- ‘Holding an imaginary glass of water in the air Deconas grimly said that ‘if the solution for AIDS would be to bring a glass of clean water to everybody in the world, we would not be able to bring that. We have not been able to stop children from dying from simple diarrhea by providing clean drinking water.’ ’ (6) - ‘Under direct orders from Dulles and President Eisenhower’s National Security Council the CIA created violent riots in Kinshasa and selected thirty-one-year-old Colonel Joseph Mobutu as the heir apparent, pending assassination of Lumumba. Two attempts to kill Lumumba using CIA-developed biological weapons failed. The CIA deliberately leaked word of Lumumba’s pending murder, causing the legally elected head of state to leave the capital for distant Lumbumbashi. There, with CIA assistance, Mobutu’s troops surrounded and murdered unarmed Lumumba on - ‘Mobutu is estimated to have amassed a personal fortune equal to - ‘From its outset MSF was committed to principles atypical for international relief organizations: its staff did not seek governments’ permission to assist in civilian crises; doctors were encouraged to publicly denounce political or economic conditions they felt contributed to such catastrophes; and nobody in MSF was expected to make a lifelong career of such work. The organization strongly believed that career relief workers tended to make too many compromises with corrupt governments or use local disasters as rungs on their personal ladders of prestige ascendancy.’ (79) - ‘For [Congoans] poverty had become a constant. A local Catholic nun put it in perspective by noting that her order found the resources to supply one pen to each family every school term. When siblings took exams in school, they shared their family’s sole writing implement.’ (115) - ‘ ‘That’s the usual behavior of international people,’ DROC’s Health Minister Dr. Jean-Baptiste Sondji said dismissively. ‘They came when there is a lot of coverage in the media, then they leave as if nothing happened.’ ’ (117) - ‘The public health situation [in - ‘If there was one thing the Soviet Union seemed justified in bragging about it was their health care system. In a series of bold five-year plans executed from - ‘Stalin, who had terrible scars all over his face that attested to his childhood battle with smallpox, embraced the battle against infectious diseases. It was wholeheartedly enjoined by the new public health establishment – Stalin-style. A vast network of sanitation and epidemiology was created, eventually reaching into nearly every village in the nation. Medical schools and sanitation training centers were constructed all over the - ‘After the fall of the - ‘Regionally violence, particularly against women, rose in tandem with soaring male alcoholism. Up to ten percent of women in the region, according to UNICEF in 1999, reported experiencing at least one beating from a spouse that was severe enough to require hospitalization, and about a fifth of married women complained of regular beating.’ (137-138) - ‘Some estimates were that eighty percent of all Russian men were alcoholics, consuming in 1999 – on average – 600 grams of booze a day, or roughly three liters of vodka every week. The male alcohol poisoning death rate in - ‘ ‘Between December 1990 and December 1994, consumer prices [in Russia] increased by 2,020 times for all goods and services, by 2,154 times for food products, but only 653 times for alcoholic beverages,’ stated a report issued jointly by the California-based Rand Corporation and Moscow’s Center for Demography and Human Ecology. ‘This means that over this period, in relative terms, alcohol became over three times cheaper than these other products.’ ’ (139) - ‘In 1997 the Moscow Human Rights Research Center estimated that there were a million homeless children in - ‘Terentjeva’s staff had just completed surveys in - ‘ ‘The whole world should work on safe fuel for rockets,’ Cherkasova says, insisting that children all over Russia and Central Asia were dying due to exposure to missile fuel. Other key contributors to the region’s dying rates, the fifty-five-year-old ornithologist says, are dioxins, lead, DDT, and a generalized dampening of people’s immune systems prompted by environmental assaults.’ (163) - ‘Overnight millions of workers lost their jobs, and the majority of the people residing in the Eastern Bloc and former Soviet Union fell into poverty – perhaps 25 percent of them were, according to UNICEF, living in acute poverty within eighteen months of the breakup of the Soviet Union. In - ‘The gap between rich and poor had reached levels not seen since the days of the czars.’ (167) - ‘In late 1998 the University of North Carolina conducted a survey that revealed that all – 100 percent – of Russian children suffered iron deficiencies, most having only 3 to 4 percent of minimum daily requirement needs met in their terrible diets.’ (169) - ‘At the close of 1995 the Russian Environment Ministry concluded that half of the nation’s drinking water supply was unsafe, either due to severe industrial pollution of biological contamination.’ (183) - ‘What happened in these arenas after 1991 constituted collapse of houses of Communist cards, not decimation of once-solid systems of public health.’ (185) - ‘According to TB experts, staying just three years in the Russian jail system – home to an amazing 1 in 148 Russian residents in 1997 – was tantamount to a death sentence from tuberculosis. And world health experts argued that unless - ‘It remained standard practice to give prisoners only one or two antibiotics at a time, rather than the four or five recommended by the World Health Organization. And the drugs were often catch-as-catch-can, since ministry officials allocated little money to the effort. Further, prisoners were subject to frequent transfers among jails, which meant they often underwent the type of treatment changes that promote the emergence of drug resistance. And once released, 95 percent fell out of the public health system entirely. The result: Dr. Alexey Priymak, then director of TB services for the Ministry of Health, said that about 80 percent of all infected ex-prisoners in Russia carried drug-resistant strains of bacteria, and half would die of TB-related symptoms within twelve months of their release from prison.’ (190) - ‘HIV was one of the world’s most rapidly mutating viruses, and it responded quickly to changes in its target human population. For example, most infected drug users and gay men in the world carried the B subtype of HIB, while female prostitutes in Africa and Asia predominantly had the C, D, A, and E subtypes. But only a tiny minority of the world’s AIDS population moved in social circles that allowed them exposure to widely divergent HIV subtypes, so few people in the 1990s carried two or more subtypes in their bodies at the same time. When such superinfections occurred, HIV had a golden opportunity: it could trade genetic chunks of its RNA from one subtype to another, creating new genetic forms that could include the ability to infect a wider range of cell types, outwit certain drugs, or cause more rapid illness.’ (218) - ‘Since the 1989 Velvet Revolution of Czechoslovakia, the 1990 fall of the Berlin Wall, and then the 1991 collapse of the Soviet Union prostitution had transformed in the vast region from a rightly controlled cottage industry into a multibillion-dollar, multinational enterprise controlled by sophisticated organized crime rackets that transported tens of thousands of women – and in all too many cases girls and boys – from the poorest formerly Communist countries to pockets of plenty along the borders of wealthy Western Europe and the Middle East.’ (227) - ‘In this manner about a half million women from Eastern Europe and the former Soviet Union had been smuggled into Western Europe and forced into prostitution by 1995, Gramegña said. And thereafter the scale of the operation escalated, with up to 300,000 more women trafficked into - ‘By early 1998 the ‘slave prostitute’ trade was netting at least $20 billion a year in - ‘The Soviet public health planners believed risk was segregated, and thereby limited: the society at large need not fear syphilis, TB, or diphtheria because all of the carriers were routinely rounded up and placed in sequestered facilities.’ (237) - ‘At least fifteen thousands Ph.D. scientists left - ‘In 1989, months before the fall of the Berlin Wall, the Iron Curtain weakened enough to allow some 400,000 Germans from the East to visit the West, and 1 percent of her scientists relocated westward. Those scientists who went west told colleagues back home that they found their skills woefully backward. In particular, the almost complete lack of computer skills and knowledge of computer-driven research tolls put the Easterners twenty years behind. And after the fall of the Berlin Wall the West German scientists were shocked to see how completely the Communist Party controlled Eastern science, allowing dogma to carry greater weight than such seemingly irrefutable foundations as the law of physics.’ (251) - ‘Government is not the solution to our problem; government is the problem.’ Ronald Reagan, presidential inaugural speech, - ‘Even in wealthy - ‘A few hospitals in the - ‘One of the key sources of nosocomial infection was contaminated intravascular catheters. Such devices were placed in nearly all postsurgical patients. If contaminated with pathogenic bacteria or fungi the result was blood poisoning, or septicemia…The bottom line: by the close of the 1990s somewhere between one hundred thousand and one hundred fifty thousand Americans were dying each year, felled by infections they caught inside US hospitals.’ (271-272) - ‘In 1850 the average - ‘Child mortality was also astronomical. In 1850 children growing up in large American cities had about fifty-fifty odds of reaching the age of five years without succumbing to disease or malnutrition. Odds were even worse – three to one against them – for children of the poorest urbanites: immigrants and African-Americans.’ (286) - ‘By the 1840s - ‘Most Americans in the 1840s were staunchly antigovernment, as well as anti-intellectual.’ (267) - ‘The Gay Nineties, as the 1890s were called, were times of social change that benefited public health. Some such changes arose from a growing civic pride – parks, paved roads, public transit. Some were the result of mass activism on behalf of labor and the poor. The antitenement movement focused scrutiny on the lives of slum dwellers, lives made unbearably grim by the appalling conditions of their crowded, pestilent, unmaintained dwellings, workplaces, and schools. In addition, union agitators, anarchists, socialists, and Communists were all gaining strong followings. Social movements were arising across the industrialized Northeast and - ‘Despite a 1905 Supreme Court ruling that the right of individuals to opt for or against a medical procedure were far outweighed by the powerful need to protect the community as a whole, as each new vaccine was developed and health authorities pushed to add it to the list of compulsory child immunizations, a nationwide pattern of opposition was repeated.’ (301) - ‘The field of public health would become so wretchedly remunerated compared to curative medicine that its professionals were likely to be drawn from one of two pools: highly motivated altruists or mediocre scientists, doctors, and nurses.’ (329) - ‘Though the administrations of Eisenhower, Kennedy, and Johnson marked a time of remarkable prosperity and economic growth for the nation as a whole, more than half of the nation’s black population lived in poverty throughout the 1950s and well into the 1960s.’ (341) - ‘Five days after the tragic assassination, President Johnson told a joint session of Congress that ‘no memorial oration or eulogy could more eloquently honor President Kennedy’s memory than the earliest possible passage of the civil rights bill for which he fought so long.’ ’ (343) - ‘Most of tobacco’s protectors on Capitol Hill were Republicans and Southern Democrats, who justified their opposition to smoking-related public health measures on two grounds: job protection for tobacco farmers and industry employees and philosophical opposition to any regulations that fettered free enterprise – including health laws aimed at saving tens of thousands of lives every year. The politicians were less open about reason number three for their staunch support of tobacco: money.’ (356) - ‘Neurostimulation is a greedy mistress. The brain wants more and more of it the longer a smoker uses cigarettes, the more the brain actually changes physically, adapting to nicotine stimulation so thoroughly that it can not readily function without it.’ (357) - ‘In his published diary of 1969, Nixon aide H. R. Haldeman noted that the president ‘emphasized that you have to face the fact that the whole problem is really the blacks. The key is to devise a system that recognizes this while not appearing to.’ ’ (367) - ‘It is estimated that up to 20 percent of the [ - ‘Is it a coincidence that over the last fifteen years these public health reports have emphasized personal responsibility at a time of conservative government? These are ‘blame the victim’ approaches. It’s clearly cheaper than funding public health.’ William H. McBeath, executive director, American Public Health Association (380) - ‘By October [1981] 56 percent of - ‘The act, which enforced the FY 1982 budget cuts, was found to increase the total poverty rate during the fiscal year by 2 percent, and by 2.9 percent among children. The increase in childhood poverty was largely caused by the budget reductions that removed 493,000 cases from the Aid to Families with Dependent Children program.’ James Savage (384) - ‘Government – or, at least, federal government – was bad, the president said. Programs should be handled at the more accountable local level. If people locally didn’t want to pay for them, well, that’s democracy.’ ’ (387) - ‘Bigotry against homosexuals and injecting drug users had blinded the general public, politicians, the medical community, and, sadly, many public health leaders to the urgency of responding to AIDS when effective action might have had a profound impact: between May 1981 and the end of 1984.’ (404) - ‘A New York Times/CBS poll in 1988 found that more than 75 percent of respondents had ‘no sympathy for homosexuals suffering from AIDS.’ A shocking 19 percent said they had no sympathy for AIDS patients regardless of how they acquired their HIV infection, even if the individuals were infant or transfusion recipients.’ (404-405) - ‘Needle exchanges would probably have had a powerful impact from 1981 through 1984 when the incidence of HIV in that community was still manageable. But by Reagan’s second term, many cities were reporting HIB rates of 35 to 60 percent among injecting drug users.’ (408) - ‘The tragedy for public health was that drug abuse treatment programs worked. They were proven – better proven, in fact, than needle exchange efforts. Numerous studies demonstrated that regardless of the type of treatment programs offered or to what sort of drug(s) an individual was addicted, simply having an environment in which to address his or her problem successfully weaned the user from drugs 40 to 50 percent of the time, with a recidivism rate of 20 to 30 percent.’ (409) - ‘When the societal costs of HIV and other infections spread via contaminated needles were factored in, the cost effectiveness of treatment was calculated to approach fifty dollars saved for every one dollar spent.’ (409) - ‘The majority of all cocaine users during the Reagan and Bush years were white; but arrests were overwhelmingly black. And by 1993 four million Americans, most of them African-American, would have lost their right to vote due to criminal drug convictions.’ (413) - ‘The War on Drugs put up to a quarter of the nation’s African-American young men in jails and prisons.’ (415) - ‘The mass incarceration of black men and Latinos created a unique HIV amplification system: it spread through forced homosexual activity in a prison or jail setting where condoms had officially been declared illegal. As the black male population cycled in and out of this prison milieu, HIV soared among African-Americans. By 1998 AIDS would be the number one cause of death for black men and women aged twenty-five to forty-four and the CDC would estimate that some one hundred thousand African-Americans were HIV positive. That year, though blacks comprised just 13 percent of the - ‘If individuals cannot perceive a personal or community interest in public health goals, [Daniel] Callahan argued, the institutions of health and medicine will be viewed by those alienated groups with the same disdain and hostility as is directed toward other government institutions, such as the police, FBI, CIA, and the military.’ (417) - ‘A striking twenty-five year survey of insured and uninsured Americans who were followed from 1971 to 1987 proved the intuitively obvious: namely, that lacking medical insurance was bad for one’s health. In the study, insurance status was a more powerful predictor of life expectancy than social class.’ (430) - ‘In July 1994 Undersecretary of State Timothy Wirth announced the results of that governmentwide [sic] survey: emerging infectious diseases represent ‘a national security threat….We are once again losing the battle against infectious diseases in many parts of the world, indeed in many parts of the United States. These diseases know no boundary.’ ’ (436) - ‘For some agencies, the connection was straightforward: if US troops hunkered down in trenches somewhere suddenly started dying of disease by the thousands – as happened during World War I as a result of influenza – the nation’s security would be imperiled because its soldiers could not fight in its defense. And security experts noted that there really was no way to distinguish a naturally emerging disease threat to soldiers from one that was deliberately set loose as an agent of biological warfare.’ (436-437) - ‘By 1997 Hispanics were more likely than any other population group in the country to lack health insurance, have no regular physician, use emergency rooms of public hospitals for all of their health needs, and delay treatments until their problems had become emergencies.’ (449) - ‘Home water filters, which were all the rage in the - ‘For the patients, taking HAART [anti-HIV] could become a full-time job. Some drugs had to be taken six times a day, some once, some twice. Some had to be ingested on a full stomach, others before eating. And all well-managed HIV patients also took a host of prophylactic drugs that prevented common opportunistic infections.’ (477) - ‘ ‘Could it not be contrived to Send the Small Pox among those Disaffected Tribes of Indians?’ Sir Jeffrey Amherst, British commander-in-chief, American colonies, July 1763, writing in reference to an uprising among the - ‘ ‘Above 700 Negroes are come down the River in the Smallpox. I shall distribute them about the Rebel Plantations.’ British General Alexander Leslie, - ‘Despite spending more on their health than any other peoples, citizens of the United States had the slowest rate of improvement in life expectancy of any industrialized nation. Americans born in 1960 had a life expectancy of 69.7 years, and in 1996 of 76.1 years, for a gain of 6.4 years. In contrast, Japanese born in 1996 could expect to live 80.3 years, with a gain of 12.6 years since 1960.’ (556) - ‘By 2020 the individual medical costs per elder were expected t have risen from $9,200 on average in 1995, to more than 25,000.’ (557) - ‘In 1996 just 358 superrich individuals controlled as much personal wealth as the combined income and assets of the 2.3 billion poorest people in the world. Three men – Bill Gates, Warren Buffett, and Paul Allen – had a combined 1999 wealth of $156 billion, or $20 billion more than the combined GNPs of the forty-three poorest nations.’ (561-562) - ‘A careful reading of the data also demonstrated that adult literacy rates correlated more closely with life expectancy and infant mortality than did GDP per capita.’ (563) - ‘When the messenger was perceived as the ‘white government’ the message was viewed with suspicion, even hostility. The - ‘When such [government] subsidies were factored into the R&D equation industry claims of justifiable profit margins withered. Even more challenging to the industry’s economic calculus was mounting evidence that drugs were deliberately marketed in the US at price significantly higher than those demanded of medical consumers in Europe and Canada.’ (575) - ‘What was to be done? The MSF group offered a list of recommendations, beginning with changes in global treaties that protected patents and pharmaceutical trade and allowing ‘realistic pricing of potential drugs’ sold in developing countries in exchange for local parent enforcement. The group also called for a far more activist role in these issues on the part of the World Health Organization. And insisted that strong financial incentives would be needed to propel the otherwise dismal state of research and development on tropical diseases. The MSF group concluded that access to lifesaving medicine was a human right.’ (576) - ‘ ‘The critical difference,’ [Larry] Gostin continued, ‘is that at those times we as a world community say by and cried because we couldn’t do anything. And now we stand by and watch, expressionless, because we choose not to do anything.’ ’ (579) - ‘The HAART model opened a set of profitable doors for the pharmaceutical industry. First, it allowed an acute infection to be treated as a chronic disease, dragging out treatment (and drug sales) for decades. Second, it escalated the level of socially acceptable public health disparity in the world, finding the companies and wealthy world government facing remarkably little criticism for sparing the lives of European and North American citizens while witnessing obliteration of populations elsewhere. Third, the treatment was based on a class of drugs, called protease inhibitors, that were very costly and difficult to produce; patent violation was minimized by the sheer scale of production obstacles. And fourth, even an extraordinarily expensive set of drugs could prove profitable within targeted wealthy nations if the sense of urgency was high enough to commit governments to their subsidized purchase.’ (581) - ‘In 1998 the World Health Organization launched the Roll Back Malaria campaign, working with UNICEF and the World Bank to find incentives for development of new antimalarial drugs. Though there were promising potential drugs in the research pipeline, no pharmaceutical company in 1999 had an internal malaria research program.’ (582) - ‘In the end, [HHS Secretary Lee] argued, humanity was left with a disturbing, contradictory picture of the New Medicine. On the one hand, true miracles were ahead. On the other, a grim global social context challenged all optimism.’ (585) - ‘After the millennium it would be difficult to dodge a charge of negligent homicide against a national leader who deliberately shunned provision of safe drinking water in favor of military or grandiose development expenditures.’ (591) | 1) One-click book searches! Simply click on the book title below! All You Can Eat American Fascists American Power and the New Mandarins The Autobiography of Malcolm X Bad Samaritans Banker to the Poor The Beak of the Finch Betrayal of Trust Better Beyond US Hegemony? 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