The Zika Virus and Politicized Science

Science today is regularly distorted to serve other ends. The religious right, for instance, claims that “creationism” should be taught in public schools as a scientific alternative to the theory of evolution. The environmentalist left, for instance, claims that science reveals genetically modified foods to be harmful to one’s health. Both groups subordinate the facts of science to other considerations, whether Biblical or ideological.

The same dishonesty is shaping the response to the Zika virus.

The Zika threat is causing great concern at the Rio Olympics, with some athletes having chosen to avoid the Games altogether rather than risk infection. Florida recently reported the first locally contracted cases of Zika in the United States. And the Centers for Disease Control is advising pregnant women not to travel to certain areas of Miami—the first time the agency has ever issued such a warning for the continental U.S.

But among the measures being taken around the world to combat this danger, one is notably absent: the use of DDT.

Zika is carried by mosquitoes, and DDT has been highly effective in eliminating mosquito-borne diseases. India, for example, had 75 million malaria cases in 1953, but only 50,000 by 1961, after DDT had been introduced. In Sri Lanka close to 3 million cases of malaria occurred in 1948; 15 years later, owing to DDT, the number dropped to 17. (Source.) The National Academy of Sciences stated in 1970: “To only a few chemicals does man owe as great a debt as to DDT. . . . It is estimated that in little more than two decades, DDT has prevented 500 million deaths due to malaria.”

But strong opposition to DDT arose, spurred by the 1962 publication of Rachel Carson’s Silent Spring. Environmentalists got DDT banned in the U.S. and, eventually, in dozens of other countries. Western nations, which fund anti-malaria campaigns throughout the world, largely refused to underwrite any efforts that employed DDT. As a result, DDT use shrank–and malaria surged.

In India the number of cases increased to 30 million in 1977. In Sri Lanka the number went to 2.5 million in 1969. (Source.) More recently, other forms of malaria control—such as installing bed-netting and reducing the presence of standing water–have lowered the incidence of the disease worldwide. But they are generally less effective than DDT. In South Africa, for example, after DDT spraying was halted in 1996, malaria infections rose from under 5,000 in 1995 to over 60,000 in 2000. At which point DDT was reintroduced—and six months later the number dropped by half. (Source.)

This hostility to DDT was not based on science. For instance, DDT was said to be carcinogenic, because of studies in which mice developed liver tumors—but only after receiving doses of DDT 100,000 times higher than what a person would typically absorb (Source.) Further, the opponents of DDT ignored many facts contradicting their views—such as the fact that during the period of highest DDT use (1944-1972), deaths from liver cancer fell by 30 percent (source)—or that workers who regularly handled DDT were found to have no higher rates of cancer than the general population (source)—or that people who voluntarily ingested  DDT daily for up to two years suffered no ill effects (source)—or that the amount of DDT (per kilogram of body weight) required to kill mice is greater than that of aspirin (source).

What, then, was the motive behind the anti-DDT crusade? It was based on the premise that the man-made is inherently suspect—that the natural is good and the non-natural is bad, that human “intervention” in nature is deleterious and that we have to protect nature from man, not for man. The millions of lives saved by our “non-organic” use of DDT—and the millions lost when it was not used—were disregarded. Instead, the thinning of the eggshells of the bald eagle was presented as an intolerable effect of DDT.

As explained by David Graber, a biologist with the National Park Service, environmentalists

value wilderness for its own sake, not for what value it confers upon mankind. . . . We are not interested in the utility of a particular species, or a free-flowing river or ecosystem to mankind. They have intrinsic value, more value—to me—than another human body or a billion of them.

True, there is evidence that some mosquitoes are developing resistance to DDT. But even where DDT’s toxicity has been diminished, its repellent properties still work. When house walls are sprayed with DDT, even resistant mosquitoes are repulsed and don’t enter. More important, though, one’s attitude should be: “If DDT’s effectiveness is lessening, let’s find some way to make it work better.” Instead, the operating premise seems to be: “Man-made chemicals interfere with nature, so let’s find some way to prohibit them.”

Man survives and prospers, not by living “in harmony” with nature, but by reshaping it—by creating houses and roads and factories out of the wilderness, by transforming nature into a tool that serves human purposes. The problem with environmentalists is not that they have an ideology, but that it is an ideology with an inverted standard of value. It is an ideology that regards the very means of human flourishing as destructive. In assessing DDT, therefore, if your overriding concern is to restructure nature in order to promote man’s well-being, then you will focus on whether DDT does in fact save human lives. If, however, your overriding concern is to preserve nature against human encroachment, then you will focus on the “evil” of injecting chemicals into nature’s domain. And you will be drawn to any arbitrary claim about adverse consequences of those chemicals.

My primary aim here is not to argue for the use of DDT, but to underscore the need for objectivity is dealing with such issues. We should not uncritically accept the assertions of those who are hostile to technology and industrialization. We should not accept any allegations of some product’s harmfulness—say, that DDT causes Alzheimer’s, or that vaccines cause autism or that fracking causes earthquakes—without being certain they rest on genuine, unpoliticized science.♦♦

[The above article was published at Huffington Post on 8/22/16.]

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The Shackles of Paternalism

Today, the “nanny-state” is omnipresent. Its latest pernicious intrusion pertains to pain-relief medication. Doctors are being told to restrict their prescriptions of opioids, the drugs (such as Percocet and Vicodin) used to reduce extreme pain. Why? Because the government is concerned about patients who overuse the drugs, leading to addiction and sometimes death.

The idea of a paternalistic government, deciding what is best for each of us, rests ultimately on the ethics of self-sacrifice. It rests on the altruistic premise that you have a moral duty to surrender your self-interest for the sake of others, that you must subordinate yourself to the needs of your neighbor. Thus, those who genuinely require strong pain medication must suffer, so that their neighbors not be able to use the drugs irresponsibly.

A story in today’s NY Times describes the effects of these new controls on one doctor’s patients. “ ’I have a patient with inoperable spinal stenosis who needs to keep chopping wood to heat his home,’ said Dr. [Robert] Wergin, 61, the only physician in this rural town. ‘A one-size-fits-all algorithm just doesn’t fit him. But I have to comply.’ ” Another patient, a 55-year-old woman, “had three rotated vertebrae in her lower back, migraines and a mastectomy for breast cancer this fall. . . . Her fibromyalgia was flaring up, she told Dr. Wergin. Pain was aggravating her insomnia. ‘And you have to cut my pills again?’ she asked.  Dr. Wergin nodded.  ‘It will be very difficult to get an override for your dose.’   . . . ‘It’s rough cutting back when I’m at a level that almost works,’ she said to Dr. Wergin. A rare flicker of frustration crossed his face. ‘I’m sorry,’ Dr. Wergin said.” He could do no more for her.

As I wrote in IN DEFENSE OF SELFISHNESS (p. 165): “[T]he government regulates the medicine you may use, because other people might be tempted to take it when they shouldn’t; it regulates your retirement program, because of those who might squander their savings; it regulates your educational choices, because of those who might make foolish decisions about the schools to which they send their children; and it regulates your intake of food, because of those who might be oblivious to their health requirements. You are forbidden to choose—because of those who do not wish to be burdened by the onus of choice. You must sacrifice your freedom—because of those who are indifferent to freedom. Everyone must be dragged down to the level of the worst, and be shackled to their needs. This is how the individual becomes subservient to society.”

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What If We Had No FDA?


[This appeared originally in Huffington Post, 12/7/15]

Because the Food and Drug Administration forbids even terminally ill people from taking unauthorized drugs that could save their lives, twenty-four states have now passed laws to deal with the problem. They have enacted “right-to-try” legislation, which allows patients with fatal illnesses to take experimental drugs that have not received FDA approval.

Commendable as these actions are, they don’t go nearly far enough.

Most of the criticisms of the FDA focus on the agency’s delays in approving drugs. People are dying while waiting for the FDA to decide whether to give them access to vital medication. The average drug now takes fourteen years to reach the market (almost double what it took in the 1960s). New drugs are often available in other industrialized countries while they are still illegal in America.

For instance, after clinical testing showed that Provenge, a novel vaccine for advanced prostate cancer, increased patients’ survival rate, the FDA’s own advisory panel in March 2007 voted 13-4 to endorse the drug’s effectiveness, and 17-0 to endorse its safety. Nonetheless, the FDA refused to approve the drug until April 2010. During those three years, close to 100,000 people in the U.S. died of prostate cancer. Or take the case of Esbriet, designed to treat a fatal lung disease that kills 40,000 Americans yearly. It was okayed by the FDA in 2014—four-and-a-half years after its advisory panel recommended approval (and after it had been available in Europe for four years, and in Japan for seven). Obviously, no one can know precisely how many of those who died during these periods might have been saved; the only certainty is that none were allowed to find out. There are, sadly, many such examples. (And even the FDA’s “compassionate-use” program, designed to permit the terminally ill to use certain unapproved drugs, is laden with bureaucratic obstacles for patients, doctors and pharmaceutical companies.)

But these unconscionable delays are merely symptoms of the problem. The underlying cause, along with the underlying injustice, is something else–namely, the FDA’s life-and-death power over all of us.

Like any government entity, the FDA is an agent of force. It exists, not to inform or persuade us, but to legally stop us from taking a drug we think might be good for us. Here’s what the FDA typically does in prohibiting a drug. It takes a company’s research data, which identifies the drug’s risks and benefits, and decides that the statistical probability that the drug will help you is not worth the risk of unwanted side effects. This then becomes a dictatorial edict, by which you must abide.

But why shouldn’t you be permitted to make that decision? Your doctor may disagree with the FDA’s conclusions (as there is often disagreement among scientists and physicians within the FDA itself). You and your doctor may believe that, for your particular circumstances, an unapproved drug is worth the risk.

Obviously specialized knowledge is required to assess any drug. But once we remove the FDA’s coercive monopoly over the evaluations of drugs, numerous private alternatives will arise—alternatives that physicians will use in advising you. There will be competing sources of information, as there are now when it comes to assessing everything from electrical equipment to mutual funds to fire extinguishers. Your doctor will consult medical journals, private certification laboratories, professional colleagues, etc., in offering you his recommendation. Why are you not entitled to follow it?

If we live in a free society, it is you who should have the right to decide whose judgment to accept about the value of some medication—and not only if you have a terminal disease, but any affliction. Whatever your condition, it is your life and health at stake, and you should be the one making the choices. You go skiing, you ride a bicycle—you weigh risks and benefits to yourself all the time; why should the same freedom be forbidden to you with respect to something as crucial as drugs? Why should the FDA be allowed to play God?

Yes, there are risks. Some new drug may turn out to have side effects unknown when it was first released. This is what happened, for example, with thalidomide in 1961. The deformed babies born from mothers who had taken thalidomide during pregnancy were not caused by mindless “greed” on the part of the drug manufacturer. The tragedy was the result of a lack of knowledge at the time–by scientists, by pharmaceutical companies and by the FDA—about the effects of drugs passing through the placenta. The FDA’s own requirements did not include testing on pregnant subjects, neither animals nor humans. (For elaboration, see pp. 149-150 in my book In Defense of Selfishness [Palgrave Macmillan].)

The full properties of a drug are sometimes not known, and not knowable, until after a vast number of people, over a long period of time, have used it. This is part of the inherent risk one accepts if one wants the benefits of a new drug. That is, one chooses the risk of taking the drug over the risk of not taking it.

Of course, private citizens can make mistakes–but so can government bureaucrats. And of course, if left free, some people may unthinkingly endanger themselves for no good reason—just as people may thoughtlessly harm themselves, even fatally, by improperly using a drain cleaner, a ladder or a bathtub. But the actions of such people do not justify the imposition of straitjackets around the rest of us. The same principle applies to drugs. Rational people should not be forced to suffer and die needlessly, by being denied access to needed medication, simply because others may use their freedom irrationally.

The FDA has been given the power to force people to delay, whether for a day or forever, taking the medicines they believe will improve, or save, their lives. And the question we all should be asking is: By what right?

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