Monday, October 31, 2005

The New York times: "Gates Announces Anti-Malaria Donation"

"The Bill and Melinda Gates Foundation will donate $258 million to research on malaria, which kills 2,000 African children each day, Mr. Gates announced yesterday.

"About $108 million will be put toward a vaccine, $100 million for new drugs, and $50 million to develop insecticides and other forms of mosquito control.

"Since 1999, the foundation has donated about $230 million to malaria research. Six new drugs for the disease are now in clinical trials, compared with none five years ago, and an experimental vaccine that protects about 30 percent of inoculated children has been developed."

Michael Brown, Redux

Read the full editorial in The New York Times (subscription required.)

"Responding to questions from three Democratic senators - Barbara Boxer, Paul Sarbanes and Barack Obama - at her confirmation hearing last week, Ellen Sauerbrey, the former Maryland state legislator nominated by President Bush to head a key State Department humanitarian bureau, could come up with no convincing reason for why her lack of any relevant experience coordinating emergency aid shouldn't disqualify her from the job. And yet the Senate once again seems to be on the eve of confirming another clearly unqualified Bush appointee.

"As for her credentials, Ms. Sauerbrey apparently did a fine job serving as the state chairwoman of Mr. Bush's 2000 campaign. She is currently serving as the American representative to the United Nations Commission on the Status of Women, where she has zealously pursued an anti-abortion and anti-family-planning agenda. She has alienated many human rights groups, but endeared herself to the White House and her party's far-right wing. "

Friday, October 28, 2005

Conventional Wisdom and Freekonomics

I just read the great chapter on "Conventional Wisdom" in John Kenneth Galbraith's 1958 book, The Affluent Society. It is a riff on the way in which knowledge that is acceptable drives out knowledge that is right (but forbidding) in the short run, but on the way knowledge that is merely acceptable deteriorates in the long run. I recommend it.

I thought to go back and read Galbraith after I read a long quote in Steven D. Levitt and Stephen J. Dubner's book, Freakonomics : A Rogue Economist Explores the Hidden Side of Everything. It is not surprising that an unconventional book on economics which is itself a pleasure to read, refers to Galbraith's earlier book with the same virtues. Levitt takes great pleasure in finding gaps between knowledge that is acceptable and knowledge that is right, and exposing those gaps. He often uses indirect and inconspicuous indicators in the process, such as statistics on the elimination votes on the quiz show, "The Weakest Link," to measure discriminatory attitudes.

Thursday, October 27, 2005

"If you build it, they will pay"

Read the full article by Catherine Zandonellain the IAVI Report

"A novel incentive called an Advance Market Commitment could help spur private sector investment in AIDS vaccine research and development."

"What if you could order your dream house, the perfect abode that would take years to design and build to perfection, but only have to pay for it on the day you are ready to move in? Global public health experts are exploring just such a concept, only the "house" is a vaccine for a disease such as AIDS and the people buying it are international foundations and governments that want to provide the vaccine to the poorestnations on the planet. The important part is these donors only have to pay for the vaccine once biopharmaceutical companies create it.

"Under an AMC, donors would pledge to purchase a new vaccine for one of these developing-country diseases at a price that would generate revenues that match other health products in a global competitive marketplace. The donors would commit to pay a set price for a certain number of people immunized, after which the vaccine company would be obligated to sell to eligible countries at an agreed-upon lower price that is affordable in the developing world.

"'The goal is to create a market of sufficient size to encourage industry to invest in vaccine development,' says Robert Hecht, senior vice president for public policy at IAVI, one of several organizations exploring the concept.

"IAVI envisions AMCs as part of a comprehensive strategy. The commitment would "pull" on industry to engage in vaccine research and would complement existing "push" mechanisms such as funded research in academic labs and biotechnology companies. To make the concept successful, the global health community must also work on removing barriers to vaccine research across a range of issues, including clinical trials, intellectual property, and liability. "Advance market commitments are part of a menu of things that are necessary, none of which alone is sufficient," says Seth Berkley, president and CEO of IAVI."

Senate Initiative to Spur Vaccine Research and Development

International AIDS Vaccine Initiative (IAVI) homepage with the story.:

"The International AIDS Vaccine Initiative (IAVI) applauds Senators John Kerry (D-MA) and Richard Lugar (R-IN) for introducing S. 1698, 'The Vaccines for a New Millennium Act of 2005,' which calls for greater resources and incentives to spur research and development of new preventive technologies to address global killers such as HIV/AIDS, tuberculosis and malaria. The increased funding, innovative financing mechanisms, tax credits, and improved regulatory procedures envisioned in this bill are key components of a comprehensive effort to accelerate product development for these diseases. "

Read Senatory Lugar's announcement.

Read Senator Kerry's announcement.

"AVIAN INFLUENZA: Preaching Against the Pandemic"

Read the full article in Science. (Subscription required.)

"In a pandemic, antiviral drugs like Tamiflu can't be more than a stopgap; only vaccines offer long-term protection. As for supply, for the next 5 years at least, the world is stuck with the nine major flu vaccine companies, which produce just 300 million doses annually using chicken eggs, a process that's difficult to scale up quickly. They could all switch to making pandemic vaccine in an emergency--but they would need to produce billions of doses instead of 300 million.

"The only way to increase supply dramatically, Fedson says, is to produce vaccines that use far less antigen, or viral proteins, per dose. For the annual influenza vaccine, which protects against three different strains, manufacturers use 45 micrograms of antigen, 15 for each strain. To vaccinate 3 billion people during a pandemic--and assuming everyone will need two shots--the amount of antigen per shot would have to come down 20-fold, to about 2 micrograms. Studies have suggested that such small doses may be effective when coupled with a so-called adjuvant, such as alum, to rev up the immune system."

"AVIAN INFLUENZA: Are Wild Birds to Blame?"

Read the full article in Science.

"Evidence implicating wild birds is starting to convince even some of the doubters. "Until about 2 months ago, I was pretty skeptical on whether wild birds were playing a role," says David Suarez, a virologist with the U.S. Department of Agriculture's (USDA's) Southeast Poultry Research Laboratory in Athens, Georgia. "But now I feel that there is much stronger evidence that wild birds are spreading the virus." What changed his mind, he says, was the death of 100 or so ducks, gulls, geese, and swans from H5N1 at a remote lake in Mongolia that he believes can't be explained by human activities. And, he and others add, in an unexpected twist, it's beginning to look as though the culprits might not be the long-suspected migratory waterfowl but another yet-unidentified wild species."

Wednesday, October 26, 2005

The Economist on Avian Influenza

Read the full article in the Economist. (Subscription necessary.)

"The most effective way to prevent a human pandemic would be to control any outbreak in domestic birds (the disease cannot be stopped in wild birds). Containing this disease would also make economic sense for the poultry industry and the many farmers in poor countries with smallholdings of ducks, geese and chicken that are a crucial part of the food supply but vulnerable to the H5N1 virus.

"The United Nations Food and Agriculture Organisation (FAO) has called on countries on the flight paths of wild birds to set up warning and surveillance systems. These include northern Africa, the Middle East, Central Europe, India and Bangladesh. In such places, people live more closely with poultry, and the arrival of bird flu is cause for concern because it could lead to many new human cases......

"In an outbreak of H5N1 in Hong Kong in 1997, the territory acted quickly to destroy 1.5m chickens, virtually its entire stock. This action undoubtedly prevented an expensive regional outbreak until H5N1 emerged again in 2003. It may also have prevented a human pandemic. If the world is to keep the threat at bay, more painful sacrifices like this will be vital.

"For that, some kind of global fund would be helpful to encourage culling, monitoring and the correct use of animal vaccines. The FAO estimates that $175m is needed to begin tackling the problem of avian flu at source by setting up control programmes. To date, $30m has been pledged but the World Bank and the European Commission are expected to invest much more in the control of flu through vaccination and better monitoring."

H5N1 Outbreaks: Jul '05 to 12 Oct'05 (Source: FAO map site.)

Tuesday, October 25, 2005

What is the Risk from a Flu Pandemic

Read the SciDev.Net editorial by David Dickson that triggered this posting.

David wrote:

"The need for clear and sound information about bird flu is obvious if such reactions are to be avoided. Government officials clearly have a responsibility to ensure that this takes place. But in an era of widespread distrust of public institutions, this is no longer sufficient. Equally, if not more, important, is the role of journalists and the media.

"The task is made both more important and more difficult when official organisations seek, for reasons of their own, to place a 'spin' on the information they present. Last year, for example, we criticised the behaviour of governments in Asia that were restricting the information they divulged about bird flu outbreaks — sometimes even denying that outbreaks had occurred (see Bird flu: the communication challenge).

"More recently a new culprit has emerged, namely the temptation by international agencies, perhaps keen to squeeze extra funding from reluctant donors, to overstate the size of potential problems they are likely to face.

"Last month, for example, the World Health Organization issued a hurried correction after its top official responsible for handling the bird flu crisis, David Nabarro, told the media that the diseases could cause 'between five and 150 million deaths', comparing the challenge to that of a combination of climate change and HIV/AIDS. The following day, the agency clarified the statement to say that its estimate of the number of people who could die was 'between two million and 7.4 million'."

What we really need, and don't have, is an estimate of the probability distribution of pandemic sizes!

The National Vaccine Program Office notes, "History suggests that influenza pandemics have probably happened during at least the last four centuries. During the 20th century, three pandemics and several "pandemic scares" occurred." I have seen one estimate that there have been ten flu pandemics in the last 300 years.

The BBC reports:
- Spanish Flu 1918-9 - Killed up to 40million. (Others suggest that the number may have been 50 million to 100 million; one of the problems is that no one really knows the numbers of people killed by these pandemics, and the farther in the past, the less certain the data.)
- Asian Flu 1957-8 - About 1million died from the flu.
- Hong Kong Flu 1968-9 - Similar death toll to the Asian Flu.

Some of the "false alarms" according to HHS:
- 1976: Swine Flu Scare (See my previous posting.)
- 1977: Russian Flu Scare (An epidemic caused by a type of flu that had disappeared for 20 years. People under the age of 20 had no immunity to the A/H1N1 virus but older people did. Thus the worst of the epidemic was confined to young people, and the event was not seen as a true pandemic.)
- 1997-1999: Avian Flu Scare (at least a few hundred people became infected with the avian A/H5N1 flu virus in Hong Kong in 1997 and in 1999, another novel avian flu virus – A/H9N2 – was found that caused illnesses in two children in Hong Kong. It is the avian flu that is of most concern at this time.)

The World Health Organization states, considering normal flu outbreaks (that is, the annual flu outbreaks caused by already circulating viruses for which there is preexisting immunity or resistance in a significant portion of the population):
"In annual influenza epidemics 5-15% of the population are affected with upper respiratory tract infections. Hospitalization and deaths mainly occur in high-risk groups (elderly, chronically ill). Although difficult to assess, these annual epidemics are thought to result in between three and five million cases of severe illness and between 250,000 and 500,000 deaths every year around the world."

Thus, we can expect a new pandemic to occur about once every 30 years, and it is more than 35 years since the last one, but we can not predict with any precision which year such a pandemic will strike.

We can also predict false alarms, in which infections occur which are perceived by public health officials to constitute important warning signs of the possibility of a pandemic, but which are not followed by the feared pandemic.

When an epidemic does emerge, the number of people infected will depend in part on the ease with which the virus is transmitted from person to person, as well as the effectiveness of public health measures taken. The number of severe cases of the disease will depend on the number of people infected, the level of cross immunity in the population (if any), and the virulence of the virus. So too, the number of deaths will depend on the lethality of the virus in those infected, and the effectiveness of the medical services in treating the very ill.

Put it another way. Perhaps 97 of the last 100 years saw "normal" flu epidemics, which might cost 250,000 to 500,000 deaths per year. Two of the hundred years saw pandemics that cost perhaps one million deaths. One year saw a pandemic that cost many tens of millions of deaths per year. On the other hand, over the last half century on the five or six occassions on which public health officials thought a pandemic likely, pandemics actually occurred twice.

Will a pandemic occur in 2006 or 2007? No one knows. Under any circumstance, flu is a major problem worldwide. Any pandemic is terrible, and it seems to me that the public health officials are telling us that one is more likely in the next couple of years than usual. Pandemics causing tens of millions of death are quite rare -- only one in the last hundred years. However, as Hurricane Katrina has shown us, one-in-a-hundred-years events do happen, and they can be so damaging that preparation is the wiser course.

Predicting the course of an epidemic shares something with predicting the course of a hurricane. During the event itself, as data accumulates, predictions become more and more accurate. Trying to predict a couple of years in advance the exact course of either a hurricane or a pandemic is a futile exercise. At best, for long term predictions one can only begin to guess at what would be a once a century event. But it is important to use the best current information to guess how likely the events in the next couple of years are to be the once-in-a-century variety.

The publication of a prediction of a pandemic by WHO to a global audience is different than the publication of a prediction by an epidemiologist in a professional journal. WHO is of course concerned with the accuracy of the prediction. It is also concerned that it not cause panic by too draconian a prediction, but that its prediction is sufficiently grave as to alert the proper authorities to take appropriate actions. It does not surprise me that WHO might waffle on the prediction. I think it unfair for David to imply it might be doing so for ulterior motives.

Influenza Pandemics and Pandemic Scares in the 20th Century

Read the brief history from the website of the National Vaccine Program Office of the U.S. Government's Department of Health and Human Services.

"History suggests that influenza pandemics have probably happened during at least the last four centuries. During the 20th century, three pandemics and several "pandemic scares" occurred. These are described in more detail below."

Bird flu update: 24 October 2005

Read the full SciDev.Net Roundup:

"A roundup of the key developments on the spread of the bird flu virus (H5N1) and the threat it poses to human health. Each title is a link to the full article."

Oral Histories Project on Stability Operations: Iraq Experience

This is a collection of very interesting interviews that have been produced by the Professional Training Program of the U.S. Institute for Peace. The 35 interviews appear all to have been conducted in 2004. The interviewees are all people who worked in Iraq in the reconstruction undertaken in the aftermath of the war. The interviews were intended "to draw lessons learned and address the challenges of post-conflict intervention." The interviews are remarkably frank. I have included the summaries of two interviews below:

"Retired USAID officer Larry Crandall pulled two tours in Iraq. Crandall was asked to travel to Iraq following a Foreign Service career throughout which he garnered expertise on war and civil conflict. His experiences include work in Haiti, Afghanistan, and Pakistan. For the two months encompassing the kinetic part of the war, he was involved in preparing plans for the demilitarization, demobilization, and reintegration (“DDR”) of Saddam’s armed forces and those of the anti-Saddam militias.

Mr. Crandall expressed several reservations with the reconstruction effort. He notes a lack of proper planning and inadequate implementation of existing plans. The latter was largely due to inexperience and became particularly problematic. He stated that the occupation led by Jerry Bremer essentially ignored the DDR plan until it was too late for effective implementation. Bremer lacked the experience to understand the political aspects of demilitarization. This lack of recognition had the result that none of the essential recommendations were undertaken.

"Crandall also witnessed planning problems as the prime deputy involved with the $18,000,000,000 reconstruction program. He found that there was no policy directing the use of the funds and that those responsible lacked the experience necessary for effective implementation. This combination led to a disconnect between quick-start projects and long-term projects.

"Crandall raises other issues, including the level of corruption among the Iraqis, the error of the total exclusion of Baathists from the reform process, the reactive mode of the public affairs (Stratcom) office, and the difficulty of recruiting the best officers to serve in Iraq due to security and career concerns. Security concerns have also damaged the ability to use development funds to carry out projects in Iraq.

Ambassador Robin L. Raphel was born in the State of Washington in 1947. She received a BA from the University of Washington, and MA's from University of Maryland in economics and from Cambridge University, Newhall College in the United Kingdom, also in economics. She entered the Foreign Service in 1977 and served mainly as an economic officer. Her areas of specialization were South Asia, she was assistant secretary for the area, and the Middle East. She was ambassador to Tunisia. She was vice president of the National Defense University when called upon to serve on the General Garner team going to Iraq. She served in Kuwait and Iraq from April to August 2003. In Kuwait while waiting to go to Iraq there was little training. The group was not prepared. Ideology was the overriding factor. She felt that there was clear political pressure, election driven and calendar driven to invade Iraq before there was sufficient preparation and significant international support. Training was not the issue, experience was from work in Afghanistan and the Balkans, but this was not tapped. She was to be the senior advisor to the Ministry of Trade.

"The Iraqi Ministry of Trade was responsible for food distribution under the Saddam regime after the sanctions. It was considered it to be an efficient system and the U.S. planned to reinstate it as an interim measure. While the top officials were gone there was a significant number of midlevel Iraqi officials to run the program. The biggest problem was looting, which had destroyed the offices of the ministry and its means of communicating with storehouse throughout the country. Initially coordination was done by messengers in automobiles.

"Foodstuffs were coming into Iraq in sufficient numbers. The Iraqis worked well with the interviewee. They were helped by U.S. civil affairs units which performed with a range of efficiency. The Kurdish area took care of itself. There were problems in the Sunni area but security was not an overriding problem until after the interviewee left. The South was poorer than the rest of the country. Trade between neighboring states quickly restored itself and in a short time the market place was bustling with no attempt to collect custom duties. There was not much initiative on the part of the bureaucratic structure as it had always been directed from above.

"The debaathification program and the demobilization of the army were unwise. These decisions were ideologically based, not on understanding or analysis. The American 'neocon' ideology was that it would be an easy war and we would be welcomed with open arms. This was ill-judged and eventually we changed our course. Regarding contractors such as Halliburton and KBR this was 'just good old boys making a lot of money, and Asian truck drivers'. When the interviewee was in Kuwait she used gallows humor and said to her Foreign Service colleagues 'Don't worry, within week we will be on our knees to the UN because we can't do this.'

"Information Society: The Next Steps "

Read the full Special on the Development Gateway's Information and Communication Technology for Development topic page.

"The Information Society has produced a tantalizing array of new information and communication technologies (ICT) that today have transformed the approach to global development. Access to these technologies is spreading rapidly. In 2005, the number of Internet users in developing countries will cross the 500 million mark, surpassing industrial nations for the first time. By some estimates, more than 75 percent of the world’s population now lives within range of a mobile network. Yet the long-heralded promise of ICT remains out of reach for most of the developing world. For the information poor, economic and social gaps are in fact widening both within and between countries.

"Following on the rapid expansion of the Information Society, the United Nations called for a World Summit on the Information Society (WSIS) organized under the auspices of the International Telecommunication Union. The two-phase summit, begun in Geneva in 2003, concludes in November 2005 with WSIS Phase II in Tunisia. The goal of this meeting is to assess progress and prompt further global action to capture the promise of ICT for all. This Special Report "Information Society: The Next Steps" looks at how the ICT landscape is changing in the developing world and what lies ahead. Experts from governments, donors, NGOs and the private sector speak out about effective policies, promising applications and innovative business models.

Monday, October 24, 2005

"Amazon Drought Worst in 100 Years"

Read the Environment News Service article.:

"Manaus, capital of the state of Amazonas, and the entire eastern region of the state are suffering the worst drought in more than a century. A government scientist who calls it an 'atypical' drought says it is chiefly caused by warmer ocean temperatures.

"Scientist Carlos Nobre, of the National Institute of Space Research (INPE), said, 'When it comes to the Rio Negro, in Manaus, this drought has no parallel in the last 103 years. That is, since 1902, when the level of the Rio Negro began to be measured,' he said.

"In the eastern part of the region, this is the worst drought in the last 50 or 60 years, he estimates. The governor of Amazonas state has declared a crisis due to the drought."

Sunday, October 23, 2005

Decision Making in the White House

Read Lawrence Wilkerson's talk at the New America Foundation.

This talk is getting a lot of attention in the media, where it is being characterized as an attack by an insider on the Bush Administration. I think it is more important than that.

Wilkerson was Chief of Staff in Colin Powell's State Department. Prior to that he worked for Powell in the private sector, and he worked directly for Powell in the Department of Defense when Powell was Chair of the Joint Chiefs of Staff. Thus Wilkerson has seen decision making personnally in three administrations. Moreover, he has taught at the Naval War College and the Marine Corps War College, focusing on the national security decision-making process. Thus he has both academic and practical experience with top level decision making.

He maintains, as I read him, that the process set up by the 1947 National Security Act under Harry Truman, has deteriorated under the administrations since that of Eisenhower, but is really broken now. He portrays the process as supposed to be fully participatory in order to get all the evidence before the decision makers and to fully enlist the collaboration of those who will have to implement the decisions. He goes back to the Constitution and the framers who recognized that the government would be run by people, not by philosopher kings, and who put checks and balances in place to assure that the decision making processes of government would be open and transparent to protect against poor decisions by average men finding themselves in charge. Wilkerson also cites the Goldwater-Nichols legislation of the 1980's that successfully confronted the problem of fragmentation of the information and decision processes among the military services of the United States.

Wilkerson says that
no one, in my study of the (National Security) act’s implementation, has so flummoxed the process as the present administration.

The core of his critique is:
What I saw was a cabal between the vice president of the United States, Richard Cheney, and the secretary of Defense, Donald Rumsfeld on critical issues that made decisions that the bureaucracy did not know were being made. And then when the bureaucracy was presented with the decision to carry them out, it was presented in a such a disjointed, incredible way that the bureaucracy often didn’t know what it was doing as it moved to carry them out......

in some cases there was real dysfunctionality – there always is – but in most cases it was Dr. Rice made a decision, she made a decision – and this is all about people again because people in essence are the government. She made a decision that she would side with the president to build her intimacy with the president.

And so what we had was a situation where the national security advisor, seen in the evolution over some half-century since the act as the balancer or the person who would make sure all opinions got to the president, the person who would make sure that every dissent got to the president that made sense – not every one but the ones that made sense – actually was a part of the problem, and probably on many issues sided with the president and the vice president and the secretary of Defense. And so what you had – and here I am the academic again – you had this incredible process where the formal process, the statutory process, the policy coordinating committee, the deputies committee, the principal’s committee, all camouflaged – the dysfunctionality camouflaged the efficiency of the secret decision-making process.

Wilkerson suggests that the Congress really needs a leader to stand up and manage a long, inclusive process to fix the government, to improve the coordination among government agencies involved in the national security process, and to reform the national security decision making process.

The following quotation from an article by Jeffrey Goldberg, based on an interview of Brent Snowcroft, supports Wilkerson's analysis:
A common criticism of the Administration of George W. Bush is that it ignores ideas that conflict with its aims. "We always made sure the President was hearing all the possibilities," John Sununu, who served as chief of staff to George H. W. Bush, said. "That's one of the differences between the first Bush Administration and this Bush Administration."

I asked Colin Powell if he thought, in retrospect, that the Administration should have paid attention to Scowcroft's arguments about Iraq. Powell, who is widely believed to have been far less influential in policymaking than either Cheney or the Secretary of Defense, Donald Rumsfeld, said, pointedly, "I always listen to him. He's a very analytic and thoughtful individual, he's powerful in argument, and I've never worked with a better friend and colleague."

When, in an e-mail, I asked George H.W. Bush about Scowcroft's most useful qualities as a national-security adviser, he replied that Scowcroft "was very good about making sure that we did not simply consider the 'best case,' but instead considered what it would mean if things went our way, and also if they did not."

The Snowcroft interview is to be published in the January 31 issue of the New Yorker (on the newstands tomorrow), but is quoted at length in Steve Clemons great blog.

The theme of my blog is the role of knowledge in social and economic development. I have often focused on the quality of knowledge that is used in decision making, and I do believe "garbage in, garbage out!" I also believe process is critially important to getting high quality knowledge in decision making. Wilkerson makes the point that it is perhaps more important that the process be inclusive, open and transparent, with appropriate checks and balances. It is a good point!

Saturday, October 22, 2005

"Hughes Misreports Iraqi History: Envoy Vastly Overstates Fact in Justifying War to Indonesian Students"

Read the full article in the Washington Post.

"Bush administration envoy Karen Hughes visited Indonesia on Friday as part of her campaign to repair U.S. standing with the world's Muslims and defended the invasion of Iraq by telling skeptical students that deposed president Saddam Hussein had gassed hundreds of thousands of his own people."

She is quoted as having said in reference to the number of people killed by poison gas:
"It's something that our U.S. government has said a number of times in the past. It's information that was used very widely after his attack on the Kurds. I believe it was close to 300,000."

"That's something I said every day in the course of the campaign. That's information that we talked about a great deal in America."

The article also states:

"State Department officials later acknowledged that Hughes, tapped by President Bush and Secretary of State Condoleezza Rice to set the record straight on U.S. policies in the Muslim world, had misreported history.

"Although at least 300,000 Iraqis are reported to have died during Hussein's 24 years in office, his government's use of chemical weapons against Iraqi Kurds cost the lives of only a small proportion, most notoriously an estimated 5,000 people who died in a 1988 military campaign in the northern town of Halabja.

"Hughes, who is undersecretary of state for public diplomacy, made her remarks at Syarif Hidayatullah State Islamic University, south of Jakarta.......Hours later, Hughes was asked twice for the basis for her numbers during a meeting with journalists from foreign news organizations.......

"Though a longtime political adviser and confidante of Bush, Hughes is a relative newcomer to international affairs. She was appointed this year to energize the State Department's public affairs efforts and burnish the U.S. image, which has been badly tarnished in the Muslim world by the invasions of Iraq and Afghanistan and support for Israel in its conflict with the Palestinians."

How can the Undersecretary of State for Public Diplomacy, on a trip to brief people in Muslim countries, not have fully mastered the information on the decisions she seeks to defend?

"Avian flu on the wing: are wild birds to blame?"

Read the entire SciDev.Net article:

"The bird flu H5N1 virus is spreading fast, and the general view presented in the media is that migratory birds are to blame.

"Yet, writes Dennis Normile in Science, bird experts have been almost unanimously sceptical about this theory. They argue that sick or dying birds cannot fly very far, and that even if they were carrying the virus, H5N1 should already have arrived in places where it has not."

Friday, October 21, 2005

"African countries act on bird flu"

Read the full article on BBC News.

"At least seven African countries have banned imports of poultry from parts of Asia affected by bird flu."

"Bird Flu Drug Tamiflu's Primary Ingredient Washed Out in Mudslides"

Read the full article in Avant News.

"With bird flu, also known as avian flu, now confirmed to have mutated into a form that can be transmitted human-to-human, international disease control agencies are concerned by a new report that virtually all of this year's star anise crop, a vital component of Tamiflu grown only in four provinces of China, has been wiped out in a series of mudslides brought on by unseasonably strong tropical storms in the region. Tamiflu, the antiviral medication produced by Roche of Switzerland and one of the few treatments available for those who have already contracted bird flu, requires star anise, specifically Shikimic acid, a star anise derivative, as a primary ingredient."

Thursday, October 20, 2005

Microlivestock and the Avian Flu

Avian flu is sweeping Asia, beginning to enter Europe, and is expected soon to arrive in Africa. A key public health measure is to get rid of flocks of poultry that have been infected. The impact of such measures may be severe.

Poor farmers in many countries depend on their flocks of chickens or ducks for protein and for income. People who could not afford to keep cattle, or even sheep or goats, keep a few birds. What are they going to do if that is no longer possible?

Some years ago, the National Academy of Sciences published a monograph titled "Microlivestock - Little-Known Small Animals with a Promising Economic Future". It discussed microbreeds of goats, sheep and pigs but it also focused on rabbits, rodents, and lizards as potential microlivestock. It may be time to consider large scale programs to introduce such animals in place of poultry.

One project that comes to mind is Heifer International. Among its efforts are rabbit projects, that introduce rabbit culture into developing nations.

Are there any other good projects out there that promote microlivestock. Comments would be most welcome!

Housing/building Technology

Some years ago the U.S. National Academy of Sciences did a couple of studies for USAID on housing technology, and later the Office in which I worked funded a couple of small projects in that field. Apropriate Technology International (ATI) also did some work in the field. And of course, as a Peace Corps Volunteer, 40 years ago, I helped build a couple of prefab houses. All of which apparently gave me an enduring interest in housing and building technologies appropriate to the needs of poor people in poor countries.

This week I came across a couple of projects in this field, both of which seem interesting.

The Federation of American Scientists Housing Project: "The FAS Housing Technology Project collaborates with scientists and engineers that specialize in building materials, structural engineering, indoor air quality and energy-efficiency to create safe and affordable housing to people in the US and abroad." It has been working especially with "Affordable, Safe Housing Based on Expanded Polystyrene Foam and Cementitious Coating."

UNIDO's International Center for Science and High Technology is organizing a meeting in Thailand in November on "Appropriate technologies for sustainable building in developing countries".

The UN Convention on the Law of the Sea

Read the October 2005 UNA-USA fact sheet.

"The Law of the Sea Treaty was adopted by the United Nations in 1982 and entered into force in 1994. Although the United States played a lead role in drafting the treaty, the Reagan Administration did not sign it due to concerns relating to certain deep seabed mining provisions. However, since the negotiations began in 1973, every US Administration has supported the treaty in its entirety except for the deep seabed mining provisions, and the United States has accepted and complied with all other provisions of the treaty. In 1994, a legally-binding agreement altering the treaty was concluded, addressing all US concerns regarding deep seabed mining. The agreement was subsequently signed by the United States and must now receive the advice and consent of the Senate before it can be ratified by the United States.

"United States accession to the treaty has recently been strongly endorsed by President Bush; the Departments of State, Defense, and Homeland Security; the US Navy; the US Coast Guard; a bipartisan collection of congressional leaders; and a diverse group of environmental organizations, trade associations and business groups. Despite such broad bipartisan support, the treaty was never considered by the full Senate last year after the Foreign Relations Committee unanimously approved it in early 2004. However, late last year the congressionally-mandated US Commission on Ocean Policy and the Bush administration’s official response, the US Ocean Action Plan, both called for the Senate to approve the treaty as soon as possible. During her nomination hearing in January 2005, Secretary of State Condoleezza Rice urged the Foreign Relations Committee to again approve the treaty and pledged the Administration’s support in securing a vote in the full Senate.

"As the world’s leading maritime power, with the longest coastline of any country and some of the earth’s richest waters, the United States stands to benefit from the protections provided by the Law of the Sea Treaty more than any other country. Indeed, the US has long sought the establishment of a comprehensive, widely accepted legal framework that regulates all uses of the world’s oceans. The Law of the Sea Treaty, with 149 states parties, including every other permanent member of the Security Council and all other major industrialized nations, provides just such a framework. United States accession to the treaty would provide vital security, economic, and environmental benefits, and would greatly enhance our influence in the development and interpretation of maritime law."

Maryland Group Moves to Get TB Vaccine for World's Poor

Read the full Washingtop Post story.

"A Bethesda foundation developing vaccines for tuberculosis plans to announce a deal today with a large drug company to move forward with human tests of a promising new injection it hopes will prove useful in poor countries.

"If all goes well, the arrangement would allow the Aeras Global TB Vaccine Foundation to produce an effective tuberculosis vaccine within a decade. The partnership is also a test of whether public health experts can help solve some of the pervasive business problems that have plagued research on vaccines for poor countries."

TB is a major global health problem, worsening due to AIDS. Since the disease was largely beaten in the rich world, the potentials in modern science have not been fully realized and applied as technologies for TB control.

"With more than $100 million from the Bill & Melinda Gates Foundation, of Seattle, Aeras has set out to change the situation. Under an arrangement to be announced today, Aeras will spend as much as $13 million over the next two years to accelerate work on a tuberculosis vaccine by GlaxoSmithKline PLC, of London."

Wednesday, October 19, 2005

The Great Social Bookmarking Survey - Participate and Learn!

Participate in the survey
This is a survey of user desired features for social bookmarking platforms. The survey results will be made widely available. I hope readers of this blog will participate.

The survey is brought to you by the company that has produced Blinklist, one of the social bookmarking sites.

U.S. Prepares Plan to Ration Flu Drug

Read the National Public Radio story in full.

"Health and Human Services Secretary Michael Leavitt told NPR that the Bush administration is working on a plan to ration Tamiflu, a scarce drug that's currently the only medical weapon against a pandemic flu virus. If a global outbreak occurred anytime soon, the nation's limited supplies of the drug would go first to medical personnel, said Leavitt."

Fresh bird flu outbreak in China

BBC NEWS story in full:

"China has announced a fresh outbreak of bird flu, saying 2,600 birds have died from the disease in Inner Mongolia. "

Swiss Firm May Cede Bird Flu Drug Rights

Read the full story in the Washington Post

"The manufacturer of the leading drug against avian flu said yesterday it was willing to discuss arrangements for other companies to produce it despite having an exclusive patent.

"A spokeswoman for Roche Holding AG, a Swiss multinational company, said it might agree to allowing both governments and companies to produce the antiviral drug Tamiflu under sub-licensing agreements.

"The statement came on the same day that Sen. Charles E. Schumer (D-N.Y.) called on Roche to reach an agreement within the next month to permit five American companies to manufacture Tamiflu, or face legislation that would strip the company of the patent. Schumer and others have criticized the pace of Roche's efforts to meet fast-growing world demand for its product."

The Tamiflu website states that in clinical trials, Tamiflu reduces the duration of episodes of the flu, reduces the duration of fever associated with the flu, and reduces viral shedding. While it is widely effective against existing flu varieties, it of course has not been tested against varieties of flu that have not yet emerged, and may not be as effective against an emerging avian flu. And of course, its effectiveness depends on being taken by a flu victim early in the course of the disease.

Still, it would be good news if Roche licenses the drug to other companies so that much larger supplies are made available.

By the way, I am planning to get my flu shot (for the current variety) this weekend. Please get yours. No flu is worth treating lightly, and we don't want people getting infected with an avian flu and simulaneously with a flu that is easily transmitted not only because that person will be very sick, but also because of the public health implications.

International Stem Cell Initiative Planned: Collaboration on Cloned Embryos and Disease Research to Be Announced Today

Read the full Washington Post story.

"Korean and American researchers are expected to announce a broad collaboration today under which cloned human embryos will be created in the United States, Britain and South Korea in an effort to develop new ways of studying -- and perhaps curing -- human disease.

"Advocates said the collaboration, to be known as the World Stem Cell Hub, will seek to marry Korean expertise in cloning, a field in which that country has become a world leader, with the deep knowledge of U.S. and European researchers in the biology of human diseases. The plan could accelerate some types of medical research that have gotten off to a slow start because of political opposition in the United States, its backers said."

Tuesday, October 18, 2005

Administration mobilizes to prepare U.S. for possible pandemic - Yahoo! News

Read the entire Yahoo! News/Knight Rider article of October 16, 2005.

"The Senate voted Sept. 29 to provide $3.9 billion for the purchase of more Tamiflu and other items for the Strategic National Stockpile, a federal reserve of medicines and materials that would be distributed during a major health emergency when local supplies are exhausted."

There is also an authorization bill in the Congress, "Attacking Viral Influenza Across Nations Act of 2005". (The House Version and the Senate Version seem ideantical so far.)

The Avian Flu

I have posted a number of comments on Avian flu in past months. You can find them linked to my bookmarks. I think some summing up might be in order.

As of now, there seems to be a spreading epidemic of H5N1 flu among wild birds that is infecting domestic poultry in Asia and now Europe. Efforts to combat the spread of this disease in poultry have already cost billions of dollars.

There have been a relatively small number of cases reported in which humans have contracted the disease from birds. Many of these people have died, but so far it seems that it is difficult for the virus to travel from person to person.

On the other hand, the virus mutates rapidly, and the more birds are infected, and the more infected birds come in contact with people, the higher the risk of a strain developing that will be epidemic or pandemic in humans. This can occur either by mutations accumulating in the virus, or by reassortment of the viral genes in persons infected with both human and bird flu.

The threat from the H5N1 flu is that the current human population has not yet been exposed to a flu virus with these surface proteins, and so there is no immunity. There are other flu viruses out there that would be just as dangerous if they got loose in the human population. Flu viruses survive in animal host populations, and there don't seem to be any other flus out there as poised to jump into man. Still, unless science and technology develop a great deal, that will happen eventually.

Flu is with us always, and the annual outbreak of the disease kills many people. Pandemics, caused by the unleashing of a new strain of the flu virus against which there is no immunity, occurs periodically. Of course, the pandemic requires both that the new virus evolves into something that is relatively easily transmitted from person to person, and viral strains differ in their virulance among those who catch the disease.

Three pandemics occurred in the 20th century, and the worst killed an estimated 50 to 100 million people in 1918. The situation could be worse today. Modern transportation would allow the virus to travel faster. Population densities are much greater, not only putting more people at risk, but increasing the contact rate between those infected and new victims. While the portion of people too poor to protect themselves has gone down, there are still billions of people below any reasonable poverty line. And there are now large numbers of people with weakened immune systems.

Of course, we might also be lucky. The next new virus might not be especially communicable or might not be especially virulent or lethal. There have been 10 pandemics in the last 300 years, and most have not been as serious as that of 1918.

A major pandemic would likely sweep the earth in two or three successive years, reaping havoc each time. Of course, the problem would not only be that many people would die, but also that huge numbers would be too sick to work for a while, and very large numbers would require medical attention. First line health workers tend to be most exposed to the disease, and high levels of illness among them would make the provision of health care more difficult. The social implications of billions of sick people, hundreds of millions seeking hospitalization, and tens of millions dead would be very large.

Fears of a pandemic of swine flu developed in 1976, and the United States embarked on an ambitious program to deal with the threat. Fortunately, the virus did not cause a major epidemic. Unfortunately, the program got out of hand, and large amounts of money were wasted, tens of millions of people were immunized against a disease that did not really ocnstitute such a threat, and there were many complications attributed to the unnecessary immunizations. Very well intentioned people lead the effort which went so far out of control.

Part of the problem is that there are big delays and uncertainties in mounting a program of this kind. The development of a new vaccine, the production of billions of doses of the vaccine, and the implementation of mass immunization campaigns all take time and money.

Still, experience suggests that there are many pitfalls in preparing for flu epidemics and pandemics. The only response is to put fully trained people hard to work on the problem, to encourage them to learn from the past, and to give them the resources they need.

The current situation seems to be complicated by the lack of suitable medical technology. There are only a few antiviral medicines developed to be effective against flu. Apparently the bird flu is resistant to two of these (perhaps because they have been used in poultry foods in Asia). Thus only Tamiflu is available to doctors to treat the disease in patients. Without Tamilflu, treatment is limited to dealing with symptoms or complications of the disease -- important, but not as cost-effective as preventing the disease in the first place, or curing it quickly when it occurs.

Tamiflu is a proprietary drug. While an Indian firm has announced it is going to go ahead and produce a generic version, there are no plans for the United States nor other developed nations to seek alternative sources. The company owning the IPR can produce only a limited amount of the drug.

For the United States, the current supply will not cover the 10 million front line health workers, much less the victims of a possible pandemic. European countries are somewhat better off, but they too will not have enough. The developing world is out in the cold. The U.S. government has ordered more Tamiflu, and Congress has passed legislation to pay for a stockpile, but it is back in the queue for delivery of the drug.

Vaccines would be great, and some progress has been made in developing a vaccine against H5N1 flu. That work will be useful, but until a pandemic strain actually emerges, it will probably not be possible to fully develop a vaccine against it.

Commecial ventures have not found vaccine production very profitable. Part of the problem seems to be the liability a vaccine maker faces from side effects of immunization. Part of the problem is perhaps that people are willing to pay more to deal with a disease that they have and are suffering from, than to protect against a disease that they might get in the future. In any case, it seems that firms may not have invested adequately in improving vaccine production technology. The production technology has not advanced as much in the last 50 years as one might have wished. New approaches are under development, but it is not clear that they will be perfected in time to prevent an bird flu pandemic.

It is estimated that it will take two doses of the new vaccine to provide protection against the new flu, when that flu occurs. It may be that the vaccine will not be 100 percent effective, so large numbers of people may have to be immunized to cut down on the spread of the disease. Thus, experts fear that hundreds of millions of doses might be needed to achieve herd immunity in the United States' human population. There seems no likelihood of those amounts of a vaccine being available in the next year or two. (Remember the flu vaccine shortfall last year.)

Therefore, in the United States, there is little likelihood that enough vaccine or medicine would be available to prevent an epidemic if the rest of the world suffers a pandemic. One therefore hopes that both Tamiflu and the vaccine (when it becomes available) would be allocated so as to do the most good.

There is little likelihood that a world pandemic, focused in poor countries, could be prevented if and when the feared virus does emerge. Neither the vaccine nor Tamilflu would seem likely to be available in sufficient quantities for that to happen. Nor would the public health systems in poor nations be up to the job. Still, WHO and the world public health community are working hard on the problem.

The United States government has been shown to be unprepared for 9/11 and for Katrina. It appears that the government has not made adequate preparations against a flu pandemic in recent years. The current Administration is now making very visible moves to prepare for a possible flu pandemic, perhaps alerted by its recent failures. President Bush met with industry leaders, an international meeting was held in the State Department, legislation was introduced to fund medical stockpiles, a draft pandemic flu plan is being dusted off and published, and Secretary Leavitt of HHS is traveling to Asian nations in the front line against this flu. Unfortuantely, key people in the Administration's line of control seem to have political rather than public health backgrounds.

The best that can be hoped is that proper preparations will made, but that the threatened pandemic does not occur this time. Unfortunately, the recent activities of this Administration may prove to be too little and too late. There is also, of course, a chance that the fear will outrun the reality of the threat -- that lots of money, time and effort will be wasted. Worse, the government may be seen as crying wolf, making it harder to generate proper concern in the future when new threats of pandemics arise, as they surely will.

EU ministers hold emergency bird flu talks

Read the entire Reuters/Yahoo! News story.

"EU foreign ministers held emergency talks on the approaching danger of avian flu on Tuesday, as Greece investigated what could prove the first appearance of the deadly strain in an EU member country."

New Vaccines For A Pandemic

Read the entire Yahoo! News article

Two new approaches to producing a flu vaccine are described: producing vaccines in cell culture, instead of eggs, and DNA vaccines. Neither is a proven technology. Both offer the possibility of greatly speeding up the process, currently requiring about a year, of moving from a selected vaccine to having adequate stocks of the vaccine produced, to immunizing large populations.

It is often the case that the advocates of such technologies are optimistic about their development and eventual utility.

It seems to me that development of technologies to improve the vaccine production process should be given high priority. It seems likely that some of the alternatives will eventually succeed, and whether useful for the immediately threatened flu epidemic, they would be very useful in the long run.

It also seems to me that it would be unreasonable to put too much faith in the development of new technologies to solve our problems in the next year or three.

Monday, October 17, 2005

Avian Influenza A (H5N1) Fact Sheet

Avian Influenza A (H5N1) Fact Sheet

The Federation of American Scientists provides this fact sheet with basic information on Avian flu.

DRUG REGULATION: Plan B: A Collision of Science and Politics

Read the full article in Science magazine (subscripriont required.)/a>: Couzin 310 (5745): 38 -- Science

"Researchers see ideology trumping sound science"

On 26 August, after more than 2 years of deliberation, and a contentious advisory committee meeting, the U.S. Food and Drug Administration (FDA) put off indefinitely a ruling on the application to move Plan B to over the counter (OTC) status.

"The problem, agency officials said, was a dearth of information on whether the drug, approved for prescription use in 1999 and widely available in European pharmacies, would negatively influence the sexual behavior or health of adolescents. FDA was unsure how to restrict the drug's OTC status to older age groups." (Science notes, "Emergency contraception is available OTC or from a pharmacist in 39 countries. In France, it's provided by school nurses in every senior and junior high school.")

Plan B, or levonorgestrel, is a "morning-after" pill. It is a progestin-only pill that interferes with ovulation and perhaps with fertilization. Its effectiveness declines with time, which argues for making it rapidly available. Plan B is distinct from, but sometimes confused with RU-486, a drug that chemically induces an abortion in the early weeks of pregnancy. Both drugs are sold to be taken after unprotected intercourse to prevent pregnancy.

Two FDA advisory committees--on Reproductive Health Drugs and Nonprescription Drugs--together considered the application for OTC status in December 2003. Most members agreed that it met the OTC criteria: First, the drug is designed for an event (unprotected intercourse) that a patient can easily diagnose. Second, Plan B doesn't come with undue monitoring requirements, such as regular blood tests. And finally, side effects are few and can normally be managed without help from a doctor. The advisory committees voted unanimously that the drug was safe for OTC use.

Several studies published in peer reviewed journals have indicated that the availability of the pill does not affect sexual behavior of young women. Opponents' concern that frequent use of the drug might have long-term phsical effects on young women is apparently not widely shared by those specializing in female reproductive biology, and runs counter to FDA's own earlier rulings. In any case, studies suggest that even when they have the drug available, women don't tend to use it often.

"By 2004, the American Academy of Pediatrics, the Society for Adolescent Medicine, and the American College of Obstetricians and Gynecologists had all expressed their support for making Plan B available OTC.....An internal memo in April 2004, from John Jenkins, head of FDA's Office of New Drugs, notes that 'both [FDA] divisions and offices responsible for this application have recommended approval.' Jenkins concurred with that assessment and added his own support for Barr's application."

"The head of FDA's Office of Women's Health, Susan Wood, resigned and publicly stated her disagreement with the Plan B decision. On 22 September, a New England Journal of Medicine editorial written by the journal's editor and two members of the two FDA advisory committees that voted in favor of the shift, citing the drug's safety, proclaimed that FDA's recent actions 'have made a mockery of the process of evaluating scientific evidence.'"

FDA commissioner Lester Crawford made the announcment that Plan B's OCT status would not be approved in August . Senators Hillary Clinton (D-NY) and Patty Murray (D-WA) had voted to confirm Crawford as Commissioner in July only after he promised a quick decision on Plan B. In late September, Crawford resigned suddenly from the FDA post.



Go to Google, type in the word "failure" (without quotes) and this is the website that comes up first.

No nation properly prepared for bird flu

Read the whole Yahoo! News story

"No country is properly prepared for a bird flu pandemic, the U.S. health secretary said in Indonesia on Monday, adding that efforts were being stepped up to boost a network of surveillance to detect the virus."

Wednesday, October 12, 2005

Inexpert Selection

Read the editorial in the New York Times (Free registration required.)

"The list of Bush appointees who seem to be rising on political connections rather than expertise continues to grow. A recent example is President Bush's choice to head a key office at the State Department that coordinates the delivery of life-sustaining emergency aid to refugees of foreign wars, persecution and natural disasters. The nominee is Ellen Sauerbrey, the former Maryland state legislator and twice-defeated Republican candidate for governor who was state chairman of Mr. Bush's 2000 campaign.........

"Ms. Sauerbrey has no experience responding to major crises calling for international relief. As assistant secretary of state for population, refugees and migration, she would oversee a vital $700 million a year bureau that coordinates with private relief groups and other international players like the U.N. High Commissioner for Refugees to set up refugee camps and arrange for adequate food, protection and other crucial assistance. She also would oversee the admissions of refugees for permanent resettlement in the United States. This is a post for an established expert in the field."

As the world is facing huge flows of refugees and migrants, with great disasters in Pakistan and Indonesia in the news, and a flu pandemic threatened, the Bush Administration seems to have chosen political connections over expertise again! Too bad!

US blocks U.N. briefing on atrocities in Sudan

Read the full story on Yahoo! News

"U.S. Ambassador John Bolton blocked a U.N. envoy on Monday from briefing the Security Council on grave human rights violations in Sudan's Darfur region, saying the council had to act against atrocities and not just talk about them.

"Bolton, joined by China, Algeria and Russia, prevented Juan Mendez, Secretary-General Kofi Annan's special adviser for the prevention of genocide, from briefing the council on his recent visit to Darfur, despite pleas from Annan and 11 other council members that Mendez be heard.

"'I strongly regret and deplore that Mr. Mendez ... was not authorized to brief the council today as Mr. Kofi Annan had asked,' French Ambassador Jean-Marc de la Sabliere told reporters outside the council chambers."

Issues in S and T, Summer 2005, Secrets of the Celtic Tiger: Act Two

Issues in S and T, Summer 2005, "Secrets of the Celtic Tiger: Act Two" (By William C. Harris)

"Ireland’s brilliant catch-up strategy of the 1990s offers important lessons for countries that want to build a modern technology-based economy. But Ireland is not growing complacent. It knows that a decade of steady and strong economic growth, high employment, and success in recruiting foreign investment hardly guarantees future results. Ireland is now supporting R&D activities designed to help it prosper not simply for years but for generations. This new effort might be instructive for the United States and other technology leaders."

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Nanotechnology for Development

Here are some key websites for those interested in Nanotechnology for Development.

The Development Gateway Nanotechnology for Development topic page

SciDev.Net Quick Guide to Nanotechnology

The Meridian Institute's Project: Nanotechnology and the Poor: Opportunities and Risks

Todd Barker et al, "Nanotechnology and Poor: Opportunities and Risks: Closing the Gaps Within and Between Sectors of Society" The Meridian Institute, January, 2005.

International Dialogue on Responsible R&D, The Meridian Institute, Report of a meeting, 2004.

Salamanca-Buentello F, Persad DL, Court EB, Martin DK, Daar AS, et al. "Nanotechnology and the Developing World" PLoS Med (2005)

Peter A. Singer, Fabio Salamanca-Buentello and Abdallah S. Daar, "Harnessing Nanotechnology to Improve Global Equity," Issues in Science and Technology, Summer, 2005.

Bryan Bruns, "Applying Nanotechnology to the Challenges of Global Poverty," 1st Conference on Advanced Nanotechnology: Research, Applications, and Policy, October, 2004.

2003 UK Nanotechnology enquiry, evidence from Brazil, Alexandra Ozorio de Almeida

NanoScience and Technology in China,, December, 2004.

"Why Nanotechnology Holds the Key to (India"s) Future," R Subramanyam, Times News Network, March 23, 2005.

"Nanotechnology in the new EU Member States and the Candidate Countries. Who`s who and Research Priorities," Nanoforum Consortium, September, 2005.

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Tuesday, October 11, 2005

Nobel Prize for Economics 2005

Prize winners:

Robert J. Aumann andThomas C. Schelling:

"for having enhanced our understanding of conflict and cooperation through game-theory analysis"

Dr. Schelling began his career spending five years negotiating foreign aid under the Marshall Plan.

Invitation to Social Bookmarking

I posted an inviation to social bookmarking on the Monitoring and Evaluation topic page of the Development Gateway. Check it out.

Invitation to Social Bookmarking

Check out the highlight I wrote for the ICT for Development topic page of the Development Gateway.

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"Look Who's Ignoring Science Now"

Read Sebastian Mallaby's Op-Ed piece in the October 10 Washington Post:

"The flip side of Bush cronyism is hostility toward experts -- toward people who care about what's what rather than who's who. Economists have depressingly little influence on the Bush economic policy. Climate scientists are incidental to the Bush climate-change policy. Health experts seldom decide issues like the provision of clean needles to HIV-vulnerable drug addicts or poor countries' access to generic AIDS drugs. But it's not just the Bush administration that spurns data and evidence. Consider the case of dichloro-diphenyl-trichloroethane, on which the Bush administration is marginally better than the European Union.

DDT, to give that chemical its more familiar name, works miracles against diseases that are spread by insects. During the Second World War, vast quantities of the stuff were dusted over troops and concentration-camp survivors to kill the body lice that spread typhus. Later, DDT was used widely in Latin America to beat back dengue and yellow fever. But the chemical's noblest calling is to combat malarial mosquitoes..........

The European Union is apparently proposing to require Uganda to mount an expensive program to monitor food for DDT residue, if it plans to export into Europe, because Uganda is planning to do household spraying with DDT against mosquitos. This ignores the fact that there is little danger of DDT from the interior walls of Ugandan houses contaminating food harvested for export.

"Why does Europe impede Uganda's fight against malaria? The standard answer starts with "Silent Spring," the book that helped launch the environmental movement in the 1960s and that painted a scary picture of DDT's potential impact on the food chain. But this is only half right. The book's overblown claims led to the banning of DDT in the United States in 1972 and its disappearance from aid-funded programs thereafter. But "Silent Spring" was really about the dangers of large-scale agricultural use of DDT, not the limited spraying of houses. Today mainstream environmental groups concede that in the context of malarial countries, the certain health benefits of anti-malarial spraying may outweigh the speculative environmental risks.

"So the sin of the environmental movement -- at least of its more responsible exponents -- is not that it's flat wrong on this issue. Instead, it is more subtle. Environmentalists think it's their responsibility to campaign against the damage done by toxic substances, but not to campaign against the damage done by the over-regulation of substances that actually aren't very toxic. Of course, the environmentalists' credibility in calling for necessary regulation would be enhanced if they were willing to denounce unnecessary regulation. But you don't hear them yelling about the European Union's absurd position on Uganda.

"The result is that there's no counterweight to consumers' food-safety paranoia, and politicians refuse to countenance DDT spraying "just to be on the safe side." This cowardice is no different from the Bush administration's indifference to scientific sense on climate change, though you won't catch the environmentalists saying that. And the consequences are rather more immediate. Think what being on the "safe side" means to malaria's victims."

Debate on "The Republican War on Science"

Check out the debate.

TPM Cafe this week is featuring a debate on Chris Mooney's book, "The Republican War on Science". The debate is pretty philosophical, with some interesting thoughts about the use of knowledge in government. (For anyone who has not yet discovered TPM Cafe, it is regularly worth reading!)

Sunday, October 09, 2005

ICT, Globalization and Poverty: Wishing Won't Make It So

Optimists think:
that ICT improves the flow of information,
that information leads to knowledge,
that knowledge leads to truth, and
that the truth will make us free.

T.S. Elliot said:
Where is the wisdom we have lost in knowledge?
Where is the knowledge we have lost in information?

We want to believe that good things go together.
We like democracy; we dislike terrorism.
We believe democracy must work against terrorism.
But this seems not to be true.
Dictators plot how they can use the technology to coerce and corrupt.

Globalization is a great beast, partially dedicated to the service of mankind.
Its nervous system is the global information infrastructure.
It serves through a process of creative destruction.
Huge benefits flow from its great power.
Huge too is the damage inflicted during its clumsy maneuvering.
Why are the poor so often trampled under the foot of Globalization?
Why are those who have, so often those to whom Globalization gives still more?

Friday, October 07, 2005

The Avian Flu Quandry

I may not have been sufficiently specific in my last posting.

An epidemic of avian flu is sweeping Asia. Billions of dollars of costs already have been incurred to destroy poultry that might be infected. Hundreds of human cases have been reported, and many of those people have died. We know that the 1918 flu, which has been estimated to have killed some 50 million people, made the leap from animals to man relatively quickly. Many of the genetic changes that would be required for the current bird flu to do so also have already been reported. Stocks of antiviral medicines that might be used to prevent or delay a pandemic are low, the drugs are expensive, and it would take time and money to increase the supply given their manufacturing difficulty. A vaccine similar in properties to the one likely to be needed has been developed, a very good sign, but there is real fear that not enough vaccine can be produced in time to prevent an epidemic from turning into a pandemic. Moreover, it seems likely that the few countries with industries able to produce quantities of such a vaccine are likely to commandeer all that becomes available to protect their own populations, rather than prevent a world pandemic.

The last time such a threat was perceived was in 1976. It seems that the U.S. government, under the administration of many of the same people in the current administration, responded poorly. The government acted promptly to the swine flu threat, but failed to modify its actions as it later developed that the strain of flu was not as virulent as had been feared, and the swine flu was not becoming epidemic in the United States nor abroad, In 1976, tens of millions of people were immunized, hundreds of negative reacions to the vaccine developed, and ultimately the process cost the government US$400 milion, in the strong dollars of the late 1970's.

We are walking the tightrope again. How much preparation is enough? How much would be too much?

The key officials in charge in the Department of Health and Human Service's flu effort appear to be a lawyer who became Assistant Secretary as an political associate of the former Secretary of HHS, and an educator whose term in HHS's international office has been very controversial and who is a godson of former president Bush. I would like to see experts in international communicable disease control in their places.

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Lessons learned from the 1976 Swine Flu Program

Read Annex 11 to the .Pandemic Influenza Response and Preparedness Plan in full.

"On January 27, 1976, an outbreak of respiratory disease was identified at Ft. Dix, New Jersey. On February 12 the CDC influenza laboratory notified the CDC Director that a swine influenza virus strain had been isolated from patients that possessed hemagglutinin and neuraminidase subtypes that had not circulated for more than 50 years.......An emergency interagency meeting was held on February 14, and state health officials were notified on February 18. On March 10, the Advisory Committee on Immunization Practices (ACIP) reviewed available data and concluded that person-to-person transmission of swine influenza had occurred but there was no way to determine whether or not a pandemic would occur. CDC notified the Department of Health and Human Services and recommended mass immunization. On March 24 President Ford met with CDC, FDA, and NIH representatives and other experts. There was a unanimous recommendation to initiate mass immunization.......

"The first vaccine was shipped to State Health Departments on September 22 and the first injections were given on October 1. Vaccination programs proceeded based on state plans and capacities, with some aggressively implementing mass vaccination and others implementing more limited programs. Overall, between October 1 and December 16, more than 40 million civilians were vaccinated; 85% by public sector providers (this compares with ~10 million persons vaccinated during the previous influenza season). Several million more were vaccinated in Veterans Administration and Department of Defense programs..........

"By the time the vaccination program ended, 532 GBS (Guillain-Barré syndrome) cases and 32 deaths had been reported. CDC surveyed neurologists in several states and calculated the GBS risk among vaccinated and unvaccinated persons. The results suggested an increased risk among those who were vaccinated. On December 16, based on CDC�s recommendation and after consultation with the President, the Assistant Secretary for Health announced the suspension of the swine influenza vaccination program. Although some persons at high-risk for severe influenza complications received the swine influenza vaccine subsequently, the large-scale vaccination program was not resumed. Neither a swine influenza pandemic nor focal outbreaks following the one initially identified at Fort Dix occurred.....

"Program decisions made early in the process were not modified based on new information Â? e.g., the absence of any Swine influenza cases detected by surveillance following the Ft. Dix outbreak Â? because of concerns over logistical obstacles and impact on program support by the medical community, policy-makers, and the public....

"Drs. Feinberg and Neustadt were asked by the Carter administration to review the swine influenza program, focusing specifically on the decision-making process. They concluded in The Epidemic That Never Was, 'Decision-making for the swine flu program had seven leading features. To simplify somewhat, they are:
Â? Overconfidence by specialists in theories extrapolated from meager evidence.
Â? Conviction fueled by a conjunction of some preexisting personal agendas.
Â? Zeal by health professionals to make their lay superiors do right.
Â? Premature commitment to deciding more than had to be decided.
Â? Failure to address uncertainties in such a way as to prepare for reconsideration.
Â? Insufficient questioning of scientific logic and of implementation prospects.
Â? Insensitivity to media relations and the long-term credibility of institutions.'"

I worked on an international health plan in the White House in 1977, early in the Carter Administration. I recall the mass immunization campaign against the swine flu organized by the previous administration as a debacle, costing a fortune, and probably causing some real harm in the hope of preventing a threat of a pandemic flu -- a threat that was not on that occassion real. A Washington Post reporter totalled the cost:
About 45 million people had been immunized. The federal government eventually paid out $90 million in damages to people who developed Guillain-Barre. The total bill for the program was more than $400 million.

Other observers are even less sympathetic to the Ford Administration. Donald Rumsfeld, who was then and is again the nation's Secretary of Defense, it has been charged by the Whale website, "made the imminent 'swine flu' a political issue to add some spark to the campaign of President Ford." Lawrence Gostin of Georgetown Law School gives Big Pharma a share of the blame: "The pharmaceutical industry convinced political leaders to hold it harmless against lawsuits while, at the same time, profiting from a massive vaccination program actively promoted by government."

This time there seems to be a lot more evidence that an Avian Flu pandemic is a serious and imminant threat. Public health officials recall both the history of the 1918 flu pandemic and that of the mythical 1976 swine flu pandemic. Still, we walk a fine line between inadequate reaction and over reaction to the threat. Certainly we need to postpone decisions that can be postponed, and reexamine dicisions with new evidence as time goes by and experience with the epidemic accumulates. Certainly too, it is wise to invest in means to prevent a possible pandemic, even if that pandemic never actually occurs. Still, one hopes for people with the proper training, long experience, and mature professional judgment to lead in the decision making. My recent blog entries include evidence suggesting that President Bush's top flu pandemic advisors, William R. Steiger and Stewart Simonson, may not have that needed background.

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Breaking America's grip on the net

Read the full October 6, 2005 article in The Guardian.

Lead: "After troubled negotiations in Geneva, the US may be forced to relinquish control of the internet to a coalition of governments." At the third and final preparatory meeting for next month's World Summit on the Information Society, the EU came out for a plan to end the U.S. government's unilateral control of the internet and put in place a new body that would now run this revolutionary communications medium. The U.S. Department of Commerce (DoC) years ago created a private company, the Internet Corporation for Assigned Names and Numbers (Icann) to run the Internet, "but the DoC retained overall control, and in June stated what many had always feared: that it would retain indefinite control of the internet's foundation - its 'root servers', which act as the basic directory for the whole internet." Brazil, China, Cuba, Iran and several African states represented in Geneva insisted the US give up control, and the meeting "was going nowhere", when the EU proposed two stark changes: a new forum that would decide public policy, and a "cooperation model" comprising governments that would be in overall charge. The proposal proved popular with other nations, but not with the U.S. and its refusal to budge apparently strengthened its opponents. "Now the world's governments are expected to agree a deal to award themselves ultimate control. It will be officially raised at a UN summit of world leaders next month and, faced with international consensus, there is little the US government can do but acquiesce."

"Pandora’s Box – Bringing Science into Politics: The Debate on Scientific Integrity in U.S. Policymaking"

Read the full article.

Philipp Steger, Attaché for Science and Technology at the Embassy of Austria in Washington, D.C, published this article in Bridges, the Embassy's S&T Policy publication, in April 2005. It contains a useful history of the controversy over the claims that the Bush Administration has politicized science to an unacceptable degree. It also has a great set of links to sources relevant to the controversy.

Some excerpts:

Barry D. Gold, a former staffer at the House Science Committee who is now in charge of science-based conservation programs at the David & Lucile Packard foundation, sums it up well when he says: “Unfortunately, the issue of politicization of science, itself, got politicized.”
It is unlikely that the debate’s politicization will be helpful for science. One reason is that it has reduced the likelihood that Congress will come up with any meaningful responses to the issue. Of even more importance: the debate has eclipsed a crucial issue, namely whether there really is a consensus on the appropriate role of science in policymaking.
What the critics of the Bush Administration’s handling of science in policymaking are saying in essence is that the credibility of science is being misused to further a political agenda. And the administration is responding by saying that it’s not abusing the credibility of science. Hardly anyone seems to wonder whether the tendency to give a priori credibility to science simply because it comes under the cloak of Science may be part of the problem.

I would suggest, as I have in the past, that there is reason to give added credibility to "scientific knowledge", where the term is intended to mean knowledge:
- that is related to an establish basis in scientific theory;
- that is based on controled observations, that have been replicated;
- that has successfully passed peer review processes in established journals.

It seems to me that such knowledge has epistemological quality that is lacking in many kinds of knowledge (e.g. bureaucratic, political, or "common" knowledge), and thus is more credible than most. I would not ever suggest that it must be believed, nor that it alone constitutes a unique basis for political action.

Steger makes the point, quoting others, that frequently scientists can be found on various sides of an issue. Indeed, this is true, when there has been a serious effort to obtain balanced, independent scientific advice. The issue of concern is of course whether there is adequate effort to assure expertise, independence, and balance on the hot politico-scientific issues of the day.

William R. Steiger

William R. Steiger is the Department of Health and Human Services' "point person for international health" and is presumably a key person in the internatinal meeting on Avian Flu starting today in Washington (see previous posting). He has held the position of Director of the HHS Office of Global Health Affairs for some time. According to his official biography, "Dr. Steiger was previously Education Policy Advisor for Wisconsin Governor Tommy G. Thompson. His portfolio included finance and policy matters for primary, secondary, university, and technical education in the state." He seems to be trained in education rather than public health, with little previous international experience.

According to a news story in Science magazine last year, "Steiger, 34, a political appointee who has close ties to the Bush family." The article noted, that "when HHS clamped down on foreign travel by its scientists, Steiger began personally approving each trip. When industry groups criticized a World Health Organization (WHO) report on nutrition, Steiger slammed it as scientifically flawed. When the department declared that it would choose which U.S. scientists WHO could invite as expert advisers, Steiger signed the memo." (Another source identifies Steiger as George H.S. Bush's godson.)

In April 2004, Steiger, according to another report, "wrote government scientists informing that they must receive pre-clearance by his office to act as consultants in meetings of the World Health Organization. As a condition of their employment with WHO, scientists must agree to advocate U.S. policy. A Health and Human Services (HHS) spokesperson defended the decision stating, 'No one knows better than HHS who the experts are and who can provide the most up-to-date and expert advice.' But Dr. D.A. Henderson, an epidemiologist who received the Presidential Medal of Freedom in 2002 and acts as an advisor to HHS Secretary Tommy Thompson, stated, 'I do not feel this is an appropriate or constructive thing to do. In the scientific world, we have a generally open process. We deal with science as science. I am unaware of such clearance ever having been required before.'"

Sharon Hrynkow, acting as director Fogarty International Center at NIH, is reported in 2004 to have sent the following to NIH staff:
"NIH has been instructed by the Office of the Secretary, Office of Global Health Affairs, that travel of NIH staff to U.N. international organizations located in the United States is to be considered foreign travel, thus requiring ICs [institutes and centers] to submit [Notifications of Foreign Travel] per the usual process,"

The World Bank, the Pan American Health Organization, UNICEF, the United Nations Development Programme and other U.N. organizations were covered by the dictum.

When I worked in the Office of International Health, which eventually became the Office of Global Health Affairs, it was headed by the then Acting Surgeon General, and lead by public health professionals with distinguished careers in international health. I would feel more confident if the U.S. effort to energize the world against Avian Flu were headed by such people today! This does not seem to be the case, however.

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Nations to Discuss Potential Flu Pandemic

Read the full article in the Washington Post.

"Amid growing concern that the world may be on a collision course with a deadly avian flu pandemic, health officials from about 80 countries are meeting in Washington today to map a collaborative strategy for minimizing the deaths and disruption an outbreak might wreak.

"The meeting, hosted by the State Department, marks the beginning of a major international trust-building project that U.S. officials said must be successful if scientists and public health officials are to have a fighting chance of quenching a nascent outbreak before it goes global.

"'Pandemics are diseases without borders and that's why we're focusing our attention on them,' said William R. Steiger, the Department of Health and Human Services' point person for international health, in an e-mail yesterday. 'We know that a threat against one nation is a threat against the world.'

"Today's meeting is part of a flurry of activity in the United States and abroad, all spurred by evidence that a strain of bird virus endemic in Southeast Asia is accumulating mutations that could ease its lethal spread from person to person......

"President Bush is scheduled to meet with drug company executives today to discuss strategies for developing new and speedier methods for making flu vaccine. Current techniques take many months to ramp up -- a time scale that is acceptable for the routine annual production of vaccines but that would be wholly inadequate if a rapidly spreading and especially deadly strain of avian flu were to erupt."

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IAEA, ElBaradei Share Nobel Peace Prize

Read the full article in the Washington Post.

"The International Atomic Energy Agency and its chief, Mohamed ElBaradei, have won the 2005 Nobel Peace Prize and will share the world's most prestigious prize.

"The prize, announced Friday, went to the two "for their efforts to prevent nuclear energy from being used for military purposes and to ensure that nuclear energy for peaceful purposes is used in the safest possible way."">IAEA, ElBaradei Share Nobel Peace Prize: "The International Atomic Energy Agency and its chief, Mohamed ElBaradei, have won the 2005 Nobel Peace Prize and will share the world's most prestigious prize.

"ElBaradei, an Egyptian lawyer, has headed the U.N. nuclear agency as it grappled with the crises in Iraq and North Korea and now Iran.

"ElBaradei has led the International Atomic Energy Agency as it rose in prominence from a nondescript bureaucracy monitoring nuclear sites worldwide to a pivotal institution at the vortex of efforts to disarm the two regimes."

Thursday, October 06, 2005

"Unqualified Crony in Charge of Pandemic Response"

Read the full entry on Transparent Grid.

Function 8 of the Department of Homeland Security's "National Response Plan" (NRP), tasks the Secretary of the Department of Health and Human Services (HHS) with leadership in responding to a health crisis, such as a flu pandemic, through the Assistant Scretary for Public Health Emergency Preparedness (ASPHEP).

"The former Assistant Secretary, Jerome Hauer, was also the director of the Response to Emergencies and Disasters Institute at The George Washington University. Prior to being appointed as assistant secretary, Hauer served as Director of Emergency Management for New York City. Hauer is a gradaute of the Johns Hopkins University School of Public Health and has served on the National Academy of Sciences Institute of Medicine's Committee to Evaluate R&D Needs for Improved Civilian Medical Response to Chemical and Biological Terrorism.

"His succesor, appointed in 2003 as ASPHEP, is Stewart Simonson. Like Michael Brown at FEMA, Brown is a lawyer who was close to a political benefactor. Simonson graduated from the University of Wisconsin law school in 1994 and served as legal counsel to Tommy Thompson while he was governor of Wisconsin from 1995 to 1999. Simonson then followed Thompson to Washington when the governor was appointed as head of HHS. Simonson's bio at HHS states that 'from 2001-2003, he was the HHS Deputy General Counsel and provided legal advice and counsel to the Secretary on public health preparedness matters. Prior to joining HHS, Simonson served as corporate secretary and counsel for the National Railroad Passenger Corporation (AMTRAK).'"

As readers of this blog know, the threat of a global flu pandemic is real and immediate. One would surely hope for a fully trained and experienced public health expert to lead the United States' efforts to avert and respond to this threat. Apparently, we have a lawyer with ten years legal experience instead.

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