Malaria Kills Millions Every Year in Africa. It is responsible for anywhere from 1 to 3 million deaths per year, most of them in sub-Saharan Africa. Efforts to eradicate the disease are mounting: in the year 2000, just 3% of children under 5, in sub-Saharan Africa, slept with mosquito nets; by 2008, that figure had risen to 56%. Aid groups now project that aggressive preventive measures can protect 100% of the population by the end of 2010 and reduce the number of deaths to near zero by 2015.

Doing so requires an aggressive and coordinated effort by governments across the region, in concert with world health experts, the UN’s WHO, aid organizations and local communities. Malaria, originally named “the bad air” because it was thought to be airborne, is actually a water and blood-borne disease, transmitted by a particular variety of mosquito. The scarcity of safe drinking water across much of the region leads to ill-advised practices like leaving whatever standing water one can find at hand for human consumption.

This allows mosquitoes to breed and proliferate. Advanced plumbing, with enclosed water systems, could help prevent the constant rampant spread of the disease, but other measures need to be taken first in order to secure the region’s water resources and ensure equitable distribution, to prevent water-linked trade and military conflicts and the further deterioration of troubled civil infrastructure, the collapse of which favors contagion. [Complete text...]

What measures can be most effective for ensuring the solutions best suited to combatting malaria in any given location can reach the people most in need? Can transport, agriculture and hydrological infrastructure all be strengthened simultaneously, or do we need a form of engineering triage aimed at doing the most good as quickly as possible? Which international efforts are doing the best work? What local efforts are most effective?

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Geneticist and biotech pioneer Craig Venter unveils the process of experimentation and research that allowed his team to create the “first synthetic cell”. The video includes not only information about how the genetic code was created first on a computer and includes “watermarks” such as the name of the new species’ official website, but also about how the team studied ethical issues relating to the project of creating synthetic life. The project took 15 years and was aimed at creating “error-free genetic code”.

Venter announced that aside from the names of over 40 researchers and a web address, the genetic code for his synthetic organism also contains several quotes, such as “To live, to err, to fall, to triumph, to recreate life out of life”, by James Joyce. The team also included a quote from American Prometheus, a biography about Robert Oppenheimer: “See things not as they are but as they might be”. Observers note that routine cellular mutation will likely cause these watermarks to morph over time.

Intellectual property laws designed to help protect the ability of researchers to retain compensation for major innovations have led to a uniquely problematic “innovation” in the laws themselves, where specific genes, or the informational access to them, are patented, barring individuals or their physicians from dealing directly with those genes except through the for-profit patent-holders.

There are critics of these patents that say they are actually an impediment to the advance of research in the field. And some patients have already experienced the unenviable situation in which a “risk-of-cancer” diagnosis cannot be double-checked, because the patent-holder for a specific gene will not permit a second opinion to be obtained through any other entity.

There is strong legal theory behind the view that this type of patent is an aberration and possibly even an unconstitutional hijacking of the private biological information of individual citizens.

Patent-law principle: it is a fundamental requirement of US patent law that patents be applied to specific mechanisms that are not naturally occurring and which are “non-obvious” as extensions of existing mechanisms. Genes are, of course, naturally occurring, constitute mechanisms nit created by their discoverers, and should be considered “evident” in themselves, given the now extensive scientific understanding of their composition and function.

What’s more, they not only already exist, but they exist in the native biology of every human being, 100% independent of the labors of scientific researchers. A fair analogy in the way of intellectual property, regardless of natural occurrence, might be copyright law and music. No one is allowed to copyright musical notes themselves, nor “discoveries” made by listening to a specific copyrighted series of notes both would clearly hinder creations or “innovations” reliant on those notes, only specific texts rendering unique sounds in a precise sequence. Copyrighting individual notes would clearly hinder “innovations” reliant on those notes.

US Constitution: the Fourth Amendment reads as follows: “The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.”

Those interested in patenting human genes, or securing the sole legal right to test, access or report on specific genes, would argue the Bill of Rights only regulates government actions, but a patent is a legal ban imposed by the government, and supported by law enforcement. Surely, if all people have the right “to be secure in their persons”, placing a government imposed order on something already biologically fundamental to the inner workings of the body could be constituted as a “violation”.

Now, imagine you seek health treatment, but cannot access or control the information about your own genes, due to a patent that gives a for-profit firm exclusive “rights” over your genetic information.

What benefit to society is there in allowing your health treatment to hinge on whether or not you can afford to pay a specific firm a high fee for access to your own biological information? Is it just that your health outcome depend on whether or not they will grant you access or whether their specific mode of treatment is trustworthy and effective, when others might be better able to apply the necessary techniques?

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The date was 3 December 1984. The people of Bhopal, India, were the victims of a chemical spill of unprecedented proportions. 40 tons of toxic gas spilled into the city, killing tens of thousands of people. Methyl isocyanate, the substance that caused the mass death, prevents oxygen from entering the blood when inhaled. In just one night, thousands were killed, literally drowning in their own bodily fluids. At least 15,000 more people were killed over the next several weeks, and many believe the total number of those killed from exposure to methyl isocyanate is well above 30,000.

Hundreds of thousands of people are still exposed to the toxin through its presence in ground water and plant life, and there is an international movement to punish those responsible. Now, on the 25th anniversary of the disaster, there are reports the old pesticide factory, owned by the chemical giant Union Carbide, continues to leak lethal toxins into the soil and groundwater. The plant is reported to have been abandoned, with insufficient efforts made to safeguard against the ongoing release of lethal chemicals.

According to the Guardian’s George Monbiot:

After drinking half a glass of water that the people of the city drink every day, the author [of Five Past Midnight in Bhopal] Dominique Lapierre reported that “my mouth, my throat, my tongue instantly got on fire, while my arms and legs suffered an immediate skin rash. This was the simple manifestation of what men, women and children have to endure daily, some 18 years after the tragedy.” Seven years on, nothing has changed. There has been no cleanup, no attempt to prevent the leakage from the site that takes place during every monsoon.

The site of the chemical accident continues to be one of the most toxic and unsafe in the world, yet comprehensive clean-up efforts have never been compelled. Union Carbide, now owned by Dow Chemical, paid a $470 million out-of-court settlement in 1989, in a bid to put avoid further legal responsibility for the tens of thousands of deaths and chronic pollution. The accusation has always been that the chemical plant was poorly maintained, lacked basic standard safeguards and failed to report ongoing containment problems.

There had also been accusations that top executives for Union Carbide may have had direct personal knowledge of the inadequate safety conditions and either did nothing to fix the problem or even deliberately concealed the poor maintenance, assuming it was the best way to keep costs down.

Wikipedia explains:

The Union Carbide India, Limited (UCIL) factory was established in 1969 near Bhopal. 50.9 % was owned by Union Carbide Corporation (UCC) and 49.1 % by various Indian investors, including public sector financial institutions.[2][3] It produced the pesticide carbaryl (trademark Sevin). In 1979 a methyl isocyanate (MIC) production plant was added to the site. MIC, an intermediate in carbaryl manufacture, was used instead of less hazardous but more expensive materials. UCC understood the properties of MIC and how to handle it.[12][13][14]

During the night of December 2–3, 1984, large amounts of water entered tank 610, containing 42 tonnes of methyl isocyanate. The resulting reaction increased the temperature inside the tank to reach over 200 °C (392 °F), raising the pressure to a level the tank was not designed to withstand. This forced the emergency venting of pressure from the MIC holding tank, releasing a large volume of toxic gases. The reaction sped up because of the presence of iron in corroding non-stainless steel pipelines. A mixture of poisonous gases flooded the city of Bhopal, causing great panic as people woke up with a burning sensation in their lungs. Thousands died immediately from the effects of the gas and many were trampled in the panic.

The various attempts to investigate what exactly took place on the night of 2-3 December 1984 have failed to determine the precise cause of the spillage and the ultimate chemical catastrophe. There is a grassroots movement both in India and around the world, that continues to press for answers, for clean-up and for justice for the hundreds of thousands whose lives are intimately affected by the chemical release, seepage from which continues to be a threat to this day.

Scientists have discovered evidence that human hearing is in part dependent on tactile cues that come not from audible sounds, but from pressure fluctuations and air-particle displacement against skin around the ear.

The BBC reports on the findings as follows:

In the latest study, researchers at the University of British Columbia in Vancouver wanted to look at whether tactile sensations also affected how sounds are heard.

They compared sounds which when spoken are accompanied by a small inaudible breath of air, such as “pa” and “ta” with sounds which do not such as “ba” and “da”.

At the same time, participants were given – or not – a small puff of air to the back of the hand or the neck.

They found that “ba” and “da”, known as unaspirated sounds, were heard as the aspirated equivalents, “pa” and “ta”, when presented alongside the puff of air.

The research is new evidence that each of the senses depends in some way on information fed in from other senses to build a complete picture of the information it is focused on detecting. So while the eyes help us hear by giving us visual cues, and our sense of taste is dependent in part on our sense of smell, touch may play a role in how we hear and whether we can make sense of specific environmental cues.

The discovery, if verified in studies of common human interaction, could significantly improve the methods used to compensate for hearing loss, and build better hearing aids. It could also give us an entirely new and far more complex understanding of what the senses do and how they do it.

Pranav Mistry, inventor of the SixthSense physical-to-computation convergence technology, told the TED India conference earlier this month that he is often told his invention could lend itself to a “FifthSense” product that helps to compensate for or restore a diminished sense capacity, as with the hard of hearing or the blind.

What innovations are showing us the multiple and interdependent quality of human sensation? And what new technologies are allowing us to take advantage of that new knowledge to improve treatment, recovery and replacement of sensory ability?

Malaria is one of the 21st century’s great plagues. It is responsible for anywhere from 1 to 3 million deaths per year, most of them in sub-Saharan Africa. Efforts to eradicate the disease are mounting: in the year 2000, just 3% of children under 5, in sub-Saharan Africa, slept with mosquito nets; by 2008, that figure had risen to 56%. Aid groups now project that aggressive preventive measures can protect 100% of the population by the end of 2010 and reduce the number of deaths to near zero by 2015.

Doing so requires an aggressive and coordinated effort by governments across the region, in concert with world health experts, the UN’s WHO, aid organizations and local communities. Malaria, originally named “the bad air” because it was thought to be airborne, is actually a water and blood-borne disease, transmitted by a particular variety of mosquito. The scarcity of safe drinking water across much of the region leads to ill-advised practices like leaving whatever standing water one can find at hand for human consumption.

This allows mosquitoes to breed and proliferate. Advanced plumbing, with enclosed water systems, could help prevent the constant rampant spread of the disease, but other measures need to be taken first in order to secure the region’s water resources and ensure equitable distribution, to prevent water-linked trade and military conflicts and the further deterioration of troubled civil infrastructure, the collapse of which favors contagion.

Water-related conflict is an increasing threat to political stability across Africa, and ongoing “low-intensity” conflicts, including some that are taking thousands of lives, undermine basic pillars of organized society, like sustained agriculture, water quality, transport infrastructure, communications infrastructure, electricity and public health contact points. Populations deprived of one or more of these basic services are more likely to suffer from epidemic contagion.

Malaria is a disease that “comes back to visit”, according to Dr. Maghan Keita, of Villanova University, who addressed a gathering hosted by the Blood:Water Mission charity organization, on 19 November 2009, on Villanova’s campus. The Blood:Water Mission event was held to highlight both the gravity of the malaria pandemic, including the millions of deaths, but also to report on promising successes in spreading awareness and prevention to some of the most affected populations.

Dr. Keita, a leading Africana studies scholar who has studied epidemiology and migration in Africa, says sickle-cell anemia and other responses and after-effects of malaria infection can migrate in the blood of people never exposed directly to malaria itself, causing debilitating conditions and even death for some people. The malaria patient can also experience the direct return of the infection, even after it is treated, so prevention is the single most necessary mode of combating the disease in human beings.

LLIN (also known as long-lasting insecticidal nets) and other ITN (insecticide-treated nets) are now the front-line preventive measure of choice across sub-Saharan Africa. They can be up to 100% effective in mitigating the threat of mosquito-borne infection during sleep, not only due to the protective barrier they provide, but also as a result of being infused with insecticidal chemicals that can kills mosquitoes on contact, without endangering the health of human beings using them.

A UNICEF report on the subject notes the need to ensure the pesticides are safe for deployment in such proximity to human beings:

• In all cases, national governments must approve the use of insecticides prior to importing them into the country.
• ITNs, LLINs and insecticide treatment kits are for domestic use and can be handled by family members.
• It is advisable to order untreated nets set-packed with an insecticide treatment kit so that the net can be treated prior to use. It is also important that the user is made aware from the beginning that the net needs re-treatment.
• Each insecticide treatment kit is for the treatment of one ITN and consists of a measured dose of insecticide, a measuring bag, protective gloves and instructions on how to impregnate one net.
• The insecticide is public health grade and WHOPES (World Health Organization Pesticide Evaluation Scheme) approved.

The plant variety artemisia annua, a Chinese wormwood, has been found to have strong anti-malarial properties, and is being planted in Africa in hopes it will take to the sub-Saharan climate, and help produce a potent, locally grown pharmaceutical treatment to prevent or treat malaria. According to USAID:

The fight against malaria increasingly uses Chinese sweet wormwood, but demands for the plant have exhausted supplies, leading USAID to promote new plantings in East Africa.

The Agency is working with the World Health Organization (WHO) to transplant the ancient Chinese remedy to Africa, where the soil and climate are suitable. Artemisinin is the extract of wormwood that is useful against malaria.

Planting of 450 hectares of Artemisia annua began in Kenya in January 2005. In spring 2005, 450 hectares will be planted in Tanzania.

“By this time next year, we will be looking at the extraction of 20 metric tons of artemisinin,” said Dr. Dennis Carroll, malaria expert with the Bureau for Global Health (GH). Malaria kills more than one million people each year.

The artemisia annua shrub appears to have been found to also work against certain parasitic worms that can infect human beings leading to a number of disease symptoms. As reported on the Science and Development Network:

Different forms of bilharzia — also known as schistosomiasis — occur throughout the tropics. Together, they kill 15,000 people each year, according to the World Health Organization.

The disease is caused by five species of worm that enter humans through their skin as juveniles, then mature and reproduce in the blood vessels. The worm eggs are usually evacuated from the body in urine or stools but some remain in the body leading to disease symptoms, which include damage to the kidneys, spleen and bladder.

The plant produces extracts that might be able to help combat parasites that are developing a dangerous resistance to current modes of treatment. The hope is that use of the artemisia extract to fight malaria and/or parasitic worms, could also lead to new research as to how to target and eventually eradicate such disease agents.

It is estimated that as many as 15 million cases of malaria infection were treated by way of artemisinin-based combination therapies (ACT), a “cocktail” of drugs that work in sequence and in concert to destroy the parasites that cause the disease. The WHO reported that by the end of 2006, demand had risen to 150 million cases.

Logistical challenges related to treating 150 million to 200 million cases across dozens of countries are one of the chief remaining obstacles to effective global prevention and eradication of malaria. In many countries the response is fourfold: nets, chemical treatments, drugs and landfill, to eliminate standing water. Only nets are minimally problematic in terms of side-effects and environmental fallout.

One in 91 American children is now reported to be afflicted with autism spectrum disorder. A number of potential culprits has been suggested over the years, as autism figures have steadily risen, including vaccines, antibiotics, hormones, pesticides, coal waste and radiation.

What is now being termed ‘autism spectrum disorder’ is a more inclusive diagnosis than trafitional full-scale debilitating autism, but researchers say within the overall figures, there is a dramatic increase in cases, for which a specific cause or constellation of causes has yet to be identified.

But in the midst if this apparent epidemic of developmental autistic disorders, we need to be asking ourselves what role environmental, chemical and energy regulation might play in rolling back the advance of autism.

As Medscape reports:

[The new study] found that the prevalence of ASD was 110 per 10,000 children, markedly higher than previous estimates. According to background information in the study, prevalence estimates have risen steadily, from the 1960 to the 1980s, when estimates ranged from 2 to 5 in 10,000, to the 2000s, when estimates ranged from 30 to 60 in 10,000; in most recent reports, estimates range from 50 to 90 per 10,000.

With more than one percent of the population now being born diagnosed as falling within the spectrum of autism-related symptomology, we face the prospect of needing to care for over 3 million emotionally and intellectually challenged individuals who may not be able to lead independent fully independent lives.

The figures could soon be so high as to spur the emergence of a new workforce of hundreds of thousands of related specialists and support staff, including special employment management, home-visitation and psychological care services.

Autism is now approaching the level of commonality as more familiar ‘conditions’ that are rare but genetically regular. For instance, only 2% of the US population are natural redheads, compared with roughly 1.1% of this new generation having autism spectrum disorder.

The Clean Air Act and Clean Water Act have been in effect a relatively short time and while taken for granted as cornerstones of a sweeping public health and environmental protection system, remain controversial to some in industry who view such constraints as an insurmountable challenge to their profit scheme.

That open and sometimes combative controversy signals a very strong possibility that laws are being ignored and regulations going unenforced. In many areas of chemical safety regulation, regulatory supervision or intervention amounts to little more than reviewing companies’ reports for irregularities.

We have also heard for decades the all-too-questionable argument that investigation into the possible ill effects of vaccines or chemical compounds on children should not be too far-reaching because it might hamper the ability of industry to do business. If that’s true, of course, It would have to be because the work being done to prevent those ill effects is known to be insufficient.

Now that we know we are in a statistical red zone, in the midst of a generational outbreak of a disease that is not supposed to be contagious, we need to get serious about finding out why it’s happening and how we can reverse the trend. Finding out what causes any of the disorders within the autism spectrum is a complex task, because the nature of what is actually wrong physiologically is not clear and may vary patient to patient.

According to US News and World Report:

We don’t know what causes it, and there’s no good treatment. All the more reason we need to figure out now what’s causing autism and then develop treatments that really work. No one cares more than a parent about that; so why not involve them in that process?

That’s just what the Interactive Autism Network is doing. Parents of children with autism from around the country collaborate in building what has become the largest online autism registry in the world. The IAN registry was launched by Baltimore’s Kennedy Krieger Institute in 2007. By making use of the power of the Internet, it has registered 30,000 people from all 50 states. The database created by this volunteer effort is being used by autism researchers around the world and is also used to match families with individual studies they can join.

That project has now expanded to allow grandparents to feed information into the system specifically from the point of view of grandparents of potentially autistic children. Such information can be helpful for determining what environmental factors may play a role and what behavioral abnormalities are unique to those cases.

Clean, safe drinking water is scarce for over 3 billion people across the world. At least 1 billion literally never have access to clean, safe drinking water, putting them at constant risk of severe thirst-related ill health effects, infectious diseases or toxic contamination. Over 100 countries face either sporadic or chronic crisis-level problems related to clean water scarcity.

As the Innocentive project reports:

Yet, over half of the world’s population is at risk for water shortages, with far-reaching effects. Lack of adequate clean water has serious health implications, including the prevalence of water-borne diseases such as cholera, typhoid, hepatitis A and E, and diarrhea. Globally, diarrhea is the leading cause of illness and death and 88% of those deaths are due to inadequate sanitation and availability of clean water. Water shortages also foment civil unrest and often lead to violence and regional conflicts, as we have seen in Darfur, Somalia, Chad, Nigeria and Sri Lanka, among others. Lack of water perpetuates poverty, increases the risk of political instability, and affects global prosperity.

The Clinton Global Initiative is working to bring water purification packets to remote areas around the world where available water poses a threat of toxic agent or disease transmission, in order to speed the delivery of clean, safe drinking water to affected populations. Innocentive is offering possible financial benefit for solutions to what may be the world’s most severe public health crisis.

Use this discussion to share your ideas and experiences, including links to research and reports about best practices for solving the world’s water crisis…

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A new innovation developed by scientists in Israel may be able to detect traces of lung cancer in human breath, by identifying molecules linked to the condition. The device would be hand-held and easy to use, and could potentially be available at any family doctor or general practitioner’s office, in the future.

1.3 million people die of lung cancer every year, with 50% dying in the first year after diagnosis, and 80% within the first two years. It is notoriously difficult to detect while in early stages.

Dr. Hossam Haick, the device’s inventor, says he hopes a similar process, or even a single device, would be able to diagnose nearly any cancer in the future. Such an achievement would dramatically increase survival rates for nearly any cancer that could be detected that way, since cancer is most treatable when detected early.

The process was tested on 62 human patients, two-thirds of which have cancer. The study is published in Nature Nanotechnology. The device was said to have 87% accuracy in diagnosing early-stage lung cancer. Making such tests a routine part of doctors’ check-ups could make a significant difference in the number of people dying from the disease.

Dr. Haick says the device itself may eventually be brought down to the size of a mobile phone. It had previously been found that dogs can detect the presence of cancer, but only with about 50% accuracy.

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Life expectancy in the United States is 78.11 years, 50th in the world, behind the Wallis and Futuna Islands and just ahead of Guadeloupe. Canada is 8th, at 81.23 years; France is 9th, at 80.98; Sweden is 10th, at 80.86. Despite Canada’s “socialized” healthcare system, the average Canadian can expect to live more than three years longer than the average American.

Life expectancy is often cited as one of the prime measures of the degree of “success” or achievement of a healthcare market. While certain elements in the US political sphere continue to rant about the disaster of government “intervention” in medical insurance, life expectancy seems to indicate that healthcare systems where coverage extends to all but government does not interfere with treatment decisions, enjoy a higher life expectancy.

In the United States, a major contributing factor to the lower age for average life expectancy is the lack of access to care that affects tens of millions of people who cannot obtain sufficient health insurance coverage. Whether reforms currently under consideration would solve that problem is a matter of ongoing debate, but the reforms’ backers consistently affirm they are aimed at achieving that goal.

For the few Americans who both have the resources to cover all the costs of healthcare plans available to them or to which they are limited through denial of access standards, the system may provide a better likelihood of long life. But for the 52 million with no coverage, and the tens of millions more with insufficient coverage or whose costs are unsustainable given their personal or family income, the status quo means private health insurance often limits access to care and prevents patients from obtaining sustained preventative care.

In fact, of the industrialized democracies with some form of guaranteed universal coverage, every one of them is ahead of the United States in the ranking of overall average life expectancy. Japan is 3rd in the world, at 82.12 years; Australia ranks 7th, at 81.63 years; Switzerland ranks 11th, at 80.85 years, using a unique fully private insurance model where the government organizes and mandates standards for coverage.

Israel, whose system is also universal, mandatory and government organized, ranks 13th in the world, with life expectancy of 80.73 years. Iceland, whose universal healthcare system spends less per person than the US government already does, ranks 14th, at 80.67 years. Italy ranks 19th, at 80.2 years; Spain ranks 23rd, at 80.05; Norway ranks 24th, at 79.95.

Even the United Kingdom, whose universal government funded and managed National Health Service (NHS) does notoriously ration care and calculate what maximum amount certain life-saving treatments should be worth, ranks 37th, fully 13 places above the United States, at 79.01 years, nearly one full year more of expected longevity per person than in the US.

Any discussion of the virtues of existing reform proposals in the US must take into account that they are specifically designed to avoid government control of treatment and are intended to avoid anything like the pitfalls of the NHS. While critics of reform warn that expanding coverage at all will put added financial burden on the already-insured, proponents of reform say the current system already rations care and denies treatment to millions every year.

One of the great complaints heard from groups opposing comprehensive health insurance reform, especially from quarters where the chief concern is to prevent a drop in private profit related to healthcare services, is that reform will strip away incentives to devote funding to medical research, in pathologies, treatments and technology. This is a point of philosophical dispute, but to make sure we enact reforms that will not curb research incentives, we should institute a new medical research tax credit.

The program would make all donations to medical scientific research tax deductible, or in some cases, eligible for rebates, designed to steer research into certain pressing areas of health treatment. This would incentivize investment into medical research, whether by for-profit firms or not-for-profit foundations or by individuals giving charitably. That incentive is important, because too many pseudo-theories about the economics of healthcare link the incentive to invest in medical R&D to the profit motive.

In fact, of the $28 billion in funding the NIH devoted to medical research in 2004, $13 billion went to medical schools and teaching hospitals and fully $8.5 billion went to universities, non-profit research foundations, other hospitals and research entities. Only $1.9 billion, or 8%, went to private for-profit firms. This is, in part, owing the fact that those firms have enormous reserves of cash they can devote to R&D, but it is also owing to the fact that the institutions receiving the bulk of the funding actually conduct the bulk of the research.

For-profit firms do conduct R&D, but much of it is related to products already in production, shepherding products in the works through the regulatory process and marketing and cross-marketing (alternate uses) for those products. The logic of private for-profit enterprise tends to dictate that it is more cost effective to let the universities and research foundations do the bulk of the total research, then pay for the right to produce something based on the most promising research.

This means for-profit entities actually contribute far less to the overall fund for medical research in the US, substantially less on an annual basis than the NIH itself does. The idea that the “public option” would strip away market incentives for investment in medical research is at best a fallacy, based on philosophical assumptions about the reach and motivation of for-profit entities; at worst, it is a misleading rumor designed to kill what might be the most significant way of reducing costs across the board, optimizing healthcare spending, and spurring new revenue streams (52 million uninsured that would be covered).

What is certain is that pharmaceutical companies reap huge profits from spending on brand-name prescription drugs, and they want to make sure the pool of people spending on those drugs is expanded. With 52 million people currently uninsured, treatments to those people, wherever they occur, often wind up falling into the category known as “uncompensated care”, which puts downward pressure on health centers’ (hospitals and private clinics) inclination to prescribe the costlier drugs.

A market expansion of 52 million individuals (millions more than the entire population of Spain) means a huge windfall just over the horizon for the pharmaceutical industry as a whole, even if costs per patient or per pill come down significantly. Bringing costs per patient down 10% overall, but expanding the market by 20.23% (52 million is 20.23% of the total number of people currently insured by public or private plans), means a huge expansion of revenues.

This, coupled with the fact that major pharmaceutical manufacturers not only don’t provide the bulk of research funding, but also know the system which funds research through other entities is far more efficient than if they did provide the bulk of funding, means the industry is in favor of the current proposed reforms, which aim to bring “quality, affordable healthcare” to all Americans.

PhRMA —the Pharmaceutical Research and Manufacturers of America lobby umbrella group— has announced it will spend $150 million in a national ad campaign to support Pres. Obama’s healthcare reform plans, as laid out by Congressional legislation. Ken Johnson, senior VP of PhRMA, has said “The new ads will focus on the importance of making certain that everyone has high-quality, affordable health insurance, including affordable co-payments and does not deny coverage because of a pre-existing condition.”

The pharmaceutical industry does not, apparently, believe the proposed reforms would hamper its own ability to fund research or the broader national funding system for advanced medical research. But taking additional measures to both expand the funding opportunities for bold innovators and for research attuned to the new market environment for medical study and application can only reinforce the dynamics of the market that emerges from these reforms and ensure better care for all who are part of that system.

A medical research tax credit would guarantee that real direct incentives for foundations and enterprises to conduct meaningful innovative research in medicine and medical technologies insulate the research sector from any marketplace upheaval related to health insurance reforms, either those mandated by legislation or those enacted in response by the private sector. It would also liberate private-sector entities to make their pricing schedules more competitive and consumer-friendly and could speed the development of best-results new treatments and paradigm shift discoveries, by putting science at the center of the process.

Hours before sunrise, a crowd numbering in the hundreds had already begun gathering outside the Inglewood Forum, in hopes of being able to take advantage of a free health check-up offered by the Remote Area Medical Volunteer Corps (RAM). RAM will be hosting the free health clinic from 5:30 am to 6 pm over 8 days, in hopes of bringing much needed routine medical care to the urban uninsured excluded from the healthcare system due to cost.

According to the LA Times:

Only 1,200 people a day will be scheduled for the 45 medical exam rooms, 100 dental stations and 25 eye exam sites set up at The Forum, they said. Full exams, including Mammography, chest X-rays, PAP smears, blood pressure screening and diabetes screening will be offered. Prescription eye glasses will be fitted and prepared on site, said organizers.

RAM has treated over 400,000 people in remote areas over the last 24 years, and has shot to the national stage as the Forum event highlights the crisis of uninsurance in the midst of a heated national debate on healthcare reform. The Healthkicker blog reports that aside from dental and eye exams, the Forum free clinic will provide:

Mammograms and Pap smears; pediatric exams; adult physicals & medical consults (including diabetes and hypertension); chiropractors; acupuncture; blood lab work; chest X-rays; medication assistance; and many other medical specialties available…

CNN has reported the clinic has a shortage of needed medical personnel, and the RAM website main page says the group is looking for additional medical volunteers:

RAM needs:
Medical Doctors (all specialties) and Nurses, Ophthalmologists, Optometrists, Opticians, Ophthalmic Techs, Paramometry Techs, General Dentists, Oral Surgery, Pediatric Dentistry, Registered Dental Hygienists, Dental Assistants.

CALIFORNIA LICENSED HEALTH CARE PROFESSIONALS ONLY

CONTACT
Jean Jolly, Volunteer Coordinator, Remote Area Medical
jeanjolly@ramusa.org
865.579.1530

A similar mass free clinic will be held at Fort Duchesne, Utah, from 21 August through 26 August, and the same call for specialized local medical staff is being issued. The group’s Reach Across America program seeks to raise $1 million in charitable donations to “develop the airborne capability” needed to bring RAM clinics to remote areas and to send advance logistical teams to help set up mass free clinics like the Inglewood or Fort Duchesne projects.

TheHotSpring.com :: DNA is an amazingly efficient memory bank for the design and scheduling of biological development. Cell DNA have their own replication systems, but human scientists who want to interfere with the content of the genome have been working to find ways to achieve artificial replication and synthesis of disparate properties, and now they may have achieved a landmark breakthrough.

The new process capitalizes on innovations in genome sequencing (reading DNA). Automated genome sequencing allowed for great leaps forward in the processing of daunting amounts of genetic code, and the eventual sequencing (mapping) of the entire human genome. Decoding the information contained in that map of human genetics was possible only because automation had allowed for a rational amount of time spent to sequence any particular strand.

Now, Harris Wang, a biophysicist from Harvard University, in Cambridge, Massachusetts, and George Church, have co-authored a study, published in this Sunday’s edition of the journal Nature, in which they explain how automated merging of biological DNA and synthetic re-ordered DNA can allow for an automated replication process in which the engineering of whole new genomes piggybacks on the already existing natural process of cell division.

As reported by Wired Science:

Earlier methods of manipulating genomes involved a painstaking biological cut-and-paste process, with target genes removed, tweaked and reinserted, one at a time. Alternatively, bioengineers could use a mutagen that turned genomes to hash.

The technique developed by Wang and Church is called Multiplex Automated Genome Engineering (MAGE), and involves customized single strands of DNA, designed to link up with existing DNA at specific target points. A burst of energy opens the target cell, allowing the synthesized DNA to enter, and in a process akin to how viruses use cell-division to self-replicate, the cell includes the new DNA in its own replication process.

The result is a new “modified” genome, inclusive of the synthesized DNA. The process is far faster than the standard method of “pasting” specific strands of DNA into specific locations in the existing genome. The machines Wang and Church use to process these genome adaptations can reiterate the insertion over and over, creating ever-evolving variants of a given genome, with each replication.

They can also provoke or interact with naturally occurring mutations, which the scientists hope can be tracked and predicted, to make the reworking of DNA both more predictable and more efficient. The technique is optimal at present for conducting research on the nature and evolution of genetic properties, and on testing bold hypotheses for developing functional alterations to existing cells.

For instance, in one MAGE modification, reported in the Nature article, Wang and Church successfully converted E. coli bacteria to work as “factories for lycopene”, producing the special antioxidant that is thought to have properties that allow it to scale back or work against the onset of cancerous tissue.

One potential use for the MAGE process would be the creation of lab “models” of infectious diseases, complete with major genetic alterations or projected mutations, allowing for research on how to confront such evolutions if and when they arise. Such research could allow for the development of anticipatory drug treatments for drug-resistant microbes that have evolved from existing treatments.

TheHotSpring.com :: Researchers have stumbled upon a surprise possible treatment for swelling of nerves in the spinal cord. It turns out that FD&C blue dye No. 1 bears certain key similarities to a compound used to treat nerve inflammation. Since there is no active immediate treatment for spinal cord injuries, and secondary inflammation often leads to long-term damage, this treatment holds great promise. The one side-effect observed: the rats’ skin turned blue.

According to Wired:

In 2004, [neuroscientist Maiken Nedergaard of the University of Rochester Medical Center] and colleagues discovered that swelling around the cord is caused by the rapid release of ATP, the molecule that normally provides energy for the cell. Excessive amounts of ATP overstimulate nerve cells and cause them to die of metabolic stress. The researchers found that blocking an ATP receptor called P2X7 prevented much of the inflammation associated with spinal cord injury. But until now, they hadn’t identified a clinically useful drug that could block the receptor.

“We just had proof of principle,” Nedergaard said. “We didn’t have anything we could give to patients.” Then, while searching for chemicals with structures similar to the P2X7 receptor, the scientists came across FD&C blue dye No. 1, completely non-toxic and approved by the FDA in 1928.

The huge amount of blue dye consumed by Americans every year —100 million pounds in total— is an effective demonstration of the chemical’s non-toxicity. It has also been demonstrated that the substance is able to transfer across the blood-brain barrier, making it possible to treat nerve inflammation without a direct spinal injection, which could present added risks to patients already suffering injury to the spinal cord.

Wired reports that “Animals who received the blue dye recovered much faster than animals who didn’t: By six weeks, the treatment group could walk with a limp, while the no-treatment group never recovered the ability to walk.” That result came when the treatment was given within 15 minutes of a weight falling on the rats’ backs (under anesthesia). The 15-minute treatment time-frame is a problem, because most human victims of spinal cord injury are not able to receive diagnosis and treatment so quickly.

Further testing may be attempted, to see if there may be positive effects in treatment delivered long after injury. With such a dramatic difference in outcome —six weeks to walking as opposed to never walking again—, the discovery of blue dye’s anti-inflammatory properties will result in some innovation in the spinal cord injury treatment regime, which is, at present, desperately in need of reliable options.

The effectiveness of blue food dye in treating inflammation in such delicate tissue as spinal cord nerve cells could translate into broader anti-inflammatory uses for the active chemical, but such studies have not yet been conducted. The focus will remain on the most effective gain over standard current practice, a direct, targeted treatment for reducing inflammation in spinal cord tissue. A first step will be to try to reduce the bluing effect of the treatment. Further research may change the way inflammatory injuries are understood broadly.

From other sources:

• Tissue Engineering for Spinal Cord Injury
• Jell-O Fix for Spinal Cords
• Spinal Cord Regeneration in South Carolina
• Stem Cell Success for Spinal Injury in India
• FDA Wants Anti-Radiation Drug

Preventive use of antibiotics has one salient effect: it speeds the evolution of targeted bacteria, allowing them to develop pervasive resistance to known treatments. In short, preventive administration of antibiotics makes diseases far more dangerous. The US government is now seeking to end the practice of administering antibiotics to livestock, which health officials believe is putting human health at risk.

In fact, as much as 70% of all antibiotics used in the US are used to treat healthy farm animals. In fact, factory farming practices may be promoting the spread of dangerous disease agents, for a variety of reasons. One of these is the use of antibiotics, which affect the evolution of resistant bacteria strains. But there are also suspicions that the outbreak of a previously unknown strain of flu virus, the A/H1N1 “swine flu” that reportedly emerged from La Gloria, Mexico, may have something to do with the massive factory pig farm nearby.

The Preservation of Antibiotics for Medical Treatment Act (PAMTA), H.R. 1549/S. 619, aims to prevent the erosion of antibiotic effectiveness due to overuse and has the support of the Union of Concerned Scientists (UCS). The bill would target the use by confined animal feeding operations (CAFO) of antibiotics in animal feed. The FDA would be empowered to review licenses for the use of antibiotics vital to human health in any ways that could promote resistance or otherwise put human health at risk.

According to the UCS:

CAFO operators add human antibiotics to the feed of animals to accelerate animal growth and prevent diseases common in overcrowded and unsanitary living conditions. An estimated 70 percent of antibiotics produced in this country—nearly 13 million pounds per year—are used in animal agriculture for these nontherapeutic purposes. This amount is estimated to be more than four times the amount of drugs used to treat human illness.

Antibiotic resistance linked to food animal operations is on the rise. New studies suggest that hog farms are a source of a new strain (ST398) of MRSA (Methicillin-resistant Staphylococcus aureus), a disease responsible for more deaths per year in the United States than AIDS.

As noted by Wired: “Other types of drug-resistant staph infections already kill 18,000 Americans every year. The new strain, which appears to have evolved on Dutch farms and is spreading through U.S. pigs and into people, will only add to the toll.” Efforts to combat such disease agents by blanket use of antibiotics are extremely counterproductive, actually enabling the bacteria to develop sustained, even complete resistance, to treatment with existing antibiotics.

The PAMTA bill would put 7 classes of antibiotics specifically vital to human healthcare under review, possibly allowing their use for healthy livestock to be entirely banned, based on the potential danger to human health. The Pew Commission on Industrial Farm Animal Production determined last year that “the present system of producing food animals in the United States is not sustainable and presents an unacceptable level of risk to public health”.

Of 24 findings specified by the Pew Commission for its determination that the US livestock production system was unsafe, 5 related to the use of antibiotics in farm animals. Public health officials are increasingly concerned that continued habitual use of antibiotics in factory farming could lead to the evolution of a wide array of untreatable multi-resistant disease agents, like MRSA-ST398.

While the “farm lobby” has expressed opposition to the measure, testimony before Congress suggests there is no risk to food safety from banning the use of antibiotics on healthy animals. The FDA’s principal deputy commissioner of food and drugs, Dr. Joshua Sharfstein, gave written testimony saying that any use of antibiotics for “purposes other than for the advancement of animal or human health should not be considered judicious use“.

Dr. Sharfstein also specified that “Eliminating these uses will not compromise the safety of food”. Livestock producers have long suggested using preventive antibiotics in animal feed makes the animals healthier and reduces costs of production. They have tended to ignore studies showing the resulting microbial risk to human health due to drug resistance that develops from the practice. The Congressional fight is expected to be contentious, but some who favor PAMTA want the controls put into healthcare reform legislation.

Pres. Obama’s weekly address on why healthcare cannot wait, officially dated 18 July 2009; what follows is a full transcript of his remarks…

Right now in Washington, our Senate and House of Representatives are both debating proposals for health insurance reform. Today, I want to speak with you about the stakes of this debate, for our people and for the future of our nation.

This is an issue that affects the health and financial well-being of every single American and the stability of our entire economy.

It’s about every family unable to keep up with soaring out of pocket costs and premiums rising three times faster than wages. Every worker afraid of losing health insurance if they lose their job, or change jobs. Everyone who’s worried that they may not be able to get insurance or change insurance if someone in their family has a pre-existing condition.

It’s about a woman in Colorado who told us that when she was diagnosed with breast cancer, her insurance company – the one she’d paid over $700 a month to – refused to pay for her treatment. She had to use up her retirement funds to save her own life.

It’s about a man from Maryland who sent us his story – a middle class college graduate whose health insurance expired when he changed jobs. During that time, he needed emergency surgery, and woke up $10,000 in debt – debt that has left him unable to save, buy a home, or make a career change.

It’s about every business forced to shut their doors, or shed jobs, or ship them overseas. It’s about state governments overwhelmed by Medicaid, federal budgets consumed by Medicare, and deficits piling higher year after year.

This is the status quo. This is the system we have today. This is what the debate in Congress is all about: Whether we’ll keep talking and tinkering and letting this problem fester as more families and businesses go under, and more Americans lose their coverage. Or whether we’ll seize this opportunity – one we might not have again for generations – and finally pass health insurance reform this year, in 2009.

Now we know there are those who will oppose reform no matter what. We know the same special interests and their agents in Congress will make the same old arguments, and use the same scare tactics that have stopped reform before because they profit from this relentless escalation in health care costs. And I know that once you’ve seen enough ads and heard enough people yelling on TV, you might begin to wonder whether there’s a grain of truth to what they’re saying. So let me take a moment to answer a few of their arguments.

First, the same folks who controlled the White House and Congress for the past eight years as we ran up record deficits will argue – believe it or not – that health reform will lead to record deficits. That’s simply not true. Our proposals cut hundreds of billions of dollars in unnecessary spending and unwarranted giveaways to insurance companies in Medicare and Medicaid. They change incentives so providers will give patients the best care, not just the most expensive care, which will mean big savings over time. And we have urged Congress to include a proposal for a standing commission of doctors and medical experts to oversee cost-saving measures.

I want to be very clear: I will not sign on to any health plan that adds to our deficits over the next decade. And by helping improve quality and efficiency, the reforms we make will help bring our deficits under control in the long-term.

Those who oppose reform will also tell you that under our plan, you won’t get to choose your doctor – that some bureaucrat will choose for you. That’s also not true. Michelle and I don’t want anyone telling us who our family’s doctor should be – and no one should decide that for you either. Under our proposals, if you like your doctor, you keep your doctor. If you like your current insurance, you keep that insurance. Period, end of story.

Finally, opponents of health reform warn that this is all some big plot for socialized medicine or government-run health care with long lines and rationed care. That’s not true either. I don’t believe that government can or should run health care. But I also don’t think insurance companies should have free reign to do as they please.

That’s why any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans – including a public option to increase competition and keep insurance companies honest – and choose what’s best for your family. And that’s why we’ll put an end to the worst practices of the insurance industry: no more yearly caps or lifetime caps; no more denying people care because of pre-existing conditions; and no more dropping people from a plan when they get too sick. No longer will you be without health insurance, even if you lose your job or change jobs.

The good news is that people who know the system best are rallying to the cause of change. Just this past week, the American Nurses Association, representing millions of nurses across America, and the American Medical Association, representing doctors across our nation, announced their support because they’ve seen first-hand the need for health insurance reform.

They know we cannot continue to cling to health industry practices that are bankrupting families, and undermining American businesses, large and small. They know we cannot let special interests and partisan politics stand in the way of reform – not this time around.

The opponents of health insurance reform would have us do nothing. But think about what doing nothing, in the face of ever increasing costs, will do to you and your family.

So today, I am urging the House and the Senate, Democrats and Republicans, to seize this opportunity, and vote for reform that gives the American people the best care at the lowest cost; that reins in insurance companies, strengthens businesses and finally gives families the choices they need and the security they deserve.

Thanks.

Carbon offsets allow the use of carbon-emitting processes to help fund and develop clean alternatives, which can then compete with and possibly replace the offending carbon-emitters. But there are also ways in which carbon offsetting can be used to combat poverty around the world. If offsets are focused on reducing bad habits, resulting from those engaging in those habits having either no alternative or no training to find alternatives, people living in the poorest conditions can find themselves benefitting from the clean energy revolution.

The group CarbonAided, which helps inform, and provide guidance for implementing carbon offsets, is now seeking to establish means by which carbon offsetting can produce real-world benefits for marginalized and poor communities in developing countries. Breaking the cycle of bad carbon practice the world over requires this step be taken, and the logic of doing it through carbon offsetting is that developing countries can be brought up to speed on emissions reductions by the same process that helps developed industrial countries break their bad habits.

The UN’s Millennium Development Goals (MDG) are a set of parameters set up by UN agencies, in conjunction with governments and NGOs, that aim to improve the lot of the world’s poorest people and thus help to resolve percolating crises of international scope and reduce the temptations of conflict and the risks to public health that result from scarcity and deprivation. The MDG have been difficult to meet, in part because the richer nations have treated them like a gift to the poor, an extracurricular activity whose return-on-investment they don’t know how to measure.

The MDG aim to achieve bold priorities by the year 2015: to end poverty and hunger, achieve universal education, gender equality, child health and maternal health, effectively combat HIV/AIDS, improve treatment and impede its spread, achieve viable environmental sustainability and standards of global partnership that allow the world’s nations to work together in a credible and energetic way to resolve these issues.

A shift in the carbon waste-scape could assist in changing the dynamics related to poverty, education, maternal and child health, environmental sustainability and if implemented in the right ways, be helpful in fostering global partnership. As CarbonAided artfully explains:

For example, by substituting a clean biogas cooker for an open wood fire, the air in the kitchen is transformed from an un-breathable smog which, according to the World Health Organisation is responsible for the deaths of 1.5 million women and children each year. Not only does this address the health MDG but since the women no longer have to spend hours gathering fuel wood from increasing distances they can become involved in income generating activities to reduce their poverty. Children released from fuel gathering are able to go to school. An improved energy supply also allows food to be cooked in a more healthy way thus reducing hunger. 4 MDGs are thus addressed by this type of project as well as the significant reduction in carbon and other GHG emissions.

Elimination of a cause of mass death and chronic ill-health by way of one specific, targetting program that can fit into carbon offsetting protocols, allows developed nations’ industrial activity to improve health, reduce hunger, improve education, even promote gender equality. And in the process, total global emissions are reduced, moving the world toward a healthier and more sustainable future.

One of the key factors of carbon offsetting that has spurred skeptics to doubt its practicality is the need to find creative ways to achieve real-world carbon-emissions reductions, substantial enough to offset existing emissions. Fields like the airline transport industry have traditionally adhered to the notion that their industry cannot effectively participate in emissions reductions, because they have no choice but to burn carbon-based fuels in massive quantities.

But carbon offsetting options are expanding widely, and efforts to reduce the use of carbon-based fuels and promote public health and better practice in poor countries mean there is a global menu of options to choose from, to achieve 100% carbon offsets by backing such projects. Making sure irreplaceable emissions, in the short run, correspond to real-world offsets that reduce emissions and improve standards of living elsewhere mean that burgeoning networks of sustainable development projects can help major industry reduce their net carbon footprint to zero.

The Swiss firm Solar Impulse is also building the world’s first solar-powered airplane, which would be entirely emissions free. Airlines can devote funding to such projects or place advance orders, in order to prepare for a future in which they will require fewer offsets to reach a zero net carbon footprint. In the meantime, efforts to reduce carbon emissions worldwide help slow global climate destabilization, which itself also poses more of a threat to the world’s poor than to the richest nations, for geographical and eco-economic reasons.

In India, one group working with CarbonAided, the Hassan Rural Biogas Project, has developed a mechanism for addressing the issues discussed above, related to home cooking fuel and resulting pollutants and time-consumption, but which also reduces the negative impact of farming practices on the local environment and can reduce the spread of chronic poverty:

The farmers’ situation is also not good. Because of the indiscriminate use of chemical fertilizers and pesticides the expenditure on agriculture has gone up and the land fertility has come down resulting in lower yields. The use of chemical fertilizers has made the land barren and the water retention capacity of the land has come down drastically.

To change this situation, S K G Sangha, have developed a system called ‘Composite vermicompost bio reactor. This system consists of two main parts. One part is a family size bio reactor producing clean gas which can be used for cooking and lighting and the other one is a vermicompost production unit producing high quality fertiliser.

While the composite vermicompost bio reactor system improves the quality of home cooking fuel, and exhaust, it also produces high-grade organic fertilizers. Roughly 50% of the fertilizer produced can be used on the family’s own land, to replace harsh chemical fertilizers that lead to toxic contaminants accumulating in the soil over time and running off into drinking water.

The rest of the fertilizer can be sold at market, providing a steady stream of income for the women, improving their conditions and helping the family to combat chronic poverty and better their own future. Such generative economic strategies mean carbon offsetting aimed at improving conditions in the developing world can help eliminate some of the most serious obstacles to long-term improvements in energy and environmental practice.

The influenza A/H1N1 virus, popularly known as “swine flu” was officially declared a pandemic in June. Shortly after the pandemic declaration, it was confirmed that H1N1 was confirmed in human patients in 74 countries. In the 5 weeks since then, it has spread rapidly and is now confirmed to have caused human infection in 140 countries.

In a CDC conference call, on 11 June 2009, officials reported:

Our U.S. situation, we are continuing to see ongoing transmission of this novel virus.  The virus has reached every state in the country.  Many of the states are seeing decreases in illness but there are a couple of areas where influenza-like illness is still above the baseline for this time of year.  Our case counts, we’ve been increasing them every week at this point … There are over 1,000 people who have been hospitalized that have been reported to us.

13,000 cases of infection had been reported at that time. As of 16 July, the CDC is reporting 37,246 cases of human infection and 211 confirmed H1N1-related deaths. With nearly three times the number of confirmed cases in the US now as when the pandemic was announced, officials continue to express concern the virus may be far more widespread than notable cases of illness would indicate.

Authorities in North America, including Mexico, the United States and Canada, have been persistently pro-active and collaborative in preparing to confront outbreaks of the virus and combat the pandemic, though the WHO now says its global spread is “unstoppable”. The southern hemisphere is now entering its winter and the peak flu season, so officials there are mobilizing to diagnose and separate out cases of H1N1 infection, even as they work to vaccinate and protect against the regular annual flu strains.

Reports from around the world show government orders for large amounts of new H1N1 vaccines are fast on the rise. France has ordered 94 million doses from GlaxoSmithKline, Sanofi-Aventis and Novartis, spending nearly 1 billion €. Novartis is reported to be in talks with at least 35 governments.

No less than 50 governments have reportedly placed orders for significant numbers of doses of H1N1 vaccines. The WHO this week announced it was issuing guidelines that urge all governments to begin buying and stocking H1N1 vaccines. Financial analysts at JP Morgan have estimated Glaxo SmithKline to have taken over £800 million in orders to date.

Reuters reports the WHO now estimates the global market for H1N1 vaccine sales at somewhere between $10 billion and $20 billion. The windfall potential is so high, the WHO has formally requested that manufacturers reserve a portion of their future H1N1 vaccine production for low-cost sale to developing countries, in the interests of public health and combatting the pandemic.

The WHO estimates as many as 1 million people in the United States may be infected, though not all will fall ill. WHO guidelines advise governments to direct mass vaccinations to health workers and first-responders, then to prioritize which segment of the population may be at risk, should the total number of doses require such choices.

The CDC is using social media to help spread up-to-date information about the evolving pandemic and guidance on best-practice public health responses. As reported by the CDC itself:

To encourage information sharing, collaboration, and interactivity, CDC provides social media tools. Widgets, mobile information, online videos and the like reinforce and personalize messages, reach new audiences, and build a communication infrastructure based on open information exchange.

The use of widgets that can be installed and simply relay updates on the pandemic is a savvy innovation in public health information distribution, building on the communications innovations seen in last year’s presidential campaign and demonstrating a committed filtering-through of new media experimentation to increase government informational availability to the public.

There are “flu IQ” widgets, rss feeds, Twitter postings, information delivered through “micro-blogging”, and informational resources uniquely designed for mobile phones. The CDC social networking project also focuses on social networks, like Facebook, and informational videos and images, distributed through media networking sites like YouTube and Flickr.

The use of social media and embedded updatable distributed information resources (rss feeds, video and widgets) is an important and likely landmark innovation in the standard public policy approach for addressing public health issues like the H1N1 pandemic. Such tools can help promote an active and real-time “conversation” across borders and around the world, to better develop effective measures of treatment, prevention and containment.

• H1N1 Swine Flu ‘Likely’ to Be Most Widespread Pandemic Ever
• W.H.O. Reports A/H1N1 ‘Swine’ Flu Pandemic is Unstoppable
• WHO Declares Influenza A H1N1 a Global Pandemic
• Factory Farms Could Be Promoting Dangerous Disease Agents
• Yi Guan, Virologist Famed for Isolating SARS, Says WHO Slow on H1N1
• Is Swine Flu Outbreak Contained? WHO Says No ‘Local Spread’ Outside N. America[May 2009]
• Egypt Pig Cull Suggests Ethical Risks of DNA-based Public Policy
• Obama Weekly Address: Gov’t Actions to Address H1N1 Outbreak (video + transcript)[May 2009]
• México en cuarentena por gripe H1N1 durante dos grandes fiestas nacionales
• White House Update on the H1N1 Influenza & Suggested Protective Measures (transcript) [April 2009]

Margaret Chan, director general of the World Health Organization (WHO), has told the Guardian newspaper’s Aida Edemariam that swine flu, the A/H1N1 multiple-reassorted virus strain, could be “the biggest” pandemic ever seen, in terms of its spread to so many countries around the world, though that doesn’t mean it will be the most deadly.

Chan specified:

If you’re talking about mortality then it’s different. 1918 is the biggest in terms of mortality. I would not like to make any predictions … I hope we don’t see the 1918 picture. But we should expect to see more people infected, and more severe cases coming up, including deaths…

Edemariam has written that “Swine flu is probably already much bigger than anyone knows”. In 2007, the WHO published a report titled “A Safer Future”, which projected that a major flu pandemic could affect as many as 1.5 billion people worldwide; Chan describes that scenario developing from swine flu as “Quite likely”.

She said, however, those figures would not be reached “in one run”, projecting the disease would spread in two or three major waves over multiple years. One concern of many in the public health field is that during that time, preparedness in certain regions may falter, and governments may shift their funding to other priorities. While it took several weeks for the virus to spread to three continents, the last month has seen a more rapid proliferation.

In early June, some 74 countries had confirmed cases of H1N1 infection. That total has now been confirmed to be at 140. There are estimates that as many as 1 million people in the US may be infected, though the WHO reports a total of confirmed infections across the world of 94,512, resulting in 429 deaths.

The WHO now also recommends that all nations begin national campaigns of vaccination, prioritizing medical personnel and first-responders. In the US, there are efforts at various levels of government to step up public health preparedness. The state of Ohio’s Department of Health now projects a more virulent strain of H1N1 will surface in the next few months.

Ohio will get $9.8 million in federal funding to fight the spread of the virus, part of a $260 million initiative of the Department of Health and Human Services (HHS), a response to the virus’ quick spread across the US this spring. The Dayton Business Journal reports:

Over the next few weeks, the Ohio Department of Health in conjunction with 130 local health departments throughout the state will determine what projects and activities will see the funding. The state Department of Health said the federal government is expected to provide a free H1N1 vaccine to states so the grant money will not be used to buy medical supplies of vaccines or antiviral medicines.

A supply of free vaccine may be one of the necessary logistical mechanisms for combatting the spread of the pandemic. Economic barriers to effective treatment and distribution of preparedness measures means a lax response and more cracks for the virus to slip through, infecting more people who will transmit the infection to others.

Ohio has received $19 million in “pandemic planning” funds from the federal government between 2005 and 2008, so continuing to guarantee the effectiveness of planning now in the face of an evolving pandemic is essential. In a high-level UN meeting in Cancún earlier this month, Dr. Chan told North American officials, including Mexico’s Pres. Calderón and the US secretary of HHS, Kathleen Sebelius, that the pandemic is now “unstoppable”.

Chan said that travel bans will no longer be effective at stopping or slowing the spread of the virus or impeding cross-border spread. She noted that the entire human population is more or less susceptible to a flu pandemic and for that reason, it will ”hit a given area in the epidemiological equivalent of a tidal wave”.

The WHO chief told the Cancún flu summit:

In densely populated areas, we see a steep increase in the number of cases, with a sharp peak, followed by a steep decline. Once the virus has swept through a susceptible population, transmission may continue, but at a much lower intensity.

She noted that Mexico, especially Mexico City, saw this “tidal wave” trend back in April, with the US following close behind. She noted that other nations are now experiencing the peak moment of infection (of the first wave) and that other nations will soon follow. She also warned that “we need to watch very carefully what happens during the current winter season in the Southern Hemisphere”.

She noted that “Constant, random mutation is the survival mechanism of the microbial world. Like all influenza viruses, H1N1 has the advantage of surprise on its side.” Chan also added that the human world needs to address the pandemic’s advantage of surprise with “science, and of rational and rigorous investigation … supported today by tools for data collection, analysis, and communication that are unprecedented in their power”.

She urged “collaboration and solidarity” and praised the international community for exhibiting those qualities in response to the H1N1 threat. The WHO maintains a comprehensive index of all “guidance documents” to help public health officials around the world cooperate in what may be the most coordinated, persistent, real-time epidemiological response.

Though the swine flu scare caused many to fear pigs would infect humans —Egypt culled millions of animals, despite not one single case of swine infection with H1N1— there has been no evidence of a direct transmission from pig to human. But researchers believe the pandemic status of the virus spreading in the human population means the risk of it jumping from human being to pig is now more significant.

• W.H.O. Reports A/H1N1 ‘Swine’ Flu Pandemic is Unstoppable
• WHO Declares Influenza A H1N1 a Global Pandemic
• Factory Farms Could Be Promoting Dangerous Disease Agents
• Yi Guan, Virologist Famed for Isolating SARS, Says WHO Slow on H1N1
• Is Swine Flu Outbreak Contained? WHO Says No ‘Local Spread’ Outside N. America [May 2009]
• Egypt Pig Cull Suggests Ethical Risks of DNA-based Public Policy
• Obama Weekly Address: Gov’t Actions to Address H1N1 Outbreak (video + transcript) [May 2009]
• México en cuarentena por gripe H1N1 durante dos grandes fiestas nacionales
• White House Update on the H1N1 Influenza & Suggested Protective Measures (transcript) [April 2009]

The World Health Organization (WHO) has issued a report finding that the pandemic spread of the influenza A/H1N1 virus, known as “swine flu”, is now “unstoppable”. The WHO is calling on governments to speed efforts to develop a vaccine and select which segments of their populations will be given priority, based on public health considerations, after health workers.

The Strategic Advisory Group of Experts on Immunization (SAGE), a body of the WHO set up to examine vaccine availability and procedures, including targeted patterns of vaccination to yield the optimum contagion-arrest effect in the spread of epidemic or pandemic diseases, says it has recognized the “unstoppable” spread of the new multiple-reassorted swine flu virus, and that all nations should have an adequate supply of vaccine and vaccination plans.

The epidemiology of the A/H1N1 virus has yielded some troubling new information since the initial outbreak. The new virus strain exhibits behaviors that vary from the traditional behaviors of the flu, which usually targets the very young, very old or immune-compromised. This virus strain, however, appears to be less effective than expected against the elderly and is potentially dangerous to healthy adults and particularly to obese people.

The apparent resistance exhibited by some elderly people is owing to their having survived the 1918 “Spanish flu”. As reported by Reuters:

The elderly seem to have some extra immunity to this new H1N1, which is a mixture of two swine viruses, one of which also contains genetic material from birds and humans. It is a very distant cousin of the H1N1 virus that caused the 1918 pandemic that killed 50 million to 100 million people.

A study published in the journal Nature on Monday confirmed that the blood of people born before 1920 carries antibodies to the 1918 strain, suggesting their immune systems remember a childhood infection.

There is also evidence that the H1N1 swine flu deviates from the normal preference of influenza for infection in the nose and throat and easily migrates deep into the lungs. Dr. Yoshihiro Kawaoka has done research that shows the virus replicates more easily in the lungs, a development which could make the virus more dangerous than other flu strains. There is also evidence it may lead to gastrointestinal impacts.

Dr. Marie-Paule Kieny, of the WHO’s Initiative for Vaccine Research, also speaking for SAGE, said obesity appears to be a risk factor. She added, however, that it remains unclear if obese patients might have undetected underlying health issues, or if obesity itself is somehow a risk factor with A/H1N1.

The Centers for Disease Control and Prevention (CDC) reports that 9 out of 10 patients treated for the virus in an intensive care unit there were obese. None of the 9 have yet recovered and 3 died. The CDC now estimates that as many as 1 million people in the US are now infected. The US counts 211 deaths, the WHO reports 429 deaths to date.

Numerous firms are working on developing vaccines, including Sanofi-Aventis, Novartis, Baxter, Schering-Plough’s Nobilon, GlaxoSmithKline, Solvay, CSL and AstraZeneca’s MedImmune. The WHO says it will work on providing better quality viruses for the firms working to develop the best vaccines to work against the spreading pandemic.

• WHO Declares Influenza A H1N1 a Global Pandemic
• Factory Farms Could Be Promoting Dangerous Disease Agents
• Yi Guan, Virologist Famed for Isolating SARS, Says WHO Slow on H1N1
• Is Swine Flu Outbreak Contained? WHO Says No ‘Local Spread’ Outside N. America[May 2009]
• Egypt Pig Cull Suggests Ethical Risks of DNA-based Public Policy
• Obama Weekly Address: Gov’t Actions to Address H1N1 Outbreak (video + transcript)[May 2009]
• México en cuarentena por gripe H1N1 durante dos grandes fiestas nacionales
• White House Update on the H1N1 Influenza & Suggested Protective Measures (transcript) [April 2009]

TheHotSpring.com :: The New Scientist magazine is reporting on an intriguing and brazen new Pentagon program that would create living “OrthopterNets”, communication networks made of insects implanted with special technologies to modulate their wingbeats. Crickets, cicadas and katydids, all use their wings to generate sounds, the patterns of which communicate information to others of their kind. The Pentagon wants to use this natural communications network to prompt the insects to emit specific sounds in the presence of specific chemicals.

The result would be cyborg insects, living insects with technology integrated into their physical composition. The technology could have broad application, including “sniffing” applications in the search for toxins, concealed chemical or biological agents, hazmat detection, and even the search for survivors from natural disasters. A number of factors impede the timely locating of survivors buried in rubble after earthquakes or other major disasters.

Ben Epstein of OpCoast, who reportedly developed the idea after hearing insects modifying their sound in relation to each other’s calls, said researchers “could do this by adjusting the muscle tension or some other parameter that affects the sound-producing movements. The insect itself might not even notice the modulation”.

According to The New Scientist:

As well as a biochemical sensor and a device for modulating the wing muscles, the electronics package would contain an acoustic sensor designed to respond to the altered calls of other insects. This should ensure the “alarm” signal is passed quickly across the network and is ultimately picked up by ground-based transceivers.

OrthopterNets could vastly expand the information gathering and chemical detection capabilities of authorities seeking to solve pressing security problems, like chemical and bio-agent detection at major ports or the search for survivors buried under significant amounts of wreckage after a disaster. They might also mean a more conservative option for such tasks than self-replicating nano-bots, which many fear could escape human control.

In fact, OrthopterNets offer an important and instructive test for nano-technology, in that the engineering of such miniaturized circuits may benefit from the smallest-scale engineering available to human science. Using such decentralized, spontaneous communications systems to effectively restructure and optimize information search and extraction capabilities means a landmark moment in the development of hyper-convergent communications technologies.

The overlap between planned communications networking technologies and decentralized, organic and geologic patterns is a new frontier in communications and information technology, with the cyborg sniffer insects possibly marking only the first step in that direction. Artificial intelligence pioneer Ray Kurzweil predicts the human species will adopt cyborg capabilities to vastly enhance both survival-oriented and social functions, in the not-too-distant future.

The release of cyborg crickets into a disaster area could help authorities and rescue teams create real-time, evolving chemical maps, to detect no only the possible location of survivors, but of hazardous releases possibly caused by the disaster and even —where underlying materials are known— of unstable or shifting debris. Military uses might include minefield mapping and the location of weapons stores or mountain hideouts.

The New Scientist also reported last year that cyborg insects might be used as “discreet spies”. For instance:

THE next time a moth alights on your window sill, watch what you say. Sure, it may look like an innocent visitor, irresistibly drawn to the light in your room, but it could actually be a spy – one of a new generation of cyborg insects with implants wired into their nerves to allow remote control of their movement. Be warned, flesh-and-blood bugs may soon live up to their name.

That article also notes that researchers have developed cyborg remote-control capabilities for “rats, pigeons and even sharks”. The technologies could be used for eavesdropping and other covert detection tasks. The first cyborg rat, achieved by researchers in 2002, was directed with a combination of contact and reward stimuli to specialized regions of its brain, then “freed” to use its own sniffing instincts to detect the presence of explosives in a targeted location.

Honey is a surprisingly complex and mysterious substance, known to have antibacterial properties, but which continues to reveal new qualities apparently favorable to human health. Now, scientists in Australia have discovered that a specific type of honey, is highly effective at killing the multi-resistant “superbug” MRSA. The discovery could give medical science a way to combat the spread of multi-resistant bacterial strains.

There there is no apparent “intrinsic resistance” to the special properties of at least this one type of honey, means there might be a way to prevent the evolutionary “selection” process from generating honey-resistant bacteria, buying time to develop treatments that could eradicate the threat of MRSA infection. Stopping the spread of MRSA is of vital importance to the quality of medicine in general, as staph infections impede treatment and recovery. [Complete text...]

What methods and strategies can be developed for speeding MRSA-effective Manuka honey to production and distribution for clinical treatment? What similar discoveries hold promise for treating multi-resistant bacteria?

• Join this discussion on the Hot Spring Network

Dr. Regina Benjamin, a winner of the MacArthur Foundation “Genius grant”, and a committed rural doctor who has served the poor in Bayou La Batre, Alabama, spending her own money to provide care for those who could not afford it, has been named by Pres. Obama to serve as surgeon general of the United States. Her nomination was announced in a live event at the White House, with Health and Human Services secretary Kathleen Sebelius in attendance.

Dr. Benjamin has had to rebuild her rural healthcare clinic three times, including after the devastation of Hurricane Katrina. She was the youngest doctor and first African American woman to head the Medical Association of the State of Alabama, and a winner of the Nelson Mandela Prize for Health and Human Rights. Pres. Obama focused heavily on the work of achieving comprehensive healthcare reform that will allow all Americans to afford and obtain quality healthcare, an issue he said Dr. Benjamin was eminently qualified to address.

CBS, reporting on her MacArthur grant award, noted her work to rebuild the Bayou La Batre clinic:

Dr. Regina Benjamin said the money will help rebuild her rural health clinic in Bayou La Batre, Ala., which serves 4,400 patients. It was rebuilt by volunteers after being destroyed by Katrina, only to burn down months later.

“The patients came by and they were crying,” said Benjamin, 51, remembering one woman who handed her an envelope with a $7 donation to rebuild. The new clinic is about half-built, she said.

Pres. Obama said she mortgaged her home and “maxed out her credit cards” to find funding to rebuild the clinic, and even went as far as to pay herself for the treatment her poor patients needed, when they couldn’t pay themselves. Obama reiterated again today his pledge that comprehensive healthcare reform and cost-reduction would not add to the federal budget deficit over the next ten years. He urged Congress to act to pass legislation by the end of this year.

The Washington Post highlighted Dr. Benjamin’s achievements and the president’s desire that she help the administration achieve legislation to reform the nation’s healthcare system and reduce costs:

Benjamin has also served as the first black woman to head the State of Alabama Medical Association and was associate dean for rural health at the University of South Alabama’s College of Medicine.

Obama announced her his intent to nominate her at a Rose Garden event this morning in which he also spoke of the challenges and need for health care reform. “I understand people are a little nervous and a little scared about making change. You know, the muscles in this town to bring about big changes are a little atrophied, but we’re whipping folks back into shape. We are going to get this done,” the president said.

Obama’s own high-profile use of media to explain and press his agenda for reform suggests he will favor giving the surgeon general a “bully pulpit” like that effected by C. Everett Koop, perhaps the best known surgeon general, who led the nation’s public policy push in the 1980s to prevent Americans from starting or continuing a smoking habit.

The White House’s own release notes that “Dr. Benjamin was previously named by Time Magazine as one of the ‘Nation’s 50 Future Leaders Age 40 and Under.’” Dr. Benjamin expressed her belief that major healthcare reform and work to curb the impact of preventable diseases could not wait. She said the nomination was “a doctor’s dream” and gave an emotional account of her personal knowledge of the system’s deepest flaws.

Honey is a surprisingly complex and mysterious substance, known to have antibacterial properties, but which continues to reveal new qualities apparently favorable to human health. Now, scientists in Australia have discovered that a specific type of honey, is highly effective at killing the multi-resistant “superbug” MRSA. The discovery could give medical science a way to combat the spread of multi-resistant bacterial strains.

As reported by the New Zealand-based website, Stuff:

“Most bacteria that cause infections in hospitals are resistant to at least one antibiotic and there is an urgent need for new ways to treat and control surface infections,” says Associate Professor Dee Carter, of the university’s School of Molecular and Microbial Biosciences.

“But bugs that are resistant to a huge variety of antibiotics are not resistant to honey … we’ve never seen an organism that has any kind of intrinsic resistance.”

There there is no apparent “intrinsic resistance” to the special properties of at least this one type of honey, means there might be a way to prevent the evolutionary “selection” process from generating honey-resistant bacteria, buying time to develop treatments that could eradicate the threat of MRSA infection. Stopping the spread of MRSA is of vital importance to the quality of medicine in general, as staph infections impede treatment and recovery.

And MRSA is spreading, making treatment for the bacteria itself, for staph infections, or for reliable in-hospital treatment of other ailments. The website PRLOG reports:

In 1974, MRSA infections accounted for 2% of the total number of staph infections; in 1995 it was 22% and in 2004 it was 63%.  In fact, a report issued by the Association for Professionals in Infection Control found that MRSA infections are 8.6 times more prevalent than previous estimates and that the antibiotic-resistant bacteria is found in all wards throughout most hospitals.

Manuka honey, found in New Zealand and Australia, but cultivable around the world. It’s thought to be the flowers that grow on the Manuka bush, not the bees, that are unique in generating this capability to kill MRSA bacteria. Scientists in Australia are now working to extract the specific anti-bacterial properties of Manuka honey, refine and test it in medically verifiable terms, to develop a standard of treatment for MRSA.

The Hot Spring Network has opened a discussion, in collaboration with Café Sentido, on the need to diversify the global wheat crop in order to prevent an evolved crop fungus, Ug99, from destroying as much as 80% of the global wheat harvest.

The discussion forum is oriented toward collecting and analyzing long-tested and/or cutting-edge solutions for avoiding dangerous homogenization of crop varieties, and expanding inborn resistance to crop diseases like stem rust.

As we reported on 23 June:

A crop-borne fungus that targets wheat, named Ug99 because it was first identified in Uganda in 1999, has become one of the primary threats to global food security. Newfound virulence in the evolving stem-rust strain suggests the fungus could destroy as much as 80% of the world’s most widely grown crop: wheat.

Jim Peterson, who is professor of wheat breeding and genetics at Oregon State University in Corvallis, has called Ug99 a “time bomb” for the world wheat harvest. Ug99 has already “jumped the Red Sea” and has reached as far as Iran. Concern is spreading it will soon reach the Asian breadbasket of Pakistan, India and China, and will at some point spread to North America. It’s just a matter of when.

Methods to diversify the varieties of wheat planted for food harvest around the world need to be implemented, in an accelerated fashion, to push back hard against the threat of an evolved, more virulent strain of Ug99 stem rust.

Monoculture, or the widespread planting of only one crop variety, has significant inherent perils for crop resilience and even ecosystem elasticity, and can lead to famine (as seen in the 19th century Irish potato famine, for instance), economic collapse, mass migration and the spread of disease in an undernourished human population.

• Join or browse the Hot Spring discussion today, by clicking here…

Over the weekend, the nationwide media in the US were overtaken by a firestorm of speculation that Michael Jackson’s premature and sudden death, at the age of 50, was the result of a deadly cocktail of powerful painkillers and anti-depressants. Family and friends have complained of a close entourage of “enablers”, helping to intensify a long-running addiction and lead the pop star to his demise. One is tempted to ask, however: where were the doctors?

A growing movement of people inside and outside the medical profession is voicing concern that medicine in the US has morphed into a drug-delivery system, the functional logic of which is to expand the reach and ubiquity of powerful pharmaceutical medications, often without giving enough attention to the real effects on long-term patient health.

A culture of quick fixes and mechanical processing of health issues, coupled with a dysfunctional insurance system that incentivizes doctors to prescribe costly treatments and medicate to avoid personal financial fallout, has led to an American medical system in which the best science in the world is available but is also often ignored in pursuit of practices pushed by pharmaceutical conglomerates.

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There are more and more doctors who resist this trend and who openly chastise fellow doctors for irresponsible medication prescription. The issue of peer pressure as related to antibiotics is especially severe: patients often don’t understand that antibiotics cannot cure viruses, are only effective against certain types of bacteria, and that implementing their use always enhances the likelihood of a stronger, evolved, more resistant strain.

They also tend not to understand the genetic turnover from generation to generation in a bacterial colony can be so rapid that this enhanced resistance could materialize in the same patient, before the infection is cured, thus harming the patient. Antibiotics need to be prescribed with care, and in the cases where they are most medically appropriate. Multi-resistant TB and MRSA are two bacterial strains that are now so evolved they have to be treated in all cases with a “cocktail” of carefully phased in and overlapping antibiotic treatments — a risky process that aims to wipe out all individual bacteria at once, but heightens the risk of a super-resistant bug for which no effective treatment has yet been developed.

Painkillers are also an evolutionary problem. Patients develop a “tolerance” to their effects. Cancer patients suffering with constant excruciating pain in all the bones in their body can be prescribed morphine, which has an initial palliative effect. But the dosage has to be constantly increased as the body becomes dependent. A patient taking the drug for months, with a persistent deterioration in bone and nerve health, can end up receiving 10 or 20 or even 30 times the dose that would be instantly lethal for a normal person.

If Michael Jackson, with his immense wealth and vast entourage, and a private lifestyle some have compared to the rarefied privileges of royalty —including the fear of those around him to deny his requests—, were developing an addiction to painkillers, it is conceivable that the habit would actually lead to a crippling lifestyle in which he would feel intense physical pain and discomfort from simply not upping the dose regularly.

A doctor should have seen this and prescribed a cure. The drugs should have been difficult to obtain, even given his wealth. But a medical culture that is oriented toward the delivery of medication, where prescription drugs cost considerably more —even many times more— than in any other industrialized nation, facilitates the flow of dangerous medications to individuals who should not be taking them.

What is clear, should any of the rumors that are circulating regarding Jackson’s medication regime be true, is that proper medical supervision of those treatments was not exercised. His personal doctor may not have been the source of the prescriptions, may or may not have known about it, and was probably lied to, if this was a real addiction. But the system could work better for patients’ health, with less focus on expanding the reach of prescription pharmaceuticals.

The new multi-reassorted strain of flu, Influenza A H1N1, also called “swine flu”, has been officially declared a global pandemic, with over 28,000 confirmed cases of infection across 74 nations. The classification is a geographical judgment, referring to the flu strain’s spread on multiple continents, but does not related to severity. Officials said the pandemic appears to be of moderate severity. 

140 people have been confirmed to have died worldwide, as a result of infection with the H1N1 virus, despite the 28,000 infections. The virus has continued to spread in the United States, Europe and Australia, making it an infection with persistent contagion on three continents. Africa, Asia and South America, also have confirmed cases, meaning the virus has now reached the human population in every region of the world. 

The US is the single country most affected by the virus, with 13,217 confirmed cases of infection. Canada has 2,978 and Mexico 5,717, clearly making North America the epicenter of the global pandemic. But Chile, Australia and the European Union also have over 1,000 cases each, demonstrating the virus’ global spread. 

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The World Health Organization’s (WHO) Phase 6 Epidemic Alert level, classed as pandemic underway, is the highest alert level and means “A global flu pandemic has begun, including community-level outbreaks in at least two world regions”, according to the AP. The declaration is aimed at coordinating international efforts at treatment and prevention to limit the further spread of the virus and guard against the outbreak of a 2nd strain of H1N1. 

According to Bloomberg News: 

Officials in Australia, Chile, Japan, Mexico, the U.K. and the U.S. were asked for information on cases and measures taken to mitigate the disease, known as H1N1, before the WHO moves to the top of its six-stage pandemic warning scale, Chile’s Health Minister Alvaro Erazo said in a statement yesterday.

Hong Kong has suspended classes at all schools for 14 days, beginning tomorrow, in order to prevent the further spread of H1N1 infection among students. Hong Kong’s aggressive prevention efforts stem from the 1968 Hong Kong flu pandemic, the last officially declared flu pandemic, which killed over 1 million people worldwide over two years. Hong Kong has not been significantly impacted so far by the A/H1N1 outbreak. 

The worst flu pandemic on record is the 1918 Spanish flu outbreak, which killed an unknown number of people between 20 million and 50 million, around the world, over 2 to 3 years. The 1957 Asian flu was first isolated in China, and killed over 2 million people in 2 waves of infection, the first heavily affecting children, the second the elderly. 

The number of cases in Chile has quadrupled since the government began including cases reported from private health clinics in its official national reports. It is the one country outside North America with the most infections. 

Scotland, though, has recently discovered its rate of hospitalization from the virus was on par with the US rate. The new figures prompted health officials to urge doctors to diagnose infection, to avoid lag-time for results from remote testing. The Guardian reports:

The Scottish health secretary, Nicola Sturgeon, said public health tactics had changed after it emerged the virus was spreading uncontrolled.

Sturgeon told the Scottish parliament this morning that hospitalisation rates were similar to those in the US. She indicated that attempts to contain the virus had failed and the strategy would be to limit its spread. Doctors in the most-affected areas – Glasgow, Dunoon and Paisley –would be allowed to make a swine flu diagnosis in their surgeries rather than wait for specialist or laboratory tests.

The UN Sec. Gen. Ban Ki-moon has said the world “must be watchful” and that the alert is of vital importance to public health, but not grave cause for concern. The fatality of the virus has been less than expected, but officials want to be on guard to ensure that future outbreaks are not more aggressive or widespread than the pandemic seen to date.

The current debate over how to reform healthcare insurance in the United States revolves around what insurers can and can’t do in order to turn a profit. One major area of concern is whether coverage can be denied for pre-existing conditions. Another is whether there should be a “public option” where a government agency acts like an insurance fund in order to provide a care-centered, not-for-profit option.

The “public option” issue is about competition. With that competitive edge —no profit motive—, such an insurance plan could reduce costs across the board, for all who seek coverage. This raises the question of whether a new paradigm might be private not-for-profit insurers, possibly organized through doctors’ associations and hospitals, which seek to establish a more reliable payment structure, under a larger-pool of coverage.

What might be needed to launch private not-for-profit healthcare insurers that meet Pres. Obama’s call for a system that 1) covers everyone, 2) does not deny coverage for pre-existing conditions, and 3) provides quality care at affordable prices?

• Join the discussion on The Hot Spring Network

Transcript of remarks delivered at 14.31 EDT, by Pres. Barack Obama

I want to — thanks — I want to say thank you to all of my former colleagues for taking the time to visit here today at the White House. I want to particularly thank Senators Baucus, Senator Dodd, all the senators who have been fighting tirelessly on behalf of health care reform — for many years, in some cases.

I want to mention, by the way, that I spoke to Senator Kennedy earlier this morning. He is gung-ho, ready to go. He had a whole range of ideas in terms of about how he’d like to see this move, and he’s grateful that Chris has been taking on a lot of the work in the health committee, but he is very enthusiastic about our progress.

This issue, health care reform, is not a luxury. It’s not something that I want to do because of campaign promises or politics. This is a necessity. This is something that has to be done. We cannot avoid bringing about change in our health care system. Soaring health care costs are unsustainable for families, they are unsustainable for businesses, and they are unsustainable for governments, both at the federal, state and local levels.

All across the system what you are seeing are skyrocketing premiums, you are seeing people who are getting caught up in loopholes and end up not having coverage that they thought they had. We have a system here in the United States which is spending more money per capita than just about any other industrialized or advanced nation, and yet we’re actually seeing worse health care outcomes in many cases.

And to give you a sense of what we’re looking at down the road if we don’t initiate serious reform, one-fifth of our economy is projected to be tied up in our health care system in 10 years; one fifth. Millions more Americans are expected to go without health insurance if we don’t initiate reform right now. And outside of what they’re receiving for health care, workers are projected to see their take-home pay actually decrease if we don’t get a handle on this.

So we can’t afford to put this off, and the dedicated public servants who are gathered here today understand that and they are ready to get going, and this window between now and the August recess I think is going to be the make-or-break period. This is the time where we’ve got to get this running.

I want to just make mention of something that I’ve talked to many of you privately about. I want to say this publicly. As we move forward on health care reform, it is not sufficient for us simply to add more people to Medicare or Medicaid to increase the rolls, to increase coverage in the absence of cost controls and reform. And let me repeat this principle: If we don’t get control over costs, then it is going to be very difficult for us to expand coverage. These two things have to go hand in hand. Another way of putting it is we can’t simply put more people into a broken system that doesn’t work.

So we’ve got to reform the underlying system. And this means promoting best practices, not just the most expensive practices. And one of the things I’m going to be discussing with the health and the finance committees is how can we change incentive structures so that, for example, places like Mayo Clinic in Minnesota are able to provide some of the best health care services in the country at half or sometimes even less of the costs than some other areas where the quality is not as good. What we should be — and by the way, that’s not just unique to Mayo. The Cleveland Clinic in Ohio, same thing: top-notch quality, lower costs.

What we’ve got to figure out is how do we create the incentives in terms of how we are reimbursed, how we deal with getting doctors to work together more effectively, how we’re working on prevention and wellness so that we’re driving down costs across the board.

Now, I appreciate the efforts that are being made by these senators. I look forward to discussing with them their ideas. This is going to be a heavy lift, I think everybody understands that. But I’m also confident that people want to get this done this year. And under the leadership of Max and Chris and all the other participants here, I’m confident that we’re going to get it done.

So thank you very much, everybody. And now we’re going to get to work.

TheHotSpring.net :: The Urban Institute found that 22,000 people died in 2006, in the United States, specifically from lack of health insurance. Other projections, which count the accumulation of long-term pathologies, compounded ill health or medical “error” involving staff calculations about the wisdom of providing the most costly care to those who can’t pay, run into the hundreds of thousands. [Join the discussion here]

People who have no insurance avoid seeing physicians, almost universally, due to the exorbitant cost of even regular health maintenance and routine check-ups. The result is that the evolution of preventable maladies is generally much further along in the uninsured or the underinsured, when finally caught or diagnosed. Even then, treatment is not always easy to come by, and some hospitals, if they don’t turn people away, will undertreat, as a matter of policy, to avoid taking on unsustainable non-compensated expenses.

Doctors routinely complain that they suffer an unfair burden in this dynamic, where patient care might run up hospital costs, but undertreatment could lead to malpractice lawsuits. The added pressure on physicians to make judgments about care based not on professional know-how and best-science considerations, but on worry over the solvency of their employers or the risk of lawsuits, has a real, if not easy to measure, chilling effect on quality of care and doctor-patient engagement.

Some experts believe such impediments to effective doctor-patient communication and to doctors’ exercising their best judgment freely have a real adverse impact on both the cost of care in general and the risk to the health of patients without coverage.

Use this forum to gather links, statistics, and new conceptualizations of the problem, as well as to propose solutions that might allow for tens of thousands of lives to be saved each year, by expanding coverage to the whole population.

• Join The Hot Spring Network’s Healthcare Innovations group

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