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April 2011

Fighting back against the frauds at the EWG

A new force has joined us in the fight against the fear entrepreneurs. Surf over to Safe Fruits and Veggies.com, and read some common sense, which should help counteract the nonsense disseminated on a daily basis by the inaptly named Environmental Working Group. (I call it "inapt" unless they're talking about working on the environment of your wallet.)

A favorite (and unfortunately effective) technique of EWG and other bottom-feeders is to simply create a list of chemicals that might be present in a particular food or personal care item. Then, they try to scare you about it, but more importantly try to convince you to send them money.

Forget about the actual concentrations of these chemicals, or the first rule of toxicology "The dose makes the poison." Forget also, that if you were to run assays on "organically grown" crops, you would still find naturally-present chemicals such as formaldehyde. Moreover, even if you were going to get concerned over such matters, the analytical methods of EWG have often been criticized—that is, when they are even disclosed.

One the many good points made on the site is:

An analysis conducted by a panel of experts recently found that the often cited "dirty" lists of produce items are misleading to consumers, that there is no evidence that the pesticide levels found pose any health risk, and that these lists should not be used to guide purchasing decisions for fruits and vegetables.

Apparently, the EWG has already backed off from some of its initial propaganda, based on data presented on the Safe Fruits and Veggies site, and its Expert Panel Report. (pdf download)

Check it out!


Keeping track of the caregivers

My latest HND piece takes a look at the burgeoning world of home health care. According to the National Association for Home Care & Hospice...

Approximately 12 million individuals currently receive care from more than 33,000 providers (for causes including acute illness, long-term health conditions, permanent disability, or terminal illness).

But, who's making sure that the recipients of this service are actually being properly cared for?

As you might expect, there are numerous government agencies that require all sorts of reporting—especially if the providers are getting Medicare reimbursement. In fact, the burden of this reporting has led to the interesting situation whereby home health care seems to be more computerized than the conventional in-patient variety.

Another aspect of home health care is non-medical (and not subject to Medicare reimbursements or regulations) and consists of such things as help with personal care, housecleaning, meal preparation, assistance with medications, and aspects of money management. Here again, supervisors and relatives of the care recipients need to know if all the tasks are getting done.

Fortunately, there are now inexpensive web-based solutions, such as those provided by ClearCare, that can help.

Read the complete article.


You'd better get ready for therapeutic substitution

What is therapeutic substitution? It is the practice whereby the drug prescribed for you is not dispensed as written, or even as the generic of what was specified. Rather, the drug dispensed is a generic for the CLASS of drugs to which the specified drug belongs.

Thus, if your prescription says Crestor®, you could get a generic for Lipitor®. Please note that Crestor and Lipitor are not the same compound, and do not have the same efficacy, although they are both statins. Individual patient reaction—for both the indication and side effects—of these two drugs is often different.

Yet, therapeutic substitution is exactly what Pfizer, the manufacturers of Lipitor, is hoping for. After all, generic Lipitor will be introduced after November 30, 2011, and Pfizer would like nothing better than to drive down the market share of the remaining branded statins. As an added bonus, Pfizer will probably be coming out with its own generic version of Lipitor, as well.

My latest HND piece examines the encroaching phenomenon of therapeutic substitution, and lists a few drugs for which this practice has already been occurring. Bear in mind that the volume usage of those drugs does not even come close to statins. Indeed, Lipitor all by itself is the biggest selling (legal) drug of all time, and it is just one of several statins.

There is considerable pressure to institute therapeutic substitution on a much wider scale. The fear is that if the single biggest class of drugs goes this way, no one will be able to put the therapeutic substitution genie back into the bottle.

But, who cares about patient outcomes if "the system" can save a little money, right?

Read the complete article.


Some reaction to "Dog lovers and baby killers"

I got an e-mail about that posting...

Loved the piece about DDT. Even my vet makes me feel guilty when I put the needs of my elderly mother ahead of her dogs. We've all gone nuts.

 

Here's my reply:

You can call it going nuts, but another way to look at it is the nearly complete erosion of critical thinking skills. The DDT story is quite similar to the cholesterol story, whereby virtually all the science extant disproves the conventional wisdom, but since it has become a cultural meme, none of this matters. There is simply no amount of information that can be put forward--EVER--to change the public perception on such topics.

Related to this is the kiss-ass A-student in high school who has some limited "mastery" of a particular subject, but never expands on this understanding--for his entire life. A current example is prevalent thinking (especially in the North) of our Civil War, now celebrating its 150th anniversary.

What we are facing these days also is the breakdown of many models, applicable to various facets of our lives. Some of these served us well enough in the past, I suppose, but are now completely outmoded.

One especially bitter example is the way many parents cling to the pathetic notion that a "good education" will guarantee some sort of bright future for their child. There's nothing wrong, of course, with getting that education, but it provides precious little in the way of improving career opportunities. Ask any 4.0 Ivy grad who is unemployed or underemployed.

Indeed, even law and medicine do not provide anywhere near the rewards they once did.

Sadly, I think that it will only get worse.


Telecommunications can improve health care

That's the title of my latest HND piece. If knowledge really is power, then we should be taking full advantage of the Information Superhighway to improve public health.

The good news is that a number of positive things are happening in this regard, and I examine three key facets...

  • Obtaining accurate and high-quality health information on the Internet
  • Using telemedicine to improve patient care—especially in rural areas
  • Employing cloud telephony in clinical settings

Read the complete article.


Guest posting: Dog lovers and baby killers

This one is from Cyril Boynes, Jr.


If only the world cared as much about African children and families, as they do about dogs.

 

A couple months ago, when its dog-sledding business lost customers, a Canadian company had a hundred of its dogs killed. The incident "shocked" and "angered" people. The employee who shot the dogs said he suffered "post traumatic stress" from killing them and wants compensation.

Animal activists used the incident in campaigns against dog sled rides. "I don't think society is willing to accept that animals should be killed just because they are surplus or don't suit the purpose they were born for," said one. "The magnitude of this atrocity is so shocking—our heads are reeling," another said.

Huskies are beautiful, gentle animals, and I'm really sad that this happened. But the world needs to put this in perspective. Humans eat animals. Our cars kill them along highways. Wind turbines kill eagles and other birds. More important, what about people?

My wife Fiona Kobusingye lost her son, two sisters and four cousins to malaria. Her nephew is permanently brain-damaged because of it. Almost everyone I know has lost at least one child or sibling to this killer disease. Despite millions of bednets, malaria still kills more African children than any other disease.

I cannot help thinking it would really be nice if, just once in awhile, animal lovers, environmentalists, journalists and other people would care half as much about African babies, children and families, as about dogs.

A hundred dogs are killed, and activists and newspapers make it a huge story.

Last year, almost one hundred thousand Ugandan children and adults were killed by malaria. And yet, nobody seemed to care—certainly not enough to write a story about it, or get outraged that callous anti-pesticide activists lie about DDT risks and prevent the use of DDT and other insecticides that could prevent malaria, yellow fever and other diseases that cause so much suffering, poverty and death on our continent.

It's as if anti-pesticide greens believe we Africans are "surplus" people on an "over-populated" planet and don't "suit the purposes" they think people should be born for. It's as if our misery and deaths don't mean anything. This is the real atrocity, and our African heads are reeling.

Yes, government agencies, private foundations, school children and other kind people from rich, malaria-free countries do send bednets, so at least some babies and pregnant women can sleep under one. But nets get torn, people don't always use them or hang them properly, and they only reduce malaria by 20 or 30 percent. That's why we need additional weapons—like DDT and other insecticides.

DDT keeps most mosquitoes from even going into homes. It irritates any that do come in, so they are less likely to bite. It kills any that land on walls after a blood meal, so they can't transmit malaria to other victims. DDT is cheap and long lasting: one spray is good for six months or more. No other chemical in existence does all this, at any price.

To break the transmission cycle and stop malaria, we need to reduce mosquito populations, keep them away from people, and treat infected people quickly. Nets are essential. So are better houses and hospitals (with screens on doors and windows), greater efforts to remove mosquito resting areas near homes, and access to the best possible drugs.

But we also need chemicals to kill mosquito larvae, insecticides to kill adults, and DDT as a long-lasting spatial repellent to keep mosquitoes out of our homes. We need every one of these weapons, not just the ones chemical-hating ideologues approve of, or we will forever be burying our children.

We are constantly told the DDT we spray on walls to keep mosquitoes out of our houses, and the insecticides we use to kill these insects, are dangerous, have undesirable side effects and shouldn't be used. But as Dr. Rutledge Taylor explains in his new film, "3 Billion and Counting," years of research actually prove that DDT is safe for people and the environment.

As Dr. Taylor points out, no one has ever died or been seriously hurt from DDT. Its worst effects are skin rashes and speculative (but unproven) connections to early lactation failure in nursing mothers and various other minor problems. Both Dr. Gordon Edwards and Dr. Taylor have actually eaten large amounts of DDT—and not been harmed.

We all know what malaria does. Besides lactation failure and low birth weights in babies, malaria makes people horribly sick and unable to work, leaves millions permanently brain-damaged, and kills millions more in the most awful, painful ways imaginable. Why anyone—especially Africans—would oppose using weapons that can stop this terrible carnage is impossible to imagine.

But a lot of people listen to the constant lies, told by baby-killing, pesticide-hating activists—and believe them. It's bad enough that Greenpeace, Environmental Defense, Pesticide Action Network and the Stockholm Convention Secretariat tell these lies and want to ban DDT from malaria programs by 2020. It's much worse that the Global Environment Facility, United Nations Environment Programme and even some bureaucrats in the World Health Organization support the ban.

But it's unconscionable that Ugandan companies and politicians are doing it, too.

Organic food companies claim even a trace of DDT on their produce or flowers will keep them out of Europe. That is false. Their crops just cannot have DDT above certain levels—and that will not happen from DDT sprayed on walls. But what's really absurd is that tobacco companies refuse to allow the barest detectable trace of DDT on cancer-causing tobacco that they are happy to sell to Europeans, and Europeans are happy to smoke.

It's not just hypocrisy. For these companies, government agencies and activist groups to put their salaries, profits and ideologies ahead of the health and lives of African babies is immoral. It's manslaughter.

Decisions about using DDT, larvacides and insecticides (along with nets and drugs) need to be made by African health ministers—not by activists, animal lovers, or environmental and agricultural interests. These groups are spending more money trying to get rid of DDT than the world is spending to control and eradicate malaria—when almost three billion people are at risk of getting this disease, and a million die from it, year after year.

We need to use DDT and other insecticides carefully—and we are doing so. However, in the end, if we don't use them, our wonderful, brilliant, athletic, musical, hard-working children and parents will be struck down, brain-damaged and killed by malaria.

Or more accurately, they will be murdered by self-centered ideologues, businessmen, politicians, and even WHO and other medical doctors who are violating their oath to save lives.

This has to end. We need to get our priorities straight—and understand what the real risks are. We need to pray that this insane opposition to disease-preventing, life-saving chemicals will be replaced soon with a concern for babies and parents that is equal to their concern for sled dogs.


Cyril Boynes, Jr. is co-chair of the Congress of Racial Equality Uganda and a tireless advocate for health and prosperity in Africa and all other developing regions.


Improving health with microfinance

In an HND piece that appeared last Monday, I examined how microfinance can be a powerful tool in improving public health.

As one review puts it:

The evidence is instructive in clearly indicating that the addition of health-related programs to microfinance services can change knowledge and behaviors associated with important and measurable health outcomes as diverse as reductions in fertility, decreases in morbidity, abatement of gender-based violence and changes in utilization of health services.

While some of this activity comes through NGOs such as Freedom From Hunger, other microfinance institutions such as Kiva and newcomer Microfundo are also getting into the act.

Read the complete article.


Hanna

An action movie with art house sensibilities, featuring teen actress Saoirse Ronan (that's pronounced SHEER-shuh) in a bravura performance. Eric Bana and Cate Blanchett are along for the ride, but our little Irish lass outclasses everyone.

Like any modern action film, certain plot elements don't make a whole lot of sense, but grab some popcorn, and enjoy it. Meanwhile, read my complete review.