Last week, President Bush signed a bill allocating $15 billion for AIDS drugs in Africa (and funding efforts against tuberculosis and malaria). In his State of the Union address earlier this year, Bush said of the AIDS initiative that "seldom has history offered a greater opportunity to do so much for so many." It's good to hear some cost-benefit analysis being employed even on a grandiose government project, one that could easily be sold with nothing more than a tug at the heartstrings. With luck, it will pay off in millions of saved lives.
A few less-publicized events in the past several weeks held by the Sabin Vaccine Institute, TechCentralStation, Choosenow.net, and the Mount Sinai School of Medicine were reminders that good scientific ideas tend to be sold on the basis of their benefits while unscientific ideas tend to be sold through fear.
Instilling a basic appreciation of science and its fruits in the minds of Europeans is the goal of ChooseNow.net and its sister project, a poster series called Sci-Bus, displayed on public transportation. Project leader Frank Burnet, a science communication professor at the University of West England in Bristol, explained in a recent New York City speech that young people are far more likely to take an interest in science when they feel free to debate its benefits than when they're simply asked to memorize its basic principles, so he's inviting them to do so on ChooseNow.net while imparting some basic science facts at the same time (biotech is a hot topic right now).
The idea that public participation lessens fear is a popular one in England right now, and it was an idea that came up repeatedly at the May 9 conference on risk and public panics held by TechCentralStation.be (the European counterpart of TechCentralStation.com) and Spiked-Online.com, where I spoke about inordinate fear of chemicals and the relative safety of smokeless (vs. smoked) tobacco. Though the TCS crowd come mostly from the right and Spiked mostly from the left, they are both concerned that a pervasive risk aversion and timidity whether in the form of excessive environmental regulations or political correctness is stymieing innovative thinking in Europe. Panicked reactions to unfamiliar things are, of course, nothing new as I noted in a column about medieval plague fears for TCS.
What luxurious lives we must lead if we can now afford to panic over imagined side effects of science instead of the myriad ills from which science has delivered us. Luckily, there is at least one prestigious organization that still sees the big picture and honors the medical innovators who are helping to save countless lives each day. The Sabin Vaccine Institute held their annual awards dinner on May 14 (one of the last functions overseen by departing White House press secretary Ari Fleischer), bestowing a lifetime achievement award on Bernard Poussot of Wyeth Pharmaceuticals, humanitarian awards on singer Paul Simon and Irwin Redlener, M.D., for co-founding the Children's Health Fund, and an additional humanitarian award on George Washington University president Stephen Joel Trachtenberg. In his acceptance speech, Wyeth's Poussot made explicit the fact that innovators and risk-takers, not the risk averse, have been crucial in making our world a substantially safer place: "They take risks and sometimes they stumble, but when they succeed...they improve the human condition...It is dramatic to compare health outcomes in our own day to a remote century."
GWU's Trachtenberg added his own reminiscence about living in the days of polio outbreaks: "They closed the swimming pools...The first thing kids were aware of was that we couldn't go swimming...It turned a pleasure into something scary and off-limits...one of the most unsettling aspects of my childhood and many others' and then the amazing news, there was a vaccine." Trachtenberg noted that the phrase "polio vaccine" has about as much resonance for his two sons "as 'Lindy hop' and 'zoot suit' and that's a good thing; I am not nostalgic." Some of us try to remember how much we owe to modern medicine, though.
The horrible contrast between life with and without vaccines can still be seen by comparing the lengthening lifespans of people with AIDS in the West and people with AIDS in Africa. The stateside version of http://TechCentralStation.com held a panel discussion on Capitol Hill on May 14, the same day as the Sabin event, at which TCS columnist James Glassman and anti-malaria activists Roger Bate and Richard Tren described the immense benefits that could come from getting AIDS-controlling pharmaceuticals to neglected patients in Africa. Interestingly, one of their main conclusions was that drug prices are not the main obstacle to treatment which means that price controls and the abolition of patents, measures usually favored by AIDS activists, are not necessarily the best solutions to the problem. Even when pharmaceutical companies have agreed to give away drugs for free or at very little cost, some governments in Africa have been reluctant to treat AIDS. As Tren said, "Government has shown that not only is it unwilling to provide drugs itself but that it can actually be quite malicious." Even in industrialized South Africa, the president has expressed pseudo-scientific doubts about the connection between HIV and AIDS and thus been reluctant to facilitate pharmaceuticals-based treatment programs. Rather than pouring aid money into governments that don't care about AIDS patients or barely-functional, sometimes superstitious public hospital systems, Tren and Bate suggest doing an end-run around African bureaucracies and distributing pharmaceuticals through a network of private relief organizations and NGOs. Private efforts may yet be needed to make Bush's big government project work smoothly.
And while millions in Africa wait to receive the benefits of medical science, back in New York City, doctors affiliated with the Mount Sinai School of Medicine, including Philip J. Landrigan, could afford to indulge in highly speculative attacks on modern chemistry. On May 16, the New York Academy of Medicine hosted a conference on Early Environmental Origins of Neurodegenerative Disease in Later Life. As the brochure put it, "Pesticides, persistent organochlorines, and heavy metals are widely distributed in the American environment...[and] little is known about the possible long-term impacts of early exposures to these chemicals on the genesis of neurodegenerative disease of the elderly." Little is known is putting it mildly, but that won't stop Landrigan and company from making some fear-filled guesses.
All in all, from what I've heard over the past few weeks, I'll side with the risk-takers, innovators, scientists, and life-savers instead of the superstitious and frightened.