Friday, January 30, 2009

Update on the Global Health Blogging Experiment

Thank you to all who participated in our little "global health blogging experiment." Nine posts on "prevention vs. treatment" were published--out of an expected 12. Respectable numbers for an all-volunteer effort.

I do not have much time to write today, alas, but wanted to leave you with at least one thought. I was particularly intrigued that Liz Borkowski pointed us to a larger story--the gradual abandonment of anti-tobacco/anti-smoking programs in the U.S. That's the kind of piece--big and slow-moving--that can be very hard to get a grip on in the traditional media. And precisely the sort of thing that can thrive on the web.

An example comes to mind from well outside the global health sphere--how the folks at Talking Points Memo aggregated their own reporting with that of disparate professional journalists to tell the story of the number of US attorneys who had been fired under the Bush Administration for not toeing the line politically. (The TPM, incidentally, also won a George Polk Award for Journalism for its work.)

Anyway, I hope folks look at the other entries and post their own responses/analyses/constructive critiques. So, without further ado, here are the other global health posts on "prevention vs. treatment."

Healthtwine: Prevention vs. Treatment
On why "we tend to value current health more than future health."

Superbug: Prevention v. treatment (1st Global Health Blog Carnival!)
On the need for a vaccine against methicillin resistant staph aureus.

Perspectives: Prevention vs. Treatment
On why prevention vs. treatment is the wrong way to think about drug resistance to malaria.

Karen Grepin's Blog: Prevention vs. Treament in HIV: Have we given prevention a chance to shine?
Proving prevention works is a lot harder than you might think. Maybe that is another reason why there are so few studies on the effectiveness of prevention.

The Pump Handle: For Whom Prevention Pays
On one of the bigger, overlooked stories of public health in the U.S.--the faltering anti-tobacco struggle, another victim of the economic crisis.

HIV Information for Myanmar: Two Quotes from Bogyoke
A few words on the greater good from the late Bogyoke (General) Aung San, who led the fight for Burmese independence after World War II.

Health Reform Watch: Health Care, "Common Sense" and a Global Health Blogging Experiment
A bit off-topic and somewhat rambling (the French revolution?), but a look at whether concerns over health reform in the U.S. will crowd out discussion of global health.

Global Health at Change.org: Prevention vs. Treatment--an Eternal Debate?
On why good decisions in public health "are about balance, and looking for long-term systemic solutions instead of the quick fix."

And from a public relations perspective:

Ruder Finn's DotOrg (U.K.): The Lazarus Effect
Lucy asks "Are there are any differences between ’selling-in’ stories that have a prevention angle over those that emphasise treatment."

Thursday, January 29, 2009

Prevention vs. Treatment: A False Choice

The long-running debate over the relative importance of prevention or treatment is the theme that at least a dozen global health bloggers are exploring today. In many ways, the debate represents a false choice; a well-functioning health system requires both prevention and treatment. But how do you strike the right balance? Is the measuring stick simply the one provided by economics? Or do equity and fairness also play a role?

“An ounce of prevention is worth a pound of cure,” or so the old saying goes. But we don’t always practice what our folk wisdom preaches.

The U.S. medical system, as currently set up, rewards cardiac surgeons at a much greater rate than it does programs for avoiding weight gain or controlling high blood pressure.

About 5% or less of the U.S. budget on health care is spent on prevention, according to Don Wright of the U.S. Department of Health and Human Services. Most of the rest is spent on treatment—and, I would venture to guess, paper work.

And yet, you can bet that if I ever experience a gripping pain in my chest or back, accompanied by nausea and perhaps an overwhelming sense of anxiety—classic signs of a heart attack in women—I am going to get myself to an emergency room right away to get treated and be mighty thankful if the specialists at the cardiac catheterization lab can open up any blocked arteries.

The year I spent at Harvard taught me a lot about how academics argue the prevention vs. treatment debate. Indeed, just a few years ago there was that rare thing in public health—a big public debate between some folks at the Gates Foundation on one side and some at Harvard on the other about whether prevention or treatment was the better—read more “cost-effective”—approach to tackling HIV/AIDS in sub-Saharan Africa. Eventually the Harvard side won the argument—especially once the cost of anti-retroviral therapy dropped dramatically. What made the difference was the fairness issue: How could you withhold treatment when so many were dying?

A few months in rural Malawi gave me a whole other perspective. There I learned that tremendous strides have been made in decreasing maternal death rates at the Embangweni Mission Hospital through a variety of efforts—not least of which was an emphasis on both prevention and treatment.

It did not happen by accident and it did not happen overnight. When the effort began, several years ago, there was only a single sink in the labor and delivery room. So improving the physical plant was a priority in terms of providing better treatment. Embangweni Hospital also worked really hard to get the right people in the ward—namely more nurses and clinical officers—and keep up their training. Alas, hard experience also taught them they had to make the ward off-limits to many of the grandmothers or “gogos,” who would slip their daughters and daughters-in-law a powerful herbal concoction to induce labor but that also increased the risk of potentially fatal uterine rupture.

On the prevention side, community health nurses have been working throughout the South Mzimbe region for the past ten years to provide prenatal care to pregnant women. To give just one example, the community health workers I met, like Joyce Ngoma and Tamala Chirwa, work hard to identify women who may have trouble delivering—because they are carrying twins or the fetus is not positioned properly. The nurses advise those women to go to the hospital early so that they can be watched more closely and scheduled for a caesarean operation, if need be.

Each side—prevention and treatment—benefits from the other. With fewer pregnant women showing up at the hospital in crisis, the clinical officers and nurses there are able to save more mothers' lives. The nurses in the field can see that their efforts have saved lives and are encouraged to do more prevention work.

Today's posts on Prevention vs. Treatment from other global health blogs (as I learn of them):

Healthtwine: Prevention vs. Treatment
On why "we tend to value current health more than future health."

Superbug: Prevention v. treatment (1st Global Health Blog Carnival!)
On the need for a vaccine against methicillin resistant staph aureus.

Perspectives: Prevention vs. Treatment
On why prevention vs. treatment is the wrong way to think about drug resistance to malaria.

Karen Grepin's Blog: Prevention vs. Treament in HIV: Have we given prevention a chance to shine?
Proving prevention works is a lot harder than you might think. Maybe that is another reason why there are so few studies on the effectiveness of prevention.

The Pump Handle: For Whom Prevention Pays
On one of the bigger, overlooked stories of public health in the U.S.--the faltering anti-tobacco struggle, another victim of the economic crisis.

HIV Information for Myanmar: Two Quotes from Bogyoke
A few words on the greater good from the late Bogyoke (General) Aung San, who led the fight for Burmese independence after World War II.

Health Reform Watch: Health Care, "Common Sense" and a Global Health Blogging Experiment
A bit off-topic and somewhat rambling (the French revolution?), but a look at whether concerns over health reform in the U.S. will crowd out discussion of global health.

Global Health at Change.org: Prevention vs. Treatment--an Eternal Debate?
On why good decisions in public health "are about balance, and looking for long-term systemic solutions instead of the quick fix."

And from a public relations perspective:

Ruder Finn's DotOrg (U.K.): The Lazarus Effect
Lucy asks "Are there are any differences between ’selling-in’ stories that have a prevention angle over those that emphasise treatment."

Tuesday, January 27, 2009

Community Organizing Meets Global Health Blogging

Towards building a social network around global health news.

At least a dozen global health bloggers have publicly said they will be posting on the broad theme of "prevention vs. treatment" this Thursday, January 29, 2009. (Feel free to join in!) This is part of an experiment that grew out of a Twitter conversation to see if we can coordinate posts in a kind of "global health blog carnival" to increase awareness of global health issues. I'll be posting about my experience in Malawi and reflecting on whether the prevention vs. treatment debate is really a false choice.

But there are some larger questions here that I would like to explore: Is a social network around global health news starting to emerge organically on the web? What can we do to nurture it? Do economic realities dictate that this will have to be a volunteer led endeavor, at least for a while?

Or, another way of putting that last question: Is news about global health subject to the same market failures that afflict products for global health (e.g. free-market forces alone will not lead to new tuberculosis medications and other drugs that affect mostly the poorest people in the world)?

Some preliminary thoughts on the first question: Is a social network around global health news starting to emerge organically on the web?

Although blogging has been around for a while, we haven't really had the critical mass of bloggers interested in global health issues until recently.

International news coverage has suffered terribly in the retrenchment affecting the journalism industry. There are efforts to do something about that. The Gates Foundation is funding more coverage of global health issues at National Public Radio, Public Radio International and on television's The NewsHour with Jim Lehrer. The new kid on the block is Global Post, which I am happy to say, has a global health correspondent in South Africa. And let's not forget Global Voices Online, whose international health reporting is growing.

The British newspaper The Guardian is partnering with AMREF, an NGO dedicated to medical relief in Africa, to report development news from the Ugandan village of Katine. (See Laura Oliver's post on a UK journalism blog for news on the project's growing pains. Larry Hollon also has thoughts at Perspectives.)

I suspect we have only scratched the surface. In my view, a true social network for global health news would go far beyond encouraging comments, cross-linking, blog carnivals and re-tweeting. But those are the first steps.

Note to self and others: the news innovation barcamp for entrepreneurial journalists at the University of Missouri last week may give us some ideas for how to share ideas, organize efforts. They have created an online site for collaboration among groups of like-minded people (journalists and non-journalists) who want to explore new ideas for news coverage but have low or no budgets for experimentation.

Monday, January 26, 2009

Links: Journalism, Development, Antibiotic Resistance

Two important news items that should be getting more attention. The first is on a "midnight rule" change from the former Bush Administration that is just coming to light. The other is on a unique partnership between a journalistic outfit and a global development organization.

Well, this is bad news
Maryn McKenna tells us "the FDA has quietly reversed a decision it took last summer, and will allow cephalosporins, a human medicine, to be used without restriction in food animals." McKenna takes the time to put the news in context and add some of her own reporting--good journalistic habits. About that headline . . .

Media and Development
Excellent post from Larry Hollon at Perspectives about an "agreement between the African Medical and Research Foundation (AMREF) and the Guardian, the London-based daily newspaper, to document a development program in Katine, Uganda." I was most struck by Larry's concise summary of the high expectations and journalistic conflicts that accompany such projects.

Friday, January 23, 2009

Links: Ebola, Toilets and Corruption, Iodized Salt

Filipino tests positive for Ebola
From Reuters in Manila: "At least one person has tested positive for the Ebola-Reston virus in the Philippines, where the disease has broken out in pigs at two farms north of the capital, the government said on Friday."

Are Working Toilets A Good Anti-Corruption Indicator?
From the BBC's Mark Doyle: Reading official reports about corruption can be so boring. Doyle's lighthearted look at whether working toilets indicate progress against corruption in Sierra Leone.

The Challenge of Iodized Salt
From Alanna Shaikh, who just moved to Uzbekistan Tajikistan: A quick look at why it is so hard to make iodized salt universally available.

Thursday, January 22, 2009

Broken Links at DotGov Sites

Are broken web links at U.S. government sites going to be a feature of all future changes in Administration? I'm having trouble finding some of the links I had saved on a couple of global health issues from official U.S. government sites. Shouldn't we have some web continuity between Bush and Obama Administrations?

I can no longer get at a press release about human rights from Dec. 10, 2008 that was on the whitehouse.gov site. I get redirected to the Obama briefing room, not even a "page has been moved" message. Very Ministry of Truth.

Yesterday, Maryn McKenna found a broken link to whitehouse.gov that used to tell about the President's Malaria Initiative. No refer pages to where the pages are archived (although the Malaria Initiative itself is still available at fightingmalaria.gov).

I thought, okay, that is the White House--a very political place. But then in writing up my post about the Iranian AIDS doctors who were just sentenced to prison terms for trying to foment a velvet revolution via international HIV meetings (you can't make this stuff up, unfortunately), I realized that a link to an official statement from U.S. State department about the Alaei case was broken. The error message read "We're sorry. That page can't be found and may have been moved."

Since the statement was made by the Bush Administration, the contents had been moved to an archive site. Okay, fine, but at least give me the refer. I had to go and search by eyeball (keyword search Alaei brought up nothing) to find the archived statement.

That's when I started to worry. What about all the press releases at the Centers for Disease Control? Are all those links broken, too? Fortunately, as of Jan. 22, 2008, the CDC's RSS feed for press releases about vaccinations, mortality data, etc. is intact.

I used to think saving links to U.S. government web sites was a safe thing to do because, well, it's the government, they have to preserve those web pages--right? It is a matter of public record. And press releases are part of the public record. But what if the government webmasters preserve the pages and destroy the links? Makes keeping track of things mighty difficult.

It's a different kind of way of politicizing the record--every bit as Orwellian as deleting the word "abortion" as a search term from the Popline database last spring. Fortunately, that was fixed.

Is there a technological fix for broken links, too? Can the new Administration put up their stuff without losing the links to the old information? It is the same government of the same country, after all--just different temporary leaders.

Do you have any other examples of broken government links about global health post-Obama transition?

Iranian AIDS Docs Get 3 and 6 Years in Prison

While the rest of the world was focused on the peaceful transition of power in the U.S., Iranian AIDS doctors Kamiar and Arash Alaei learned on January 20 that they had been sentenced to three years and six years, respectively, in prison, according to Physicians for Human Rights.

The Alaei brothers' case is one of several recently in which professionals and religious minorities have been falsely accused of fomenting revolution. Lawyer and Nobel Laureate Shirin Ebadi's Human Rights Defenders Center was raided and shut down by police in December (Los Angeles Times). Her former secretary was arrested earlier this month in a roundup of six B'hai women (B'hai News).

(Update: The LA Times says Sylvia Hartounian, 33, a reproductive medicine specialist, was sentenced along with the Alaei brothers.)

Radio Free Europe has a good summary article that ties all these moves to internal Iranian politics--trying to sow fear among the Iranian electorate ahead of presidential elections in June.

The Washington Post quotes an unnamed Iranian official as saying the brothers' treatment is part of a "full-fledged intelligence war" between the U.S. and Iran. "A soft revolution has been programmed against our country and carried out in some instances, but it was suffocated in the cradle," the Iranian official was quoted as saying.

Further update (1/29/2009): For deep context, listen to Jeb Sharp's excellent podcast on Public Radio International's "The World" about the long-term damage to US-Iranian relations caused by the 1953 coup engineered by the CIA.

Related posts:
Jailed Iranian Docs
Jailed AIDS Docs Tried in Secret
Sentences Expected for Iranian AIDS Docs

Monday, January 19, 2009

Who Hears a Prayer About Gays, Malaria and AIDS?

The decision to censor Gene Robinson's prayer at yesterday's pre-inaugural concert in Washington, D.C. meant HBO's television audience also did not hear his call to do more about "women [who are] raped because they want an education" and the "thousands [who] die daily from malnutrition, malaria and AIDS." Interestingly, the openly-gay bishop also reminded folks of something that many conservatives have been saying lately, too--sometimes more crudely than other times--that Obama is not the Messiah.

AfterElton.com reports that HBO says it was only following the Inaugural Committee's wishes not to air the pre-concert show.

Christianity Today posted a video of Robinson's prayer on Youtube. (Episcopalcafe has text of the prayer.)

My two cents: I believe all prayers are heard by God. Whether or not the rest of us pay attention is another story.

Thursday, January 15, 2009

Proposed: Global Health Blogging Experiment

Reading Jon Shaffer's post on three top debates in global health gave me an idea. What if we organized a bunch of global health bloggers to coordinate their posts around a single topic and then picked a day where we agreed to post them all? It might increase the visibility of some of the deeper issues in global health.

Each blogger would take the part of the debate that had the most resonance to them. Say, for example, the topic were "prevention vs. treatment." Maryn McKenna might write about it in the case of antibiotic resistance. I might write about it in the community health vs hospital context. Alanna Shaikh might write about it based on her experiences in Central Asia. Then we would update our individual posts with links to what the others had to say.

You might think of it as a blog carnival (defined as "a rotating showcase of interesting writing from around the blogosphere within a particular discipline"), although that may be too organized for our first effort. The most exciting part is that we're starting to get enough of a critical mass of global health bloggers that this is even possible. What do you think?

Who Reads the Global Health Report?

Based on your comments, I would have to say you are all intelligent and thoughtful, if still a little bit shy. (To keep things civil, I delete the comments from trolls and hucksters.) Thanks to some basic web analytics software, here is what else I know about the people who visit The Global Health Report.

Just over 1500 unique visitors come to the site in December 2008, a monthly rate that has quadrupled in the past year. (Is that good or bad? You tell me.)

If I'm reading the charts right,

97% used a fast connection
2% used dialup
fewer than 1% accessed the blog from a mobile phone.

In the past year, visitors have come from 140 countries, with the following breakdown for the top five:

United States 71%
United Kingdom 6%
Canada 4%
South Africa 2%

If you have simple ideas on how to increase the international readership of the blog, please let me know.

11% of visitors accessed the site using computers on university or college networks, with the top five being:

Harvard University
Northwestern University
George Washington University
Bowdoin College
University of Washington

1% of visitors accessed the site using computers at U.S. government agencies, with the top five being:

The United States Centers for Disease Control and Prevention
The U.S. Department of State
The U.S. Department of Health and Human Services
The U.S. Agency for International Development
The U.S. Department of Veterans Affairs

Employees who use computer networks at the following press organizations (top 5):

BBC
Seattle Times
New York Times
Time Inc.
National Public Radio

Plus, a smattering of non-U.S. national and international agencies, several public relations agencies, some foundations and lots and lots of folks who I assume must be logging in from home on RoadRunner, Comcast, BellSouth, etc.

Related post:
Top 5 Blog Posts for 2008

Tuesday, January 13, 2009

Opposition to Gupta as Surgeon General

Opposition to the possible nomination of Sanjay Gupta as Surgeon General is building.

"CNN journalist lacks independent voice to be surgeon general," says Peter Canellos today in the Boston Globe. Representative John Conyers of Michigan is pushing a different candidate, Dr. Herb Smitherman, a public health advocate from Detroit.

I still find it hard to believe Gupta will take the position. He will have a much smaller staff and much tinier budget than he is used to at CNN. Sanjay looks good on television because he is talented but he also has some very capable producers helping him.

If the Surgeon General were just a health educator, then Gupta, who I like very much (for one thing, he never gave me grief when I edited his columns at TIME), would be a surprising but logical step. But there are also policy issues. The SG is supposed to lead the 6,000-person U.S. Public Health Service Commissioned Corps. (Per comments on one of my earlier posts, morale there seems very low.) There is also talk Gupta will play a role in the Office of Health Reform (Washington Post), perhaps as salesman for whatever national health care reform the Obama Administration offers?

I would also like to know a lot more about Gupta's relationship to the pharmaceutical industry. This is a question I would ask of any doctor or health journalist who is being considered for government office--and Gupta is both.

We all know that advertising and corporate sponsorship make mainstream media possible. That is why you need to look at the firewalls between the sponsors/advertisers and editorial side in any specialized field, but especially in health, to make sure they are solid.

This is especially true when there is a single sponsor for a television program or print column. Anyone who cared to flip through the pages of TIME Magazine from a few years ago would see that Gupta's column always ran next to ads from Pfizer. The New Republic has written about the pharmaceutical industry's sponsorship of CNN's AccentHealth.

In addition, the practice of accepting speaking fees from pharmaceutical companies is very controversial, to say the least, among health journalists. I have written about why I do not do it. Just last November, we learned that psychiatrist Fred Goodwin, host of NPR's Infinite Mind, received more than a million dollars in consulting fees from drug companies (New York Times). That little conflict of interest left a huge black eye on NPR.

So, I would also like to know a lot more about the speaking fees that Gupta has received over the years from pharmaceutical companies.

This is more than I had planned to write about Sanjay Gupta as Surgeon General. But this is something new for health journalism--a health journalist being tapped for a high government position.

The revolving door between government and politics is a lot more common for my colleagues in political journalism--where the potential conflicts there have been looked at in greater depth.

If Gupta and the Obama Administration are serious about the Surgeon General's position, then we need to examine this possible nomination more closely.

Related posts:
AIDS Docs, Gupta, Measles

Questions About Gupta for Surgeon General

Update: See also Gary Schwitzer's extensive critique of Gupta's journalism. Schwitzer used to be head of the medical news unit at CNN.

Monday, January 12, 2009

Global Health News Feeds, Part Three

In the spirit of sharing what you are already doing, I have made my Google reader subscriptions to the global health blogs I regularly follow publicly available. Most of these bloggers post once or fewer times a day so having all their posts collected in once place is incredibly convenient and no single voice (or small group of voices) drowns out all the others--something to cherish on the Internet and in life. No editing is involved--the posts are all generated automatically, although there is a delay between when the posts are published and when they appear in the feed but that is usually not a problem.

Separately, I am still maintaining a Global Health Mini-blog with my own picks of five interesting news and blog posts per day. In this case, I comb all my general news feeds looking for topics that have some bearing on global health issues.

I find this dual approach to feeds--one automated and one touched by human hands or "curated" in the new journalism lingo--necessary because we still do not have a semantic web that understands that items about malaria AND girl's education AND sanitation, etc. all fall under the rubric of "global health."

The next step would be to have a kind of Slashdot or Digg approach to global health news--where lots of folks post their own RSS collections of global health-specific items and then the group votes on the submissions. But there again, you would need some kind of mechanism to make sure that a few voices don't drown out all the others.

Of course, neither Slashdot or Digg even has a global health channel in the first place--another example of how the web often actually narrows the global conversation instead of broadening it. By the way, the Boston Globe had a great piece by Rebecca Tuhus-Dubrow in November 2008 about how the web drives out diversity.

Also, per John Wilpers' comment on January 8, I have agreed to share the Global Health Report's RSS feeds through Global Post, the new international news website, which is launching today.

Related posts:
How to Build Your Own Global Health News Feed
Global Health News Feeds, Part Two

Thursday, January 8, 2009

AIDS Docs, Sanjay Gupta, Measles

Iranian AIDS Docs. Revere at Effect Measure and Declan Butler at Nature both have items up about the 6-month detention, trial and expected sentencing of Arash and Kamiar Alaei, who were accused of trying to overthrow the government by going to international AIDS meetings.

Sanjay Gupta for U.S. Surgeon General. Several public health types seem disappointed but hopeful while many of the journalists I follow on Twitter and in list-servs are far more skeptical. Interestingly, the public health types emphasize Gupta's demonstrable communication skills while the journalists focus on his lack of public health experience (which, of course, is not the same as medical experience). I'll have more to say on this later when I have time to write a more thoughtful piece.

Other interesting posts on the Surgeon General at Paul Krugman's blog (see especially the early comments) and a much more positive analysis at Technology Health and Development.

Measles cases up in Europe. A Lancet study found measles cases were on track to double, from 3,909 in in 2007 to 6,269 cases in the first nine months of 2008. (Click here for full text of Lancet study on measles.)

Wednesday, January 7, 2009

Who is on Your Global Health List?

Belated thanks to Change.org for listing The Global Health Report as one of eleven essential global health resources. RadiationTechnicanSchools has GHR down as one of six top global health blogs (scroll down). I was also cited by USPharmD+ for writing one of 100 blogs that "will open your eyes."

Tuesday, January 6, 2009

Sentences Expected for Iranian AIDS Docs

Physicians for Human Rights expects Drs. Kamiar and Arash Alaei to be sentenced any day now on bogus treason charges in Iran. The brothers, who have been treating AIDS in Iran for many years, apparently became targets of the Iranian government after daring to attend a few international conferences.

PHR is requesting immediate help in their latest action alert on the situation. They think the more people protest, even electronically, the more likely the brothers will get a lighter sentence, or even have the charges dropped. Read more at iranfreethedocs.org.

Related posts:
Jailed Iranian Docs
Jailed AIDS Docs Tried in Secret

Questions About Gupta for Surgeon General

Years ago, when I was a cub health reporter, I remember the political reporters assuring me that the U.S. Surgeon General's position was a largely ceremonial one that political Washington didn't take too seriously.

This surprised me at the time--shows you what I know about politics. It seemed to me the Surgeon General's report of 1964 about smoking was an incredibly important public health policy. And I think Surgeon General Koop opened the door somewhat in a very closed Reagan Administration on AIDS policy.

Obviously, the reason I'm reminded of this is the floating of Sanjay Gupta's name as possible surgeon general nominee. Full disclosure: I worked with Sanjay at TIME and think he's very nice, an excellent neurosurgeon and obviously very telegenic.

But that's the question: is the SG position all about being a good communicator--in which case, Sanjay is a surprising but logical choice. Or is there more to the Surgeon General's position--like actually setting public health policy? If the latter, then--much as I like Sanjay--I remain unconvinced that there aren't people with better public health credentials to take the job.

I am asking about this on Twitter and in private emails and conversations I have been having with fellow journalists and public health types.

Will let you know if I learn anything good, including any interesting posts--as opposed to the many, many me-too posts that merely repeat what has already been said in the mainstream media.

Also, please point me in the direction of good information about whether the Surgeon General's position is largely ceremonial or not.

Update: See Opposition to Gupta as Surgeon General

Questions About Third-Hand Smoke

I missed this study from Pediatrics over the New Year's holiday. Researchers say "third hand smoke," which is smoking residue that lingers in people's hair or clothing, can damage the health of babies. A new survey shows that most people are unaware of the danger. So, even stepping outside to smoke does NOT protect infants from third-hand smoke. (Discover Magazine)

Obviously, no one in this day and age should be smoking--whether it is cigarettes, pipes, cigars. And yet, I have a question. Is third-hand smoking less harmful than second-hand smoking? Given the addictive nature of smoking, we don't want current smokers to just throw up their hands and decide to come into the room and smoke near the baby because they are "damned if they do and damned if they don't."

Read an abstract of the Pediatrics' study on attitudes about second-hand and third-hand smoke here.

Friday, January 2, 2009

Jailed AIDS Docs Tried in Secret

Two internationally known AIDS doctors were tried in secret in Iran on Dec. 31, 2008, according to reports received by Physicians for Human Rights. Drs. Arash and Kamiar Alaei were arrested back in June, apparently on suspicion of traveling to international AIDS conferences as a cover for spreading revolution in Iran.

Their plight has not received anywhere near as much attention as that of Iranian-American academic Haleh Esfandiari, who was detained under similar charges in 2007 before being released after 110 days in prison.

The U.S. State department released a statement (updated link here: apparently with the change from Bush to Obama Administrations, all the press releases were archived to a different place in the ether) about the Alaei brothers' situation in Iran on Tuesday, Dec. 23. In the statement, the State department also condemned the closing of the Center for the Defense of Human Rights, which was founded by Iranian lawyer and Nobel Peace Prize winner Shirin Ebadi.

Here's an excerpt from the latest press release from Physicians for Human Rights:

The doctors have been held in Tehran's notorious Evin prison since late June 2008. They were indicted in December on charges of communicating with an "enemy government" according to their attorney, Masoud Shafie.

On December 31, the Iranian prosecutor tried the brothers in Tehran's Revolutionary Court on these charges, and also informed the court of additional, secret charges which the brothers' attorney had no opportunity to refute, because the prosecutor did not disclose either the charges or the evidence on which they are based.

Related post: Jailed Iranian AIDS Docs