilogue.”

As explained then, this was not an epilogue to the outbreak in West Africa, which is likely to continue for some time. Rather, it was an epilogue to the irrational concepts of what this outbreak was exactly.

Initially, the world panicked.

Fox News, not exactly your Bible of Reality, reported in late September that there could be more than a million cases as of … today. But note that the Fox report was based, if in a skewed way, on a CDC report.

As school opened this fall, Americans in remote farm country in Nebraska were keeping their kids home.

American movies were taking over American’s minds. American greed for the macabre made it worse. Worldwide racism exacerbated notions that what was happening in West Africa was not the human normal.

In fact, what we learned was that an infectious disease is one of the best long-term indicators of the devastation of war.

Americans know of the wars in West Africa. “Blood Diamond” was released just as the wars there were finally ending. But Americans are hesitant to embrace the magnitude of these wars, just as we are hesitant to embrace the near apocalypse we’ve caused in the Levant.

It is, in fact, that near total devastation of Liberia and Sierra Leone that among so many other horrible outcomes left a densely populated area without any public health care.

Our inability to understand that parts of the world – even in Africa – might actually be better off than us came when South Africa reported it had recently and in past outbreaks adequately treated and totally contained ebola when … in Dallas, they let it walk the street.

Nothing requires public health care as much as an outbreak of an infectious disease. We learned that inside out, I’m afraid, when we first reacted to this outbreak by believing increased monitoring at airports would be valuable.

As predicted and now as proved, it was meaningless.

We learned the power of public health policy when Chris Christie quarantined an incoming health worker, and the fallacies of knee-jerk reactions that were equally meaningless.

America as the single largest economy contributes disproportionately to the health of tourism in Africa, and African companies were spinning like tops trying to figure out what to do when the ebola panic began to effect them.

Never mind that the centers of big game safari travel, in East and southern Africa, were often more distant and cut off from the ebola centers than New York. “Africa is Africa” was the juvenile mantra.

The companies responded with equally juvenile policies that tried to protect their unthreatened backsides, although that lasted only briefly. After I and many others shook Africans back into their senses, it was a simple matter of doing what any good hotelier in San Jose, California, would do if ebola broke out there.

Because, of course, it won’t.

Some tell me I’m too calloused in my blogs about ebola. They’re dead wrong.

Just because I’m as distressed with the level of child poverty or gun homicides in the U.S. or as miffed by Americans’ fear about health care while traveling in the country that performed the first heart transplant doesn’t mean that I underestimate the severity, misery and desperation that ebola causes.

It’s just that I see that same severity, misery and desperation in many places. Like Dallas.

Ebola Epilogue

Ebola Epilogue

President Hollande of France entering an ebola hospital in West Africa.
President Hollande of France entering an ebola hospital in West Africa.
The apparent slowing of the spread of ebola in West Africa is almost as worrisome as the outbreak itself.

Many will think I’m crazy to write an epilogue to this story before it really is over, but like so many global crises the ebola epidemic will become forgotten the moment headlines disappear.

We really shouldn’t do this, this time. There are four extremely important lessons to be learned, that right now I hope everyone can understand.

First, the situation today:

There are just under 7,000 reported deaths from ebola, just under 17,000 reported individual infections, and both numbers are likely low because of the difficulty of accurate reporting in the ebola infected areas.

Foreign help is working. ABC reported yesterday two pages of good headlines about ebola in Liberia, including Obama’s troops and hospitals coming online, Chinese hospitals coming online, and the possibility there will be no new cases at all in Liberia.

With all the accelerated research and development of diagnosing and vaccinating against the disease, I predict ebola in West Africa will be contained in the first quarter of next year.

In a demonstration of similar optimism, the President of France visited a hospital in Conakry, Guinea, on Friday. Conakry is an epicenter of the disease.

With an outbreak of this magnitude it’s difficult to imagine it will ever be completely over, since so much of the area retracted into primitiveness as a result of almost two generations of horrible, scathing war.

But I’m willing to take the risk of being premature for wont of not losing public attention. We have four serious lessons to take from this situation:

Lesson 1.
TERROR & RACISM RULES
American culture in recent times craves being terrorized. There could be all sorts of reasons: remnants of 9/11, poor education, the Great Recession … whatever. Whether it’s vampires at the cinema, fear of ISIS or “open borders” or ebola, we crave being threatened.

In all these cases, “The Threatener” is the demon. Imagine, for example, if some horrible virus literally as bad as ebola or worse suddenly broke out in Des Moines. We would not be closing our bridges over the Mississippi or road-blocking I-80.

A virus worse than ebola did break out in America in the 1950s. It was called polio. Some parents did keep their kids out of school, but most didn’t even do that.

Ebola happened in BLACK Africa. All our reactions this time demonstrate racism to the core of our beliefs. Polio in Pittsburgh is god’s will and we will overcome it. Ebola in Africa is the work of the devil.

Lesson 2.
KNEE JERKS precipitate KNEE REPLACEMENTS
America today leads the world in short-term thinking, and that short-term thinking is why we have an ebola epidemic to begin with.

America’s political system is the best example. We fund the government almost from month-to-month. We have no long term social plans.

We cherish quick stock trades; we tutor our third grader just enough to get into fourth grade; we hand out just enough food stamps to take us through winter.

We lay globs of asphalt in cracks rather than pieces of new cement and then get furious when the cracks get bigger the next year.

Our hearts may be in the right place, but our minds are in Pluto. We pass referendum to increase the minimum wage for a long-term benefit to everyone including the shop keeper that gets the extra dough, but then elect politicians who vow to reduce the minimum wage to balance next year’s budget.

Tom Sommerville writing today in African Journalism argues so well that the ebola epidemic today is a result of American-dominated short-term thinking manifest by the IMF and World Bank.

He’s right on, and I’m not going to summarize his thinking, just go to his link above.

Basically, you get what you pay for. America has led the world paying discount prices for a modern planet that needs a bit more quality than we’ve been willing to accept.

It’s so counterproductive! We spend literally millions of dollars to intercept ebola (so far, no one) at our airports who has a temperature, but resist funding Obama’s emergency request to build ebola hospitals! Now how ridiculous is that!

We all know where this is going to lead, don’t we? Didn’t your grandpa give you your first piggy bank? If you neglect the oil change, won’t you have to buy a new car sooner? Come on guys, get real!

Lesson 3.
EXAGGERATION KILLS
I’m probably the greatest offender, admitted, and I am constantly trying to reform myself, so at least I’m ahead of many.

So I can attest first-hand of this horrible American affliction, exaggeration. Texas has to be the biggest place. My kids are always above average, thank you Garrison. My yard has the greenest grass. My pastor is the kindest man. My dog is the sweetest and … my enemy is always the devil incarnate.

Current ebola infection stats are horrible but nowhere near as catastrophic as earlier predicted. Both the CDC and WHO are now loathe to make future predictions, since their earlier ones were so off base.

Those quantitative assessments that earlier suggested “millions” of possible cases from institutions as respected as WHO and the CDC make me wonder if those organizations suffer from the same scientific deficits as Senator Inhofe.

Opponents of realism, of what is right in the world, of what should be done morally and practically, will now use these exaggerated claims to stop funding Obama’s ebola eradication mission, and this will kill hundreds if not thousands of more people than would otherwise be saved.

Lesson 4.
GEOGRAPHY IS DEAD
When I’m working in Nairobi or Johannesburg, I’m just about the same distance from the ebola epicenter as my kids are living in New York.

Every single capitol city in Europe is closer to the ebola center than any city in the U.S.

There are three nonstop flights daily from West Africa to the U.S. (two into JFK and one into Dulles). Daily, there is only one into Johannesburg and no non-stops into East Africa. There are dozens of nonstops daily into European capitols.

It has absolutely astounded me how bad Americans’ knowledge of basic planet geography is. I started work in Africa 40 years ago, and I was astounded then that someone in Chicago thought Dakar was as close to Nairobi as Detroit is to Cleveland.

But that has persisted, and there’s no explanation except poor education.

* * * *

The outbreak of ebola, the messy containment, the lessons that won’t be learned from the situation, are every man’s responsibility, every man on earth.

America cannot yet shed its responsibility as the world’s greatest power, and so it has to assume its greatest responsibility.

Remedies begin at home, of course. They begin with adjusting ourselves to realism and moralism. It’s a very dark time in America right now. Kids, get us out of this!

New Yellow Fever Research

New Yellow Fever Research

220px-Aedes_aegypti_bloodfeeding_CDC_GathanyNew research on yellow fever could lead to improved vaccines and quick cures.

Yellow fever is a mosquito born disease that is found throughout South America and sub-Saharan Africa. While the disease is actually more deadly than malaria, it has never been as widely a threat.

In part this is because the first stages are not as severe as malaria’s and it’s usually the secondary effects that lead to mortality. These secondary effects can be quite prolonged. As a result it’s possible that many deaths in sub-Saharan Africa are actually from a yellow fever infection while being diagnosed as something else.

Mostly, however, it’s because persons who recover from the disease acquire virtually complete immunity. This is completely unlike malaria. Persons can succomb to malaria multiple times and likely achieve no immunity against a future infection.

The new research is one of the first in-depth studies that carefully looks at how the disease works. It’s complicated and fascinating. Note that the research was done on macaques, although scientists are fairly confident that the dynamics would be the same in all primates.

The virus switches on and switches off a variety of genes while it resides in the liver.

Over time this leads to a variety of pathological events, including liver and other organ failure.

In the past in Africa mosquito-born diseases like malaria and yellow fever were thought to manifest mortality more quickly and more simply.

As most travelers know there is an effective yellow fever vaccine, although it loses significant effectiveness for very young children and older adults. Persons who obtain the inoculation in their young adult years are easily revaccinated every ten years for extremely good protection.

But the vaccine is expensive and has been difficult to disseminate throughout endemic areas. It is a fragile vaccine that requires refrigeration and is a live-virus based vaccine, which means that incorrect storage or administration can actually give the patient the disease rather than the protection.

By studying the genetic trail of the disease’s manifestations, scientists may be able to interrupt organ damage by neutralizing the proteins that switch certain genes on or off.

Travelers to East Africa are particularly sensitive to not just the pathology but the politics of the disease.

Because vaccination throughout sub-Saharan Africa combined with natural immunity has minimized the disease’s effects over the last half century, many areas of sub-Saharan Africa which have not experienced any yellow fever whatever are particularly susceptible should an outbreak occur.

Tanzania, especially, has reacted to yellow fever outbreaks in neighboring countries like Uganda and The Congo by suddenly – without very much if any notice – requiring incoming visitors to have the inoculation … even though Tanzania itself is yellow fever free.

This has put it from time to time at odds with national health authorities like the CDC that recommend against obtaining the vaccination except for visits to countries that actually have disease outbreaks.

Many other countries in Africa, such as South Africa, require evidence of the vaccination if the traveler has been in an effected country within the last six months.

Genetic science is advancing so quickly that doctors are discovering methods of interruption or curing of diseases that before were thought only capable of being prevented with a vaccine, and that may the route of current science towards the management of this curious and powerful disease.

Happy Halloween, Ebola Sir

Happy Halloween, Ebola Sir

halloweenebolaNot even the outstanding basement haunted house that I so successfully ran when my children were in middle school can begin to achieve the truly absolutely unbelievable fears of ebola stoked by despicable American politicians.

“An epidemic of fear can be as dangerous as an epidemic with a virus.”

Maine health-care providers, led by the executive vice-president of the Medical Association of Maine issued that quote, in response to Maine’s T-Party governor’s abrasive and ignorant actions against a health care hero who just returned from West Africa.

A third-grader banned from attending her Milford, Connecticut grade school because she just returned from a wedding in Nigeria where she was the flower girl, had to get a court order to go back to school.

Louisiana Governor Bobby Jindal sent out letters to recent returnees from West Africa who were planning to attend this weekend’s convention in New Orleans on tropical medicine, advising them they shouldn’t come.

A Strong, Maine, elementary school teacher was ordered into a 21-day quarantine because she just returned from her vacation in Texas!

Not only did parents panic when the principal of the Hazelhurst Middle School in Mississippi returned from vacation in Zambia, so many pulled their kids out of school, it closed!

“Principal Lee Wannik had returned to school a day early from a recent trip to Africa, where the Ebola virus has been spreading fairly rapidly. Principal Wannik has just returned from attending the funeral of his brother in Zambia, Africa. A meeting was held Tuesday, October 14 in the school’s auditorium, to try to calm parents and officials who wanted the principal to leave permanently.”

Zambia is thousands of miles away from the epidemic, further than London, with no viral epidemic outbreak there and no history of ever having had one.

The day after the parents pulled their kids out of school, the rumor spread
that the principal actually had ebola.

Tuesday Nigerian applicants to a community college 60 miles from Dallas showed their rejection letters to the press: Elizabeth Pillans, the Director of International Programs, confirmed that “Navarro College is not accepting international students from countries with confirmed Ebola cases.”

The applicants who revealed the letters are from Nigeria, which is “ebola free.”

The DeKalb County (part of Atlanta) Georgia K-12 school board issued the following statement yesterday:

“…no new students from Ebola-affected West African countries, including Liberia, Sierra Leone, Guinea, and other affected areas in the United States will be enrolled or allowed to attend classes on school campuses without proper medical documentation and approval by the Superintendent.”

Yesterday Dallas County Judge Clay Jenkins, notable for supporting the grieving family of Thomas Duncan who died of ebola there, told the press:

“…my wife who was in tears [was] told that she can’t work in the [school] cafeteria by some other moms because she might have Ebola, because I might have Ebola, therefore my child might have Ebola, [and] maybe they all need to leave school.”

There’s more: London’s very somber and highly respected Guardian Newspaper ran the following headline this week:

“Panic: the dangerous epidemic sweeping an Ebola-fearing US.”

Follow the link above so that you can read how American Airlines flight attendants locked someone in an airline bathroom because she vomited, how a journalism department at Syracuse University disinvited a Pulitzer-Prize winning reporter because he had been in Liberia, and on and on and on.

Let’s stop. Drill down into each of these and you drill into a conservative, often T-Party community. I’m not saying this is wholly restricted to Republicans. My own democratic governor up for re-election is acting just as immature.

But we’ve got to fight back. The gloves need to come off. The divide is clear. We can’t be polite or shy. The more conservative an area is, the more likely it’s been fomenting this hysteria.

I’ll leave it to others to study why. Meanwhile, I’m pleading with you to join me in calling out the brazen fear-mongers wherever you see them.

Fight back. Inject some sanity back into America next Tuesday.

Good Ebola Travel Policy

Good Ebola Travel Policy

campdinnerAfrican travel companies are rethinking their ebola policy, putting their money where their mouth is, and offering unconditional refunds.

Embracing science and the history of past ebola outbreaks, companies mostly so far in East Africa are advising customers that deposits will be refunded without penalty if WHO declares an outbreak in an area in which they operate.

WHO’s designation, “outbreak,” differs from isolated cases of the sort experienced in Dallas and New York. An “outbreak” is multiple confirmed cases in separated, multiple areas. There is no history or other evidence suggesting that isolated cases lead to outbreaks.

Among the first this weekend to change their policy was Great Plains Conservation, which operates three luxury camps in Botswana and three in Kenya.

“Many of our guests are really worried about Ebola. One can’t really blame them given the media hysteria surrounding the story. We believe this will sort itself out in time as the world mobilizes to tackle this head on,” Jacqui Usher explains as the lead-in for the policy change.

The Great Plains policy will refund all monies held – no questions asked – if an ebola outbreak occurs in Kenya or Botswana.

Moreover, Great Plains has now announced that even if there is no outbreak, customers can get all their money back within 16 weeks of arrival. Most African camps require an up-front, nonrefundable 15-20% at the time of booking.

And within those 16 weeks should a customer grow weary of coming, Great Plains will roll any monies held for the customer to new booking dates up to a year in advance.

This is the gold standard of sensible ebola policy. This is spot-on reasoning, bold marketing and honest communication with consumers. No legalize or other lengthy pontificating qualify this extraordinary situation we currently find ourselves in: a hollow fear of something that will simply not happen.

Yesterday in Mwanza, Tanzania, the blood tests of a man who had died suspiciously of symptoms identical to ebola tested negative for the virus.

The possibility, though, that the man had ebola had spread like wildfire through this large Tanzania city on Lake Victoria last week. Health care workers responded in force, a public health campaign was initiated, associates of the man were quarantined and even if the man had tested positive, the spread of the disease would have been stopped in its tracks.

The Mwanza response is what is lacking in West Africa, and the reason that the disease is still spreading there.

Great Plains may be the gold standard and the first company to play it straight with consumers, but it has been resoundingly joined by others:

“Gamewatchers Safaris understands travelers’ sensitivities about planning a holiday almost anywhere in the world during an Ebola outbreak,” Jake Grieves-Cook, former head of the Kenyan Tourist Organization and now owner/operator of Kenya’s Gamewatchers Safaris explains in the lead-in to his new policy, which is similar to Great Plains’.

Great Plains and Gamewatchers were among the very first, but by no means the only companies to announce revised changes, yesterday. It’s going to be very difficult, now, for any African travel company to sit on its hind and not join this sensible movement.

And the result? Consumers will be assured that the African travel companies really believe what science and medical experts have been saying all along:

Ebola is hard to get, and relatively simple to stop spreading except in very unique areas like the three countries in West Africa just ravaged by generations of war.

Don’t Vote

Don’t Vote

sheshouldntvoteThe depths to which some Americans have descended in an hysterical attempt to protect themselves against ebola has become immoral.

The airport quarantines of health workers arriving from West Africa is dead wrong. It will impede the health services and trade, which West Africa must have to recover, and many more people will die.

In a worse case scenario, the situation which had become better will slide into worse, and the threat to Americans will increase substantially. The policy is self-destructive.

Then why is this happening?

Politics. American politics has become so corrupt our democracy is now impotent. The electorate has lost the ability to analyze issues and is controlled by false claims and fearful media.

Governors Quinn, Cuomo, Scott and Christie are hardly bar chums.

Yet they walked in lockstep to solicit their electorate’s hysteria, because they are all about to lose power, and they are getting votes however they can.

Of course their actions reveal an electorate – if they’re correct – that’s slum ignorant. Are you truly so ignorant? Or like me, do you feel helplessly manipulated?

My own governor, Illinois Pat Quinn, is no angel but I did plan on voting for him as “the lesser evil.” His challenger, Bruce Rauner, is no alternative for a progressive like myself.

So I now have no choice but not to vote for either. This is hardly democracy at work.

But it is at least myself acting on the truth that I know:

The four governors that enacted this barbarian policy are killing people in West Africa and not increasing the protection or health of their own citizens.

In fact, the policy endangers their own citizens’ health and well-being.

This political act against self-interest is what has been happening to America for a generation. Whether it is the senior voting to end Medicaid or the food server voting to end a minimum wage, Americans have been brainwashed with a thousand false ideas to act against what they know is best for themselves.

And now this toxic social personality threatens the lives of thousands.

Facts be damned. Scream don’t think. The man will do anything to stay in power.

I can’t keep him out. But I won’t vote him in.

Zuma in Wonderland

Zuma in Wonderland

ebolaidiotsWhat do the U.S. Army Chief of Staff, a governor and numerous Congressmen have in common with Jacob Zuma, the President of South Africa?

Like Zuma, they deny simple facts of science, in this case about ebola. Like Zuma, they should be sacked.

Rand Paul and Georgia Governor Zeal along with a host of other nuts in Congress are unfortunately just as astute politicians as Jacob Zuma, so I don’t expect they’ll be leaving the scene, soon.

But Martin Dempsey is a soldier, and the country’s top soldier, and Obama should immediately fire him.

“If you bring two doctors who happen to have that specialty (Ebola) into a room, one will say, ‘No, it will never become airborne, but it could mutate so it would be harder to discover.’ Another doctor will say, ‘If it continues to mutate at the rate it’s mutating, and we go from 20,000 infected to 100,000, the population might allow it to mutate and become airborne, and then it will be a serious problem.’ I don’t know who is right,” Dempsey, the chairman of the Joint Chiefs of Staff, told CNN this weekend.

This is America’s top soldier. This is one reason we have so many failed wars led by a military that’s incapable of being controlled.

Jacob Zuma contends you can simply protect yourself from AIDS by taking a rigorous shower after unprotected sex.

How the world, the U.S. or Africa, has allowed leaders whose beliefs are so warped to survive is more terrifying than any possible 9/11 threat. Neither is really a leader. Both Zuma and Dempsey are followers of the frightened and ignorant masses on which they depend.

Where I grow so angry is that at least one of them, Dempsey, can be sacked. Right now. No questions asked. If Dempsey believes what he said, imagine what he might believe about the war against ISIS.

This weekend CNN in print finally did what CNN-US never could: criticize CNN-US:

“What’s more disturbing than Ebola? The outrageous commentary,” the CNN headline by Michael Martinez read.

I hope the link above works for you, because CNN has modified its story and changed its link several times since it first appeared early Saturday morning. Clearly Martinez’ fresh and honest approach to news is anathema to Wolf Blitzer’s America.

Before all is lost, here are a few other choice comments Martinez compiled in that story:

“If someone has Ebola at a cocktail party, they’re contagious and you can catch it from them.” — Sen. Rand Paul

“The most comforting thing that I heard from (Dr. Brenda Fitzgerald, commissioner of the Georgia Department of Public Health) was that water kills the Ebola virus.” – Georgia Governor Nathan Deal

“The U.S. must immediately stop all flights from EBOLA infected countries or the plague will start and spread inside our ‘borders.’ Act fast!” – Donald Trump

“Reports of illegal migrants carrying deadly diseases such as swine flu, dengue fever, Ebola virus and tuberculosis are particularly concerning.” — Georgia Republican Rep. Phil Gingrey, a medical doctor

“I don’t know … But I think this Ebola epidemic is a form of population control.” — R&B star Chris Brown

Crazy rightest Michael Savage said President Barack Obama wants to infect America with Ebola: “There is not a sane reason to take three- or four-thousand troops and send them into a hot Ebola zone without expecting at least one of them to come back with Ebola, unless you want to infect the nation with Ebola.”

There’s more where these came from and in multitudes of other stories, and it’s a shame that CNN has been so dainty in modifying and adjusting Martinez’ first filing.

These people are influential, powerful Americans. We already know they could care less about Africa, much less any community outside of their own cocktail parties.

Their beliefs have traction in America because Americans are poorly educated and have an increasingly myopic view of themselves and their communities.

The most important fact to recognize on this day that the World Health Organization declared Nigeria “ebola-free” while America still isn’t (because of Texas), is that without much more help from the outside of the sort Obama is offering, the epidemic in Africa will get worse and worse.

It is, in fact, possible to imagine a scenario a few years down the line if people like Dempsey, Paul, Deal and others held sway, where futile attempts to isolate the current infected countries turned into a world epidemic.

That is exactly what these ignoramuses if they prevail will ultimately cause.

Donald Trump couldn’t survive a week without the government he decries, and we’ve been able to live with that contradiction for a long time. His influence on Americans is counterbalanced so far by enough of us sane people.

But his (and other’s) influence in calling for an isolations of West Africa is not so easy to contain in today’s troubled and frightened America.

If you are reading this… if you are not as troubled and ignorant as the characters above, say something, please. Just a sentence. Just a few words of truth to your neighbor.

It’s not just the survival of millions of west Africans that’s in play. It’s the sanctity of truth.

Perry’s Practicalities

Perry’s Practicalities

killwestafricansWhen tiny incidents like a few ebola cases in Dallas are properly scrutinized by the obsessed media, their exaggeration grows unbelievably large.

The media is obsessed, because the public is obsessed.

Every unnecessary harm should enrage us: including the 10,332 American deaths caused by drunk driving in 2012 (that’s 28+ per day, more than 1 per hour); or the 23,362 homicides that’s 64+ per day, almost 3 per hour).

But DUIs and homicides, much less war fatalities, poverty, infant mortality, industrial accidents and so forth, are not contagious. Is that the difference?

The obsessed public believes itself essentially so good and righteous that they would never be involved in unnecessary harm … unless they caught it?

Or: the obsessed public is so anti-social that nothing matters except individual responsibility? In other words, forget about John Doe or Jane Odhiambo, I shouldn’t get infected with something I didn’t stupidly expose myself to? And to hell with those who have?

I don’t know, but it’s a sad, sad commentary on our American society in general when the focus is so incredibly tiny.

There’s also the possibility that Americans just can’t telescope out. They’ve been so brain washed by the often useless concepts of individual responsibility and self-survival that they can’t think in macro terms.

Right now, folks, if you drive, you’re 10,000 times more likely to be killed by a drunk driver than by contracting ebola. And if you drive and aren’t a health care worker, the stat is mind-boggling: you’re millions of times more likely to be killed by a drunk driver than by contracting ebola.

Did you get a flu shot? If not, the chances you’re going to die of flu this year are in the hundreds of thousands more than that you’re going to get ebola. Even if you live in Dallas.

But people won’t get flu shots, and their Congresspersons (mostly Republican) are getting besieged by phone calls demanding that we stop all air traffic into the areas where ebola is an epidemic.

So they’ll take the same amount of time, maybe more, to ultimately kill more West Africans that would otherwise not die for an infinitesimally virtually nil insurance against they’re own getting ebola.

And then, they’ll be one of the 30,000 American deaths from flu this year. Like seniors voting to end social security, Americans just love to act against their own self-interest if only the media can tell them why.

When life-and-death becomes political, it gets dirty. Wars are dirty. Crime and punishment is dirty. And now the poor and needy have become dirty.

How utterly despicable.

Immoral Exaggeration

Immoral Exaggeration

ebolavampireAmericans do not understand the ebola epidemic: They are reacting in the same unthoughtful way they do to unvetted political ads and sound bite media.

The ebola outbreak in West Africa is serious, like a lot of other things, like poverty. In fact, diarrhea, flu and TB kill millions more Africans (and Americans!) annually.

Americans must think think they are protected from those other diseases but vulnerable to ebola.

They’re dead wrong.

A traveler today to Monrovia, Liberia, where the current outbreak is centered is more likely to get diarrhea, salmonella, TB or malaria than ebola. The several hundred patients in ebola clinics in Monrovia have all come from rural areas where even basic medical prevention not to mention simple hygiene and community sewage treatment, doesn’t exist.

The problem is squarely and simply that there aren’t enough treatment centers – which would easily contain the outbreak – to service the growing numbers contracting the disease in the remote bush.

The widely reported half dozen medical workers from developed countries who contracted the disease were all working in these remote areas. In the course of their normal stint in such an area, they expect – as my wife and I did – to contract a number of local diseases.

It has less to do with the disease than the environment in which the disease exists.

Ebola is not spreading in Monrovia, a modern city. That is not to say that Liberia doesn’t need a lot more help than the western world is giving it, because Monrovia is where the Liberian epidemic will end. But it won’t end without the help it needs!

The problem goes well beyond ebola, now. Medical worker assistants like orderlies and kitchen staff and maintenance staff in Monrovia, many of whom are not paid any more relative to medical practitioners than in the U.S., are abandoning their jobs in droves.

That has led to a reduction in overall medical care, including birthing centers and simple malaria and diarrhea recovery clinics. As the entire country gets worse medically overall, every disease – including ebola – grows in potential.

And that is a terrible – horrible – indictment of the developed world. Compare the western world’s response to the Haiti earthquake or Philippines tsunami to Liberia’s current dire need. It has been pitiful, embarrassing and I think immoral.

When ebola came to Atlanta in a chartered aircraft and the patients who contracted the disease in rural Africa were then quarantined, it did not spread. The efforts in the hospital in Atlanta to contain spreading of the virus were little different than for a variety of even more contagious diseases like numerous varieties of staphylococcus.

Antibiotic-resistant TB, which is on a dangerous increase throughout the U.S., is spread through the air – respiration: coughing, sneezing, breathing – one of several more worrisome diseases than ebola in a modern medical setting. Ebola, like HIV, is spread only through body fluids.

The unwarranted American fear to ebola is identical to Americans knee-jerk reactions to 30-second political ads or 2-minute headliner news.

And when that reaction builds, the perpetrators of that media rev it up.

Ebola outranks Ukraine on CNN, because that’s what people want to view. When Democratic Senator Mark Pryor in a political fight of his life wants attention, he talks about ebola!

CNN asked a few days ago, “Are Myths Making the Ebola Outbreak Worse?”

CNN is, unfortunately, concentrating on the growing fear in West African residents. What about the fear that CNN instills in its viewers that translates ultimately into less help from the western world?

What about people in Syria, Iraq, Ukraine much less Ferguson, Missouri, who are getting less attention because ratings demand talking about ebola?

Alright. But what if you’re planning a safari to Africa?

Right now your chances of contracting ebola during a Kenya, Tanzania or southern African safari are probably less than if you holiday in London and infinitely less than if you holiday in Morocco and a lot less than if you holiday in Greece, southern Spain or most of the Mideast.

That’s because the frequency of air travel right now between west and east or southern Africa is so much less than to those other areas I mentioned. London is about 500 miles closer to Monrovia than either Johannesburg or Nairobi. There’s a hugely greater exchange of people between London and Liberia right now than to east or southern Africa.

Moreover, it’s also true because the level of medical facilities in Nairobi is better than Monrovia, so if ebola did break out in Nairobi it would likely be easily contained. And as for South Africa? Remember about a generation ago, the first heart transplant was conducted in South Africa.

The last thing I want to do is minimize the seriousness of this epidemic. But frankly I get rather angry when I realize Americans fear this far, far away epidemic exponentially more than their own TB epidemic in poorer neighborhoods across their own country.

I just can’t figure it out. Is every American a teenage girl obsessed with Twilight?

Between Life & Death

Between Life & Death

bodyorgansforsaleTanzania has embraced a Wall Street Journal suggestion last week that a free market should be created to buy and sell human organs.

“It is none of our business,” Tanzania’s Minister for Health and Society Welfare said yesterday affirming the Tanzanian government’s position that it would not oppose such a market. He then confirmed that it’s perfectly legal for Tanzanians to sell their organs to the highest bidder.

The Journal’s Saturday essay argued that kidney transplants add more than 20 years of life to those in need, and that two kidneys aren’t necessary for a healthy life.

“How can paying for organs to increase their supply be more immoral than the injustice of the present system?” the journal asked.

The authors estimated that an open market for selling kidneys would result in an expected cost of $15,000 per kidney.

That’s approximately triple Tanzania’s average annual income.

In acknowledging the Journal article more quickly than the Tanzanian government normally acknowledges a health epidemic on its own soil, the Minister pointed out that there are already robust donor markets in Iran and India.

Two kidneys might not be necessary for a healthy life, but removal of any organ, even the redundant second kidney, is not without risks. Even if those risks are small the notion of literally selling part of yourself for cash belies desperation.

And in a “free market,” one that is truly global, there’s little doubt that the most desperate in the world would quickly become the suppliers. Suicide bombers and all sorts of other criminals are often little more than lives for sale. Reducing humanity to a commodity is the basest form of oppression.

The Journal article touched on alternatives that such countries as Denmark are employing, called “implied consent.” This presumes that everyone who dies naturally allows whatever viable organs remain to be taken and reused.

But such a policy if adopted worldwide would decimate the capitalist alternative suggested by the Journal. As shocking as it may sound, there are likely far fewer natural deaths that would result in viable organ donating worldwide, than there are living persons in the developing world willing to sell their organs.

Imagine if the going rate for a kidney in the U.S. was $150,000? That’s the equivalency with Tanzania’s economy. Imagine advertising this in Appalachia or Flint, Michigan. Imagine white buses with ambulance attendants and Brinks Trucks behind them.

There’s something terribly wrong with this scenario, whether it is in Flint, Michigan or Arusha, Tanzania.

Yet the Journal article is not ground-breaking. HBO Producer of the “Tales from the Organ Trade” and three-time Emmy winner, Simcha Jacobovici, is an aggressive advocate for allowing anyone to sell their organs for the highest price:

“For my part,” Jacobovici writes in the Times of Israel, “I am no longer a dispassionate reporter on the issue… Some suffering we cannot alleviate, but this suffering has a simple solution. While tens of thousands need kidneys, tens of thousands want to sell them. We each have two kidneys. We only need one.”

The fact of the matter is that voluntary organ selling has been occurring throughout Africa for a long time, widely reported from Kenya to Nigeria. But there has been little comment about it until now and virtually no criticism.

The Journal article has forced the topic out, giving advocates of live donor selling in the developing world significant credence to the position that there is nothing immoral to the practice.

It is an incredible dilemma. My first reaction is that there is nothing baser than turning humanity into a commodity. My second reaction is that authority over one’s own physical body is inalienable: how can we the rich tell them the poor not to sell themselves?

Religious doctrine is pretty consistent:

“The answer is a definitive ‘No.’ The selling of an organ violates the dignity of the human being,” according to the Catholic Church, and virtually all major religions argue similarly.

But religious doctrine in my opinion is largely responsible for the multitude of dilemmas Tanzanians currently find themselves in, today:

From the historical condoning of slavery in the pre-colonial era, to the submission to greater force in the colonial era, to the oppression of vicious dictators in the post-colonial era, religion has not been a very good guide for the development of Tanzania.

For many millions in the developing world selling an organ is the difference between life and death. Twice.

Code 8 To The Rescue!

Code 8 To The Rescue!

TeamCode8Risking at least irony four male university students in Kampala just won the inaugural Women’s Empowerment Award in St. Petersburg for an innovative device to easily and rapidly detect malaria.

Any notion that’s it more than ironic is lost immediately when you realize that pregnant mothers in Africa harbor a greater fear of having malaria than any other group.

This is not only because malaria can quickly end a pregnancy but because the treatment can harm the fetus and in cases where the mother is less than perfectly healthy, cause miscarriage.

The four Makere university students engineered the device which is plugged into a smartphone, and created the app software that analyzes it.

The best test for malaria is a blood test. But the test will often come back negative when in fact the patient has malaria. What? This is because the best symptom of malaria is altered red blood cells, which explode in the body during a malaria attack but then are methodically excreted. A malaria attack rarely lasts longer than an hour, but the interval before the next attack can be as long as twelve hours.

So by the time the patient gets to the clinic and waits for her test, her symptoms may have subsided. And since reading the microscopic results of a swab is a human endeavor, mistakes happen and more often when the sensitivity of a pregnant mother is considered.

My wife suffered the same incorrect diagnosis here in the U.S. after returning from a safari and contracting malaria.

We called our doctor while she was having the attack; we knew it was malaria. But by the time she felt good enough to get in the car (after the attack subsides), travel to the hospital, wait for the test, 3-4 hours had transpired and the diagnosis she received was negative.

(Aggressive protestations sufficed for us to get the right therapy, and she was cured, and a subsequent visit with a test closer to a subsequent attack before the medication began to take hold proved we were correct: she had malaria.)

The four Uganda computer science students created a simple red-light device which they call a “matiscope.” Similar, in fact, to the types of devices that read fingerprints, the red light sensor detects red blood cells without any skin piercing.

Blood cells ooze to the surface of the skin normally all the time, but are so few they aren’t noticeable. And the skin itself is porous. The light penetrates several micro layers reaching even more red blood cells.

The sensor detects a blood cell altered by a malaria attack instantly.

The four students were guests of Microsoft for the company’s annual “Imagine Cup” competition for students, this year held in St. Petersburg. While there they won the inaugural Women’s Empowerment Award organized by an UN agency.

Brian Gitta, Joshua Businge, Simon Lubambo and Josiah Kavuma call themselves “Team Code 8″ after laboring through eight different computer code designs before hitting on the one that worked.

Team leader, Gitta, told an audience he was motivated to invent the device because of his “fear of needles” and being “pricked to death” as a child who constantly contracted malaria.

But, in fact, simply reducing the time between the attack and detection is the genius of the invention. And Team Code 8’s matiscope and the software they developed to detect the altered red blood cells isn’t sophisticated enough yet to determine the specific type of malaria (there are four types) or exactly how bad the infection is, often necessary for determining proper treatment.

So it’s a first but very important step, and for millions of people who might be infected, it might be all that’s needed. Normally otherwise healthy adults who contract malaria can be prescribed rather standard levels of medication to wipe it out, without knowing specifically the malaria type or level of infection.

What it means for pregnant mothers, though, is that the doctors have to hospitalize the mother and make sure that the blood test is taken immediately as the next attack begins.

The practicality of the device, though, allows for self diagnoses very much as similar devices are being manufactured today for pregnancy and HIV AIDS.

The app for the smartphone, of course, is cheap. But right now the plug-in device is fairly cost prohibitive for most individual rural Africans, but could prove cost beneficial for remote health clinics, companies and institutions which provide on-site medical care, and of course, hospitals.

But the Team is contacting entrepreneurs around the world who with mass production could greatly reduce the cost.

Leave it to the kids, eh?

Hail to the Victor Valient

Hail to the Victor Valient

goodgovtWe’re getting oh so close to both a vaccine and simple cure for malaria! And both the journey and the ultimate victory will confirm that only governments, not charity or private enterprise, are capable of attaining such success.

Last week the National Institutes of Health (NIH) announced that it had successfully completed preliminary trials of PfSPZ, what it still calls an “investigational” malaria vaccine that was found to be “safe, generate an immune system response, and to offer protection against malaria infection in healthy adults.”

The discovery was published in the August 8 journal, Science.

This isn’t quite New York Times front page material just yet, because the study group of 57 adults between 18 and 45 years old was very small and localized, and the vaccine success depends upon large intravenous injections. But the result was 100% protection, which is unheard of in such early trials.

This comes on the heels of the discovery of another drug a few months ago that is a simple preventative and cure, which I wrote about in an earlier blog.

AND that was announced just before Africa’s first-ever drug was discovered to cure malaria by an institute associated with the University of Cape Town: “MMV390048″ is awaiting a common name but is a completely innovative malaria drug attacking the parasite at the blood stage.

The key ingredient in these three major break-through discoveries is … government funding. The latter two breakthroughs had private help (the Switzerland-based Medicines for Malaria, and the Gates Foundation.) But in both cases it’s likely they would have been developed without this private help.

But the most important discovery, the vaccine, is strictly a collaboration of three U.S. government institutions: the National Institute of Allergy and Infectious Diseases (NIAID), the Walter Reed Army Institute of Research, Silver Spring, Md., and the Naval Medical Research Center, Bethesda, Md.

I have grown increasingly skeptical over the years of private charity in Africa, and more widely, in general. There is no question that the battle to defeat malaria has benefited enormously from private charity, and specifically from the Gates Foundation.

Just as there’s been a lot of very good charity in all avenues of life throughout Africa with many successes.

But when push comes to shove not even Bill Gates’ billions is enough. Precisely because billions is not always the answer, but rather as shown by PfSPZ, years and years of expertise and experience from a variety of large government research institutions that work together.

Actually, that’s the key to the key: working together. Well meaning charity groups tend to be provincial and often secretive of their research, and I know this is particularly true of wildlife and conservation groups within Africa.

And it’s intrinsically true of private enterprise: Glaxo Smith Kline is probably the pharmaceutical that has spent the most money on malaria research. In 2009 they announced their best success yet, a vaccine that has proved about 30% effective in babies aged five to 17 months.

That’s nothing compared to the above three break-throughs.

At this point in the malaria battle it’s almost impossible to claim that any one group, including the government, has any total monopoly on research and development:

The battle against malaria has been energetically pursued by private enterprise and charity for my entire life in Africa, and before that and since the earliest development in colonial Africa, by government agencies.

So the body of research and experience regarding malaria is huge and very intermingled. Still, as demonstrated this week by the U.S. government health institutes, ultimately it is only massive and massively interconnected government agencies which can achieve the ultimate breakthrough.

And this is no less true of the battle against malaria than the battle against poverty or illiteracy or any social problem. And what’s more, when private success is achieved, it’s often only after much earlier public involvement.

Breakthrough drugs in general is the perfect example. Most drugs’ history begins in government funded public institutions, like university labs.

The irony, of course, is that Glaxo Smith Kline will likely be the principal commercial benefactor of the U.S. discovered malaria cure, as our archaic system won’t allow the U.S. government to manufacture and distribute the drug (except to our troops and civil servants).

Which, of course, is wrong. The drug would then be cheaper, and any profits could be plowed into something else … like say education or housing, instead of acid reflux disorder.

What we are learning in this fascinating journey towards eradicating malaria isn’t that there might not be a place for personal initiative or enterprise, but that the world is too large, complicated and interconnected today to achieve real social success except when governments work well.

And true, many, many don’t. But when on balance they do, like our own United States of America’s institutes of health, then yes, Virginia, happiness can be achieved.

Malaria Attacks Sequestration

Malaria Attacks Sequestration

Dr. Michael Riscoe
An exciting breakthrough may have created a new generation of effective, cheap and long-lasting malaria medicine for both curing and preventing the disease.

The breakthrough is exciting, because it came from out of the blue. We’ve been watching a number of malaria medicines and other strategies develop over the last several years, and this was not on the watch list.

It wasn’t on the watch list, because it comes remarkably from a not-for-profit, the Switzerland-based Medicines for Malaria and not from one of the world’s major pharmaceuticals, all of which have been working feverishly on achieving results that the creators of this drug believe they have accomplished.

Neither the Gates foundations or WHO or other major malaria fighting organizations were involved. It was the small Swiss not-for-profit, America’s National Institute of Health, an experimental lab at the Oregon Health & Science University and the Portland VA Medical Center.

These are not your normal worldwide players in major drugs. And kudus to them! These are … to put it mildly … social government institutions hurting from sequestration! They are examples of why government is necessary, and big government can be good government.

“We believe ELQ-300 has a chance to change the landscape of how we fight malaria across the world,” said Michael Riscoe, Ph.D., principal investigator in the research, a professor of molecular microbiology and immunology at OHSU and director of the Experimental Chemotherapy Lab at the Portland VA Medical Center.

Malaria is a highly complex disease with nine distinct stages, four in the mosquito and five in the victim, us. Virtually all previous drugs targeted one stage to disrupt the advance of the disease.

As published in the March 20 issue of Science of Translational Medicine ELQ-300 (or “Quinolone” as it’s likely to be called) targets multiple stages, finds the parasite long before other medicines detect it, can be used for both treatment and prevention with a single dose, and is inexpensive.

March 20? More than two months ago?

I can’t figure out why this news took so long to surface. The scientific report came out in late March, but worldwide media did not pick it up until last week.

When giant foundations and major multinational pharmaceuticals are involved, it can tempt one into all sorts of conspiracy theories. One wonders, for example, which multinational pharmaceutical will ultimately manufacture the drug and under what conditions.

But we may be jumping the gun. Human trials in Africa are only beginning.

But of all the malaria news I peruse, this looks extremely promising.