Sunday, April 30, 2006

Medical Morons

Percent of people with HIV in Africa 1999-2001

Check out this recent headline – Circumcision, Fidelity More Effective HIV Prevention Methods than Condoms, Abstinence, Researchers say.

I touched on this in a prior post,

Researchers have found that male circumcision reduces the risk of contracting HIV by 70%. Why does this make the Roundup? Because the world is spending billions of dollars to find an HIV vaccine whose targeted risk reduction level is only 30%. When are people going to realize that scientists are mostly a government subsidized welfare demographic?

Now that headline is somewhat whacky. I am not sure how anything could trump abstinence but nevertheless, it echoes what I previously said about circumcision.

The researchers said,

...they have tried to “put aside intuitions, emotions, ideologies and look at the evidence in as coldhearted a way as we can.”

Do you believe this? This is like a judge saying that he tried to consider the law before making a ruling. Scientists should learn objectivity when they are around nineteen years old. It’s almost like they want extra credit here. They also seem to be apologizing for ignoring ideology. Sorry, this AIDS stuff is serious business unlike “global warming” where it’s de rigueur to have ideology marching as the lead explanatory variable.

At any rate, the scientific community should put an asterisk next to this uniquely objective report.

So while millions of Africans are dying of AIDS, governments, NGOs, and philanthropists like Bill Gates are wasting mucho dinero on vaccine development despite the fact that a simple snip snip would do.

There’s actually a whole movement devoted to fighting circumcision with books out titled, Circumcision – The Hidden Trauma, websites like Mothers Against Circumcision, and countless experts like Dr. Dean and Dr. Spock carrying the torch.

But what about the "trauma" of HIV infection?

In a prior post on Health Savings Accounts, I posited that,

“Something like 40% of drugs don’t work.”

(Clearly I was referring to legal, prescription drugs.)

Forbes has a decent article in the May 8th issue titled Pushing Pills – How Big Pharma Got Addicted to Marketing.

In that article they lead off with Lamisil, a pill that attacks that fungus which makes one's toenails yellow.

10 million Americans have taken Lamisil, which costs $850 for a three-month treatment.

Lamisil sales jumped 19% to $1.2 billion worldwide in 2004 and held steady last year.

Now here is the kicker,

...the drug fully cures the problem in only 38% of patients.

That entire article is worthwhile reading but the over-marketing aspect of pharmaceuticals is a subject that has been hijacked by the econo-illiterate socialists. As I have promulgated in my HSA post, one of the main problems with healthcare is the Third Party Payer system. The average Joe is going to think twice about treating his yellow toenails if he has to shell out the $850 for a pill that is only 62% effective.

The socialists would rather blame evil Big Pharma than the misbegotten government dominated healthcare system. In fact, their answer for government induced problems is unflappably, always more government. (I am not sure, but I think that Ted Kennedy championed the Health Maintenance Organization Act of 1973 that obviously spawned the modern HMO.)

There’s another illustration in that article of the brainless Third Party Payer system,

"People would come in asking for--demanding [a COX-2 inhibitor]--and sometimes threaten to find a new doctor if I didn't prescribe it," says physician John Abramson, a clinical instructor at Harvard Medical School who has consulted for plaintiff lawyers. "Vioxx wasn't a bad drug for everyone, it was a bad drug for certain patients," says Chris D. Robbins of Arxcel, which consults to pharmacy benefit managers. "Unfortunately, people saw the ads and started demanding the drugs from their doctors."

Unbelievable. Here a doctor basically admits to letting the patient pick his treatment under the threat of losing him (i.e. money) to another, more liberal script writer. Then he has the stones to go work for plaintiff lawyers.

What’s next? Kids demanding less homework from their teachers? Why not let the inmates run the asylum while we are at it?

It’s much easier to just write the script, after all, neither the doctor nor the patient is directly footing the bill. And heck, everyone else is doing it. And when something unforeseen happens, be it a drug recall like Vioxx or healthcare costs skyrocket...

...they can just blame evil Big Business.

What's cheaper? Nail polish or Lamisil?


Anonymous said...

What about all those American men who have died of HIV/AIDS? Given this country's obsession with skinning baby dick, these men were certainly circumcised.

Wannabe Amazonian said...

I heartily agree that "only a fool would forgo condoms just because he is circumcised."

At any rate, the AIDS epidemic of the past 30 years was far worse in North America than in Europe, even though a large majority of adult North Americans are circumcised, while very few non-Muslim Europeans are circumcised.

The African clinical trials shed no light on whether the North American practice of circumcising newborn babies should continue. The way those clinical trials were conducted and analysed also left a good deal to be desired.

The typical male in sub-Saharan Africa lives in a village without running water. Soap may be hard to come by. The village general store does not stock condoms. If it did, everybody would be too embarrassed to be seen buying some.

Learning about African sexual behaviour has proved to be a struggle. While Africans have a lot of premarital and extramarital sex, they are very prudish when it comes to talking about it. Hence we are still struggling to piece together just how sex works in Africa, and just how that sexual reality might augment the risk of HIV transmission.

It appears that Africans who are not austere Christians or Muslims resist the understanding of marital fidelity that is second nature to most adults in the first world. African married women have lovers they turn to when their husbands are out of town. African men freely use prostitutes when on the road. Poor African women prostitute themselves to feed their children.

Some African men have weird ideas that fun sex is "dry sex." Dry sex increases the risk of small abrasions that admit the HIV into the bloodstream.

It is possible that, in a world characterised by what I wrote above, such as sub-Saharan Africa, the snip could reduce the AIDS epidemic. I am not averse to making the snip available gratis to every African teenager or man who requests it, assuming it is done under antiseptic conditions and with a prior injection of lidocaine. However, I cannot support doing it to infants who cannot consent, either in Africa or in the world most readers of this blog live in.

In the First World, we have to continue banging the drum for condom use during all casual sex. Failing that, men should wash their penises before and after all casual sexual activity. If men won't do that, women should take matters in hand.

CaptiousNut said...


Thank you for your thoughtful response.

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