Bird flu article is finished!

I just put the finishing touches on my article for Language and Politics, an academic journal which is publishing a special issue on avian flu. This afternoon, I sent it off to the editor, two days ahead of schedule. So, in other words, I’m feeling pretty good and largely carefree right now.

The article is entitled, “The Politics of Bird Flu: The Battle over Viral Samples and China’s Entry into Global Public Health”. The basic premise is that viral samples are not just about biology, but about politicking. Access to viral samples has been a big deal over the past few years, with both Indonesia and China withholding theirs from the largely ‘Western’ epidemiological community. However, the WHO recently issued a report requesting that all nations who request samples from donor nations give those donor countries full access to the benefits (i.e. vaccines, drugs, etc.). Also, any work already done by the donor country’s scientists must be credited. My article discusses this from the vantage point of the overlap of public health and politics. I suggest that there is a new kind of diplomat on the scene – a health diplomat. I’m not the first to suggest this – in fact, I went to an entire meeting concerning the possible future training in ‘health diplomacy’ – but the article is still saying something fairly fresh and interesting.

Not that I’m biased. I’ll keep you posted on where you can find the special issue and when it is available.

The Politics of Public Health

A few days ago, the former Surgeon General, Dr. Richard Carmona, addressed a House committee – just days before the confirmation hearings of his successor. Basically, he accused the Bush administration of trying to suppress important health information that contradicted the administrations’ policies or beliefs. This is, perhaps, not so surprising. I suppose what is so surprising is that it is being openly talked about, debated, and discussed.

Science, as a rule, is seen to be somehow above and outside of the remainder of our culture. What goes on in the lab is supposed to be, for lack of a better way to describe it, sterile. We want our scientific facts to be facts. Cold, hard, and as clean as possible. What Carmona’s testimony implies is that we don’t always get what we want.

What people in science studies have been showing for years is that we have probably never received untainted facts in our entire scientific existence. It’s impossible largely because scientists, as far as I can tell, are human beings. And human beings are, as far as I can tell, human. They have wants and desires and political and religious beliefs (studies have shown that outstanding achievement in physics doesn’t necessarily belie an inherent atheism). That being a ‘fact’, I think we should take it for granted that what scientists study, what they look for, and ultimately, what they find is either stressed or downplayed or labeled ‘for further study’ due to some combination of the above human desires and beliefs.

What we want, in a perfect world, is a direct flow of information from scientists (who would ideally get money from trees to do whatever they saw fit with it) to the public health officials (who would ideally set policy based on unbiased scientific findings). We want doctors to tell us about STDs, not politicians. Though, clearly, politicians might have more practical knowledge about STDs than we would otherwise care to admit.

Admittedly, the idea of politics setting the health agenda is scary. However, I think that this is, was, and probably will be, the way things actually work. After all, the government and/or private industry fund research, and they generally fund projects that they like, for whatever reason they deem appropriate (profit-making potential, accordance with religious beliefs, etc.). This is how research gets done and how science progresses.

The good news is: the people who pay for and discover ‘facts’ usually don’t have much end-user control over them. Just look at nuclear technology, for one potent example (though this is an example of the nastier side of the point I’m making), or program codes. Technology and research are incredibly well-traveled. What one country bans or limits (stem cell research and DVD hacking in the US), another embraces (cutting-edge stem cell research and $1 DVDs in China).

In other words, science is political. Of course it is. Not as overtly or as much as WTO trade agreements, but in a similar vein. It is called the WHO, after all. Notice the acronym resemblance? Coincidence? (I’m a budding power conspiracy theorist, in case you couldn’t tell.)

The article I’m currently researching/writing makes just my point with bird flu. It’s ironic, really, that this story came out just as I was writing my intro. I changed it, to include the debate. I think that bird flu is a significant case in point – where politics and public health rub shoulders. In the end, the public health officials of the future won’t look, sound or act much different from their cohorts in the state departments or embassies. And, to be clear, their jobs will be just as important as a general’s or an ambassador’s. Certainly in the case of bird flu or XDR-TB, lives will be at stake.

Back to Bird Flu – Politics and Public Health

I’ve been asked to write an article on the political language of bird flu, specifically as it relates to the recent battles over viral samples from China and Indonesia. I’ll be focusing upon China, and discussing how public health is pretty much synonymous with politics these days. Basically, everything about global public health as it concerns bird flu has been turned into political maneuvering. It’s a fascinating and completely muddy topic. Just slogging my way through the media accounts is difficult.

For anyone interested, there is a site which lists all the stories and blogs about bird flu. You can find it at :

http://www.birdflubreakingnews.com/

It’s up-to-date and exhausting. Even without the hype, the stories are endless. Bird flu is a topic that seems to have entirely captured our imaginations. What does it stand for? Our fears about globalization? Our discomfort with “others” and anything “foreign”? There is actually a headline from the BBC not long ago that read “Duck with Bird Flu Not from UK”. Really? Even ducks have nationalities now? Do they need passports, too?

Pardon my skepticism. I’m not saying that bird flu as a real biological entity doesn’t exist. Clearly, it does. I’m also not saying it doesn’t have the potential to harm a lot of people. Obviously, it does. What I do question, however, is the language of risk, danger and foreignness surrounding it. I’m concerned that localized outbreaks are being made into global events by a collusion between media – eager for a story, and government – eager for a reason to broker power and scare people. Disease is a very effective weapon for terrifying a populace. And terrified citizens are more likely to approve of increased spending in order to “protect” them from the latest bogeymen. Bird flu being just one case-in-point.

So, this is what I am working on now. I’m knee deep in it, and I have no idea how I’m going to wrestle this down into something readable and understandable. It’s such a big topic, I’m not sure I can make that much sense of it myself.

Pig Death Mystery Solved

I take it back. There is disease news to disseminate from the road.

Officials in China have confirmed that the microbe causing the mysterious epidemic in Guangdong, in which 300 pigs have died, has been identified. According to the Xin Hua news agency, it’s apparently a common pig illness called ‘blue-eared pig disease’. The People’s Daily reports that:

The PRRS virus entered China from overseas in the mid 1990’s and has recently shown signs of mutation. It cannot spread from animals to people and is said to be under control in the district.

Tests for the disease are available, and a vaccine against the disease has received State approval and is to be distributed soon, said the statement.

Meanwhile, Yang Weixin, head of Silao Town, where most of the pig deaths occurred, denied overseas media reports that more than 80 percent of the 10,000 pigs in the area had died.

He said the pigs produced there were mostly consumed locally. Media reports said sales of pork in the affected area had dropped significantly since the outbreak.

For those of you more interested in epidemiology – like myself – you can find out more about the disease from this veterinary site:

http://mark.asci.ncsu.edu/HealthyHogs/book1993/mccaw3.htm

A Shameless Plug for my First Fiction Book – The Eye of the Virus

My novel’s main character is a virus itself – a new strain of avian influenza that makes its debut in a small village in Vietnam. Like the American movie Crash, the story follows the virus as it travels first to Hong Kong and then to the United States. Like a ricocheting bullet, the virus affects the lives of businesspeople, wives, children, doctors, and politicians until it is stopped by a team of Chinese epidemiologists in Beijing and Hong Kong. The story follows six main characters – in addition to the virus itself – in their efforts to cope with the global pandemic and its effects on their individual lives.

Myriam is a British PR executive on holiday with her husband when he becomes the first person infected in Hong Kong. Her life is completely changed by the experience, in ways she never predicted, including an involvement with a Chinese-American doctor who works for the World Health Organization.

Brian is an American scientist who invents a new antiviral medication, but fakes test data so that it can be released early. When the drug begins losing effectiveness, the world discovers that it also has negative psychological side-effects, ultimately causing Brian himself to commit a rash, violent act.

Casey is Brian’s girlfriend, who finds herself stuck on a small island off the East Coast during the pandemic. After losing both her parents to the flu, she loses herself.

Jie is an epidemiologist with ties to Harvard and a director at the Chinese CDC in Beijing. When she gets a call from her old classmate, Will Shen, a WHO worker stationed in Hong Kong, the two work to solve the puzzle of the new virus.

These are just a few examples of the multiple, interweaving storylines followed in my book. As the unknown virus quickly spreads its way across the globe, entire societies are affected and changed by the outbreak, leaving the reader with the ultimate question: What would be important to you, what would you do, if a pandemic actually occurred?

Year of the Golden Pig – with an ironic twist . . .

The New York Times reported last week that an epidemic was killing pigs across the border from Hong Kong in mainland China, in two areas in Guangdong province.

This is ironic because this is the year of the pig in China, and the mystery disease allegedly began to surface immediately after the New Year celebrations. I’m no expert, but even in their golden year, this doesn’t bode well for pigs. Efforts are being made to slaughter the infected pigs and to prevent any spread of the disease.

All joking aside, however, this story raises new concerns about the age-old issue surrounding Chinese transparency and global health issues. The entire Southeast region of China has residual fears from its bout with SARS in 2003, and Hong Kong authorities are especially concerned about the issues both of accurate and timely reporting and effective containment of outbreaks. Although this disease does not appear to have any of the same symptoms of either SARS or bird flu, concern remains since pigs’ immune systems are very similar to our own. Pigs are often key links in the natural chain of disease transmission, which is why this story is causing so much alarm in Hong Kong in the first place. Authorities both at the WHO and in Hong Kong are worried that China is not being quick enough to disseminate information and, when an official report is finally released, it is perhaps not entirely forthcoming.

The link to the full story is here:

www.nytimes.com/2007/05/07/world/asia/07cnd-hongkong.html

Good thing I wrote my fiction novel (Eye of the Virus) about a pandemic early! Gallows humor is my forte, just to be clear. I’ll keep an eye on this story, but unless it’s serious (in which case we’ll all know more about it because CNN will pick up the thread and the panic button will be pushed), it will largely fade into the “needs further investigation” file. As somewhat of a layman disease expert, I know that something will eventually break through our largely inadequate surveillance system, but I hope it’s not in the near future.

But I live in the San Francisco Bay Area, so it behooves me to be optimistic about any predicted catastrophes.