Naming Diseases After One’s Enemies

This is an interesting graphic showing the initial names giving to syphilis in various jurisdictions.
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The WHO recently came out against naming diseases after people, foods, animals, occupations, or places. However, this decision has raised some new concerns. According to Science:

Many scientists agree that disease names can be problematic, but they aren’t sure the new rulebook is necessarily an improvement. “It will certainly lead to boring names and a lot of confusion,” predicts Linfa Wang, an expert on emerging infectious diseases at the Australian Animal Health Laboratory in Geelong. “You should not take political correctness so far that in the end no one is able to distinguish these diseases,” says Christian Drosten, a virologist at the University of Bonn, Germany.

Naming diseases has long been a fraught process. Badly chosen names can stigmatize people, as did gay-related immune deficiency, an early name for AIDS. They can also lead to confusion and hurt tourism and trade. The so-called swine flu, for instance, is not transmitted by pigs, but some countries still banned pork imports or slaughtered pigs after a 2009 outbreak. More recently, some Arab countries were unhappy that a new disease caused by a coronavirus was dubbed Middle East respiratory syndrome.

 

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A Tentative (Mixed) Public Health Victory: The Slow Retrenchment of HIV-AIDS

This is from the Economist, on the state of the fight against HIV-AIDS.

The next UN target is that, by 2020, 90% of those infected should have been diagnosed and know their status, 90% of those so diagnosed should be on ARVs, and 90% of those on ARVs should have suppressed viral loads. That is ambitious, but history suggests those in the field will rise to the challenge.

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The blue line is testament to George W. Bush’s No. 1 foreign policy success: PEPFAR.

But we should count our chickens just yet. The trends in the graph above are not uniform across the globe. As I noted in a previous post, there is quite a bit of heterogeneity both across and within countries. For example, in East Africa, Uganda is lagging Kenya and Tanzania in the quest to tame the virus (see below).

On a different note, this is yet another data point to suggest that Yoweri Museveni has hit the inflection point, and from now on all his machinations to stay in power will wipe out the achievements of his first 20 years in power.

Quick hits

Follow the goings on in the DRC (especially this election season) over at Alex Engwete’s blog.

Living under the shadow of Kony and his men in Eastern CAR.

On a related note, the Ugandan army’s dirty war in the Congo and CAR.

Shame on the ANC. But there is still hope for cleaner politics in South Africa. The ANC is an over-size coalition with a high chance of internal breakup in the not so distant future. It might even occur sooner, over the Zuma succession. And this time it might not be a rather benign COPE affair. You can read more on the controversial bill over at the Economist.

Trying God? Churches claim to have cured HIV positive congregants. This goes beyond faith, it is naked exploitation. And a call for government involvement.

And lastly, a very dictator Christmas (via Blattman)

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The Catholic Church and AIDS: A Sorry Case of Denial

The Church’s continued ostrich approach to the catastrophe that is HIV/AIDS on the continent:

Pope Benedict XVI on Saturday signed off on an African roadmap for the Roman Catholic Church that calls for good governance and denounces abuses, while labelling AIDS a mainly ethical problem. Benedict signed the apostolic exhortation called “The Pledge for Africa” during a visit to the West African nation of Benin, his second trip to the continent as pontiff.

The document says AIDS requires a medical response, but is mainly an ethical problem.

Changes in behaviour are required to combat the disease, including sexual abstinence and rejection of promiscuity, it adds. “The problem of AIDS in particular clearly calls for a medical and a pharmaceutical response,” it says. “This is not enough however. The problem goes deeper. Above all, it is an ethical problem.”

More on this from the Daily Nation.

I have written against the Church’s policy on birth control here, here and here.

Can the fight against aids be won?

There is hope that the fight against AIDS can be won.

Over the last 30 years the disease has killed millions and created millions of orphans.

It’s lasting impact persists in lost human capital and reduced labor productivity (see paper on this here). But if the optimism of the Economist (and they are not known for their love of the bright side of things) is anything to go by, things might be changing for the better.

The 30th anniversary of the disease’s discovery has been taken by many as an occasion for hand-wringing. Yet the war on AIDS is going far better than anyone dared hope. A decade ago, half of the people in several southern African countries were expected to die of AIDS. Now, the death rate is dropping. In 2005 the disease killed 2.1m people. In 2009, the most recent year for which data are available, the number was 1.8m. Some 5m lives have already been saved by drug treatment. In 33 of the worst-affected countries the rate of new infections is down by 25% or more from its peak.

Even more hopeful is a recent study which suggests that the drugs used to treat AIDS may also stop its transmission (see article). If that proves true, the drugs could achieve much of what a vaccine would. The question for the world will no longer be whether it can wipe out the plague, but whether it is prepared to pay the price.

More on this here.

south africa steps up fight against aids

The most embarrassing part of Thabo Mbeki’s presidency was his bizarre approach to South Africa’s AIDS epidemic. Together with his nutty health minister, President Mbeki refused to dot the lines between the HIV virus and AIDS. The Minister was known to traffic in the idea that beetroots and traditional herbs could confront the deadly virus.

It is thus encouraging that Mr. Zuma, Mbeki’s successor has taken a more rational approach. Mr. Zuma recently declared that he is HIV negative. The country is currently in the midst of a massive campaign to have at least 15 million South Africans tested by June 2011. South Africa has 5.7 million HIV positive citizens, the biggest number of any country.

Mr. Zuma himself is known to have had sex with a HIV positive woman. This particular sexual encounter was the subject of a public trial in which Mr. Zuma was accused of rape. The South African president prevailed in court in a ruling with which many were not satisfied.

South Africa’s liberal streak…

South Africa is the only country in Africa (and one of only five in the world) to legalize gay marriage – It did so in November of 2006. And now if some progressive politicians have it their way prostitution will become legal too in the country. The advocates of the move are arguing that if the oldest profession is made legal in South Africa, it will enable the government to regulate it, tax it and curb the spread of HIV/AIDS through better provision of health services and sex-ed to the commercial sex workers. On the other side of the argument are those concerned with morals and the effect this may have on South African family values.

I must say I am impressed by the boldness of those advocating for legalization of prostitution in South Africa. The country has one of the highest HIV infection rates in the world – perhaps an indicator of a thriving albeit life-sucking sex industry – and it would make sense for the government to be able to provide healthcare to registered sex workers. The Mbeki administration was grossly incompetent in addressing South Africa’s AIDS problem. It is my hope that the Zuma administration will steer clear of Mbeki’s bizarre AIDS policies, and what better way to start than by making sure that sex workers are not spreading the disease.

As for those concerned with morals, the high HIV infection rates in South Africa should be a wake up call. Yes we should preach abstinence as the ideal and try as much as possible to instill proper family values in young men and women. But at the same time we should acknowledge the simple truth that people will always have sex, period. Pretending otherwise will only lead to more deaths, more orphans, lost productivity and a whole lot of misery for those left behind.

The AIDS-TB killer monster

March 24th, is world TB Day. But this year’s commemoration was tainted by the bad news about the drug resistance strains of TB whose incidence seems to be on the rise. IRIN News (an excellenet news source on matters third world) is reporting that the incidence of the drug resistance varieties of TB are on the rise. The WHO, according to the IRIN report, blames this on “non-existent labs, lack of inspection control and diagnostics, and poor treatment adherence.” African countries are the worst affected (surprise??). Healthcare expenditure still remains low in most of these countries and the very high incidence of HIV/AIDS on the Continent only serves to complicate matters. TB fatality rate (for those with drug resistance strains) is as high as 90% for people with HIV/AIDS.

Disease treatment/control is still last-century in most of Africa. For most Africans, the choice is sometimes between putting a meal on the table or getting treatment. The other contributing factor to the many epidemics that continue to rock the continent is ignorance. Indeed drug resistant varieties of TB are oftentimes a result of people not taking their daily doses as required.

Matters are not all gloomy though. Former US president Bush’s gift of PEPFAR continues to save lives in Africa and other places. But money from foreigners is not the answer but mere band aid. The strong correlation between ignorance and poverty and disease burden suggests that education and economic growth could go a long way in terms of disease control on the Continent.I only wish that African governments took disease control, education and the economic well-being of their populations more seriously.

on this one I disagree with the church

The Catholic church continues to forbid the use of condoms and all other contraceptives among its faithful. Such teaching is mostly emphasized in the third world – Africa, Latin America and Asia – where the populations continue to remain oblivious to the virtues of family planning and disease prevention through the use of contraceptives. This at a time when the Church’s home continent – Europe – is experiencing a demographic decline. People are able to better plan their lives if they can control the number of children they have. Period. The Vatican has failed to enforce its have-as-many-children-as-you-can and don’t-use-condoms policies at home and so it trumpets them abroad – and in places with serious problems of over-population. I say this is hypocritical.

Millions around the world have died of AIDS, causing untold suffering to tens of millions of orphans. The use of condoms, although not 100% efficient, has been known to substantially reduce chances of infection. So it does not make any sense that the Church would continue to ban its use. Does the Almighty really want parents dying, leaving behind orphans who can’t fend for themselves? Does He really want families having 12 children that they can’t feed or educate? Abortion might be another issue (and genuinely so) but preventing pregnancies – without having to kill any embryos or fetuses – or avoiding diseases through the use of condoms should never even be debated. It is common sense. I don’t understand how the Church can endorse the veracity of Darwin’s theories (of course as GUIDED by God) and refuse to acknowledge this simple fact.

And about abstinence. It is great, but most people never practice it. It is time the Church stopped pretending that this is a viable way of coping with the spread of AIDS. More than two decades of the disease have proven otherwise. Government health officials throughout the third world should be honest with the Church and inform them to change this weird policy or face penalties. It is lives we are talking about, not some theologian’s ideas of the ideal Christian society.

And don’t even get me started on how these weird church policies disproportionately burden women – through both risky and costly child bearing and diseases.

Just for the record, I am Catholic.