AFRICA: A VICTIM OF THE BATTLE BETWEEN PRIMARY HEALTH CARE AND MAGIC BULLETS

At the turn of the Twentieth Century, at a time when many of today’s nations, especially Africa, were colonized by the major powers of Western Europe, Paul Ehrlich, a German physician and scientist, discovered that a certain chemical compound, Arsphenamine, effectively combatted spirillum spirochaetes bacteria, the subspecies of which caused syphilis. The treatment of syphilis, using this compound, that targeted only the specific bacteria causing the syphilis, and had few if any negative side effects, was, in short, a miracle. Ehrlich reasoned that if other medications could be created that “selectively” targeted specific disease causing organisms, with few side effects, it would be a “magische Kugel”—magic bullet.

In 1908, Paul Ehrlich received the Nobel Prize in Physiology/Medicine, for his contributions to immunology. As a direct result of Ehrlich’s “magic bullet” theory, scientists and physicians around the world began their own research and experiments to discover more and more magic bullet cures.

Various and thoughtful people, from around the world, have posed an important philosophical and moral question, “Should First World countries intervene in the politics, medical practices, and social structures of Third World countries, in any manner whatsoever, even if it is to save their lives?” After much reflection, I believe the correct answer is yes, for the following reason: lives matter—all lives matter.

I would like to expand on the definition of a magic bullet, defined, “as selectively targeting a specific disease, with few or no side effects;” and create a “financial” magic bullet that selectively targets specific health needs, in a positive way, with as little collateral damage as possible. And, once again, the “financial” magic bullet will be played out in the villages of Africa.

Although Measles, in the United States and Europe, is now virtually a disease of the past, measles has been increasing dangerously in many countries in West Africa, hit hard by the recent outbreak of Ebola. A Time’s article titled, Why West Africa Might Soon Have 100,000 More Measles Cases, talks about how the Ebola epidemic has caused a disastrous overwhelming of the Primary Health Care system in West Africa, leading to increased mortality and morbidity rates, due to Measles. The author then goes on about the eradication campaign that was set up to vaccinate all the children who were born during the Ebola epidemic, before expanding to older children and adults, who are more susceptible to dying from Measles, in order to prevent an even greater Measles epidemic, in the future.

Who lives, and who dies? Who decides? Who funds the Primary Health Care facilities? In the end, the decisions are obviously made by the First World countries.

Packard, in his chapter, Malaria Dreams: Postwar Visions of Health and Development in the Third World, explains how there has been a long reach of colonial medicine and how medical colonialism and imperial conquest set the stage to practice science and medicine, abroad—mostly, in Africa.

Looking at the medical history of Africa, since the time of Ehrlich, there have been many serious outbreaks of deadly diseases, in Africa—some of them eradicated by magic bullet cures, some of them tackled and overcome by the hard work performed by Primary Health Care doctors and nurses who have employed both magic bullet cures to eliminate small pox, prevent cholera, mitigate diarrhea, treat malaria, and a host of other remedies to assuage suffering and prevent deaths.

Returning to the “financial” magic bullet, how do we know which is more effective and efficient: funding Primary Health Care systems; funding research in hopes of developing another magic bullet cure; or, funding both? And, what are the possible unintended consequences? Because there will be collateral damage, and the outcry of unwanted intervention and colonialism. For example, during the Ebola outbreak, which killed thousands, in West Africa, before the First World countries, decided it might be in their own best interest to develop a magic bullet vaccine to protect themselves—of course, the vaccine had to first undergo clinical trials in a lab setting, before being guaranteed safe for use. And, of course, there has to be a controlled study—those who receive the vaccine (and live) and those who receive placebos (and die).

As mentioned in Determining Global Health, by Farmer et al., medical history is essential to understand and predict the intended and unintended consequences of different global health interventions, and many attributes of medicine and public health are due to the unintended consequences of globalization.

 

Discussion Questions:

  1. To effectively treat diseases, does it make sense to go where the diseases exist? If there is resistance from the local population, what other methods could we use to eradicate these diseases?
  2. One or two hundred years from now, with all of the eradication campaigns and programs that are set up, do you think that most if not all diseases now existing in Africa will be eradicated? And why?

 

Course Readings:

Packard, Randall. “Malaria Dreams: Postwar Visions of Health and Development in the Third World.” Medical Anthropology . 17 (Sep 1997).: 279-296.

Paul Farmer, e. A. (2013). Reimagining Global Health An Introduction.

 

Outside Sources:

Kluger, Jeffrey. “Why West Africa Might Soon Have 100,000 More Measles Cases.” Time. Time, 12 Mar. 2015. Web. 17 Oct. 2015. <http://time.com/3742361/ebola-measles-alliance/>.

“Paul Ehrlich – Biographical”. Nobelprize.org. Nobel Media AB 2014. Web. 21 Oct 2015. <http://www.nobelprize.org/nobel_prizes/medicine/laureates/1908/ehrlich-bio.html>

 

32 thoughts on “AFRICA: A VICTIM OF THE BATTLE BETWEEN PRIMARY HEALTH CARE AND MAGIC BULLETS”

  1. Hi Claire,

    Thanks for your post. I liked how you framed this idea of a “financial magic bullet” within the scientific/biomedical magic bullets for specific diseases.

    I think you raised a lot of important questions. To answer your first discussion question, I agree that it makes sense to go where the diseases exist. I also believe that funding for research is very important but it seems to me like a lot of basic health problems (lack of clean water, safer sex and family planning resources, etc.) could be fixed or at least ameliorated without needing to spend more money on research for magic bullets. However, I think your Ebola example is a prime example of how influential the financial backing of the US can be in ultimate health outcomes. US government organizations, industries, and academia choosing to fund therapy research for certain diseases is a huge player in which diseases have better and cheaper therapy options years down the line.

    I also wanted to bring up the idea that there can be issues with the terms “First World” and “Third World” and the perceptions of different countries that come from labeling them as such. We talk about “othering” and I think this is a prime example of how it can be seen as though those of us in more developed countries need to help the “others” in these less desirable, “third world” countries. This could also manifest itself in how we frame resistance from local communities or ideas of noncompliance.

    1. Hi Methma,

      Thank you for you comment! I agree with you and think that you raised a very important point with the issues that come with using the terms “First World” and Third World”, especially with its contribution to the “White Savior effect”.

      You also brought up that we can fix a lot of basic health problems without needing more money for research and I was wondering: What you thought could be done to solve these problems?

  2. Hi Claire,
    Your article was very interesting. In response to your first question, I think it does make sense to try to eradicate or control a disease in the region it exists. This could be done in a variety of ways; using horizontal or vertical approaches. For example, a horizontal approach could be the implementation of clean water, sanitation, and greater access to nutritional foods. A vertical approach would instead target the specific disease. If there is resistance from the local populations, a couple of thing can be done. A first option would be to attempt to educate the society of your viewpoint and your goals in helping them. If this doesn’t work, another option would be instead to try to control the disease outside of that specific region. I don’t think coercion is a helpful answer in any situation. For example, in the case of the smallpox eradication campaign, coercion caused a deep distrust among the local communities of American health officials and health programs.

    1. Hi Sierra,

      Thank you for you comment! I agree that educating society on the specific viewpoint and goals of the program are very important to include and collaborate with the local population.

      I also think that your idea on an alternative by controlling the disease outside that specific region as well as taking the negative effects of coercion into account is great. What measures do you think could be implemented to control a disease using this method?

  3. Hi Claire,

    I enjoyed reading your post about primary health care and magic bullets. I was very interested to learn about the prevalence of measles in Africa–something I had heretofore been unaware of. Measles is definitely something I take for granted as not being present in my home country, and being generally avoidable, and so your example definitely brings to the forefront the issue of there still being many diseases that are relatively easy to eradicate, but are still bearing such a huge burden on certain regions of the world.

    I think that your initial anecdote about Ehrlich and the treatment of syphilis makes a good argument for the impact of vaccines on health. Vaccines have definitely been important in reducing the burden of certain diseases, as was the case with smallpox in India. At the same time, we also learned about McKeown’s hypothesis, stating that, for the most part, the improvements made in terms of prevalence of infectious diseases are more attributable to economic shifts rather than medicine or technological advancements.

    I appreciate the fact that you have given your own definition of magic bullets as “financial” magic bullets, that will effect change “in a positive way, with as little collateral damage as possible,” but I am unsure of how you would actually institute this idea as you mention no specifics of what this philosophy entails. Could you expand upon what you mean by this? Are you referring to providing fast access to funding for communities in developing countries? Or do you mean that these are financially feasible magic bullet interventions?

    In terms of your first discussion question, I agree with Methma and Sierra that we should go where these diseases are and look at all of the needs of the community — if there is a root cause to the prevalence of a disease, it would be better in the long-term to eliminate it than merely to vaccinate everyone. That may actually compromise the feasibility of the vaccine in the future due to mutations in the strains of disease. As impressive as certain magic bullet campaigns have been, how many have been completely successful and how much of that success has come at some cost to the agency or even health of local people?

    While it is a noble idea that “lives matter,” I wonder what that means in this context. As was the case in the Greenough article about smallpox, there are people with many other needs, people who are dying of everything from starvation to cancer, and so as much as we may improve the health outcomes for one disease by finding a “magic bullet” and making sure that every single person is vaccinated, they will still be dying of many other conditions, many of which are also easily treatable on an individual basis. How do we deal with the woman who is starving who refuses to be vaccinated until she is fed? How can we help the man with diabetes who is unable to take care of himself though he is now vaccinated against an infectious disease? These are questions I do not know how to answer, but are definitely ones that need to be addressed when considering the ethics of a technological “magic bullet” intervention versus a long-term horizontal plan that includes education and cultural sensitivity.

    1. Hi Zoë,

      Thank you for you comment, I am happy you enjoyed the post! I am sorry my definition of “financial” magic bullets was unclear. I wanted to use this term as a way to illustrate a miracle amount of money that would allow funding for any kind of health intervention or research for a medical magic bullet and that would provide fast access to funding for communities in developing countries. I hope this was a better explanation of what I meant by “financial” magic bullet.

      You raise an interesting point with the mutations and resistance that can arise by mass vaccinating everyone and how people do not think of the possible consequences of magic bullets. The questions you mention are also very insightful, as they were aspects that I had not though of when writing this blog. It is true that the dilemma of which disease to address first is very important and I definitely agree that the needs of the population should be a priority when setting up health interventions. What do you think are ways that we could integrate these questions into the development of global health initiatives?

  4. Hello Claire,
    I think you brought up a succinct point about how globalization can play into our concept of the “magic bullet.” In the so-called “our” world, we are often very ready to use “magic bullets” to attain biomedical success, such as in the case of syphilis or in development of new vaccines in response to recent outbreaks. But more than that, we can because we have this dual capability of simultaneously laying out preventive measures, such as educating the people through popular media or dispersing Ebola safety kits. The U.S. is in a position of financial power and thus, in a better position of successful health. We are not in an immediate war zone between “primary care” vs the “magic bullet” when it comes to infectious diseases. However, in developing countries, “magic bullets” are truly financial “magic bullets.” Direct medical interventions, though not sustainable, are the most efficacious way to treat a disease and intercept transmission at its source. This brings me to my question: are short-term financial “magic bullets” actually financially smart in the long term? How much longer can you keep financing the most immediate disease before you spent more than an alternative health systems-based approach might have cost you? Thus, in response to your first question, perhaps going to the place the disease exists isn’t enough. You need to understand why it exists.

    1. Hi Nikisha,

      Thank you for you comment! I think that you raise some interesting points when talking about the power and position the US health system and the role this plays when setting up medical health interventions

      Concerning your questions, I think that like any intervention, “financial” magic bullets can have some unintended consequences that make them not as efficient in the long run. I also think that these “financial” magic bullets are a good way to start reducing the problem to its minimum but definitely require a later horizontal approach in order to remain efficient; we cannot only rely on magic bullets. However, I would love to hear your thoughts and opinions on the questions you just raised. Do you think that there are other ways to tackle this problem?

      1. Hey Claire,
        Your thoughts on a financial magic bullet as a starting point is interesting. As I reflect back on our class discussions, we highlighted the idea that incentivizing a donor is crucial to gaining and sustaining foreign aid. Beyond that, direct initiatives allow the media to concentrate on a particular disease and potentially garner further support from the global populace (much like a “nail soup” situation). I personally sustain that perhaps this not the most efficient way to fiscally sustain global health systems; however, the desire to see value for ones’ money is inherent in a monetary exchange so it is futile to change this system. I would add that we need a “culturally-sensitive” financial bullet that gradually transitions into a horizontal approach of building health systems. If we must use a bullet as a kick start, it needs to be done with the intention of evolving and addressing social determinants of health.

  5. Hello Claire,

    Like Methma, I really liked the way in which you frame this idea of the ‘financial magic bullet’. However, the moment I think of a finance based intervention, it makes me apprehensive. I start thinking of the numerous cases in which development aid has fallen short of achieving its intended goals. How do you see a ‘financial magic bullet’ approach playing out?

    In response to your questions, I think disease needs to be tackled where it exists. One of the ways I feel resistance from local populations can be countered is by disguising the intervention in local practices of medicine as far as possible and getting local authorities involved in the dispensation of the intervention. I believe that this in combination with education and awareness is likely to help alleviate any resistance but of course, even this is not a perfect solution. In certain circumstances, I think using a discourse of fear may also help propel an intervention though I do not endorse the use of fear as a standalone feature.

    Looking forward, I feel that diseases that are prevalent in Africa are unlikely to be eradicated. I say this because I think that the kind of global hierarchies that exist today (developed and developing) are unlikely to change due to various factors. I know this sounds rather pessimistic but the stagnation of roles is evident at present and I don’t see this inertia being overcome anytime soon. Such hierarchies are at the heart of the complexity of global health interventions and need to be addressed before strides can be made towards making the world disease free.

    1. Hi Harsh,

      Thank you for you comment! I agree that setting up interventions in collaboration with local medical practices and getting local authorities involved are great ways to implement health programs without having resistance from local populations. Your mention of diseases in Africa being unlikely to be eradicated due to the imbedded global hierarchy and the stagnation of such roles was very insightful and covered an aspect of global hierarchy that I had not considered in the post. What do you think are ways by which we could reconstruct this hierarchy or how we can try to go around this issue in order to eradicate diseases?

      I also want to apologize for my unclear definition of “financial” magic bullet. I wanted to use this term as a way to illustrate a miracle amount of money that would allow funding for any kind of health intervention or research for a medical magic bullet and that would provide fast access to funding for communities in developing countries. I hope this was a better explanation of what I meant by “financial” magic bullet.

        1. Hi Claire!

          That’s one complex question. I don’t think I have an answer for it per se but I think what we read and discussed about Partners in Health and their approach to countering a health issue can be illuminating in this instance. While NGOs by themselves aren’t the answer to deconstructing global hierarchies or solving global health problem (as we read in the Zaidi article), I think they can play an important role in trying to circumvent power hierarchies.

          PIH tries to involve local and national governments in its initiatives and tries to give them agency. There are several reasons why this is important one of them being that this practice helps subvert the notion of a developed nation (or its representatives) solving the problems of a developing nation. Instead it induces a feeling of solidarity which I think is beneficial. After all, it is the people who are experiencing the problems who will know the problem inside out as for them the problem is a living reality and they have a better chance of identifying the root cause of the problem. Also, if an intervention is administered solely by a foreign agency, the likelihood of resistance to it increases.

          Also, thank you for clarifying the ‘financial’ magic bullet idea.

          1. Hi Claire!

            That’s one complex question. I don’t think I have an answer for it per se but I think what we read and discussed about Partners in Health and their approach to countering a health issue can be illuminating in this instance. While NGOs by themselves aren’t the answer to deconstructing global hierarchies or solving global health problem (as we read in the Zaidi article), I think they can play an important role in trying to circumvent power hierarchies.

            PIH tries to involve local and national governments in its initiatives and tries to give them agency. There are several reasons why this is important one of them being that this practice helps subvert the notion of a developed nation (or its representatives) solving the problems of a developing nation. Instead it induces a feeling of solidarity which I think is beneficial. After all, it is the people who are experiencing the problems who will know the problem inside out as for them the problem is a living reality and they have a better chance of identifying the root cause of the problem. Also, if an intervention is administered solely by a foreign agency, the likelihood of resistance to it increases.

            Thank you for clarifying the ‘financial’ magic bullet idea.

  6. Hello Claire,

    Your topic is very interesting and very controversial. It is a debate about the “haves” and “have- nots” and about indifference and overbearing when it comes to involvement in giving a helping hand.

    To answer both of your questions, here is my opinion:

    1. To effectively treat diseases, does it make sense to go where the diseases exist? If there is resistance from the local population, what other methods could we use to eradicate these diseases?
    2. One or two hundred years from now, with all of the eradication campaigns and programs that are set up, do you think that most if not all diseases now existing in Africa will be eradicated? And why?

    1. Yes, in order to eradicate or effectively treat a disease it is necessary to go where the problem exists. That is why they are called endemic areas because there are many features that exist in that location that facilitates the onset and spread of a particular illness, especially an infection, so they cannot be attacked remotely. It is conceivable that there is going to be resistance from the local community to intervention from strangers, which is why it is crucial to get the local community involved in such efforts right off the bat. Besides just providing medicines, educating the community about the nature of the problem, bringing awareness to the community about the tools that are available to them for prevention and cures, and providing resources to avail such tools are additional methods that need to be implemented in order to impact the community and make a difference.
    2. It is exhilarating to imagine a world without diseases be it in our lifetime or beyond. But based on the history and my own experience with malaria, such a dream is far-fetched. Granted, nothing is impossible but to answer your question realistically, it is a NO as of now. I would like to give you one example of malaria. I have been involved in malaria research for the past 4 years and have recognized the inherent capacity the parasites possess in developing resistance to new drugs at a pace much faster than scientists can produce new therapies. Besides that, there are many human elements that make it conducive for these parasites to thrive and spread the infection. Based on history it is acceptable to say that by the time we conquer one problem, ten others crop up, keeping the challenge going and the population somewhat at bay. This is the circle of life and the survival of the fittest. I would love to see at least some of preventable diseases eradicated from the face of this earth, particularly malaria as I have been working on malaria for the past few years now (www.mylaria.org)

    1. Hi Shreya,

      Thank you for your comment! I agree that the topic that I covered was somewhat controversial and that the debate between the “Haves” and the “Have-nots” needs to be taken into consideration in the implementation of health interventions. What do you think are ways that I could have integrated this debate in the context on my post?

      I also found your personal experience with Malaria very interesting and this really helped me understand your point of view on the possibility to eradicate diseases. Given your experience and your research in malaria, do you think that there is a better way to tackle these problems as a whole (maybe?) and to prevent the appearance of 10 new problems once we have fixed one?

  7. Hi Claire,
    I enjoyed your post on magic bullets and thought you brought up a lot of important points about the benefits of implementing magic bullets in undeveloped countries. You mentioned that magic bullets are important because they save lives and all lives matter. However, I think there is a danger in implementing magic bullets because of the hierarchy of who provides them and who they get distributed to. It is developed countries that find these magic bullets and then provide the to lower income countries. This creates an issue of paternalism, as it is the high income countries that get to decide how their resources are distributed. Since, they hold the magic bullet power, they will decide who will live and who will die.

    In response to your second question, in two hundred years I don’t think that all the diseases in Africa will be eradicated, even with all the eradication campaigns. I believe that the root of the problem, when it comes to diseases in the developing world is how much poverty and inequality is tied to illness. Without addressing these social issues, it is difficult to completely eradicate the diseases that will be perpetuated by lack of access to clean water, improper nutrition, etc. In addition, many of the diseases found in impoverished parts of Africa are ignored by the eradication campaigns (created by the developed countries). As noted by farmer diseases that are thought to be “emerging” are not in fact emerging but merely being noticed by people of higher socio-economic status. The poor have always been living with these conditions, but the rest of the world has ignored it because it is no longer an issue where they are living. Thus, without addressing the socio-political factors of disease full eradication in Africa seems nearly impossible.

    1. Hi Silvia,

      Thank you for your comment! I think that you raise an interesting point with paternalism and the dangers of implementing magic bullets with the present hierarchy. It is true that because developed countries take their stable health system for granted, the way they implement magic bullets will be highly influenced by their view of what the population needs instead of asking the local community directly.

      You also raise an important point of how poverty and inequality are essential in the process of eradicating diseases. What do you think are ways in which we can address and incorporate socio-political factors of diseases into the set up of health interventions?

  8. Hi Claire, thank you for your insights on primary health care and magic bullets. I enjoyed reading about your perspective on the economic implications of the “magic bullets.” It was a new angle that I had not thought about before.

    In regards to your first question, I am wary of the idea of “going where the disease exists,” simply because it seems rather invasive. The problem with vertical intervention efforts is that it involves a group of people coming in to singularly target a disease, rather than learning and addressing the needs of the community. Take the small pox initiative for instance, which eradicated small pox, but enforced suspicion and fear among local communities and breached human standards of ethics. It is problematic to use the word “resistance,” because it refers to local individuals as “non-compliant” rather than people with their own thoughts, opinions and values. The example of the woman who asked for food in exchange for taking the small pox vaccine reflects a lack of understanding on our part. We assume that our magic bullet cures will “save” other populations without trying to understand the context in which local people live. If the population does not want any help or intervention, then perhaps it is best to talk to local community leaders and individuals to best understand the needs and wants of the population and then reassess the project’s goals.

    In regards to your second question, I do not think that these current diseases will ever be completely eradicated. New strains of current viruses could potential emerge. Even if we take the best health care systems in our world today, we can still find problems in their delivery. I do think, however, that investing in campaigns in programs is essential to preserving human dignity and hope. As humans, we must do all in our power to preserve the quality of life of our fellow citizens. It may also be problematic to refer to Africa as one entity, due to the wide differences between its countries. AIDS is highly prevalent in South Africa but less so in Mozambique. Ultimately, I would hope that a hundred years from now, we would see a similar transition as to what the developed world has gone through in the past hundred years.

    1. Hi Divya,

      Thank you for your comment; I am happy you enjoyed the post! I agree that vertical approaches can be very invasive, especially if done without the collaboration of the local populations, and that developed countries often see magic bullets as the cure for everyone. I think that, as you said, it is very important to prioritize the needs of the community. However, what do you think are alternatives to eradication and vertical approaches in the context of global health (for the greater good of both developed and developing countries)?

      You also raise an interesting idea of using campaigns and programs to raise awareness on the current issues of developing countries. Media and campaigns are usually very efficient ways to put the spotlight on current problems and to make the general public of developed countries more aware of what is happening on the other side of the world. Do you think that this mean of transmission can ultimately cause a big change in the way we are eradicating diseases (increase funding or more public action or awareness)?

  9. Hi Claire,

    In response to your first question, I think it makes sense to go where the disease exists. If dealing with a specific medication, is important to actually test the medication before publicly distributing it. However I do not think there is anything wrong with testing the medication on consenting individuals for whom this medication may be their only chance. What better place to find these individuals than in an area were the disease has high prevalence rates?

    Ethical implications also come into consideration when looking at emergency situations. If a disease is immediately killing people in a community, I would think it almost unethical not to go there and try to do something, especially if you have a potential “magic bullet”.

    When it comes to any foreign medical intervention, resistance from the local community is definitely something to take into account. I think a lot of resistance often comes from miscommunication and cultural barriers. To relieve this I think conservations informing the involved communities would be a good place to start. I realize this solution almost seems too simple but I am often surprised by the lack of communication. I think it is a simple measure that goes far. Especially if you have local individuals help mediate the barrier between resistant individuals.

    1. Hi Derana,

      Thank you for your comment! I agree that resistance from the local population can be due to miscommunication and cultural barriers, and think that your idea of using conservations to increase communication and inform the population is great.

      I also think that your idea on ethical implications is also an important aspect to take into account in these emergency situations. However, as we have seen in class, biopharmaceutical companies often take advantage of crises in developing counties to test their drugs in, sometimes, unethical ways (not using the minimum level of drug needed for their control group). What measures do you think could be implemented to make sure that we are using these magic bullets to help people in need, but at the same time, that the ethical rules or research are respected?

      1. Hi Derana and Claire,
        I hope it’s okay that I’m jumping into this discussion!

        Derana, I agree with you that there are ethical implications that we must consider in global health, but I also wonder why these implications are often reserved in the case of “emergency situations” — like we discussed in class, what is an emergency/what is a state of normalcy? And, like Claire said, how do we make sure that pharmaceutical companies aren’t exploiting the local populations by testing their drugs/magic bullets? Even if the local citizens do not have access to other care, is it still ethical to bring in a POTENTIAL cure especially when informed consent may not be possible? (I’d argue that consent is actually engineered in this case because in the relationship between a company and a person looking for some type of help, the company holds the most power.)

        1. Hi Nini!

          Thank you for participating in this discussion! You are totally welcome here!

          I agree with you in that it can be very difficult to decide what an emergency situation is, since each culture and population will perceive a situation differently and what can be seen as an emergency in developed countries can be seen as a state of normalcy in developing countries. Moreover, I think that this could tie in with our debate with corporate responsibility where, like Nini says, they engineer consent in a ways that people do not realize that they are being exploited.

          For now, I think that the only way to make sure that pharmaceutical companies aren’t exploiting the local populations by testing their drugs would be by increasing regulations from the country receiving the drugs as well as the country providing the drug, and by mediatizing the drug distribution to make these companies more accountable for the possible consequences of their trials.

  10. Hi Claire!
    I thought you had a really good post and brought up some really interesting questions that deal with relevant issues in the world today such as Ebola.
    You mention that First World countries should intervene in social structures, politics, and medical practices. This reminded me of the McKeown Hypothesis, and how he argued that the epidemiological transition in the 1930’s (in the US) was not due to the medical interventions, but rather the rise in the standard of living, improvements in hygiene, and better health. Do you think that this is true? Or do you think we need a little bit of both? Personally, I think we need both, but should not rely on medicines to solve our problems. I believe that medicines solve problems at an individual, but are not sustainable in the long run.
    To answer your first question, I think that it does make sense to attack the problem at its source. We often have this view of “them” vs. “us,” but I think it’s important that the diseases “they” have can easily spread and come to “us.”
    To answer your second question, I think that it is hard to say that all diseases will be eradicated as most magic bullets have proven to have failed besides the eradication of smallpox. I very much agree with McKeown’s Hypothesis in that we need to improve the standard of living, hygiene, and health of individuals in developing countries in order to reduce the diseases in these countries.

    1. Hi Samantha,

      Thank you for your comment! I think that you raise an interesting point with the McKeown hypothesis. I do agree with you that in order to get a health impact on a population-level, we need to improve sanitation, hygiene and standards of living. As you mentioned, medication can have an impact but mainly at an individual level and it cannot make a big change in an entire population’s epidemiological transition.

      You also raise an important point of how improving sanitation, hygiene and standards of living are key to reduce diseases in developing countries. I entirely agree with you in that although medical Magic bullets can cure many individuals, it can only go so far in the process of eradicating a disease, and that prevention and increasing standards of living are needed to complement these magic bullets to eradicate diseases.

      1. Hi Claire!

        Thank you for your response.

        When do you think that magic bullets are most useful? Are they useful? Are there any ways in which we could increase their rate of success?

        1. Hi Samantha,

          I do think that Magic bullets can be useful in a context of disease eradication. Although, as we have seen through the failure of the Malaria eradication campaign, that magic bullets are not always successful, I think that disease eradication can be very efficient if the magic bullet is paired with a more horizontal approach with prevention, increasing standard of life …

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