Wednesday, April 15, 2009

Bill Gates to Face Trial by Intestinal Worms

It has long been recognized that poor health results in people being more susceptible to anything going. That's why many people aim for good overall health by watching what they eat, taking enough exercise, getting enough sleep, etc.

It was also established some time ago that poor health and a high disease burden results in populations being more susceptible to major diseases like cholera, malaria, acute respiratory infections, TB, HIV and many other things.

The connection between high rates of intestinal parasite infestation and HIV was made more than a decade ago and soon after, it was pointed out that the search for a HIV vaccine would be hampered by the high disease burden suffered by populations most affected by HIV.

Anyone seeing a connection yet? People in areas with high rates of HIV are the same people who suffer from numerous diseases, many of which are treatable or curable, they suffer from poor water and sanitation supplies, poor nutrition, etc. Oh, and low levels of education, minimal infrastructure and many other things.

On the other hand, if water and sanitation were improved, many of the most common diseases would be prevented or seriously reduced. Cholera, for a start, also intestinal parasites, also hepatitis E, the list is long. 20% of young people in developing countries die of diarrhea alone, most of the other things that kill young and old are either preventable or curable. Many relate to water and sanitation.

So why does Bill Gates want to find a vaccine for cholera. He seems to like to find a 'big one' and hack away at that. HIV, TB and malaria are three others (the third of which is also directly related to water and sanitation). He wants to create a completely unsustainable and expensive solution to cholera when the best prevention for this is good water and sanitation.

Cholera vaccine research has come up against a problem. The vaccines work well in developed countries, where water and sanitation are not such a problem, but they work badly in countries where water and sanitation are a problem.

Have I spelled it out clearly enough for Bill and his defenders? I'm not saying he shouldn't spend his money on research that could save the lives of millions of people. I'm suggesting that he could spend his money on saving the lives of billions of people. Think of the number of diseases that would be reduced if he spent his money on water and sanitation.

But he seems to like intellectual property, drugs for cholera, drugs for malaria, drugs for HIV, drugs to prevent HIV among those who are not yet infected, pharmaceutical products for the starving, in the form of genetically modified organisms, a 'green revolution' driven by locking poor famers into an agreement to be slaves for the biggest multinationals in the world.

Because Bill knows intellectual property, he made his money out of it. What is software but intellectual property, low costs but high sale price? He has been manipulating intellectual property for most of his working life and now that he has become a philanthropist, he is depending on it still.

I'm not suggesting that he has anything personal to gain, in the sense that he has shares in all these pharmaceutical companies and all the others that will make billions. Perhaps he doesn’t have shares or any kind of interest. I'm just suggesting that there are immediate things that could be done that would obviate the need for all this research into more drugs when the solution is far more basic.

People in developing countries need, in addition to water and sanitation, good education, access to health care, good nutrition and food security, infrastructure, rights, equality. Drugs come and go, that's the problem, that's one of the reasons that they are not sustainable (also the ridiculously high prices and the corruption that keeps the prices high). And why put so much money into this technology when there are solutions that will have far greater benefits?

As many as 2 billion people in the world may have intestinal worms, this will affect their health, their welfare, their intellectual and physical growth. Bill, think of what good water and sanitation could do for people, never mind the pharmaceutical companies. Beating the worms would be a far bigger reward.


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