HEALTH CARE/Joan Retsinas

A Candle in the Bleakness

Imagine the goriest, scariest horror film, with outrageous villains (all human – the extra-terrestials running amok don’t count) dreaming up mayhem – but with no 007 in the wings to save us. That scenario constitutes Today’s World 2015. Incessantly the media broadcasts news from the ubiquitous killing fields. Schools, cafes, hotels, sports arenas, hospitals – no haven is safe from murderous chaos. Everything, and everybody, is fair game. Indeed, we humans seem hell-bent (I use the term advisedly) on destroying each other and our civilizations before global warming boils the planet. We are literally turning ploughshares into swords.

So the news from the world of science sounds like a Monty Python in this long-running horror movie.

In the midst of chaos, where we are wielding astounding “weapons of mass destruction,” scientists are developing their own array of weapons to vanquish perennial killers – specifically, the diseases the planet has accepted as inevitable. Malaria, AIDS, measles, whopping cough, diarrhea, dengue fever, rubella, hepatits C. All killers, but all on the cusp of eradication, maybe. (“Eradicating Disease,” The Economist, Oct. 10).

The precedent for defeating disease exists. We developed a vaccine that relegated smallpox to the history books. Admittedly, the smallpox virus did not thrive in a mosquito. Outside a human, it dies – making the battle easier. We have just about relegated polio to the medical archives.

Crucially, the future in the disease-war looks promising. The HIV virus lives primarily in humans, does not survive long outside the human host. If – a major if – scientists developed a vaccine, we might also relegate AIDS to the history books.

For malaria, the battle is more difficult. The disease takes refuge in mosquitoes. A mosquito infected with the disease bites a human, injecting the parasite into the victim’s blood, then to his liver, then to red blood cells. When another mosquito bites the infected person, that mosquito too becomes a carrier. Insecticides have helped, particularly bed netting treated with insecticides. An artemisinin-based therapy has saved almost all infected children in some enclaves. Yet the parasites are growing resistant to many of the insecticides and drugs.

Nevertheless, 100 countries, including Swaziland in Africa, have almost eradicated the disease. Early in the 20th century, malaria killed 2 million people a year. Today it kills 450,000. The Gates Foundation has funded a massive assault on this ages-old parasite. Public health workers now test patients, map pockets of infection, distribute nets. On the horizon are efforts to develop a vaccine, to modify the Anopheles mosquito, and/or to block mosquitoes’ ability to pass on malaria.

For measles (750,000 children die each hear), mumps (not fatal, but complications include encephalitis and hearing loss), and rubella we have vaccines. If – another major if – we vaccinated people, as we did for smallpox, we might retire those diseases. Hepatitis C also responds to a vaccine. We could retire that too.

Consider filariasis (120 million people affected) and river blindness (300,000 blind, 800,000 visually impaired). People in the developing world fear these diseases; in the developed world, we have taken them off our list of worries. Thanks to the two winners of this year Nobel Prize in Medicine (William Campbell and Saatoshi Omura), we have a drug that works – indeed, a drug linked to the earlier discovery of streptomycin.

The Economist, not a normally sanguine publication, predicts that “if” we killed seven diseases, we could save 1.2 million lives a year.

Of course, we would have to look beyond all the demarcations that divide us – race, ethnicity, religion, culture, national origin, political party – and stop hating each other. Sub-Saharan Africa, a hubbub of civil insurrections, lost 8300 people to violence in January and February 2015, according to the Armed Conflict Location and Event Data (ACLED) project). Refugees fleeing violence dot the planet: they face a Darwinian trek to “safety.” And the refugee camps themselves are cauldrons of disease.

So, while we could, on the one hand, vanquish the diseases that kill us, unless we vanquish the demons within us, we won’t gain much ground. We will keep killing each other faster than the armamentaria of public health forces can save us.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, January 1-15, 2016

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