Not only do passengers worry about the safety of the plane, but now they have the paranoia that another passenger could infect them with a deadly virus. In case you have not heard, planes are not entirely safe. With the plane crash in New York a couple of weeks ago, air safety has once again been questioned. Though the airplane industry has reassured the public that the actual aircraft was not at fault and that there was really nothing that the company could have done to protect its passengers better, the fear has spread.
However, the safety of the airplane is not just about the physical structure of the plane. The spread of disease is another factor that can easily endanger the other passengers and thus merits close attention. In 1994, a 32-year old woman traveled on four different planes while infected with Tuberculosis. During her trip, she endangered over 1042 passengers. Her timely death prevented punishment for this act.
Let’s just think for a moment. What would have happened if she had been alive long enough to endure possible punishment? Would she have gone about infecting others? We have no idea, but the fact remains: air travel is a serious matter.
In fact, “Domestic air travel in the United States increased by 62 percent from 1980 through 1993 — from 275 million to 445 million passengers per year. Air travel from foreign countries to the United States increased by 182 percent, from 12.6 million passenger arrivals during 1975 to 35.5 million in 1991. The projections of the World Health Organization for the worldwide tuberculosis epidemic include 90 million new cases during the present decade. Increased air travel, the presence of tuberculosis worldwide, and immigration to the United States from countries with high rates of tuberculosis increase the probability that passengers on commercial aircraft will be exposed to persons with tuberculosis.” These were the numbers in 1993, image the numbers today.
The story of the 32 year old woman is nothing new. In fact, “the CDC received unsolicited reports of another 30 airline passengers with tuberculosis, including 10 whose diagnosis was already known at the time of travel, who were on commercial flights from July through December 1994.”
Next time you think about traveling, think again.
Monday, January 26, 2009
Sunday, January 25, 2009
TB is Not Alone
Tuberculosis is not on the only global infectious disease that merits attention. In fact, almost all disease that can be transmitted should be looked at. These diseases range from TB, AIDS, Avian Flu, and even, the flu. Why should any individual endanger another?
The flu is an infectious disease from which we cannot seem to break away. Each “flu season,” people rush in to get their shots to protect themselves against this deadly outbreak. In response to this, “the White House released the Implementation Plan for the National Strategy for Pandemic Influenza, which reiterates the importance of state and local preparedness; clarifies roles and responsibilities; and includes information, guidance, and recommendations for preparedness. While preparedness may seem largely a public health responsibility, law enforcement has a very critical role in the response to these incidents.”
This brings about a new question. What is the role of the government in deadly outbreaks? There are two types of outbreaks: manmade and naturally occurring. Though the flu is often considered to be naturally occurring, other infectious diseases do not land neatly in a specific category. On the one hand, if someone infects another person without any preconceived notion of causing harm to the individual, most likely the spread would fall into the naturally occurring category. If, on the other hand, a patient willingly knows the risks and goes about infecting another individual, then the spread is considered to be manmade.
Regardless of the type of outbreak, law enforcement officers often go about the situation in a similar manner. They may go about it by “enforcing public health orders (e.g., quarantines or travel restrictions), securing the perimeter of contaminated areas, securing health care facilities, controlling crowds, investigating scenes of suspected biological terrorism, and protecting national stockpiles of vaccines or other medicines.”
In most cases, people who are aware of the spread of a potentially dangerous pandemic often try to leave the infected area. However, what happens when they can’t leave? “Approximately 1.7 million people are housed in correctional facilities in the United States, many of whom have numerous health problems. Our nation's criminal justice system is in real danger of facing a public health crisis as a result of excessive disease and substance abuse in the inmate population. Studies clearly show that the incarcerated population is disproportionately affected by HIV/AIDS, sexually transmitted diseases (STDs), tuberculosis (TB) and other diseases.” Though the CDC, the Center for Disease Control, is trying to improve the health of these inmates, they are not often successful. “Because the identification and reporting of suspected or confirmed cases of disease among incarcerated populations is slow, incomplete or insufficient, it becomes difficult to develop a meaningful public health response or controlled effort to protect the community at-large.”
The world is a scary place. Despite efforts to protect others from the spread of infectious diseases, no human can guarantee that the risks are nonexistent.
The flu is an infectious disease from which we cannot seem to break away. Each “flu season,” people rush in to get their shots to protect themselves against this deadly outbreak. In response to this, “the White House released the Implementation Plan for the National Strategy for Pandemic Influenza, which reiterates the importance of state and local preparedness; clarifies roles and responsibilities; and includes information, guidance, and recommendations for preparedness. While preparedness may seem largely a public health responsibility, law enforcement has a very critical role in the response to these incidents.”
This brings about a new question. What is the role of the government in deadly outbreaks? There are two types of outbreaks: manmade and naturally occurring. Though the flu is often considered to be naturally occurring, other infectious diseases do not land neatly in a specific category. On the one hand, if someone infects another person without any preconceived notion of causing harm to the individual, most likely the spread would fall into the naturally occurring category. If, on the other hand, a patient willingly knows the risks and goes about infecting another individual, then the spread is considered to be manmade.
Regardless of the type of outbreak, law enforcement officers often go about the situation in a similar manner. They may go about it by “enforcing public health orders (e.g., quarantines or travel restrictions), securing the perimeter of contaminated areas, securing health care facilities, controlling crowds, investigating scenes of suspected biological terrorism, and protecting national stockpiles of vaccines or other medicines.”
In most cases, people who are aware of the spread of a potentially dangerous pandemic often try to leave the infected area. However, what happens when they can’t leave? “Approximately 1.7 million people are housed in correctional facilities in the United States, many of whom have numerous health problems. Our nation's criminal justice system is in real danger of facing a public health crisis as a result of excessive disease and substance abuse in the inmate population. Studies clearly show that the incarcerated population is disproportionately affected by HIV/AIDS, sexually transmitted diseases (STDs), tuberculosis (TB) and other diseases.” Though the CDC, the Center for Disease Control, is trying to improve the health of these inmates, they are not often successful. “Because the identification and reporting of suspected or confirmed cases of disease among incarcerated populations is slow, incomplete or insufficient, it becomes difficult to develop a meaningful public health response or controlled effort to protect the community at-large.”
The world is a scary place. Despite efforts to protect others from the spread of infectious diseases, no human can guarantee that the risks are nonexistent.
Tuesday, January 20, 2009
Mimicking Globalization
The debate continues. Whether globalization is good or bad continues to intrigue many historians, especially John Micklethwait, Adrian Wooldridge, Amartya Sen, and John Gray. These historians remain divided, refusing to come to agreements, almost like nations refusing to accept the force of globalization. Despite their differences, all of these authors seem to agree that globalization is neither entirely good nor entirely bad.
John Micklethwait and Adrian Wooldridge focus mainly on portraying a positive outlook on globalization. In “Hidden Promise: Liberty Renewed,” they claim that “restricting overmighty states and elites is all very well, but globalization increases the basic freedom of individuals as well…Globalization is helping to give birth to an economy that is closer to the classic theoretical model of capitalism, under which rational individuals pursue their interests in the light of perfect information, relatively free from government and geographical obstacles.” To them, people have more freedom because of globalization. Even more importantly, they see the main benefit of globalization as a creator. “It is also helping to create a society that is closer to the model that liberal political theorists once imagined, in which power lies increasingly in the hands of individuals rather than government, and in which people are free, within reasonable bounds, to pursue the good life wherever they find it. (17)” However, they do acknowledge that this system does not often provide those who benefit the most with the loudest voices. In fact, it is often the case that the opponents of globalization express their discontent more convincingly than the supporters. Thus, globalization has not yet achieved its ultimate success.
Amartya Sen also sees globalization through a similar pair of eyes. He wrote "How to Judge Globalism." While he strongly believes that globalization is a positive development, he explains that the lack of understanding as to the real globalization has weakened its effects. One of his main arguments is that globalization is not synonymous with the West. He explains that “over thousands of years, globalization has contributed to the progress of the world through travel, trade, migration, spread of cultural influences, and dissemination of knowledge and understanding… They have not necessarily taken the form of increased Western influence. Indeed, the active agents of globalization have often been located far from the West. (19)” The author goes further by saying that “to see globalization as merely Western imperialism of ideas and believes (as the rhetoric often suggests) would be a serious and costly error, in the same way that any European resistance to Eastern influence would have been at the beginning of the last millennium (21).” Globalization is misunderstood. These misconceptions have helped carve the way to even more crucial areas. People often go about the issue of poverty in the wrong way. Rarely do people ask about the “distribution of gloablization’s benefits (22).” Instead, they often compare the amount of wealth of a given group, which is the wrong way to go about the discussion. Like the other historians, Sen also acknowledges that the global situation needs to be improved. “Global capitalism is much more concerned with expanding the domainof market relations than with, say, establishing democracy, expanding elementary education, enhancing the social opportunities of society’s underdogs (24).” Thus, despite the success of globalization, there is still room for improvement, according to Sen.
John Gray, the author of “From the Great Transformation to the Global Free Market,” represents the opponents of globalization. According to him, globalization works against the Free-market, a system that is prized in the US and other areas of the world. He claims that “economic globalization… actually threatens the stability of the single global market that is being constructed by American-led transnational organizations (28).” He goes further by saying that “no reformist programme today has a chance of success unless it understands that many of the changes produced, accelerated or reinforced by New Right policies are irreversible (29).” Essentially, it is impossible to return to the way things initially were or were intended to be. While he does acknowledge that for a brief moment, the problems from globalization may remain hidden, they soon become apparent. Globalization creates “instability.”
John Micklethwait and Adrian Wooldridge focus mainly on portraying a positive outlook on globalization. In “Hidden Promise: Liberty Renewed,” they claim that “restricting overmighty states and elites is all very well, but globalization increases the basic freedom of individuals as well…Globalization is helping to give birth to an economy that is closer to the classic theoretical model of capitalism, under which rational individuals pursue their interests in the light of perfect information, relatively free from government and geographical obstacles.” To them, people have more freedom because of globalization. Even more importantly, they see the main benefit of globalization as a creator. “It is also helping to create a society that is closer to the model that liberal political theorists once imagined, in which power lies increasingly in the hands of individuals rather than government, and in which people are free, within reasonable bounds, to pursue the good life wherever they find it. (17)” However, they do acknowledge that this system does not often provide those who benefit the most with the loudest voices. In fact, it is often the case that the opponents of globalization express their discontent more convincingly than the supporters. Thus, globalization has not yet achieved its ultimate success.
Amartya Sen also sees globalization through a similar pair of eyes. He wrote "How to Judge Globalism." While he strongly believes that globalization is a positive development, he explains that the lack of understanding as to the real globalization has weakened its effects. One of his main arguments is that globalization is not synonymous with the West. He explains that “over thousands of years, globalization has contributed to the progress of the world through travel, trade, migration, spread of cultural influences, and dissemination of knowledge and understanding… They have not necessarily taken the form of increased Western influence. Indeed, the active agents of globalization have often been located far from the West. (19)” The author goes further by saying that “to see globalization as merely Western imperialism of ideas and believes (as the rhetoric often suggests) would be a serious and costly error, in the same way that any European resistance to Eastern influence would have been at the beginning of the last millennium (21).” Globalization is misunderstood. These misconceptions have helped carve the way to even more crucial areas. People often go about the issue of poverty in the wrong way. Rarely do people ask about the “distribution of gloablization’s benefits (22).” Instead, they often compare the amount of wealth of a given group, which is the wrong way to go about the discussion. Like the other historians, Sen also acknowledges that the global situation needs to be improved. “Global capitalism is much more concerned with expanding the domainof market relations than with, say, establishing democracy, expanding elementary education, enhancing the social opportunities of society’s underdogs (24).” Thus, despite the success of globalization, there is still room for improvement, according to Sen.
John Gray, the author of “From the Great Transformation to the Global Free Market,” represents the opponents of globalization. According to him, globalization works against the Free-market, a system that is prized in the US and other areas of the world. He claims that “economic globalization… actually threatens the stability of the single global market that is being constructed by American-led transnational organizations (28).” He goes further by saying that “no reformist programme today has a chance of success unless it understands that many of the changes produced, accelerated or reinforced by New Right policies are irreversible (29).” Essentially, it is impossible to return to the way things initially were or were intended to be. While he does acknowledge that for a brief moment, the problems from globalization may remain hidden, they soon become apparent. Globalization creates “instability.”
Thursday, January 15, 2009
Is globalization really increasing the spread of Tuberculosis? In many regards, the answer is yes. Before I elaborate, keep this in mind: it is very difficult for a patient to infect a bystander. A person must have a prolonged period of exposure for the virus to even be spread. Regardless of this fact, transmission is always a possibility and always seems to at least spread fear.
Fear was definitely plaguing many students who attend IPFW, a school in Fort Wayne, when a commuter student was supposedly diagnosed with “an active case of tuberculosis” on Monday, January 12, 2009. Though the vice chancellor of the school, William McKinney, assured the students and the faculty that transmission of the disease was highly unlikely, many students believed the unlikely. They feared that, despite the odds, they might be infected.
Why the fear? Sure there is a slight possibility that the classmates could have contracted the disease. Maybe some of them did. However, what is truly interesting is that so many people resorted to fear. This shows that few of the students actually knew a lot about TB. Why is this?
In order to help raise awareness, Hillary Clinton plans to devote more attention to the relationship between this disease and HIV and AIDS. In the words of Diane V. Havlir, a reporter for the San Francisco Chronicle, “there is a deadly synergy between HIV and TB. TB is the major cause of death among persons living with HIV. Further, TB can spread easily, from a cough or a sneeze or by breathing in the exhaled air from a TB-infected individual, and too many HIV patients may be acquiring tuberculosis as they sit in health clinic waiting rooms…At least one-third of the 33.2 million people living with HIV worldwide are carrying TB and have up to a 15 percent risk of developing active TB disease every year. Inadequate TB-control programs jeopardize success of these efforts, and fail to prevent the emergence of drug-resistant TB. Drug-resistant TB strains produce high death rates, especially among persons already infected with HIV.”
Despite the grim case stories about the disease, the US is actually faring pretty well. According to Havlir, the 2008 year ended with the fewest cases of TB reported since the tracking of the disease began. Other parts of the world, however, have yet to experience such positive statistics.
Fear was definitely plaguing many students who attend IPFW, a school in Fort Wayne, when a commuter student was supposedly diagnosed with “an active case of tuberculosis” on Monday, January 12, 2009. Though the vice chancellor of the school, William McKinney, assured the students and the faculty that transmission of the disease was highly unlikely, many students believed the unlikely. They feared that, despite the odds, they might be infected.
Why the fear? Sure there is a slight possibility that the classmates could have contracted the disease. Maybe some of them did. However, what is truly interesting is that so many people resorted to fear. This shows that few of the students actually knew a lot about TB. Why is this?
In order to help raise awareness, Hillary Clinton plans to devote more attention to the relationship between this disease and HIV and AIDS. In the words of Diane V. Havlir, a reporter for the San Francisco Chronicle, “there is a deadly synergy between HIV and TB. TB is the major cause of death among persons living with HIV. Further, TB can spread easily, from a cough or a sneeze or by breathing in the exhaled air from a TB-infected individual, and too many HIV patients may be acquiring tuberculosis as they sit in health clinic waiting rooms…At least one-third of the 33.2 million people living with HIV worldwide are carrying TB and have up to a 15 percent risk of developing active TB disease every year. Inadequate TB-control programs jeopardize success of these efforts, and fail to prevent the emergence of drug-resistant TB. Drug-resistant TB strains produce high death rates, especially among persons already infected with HIV.”
Despite the grim case stories about the disease, the US is actually faring pretty well. According to Havlir, the 2008 year ended with the fewest cases of TB reported since the tracking of the disease began. Other parts of the world, however, have yet to experience such positive statistics.
Wednesday, January 14, 2009
A Worldwide Pandemic
I’ve touched on the ethics behind TB and described various case studies regarding TB, however, I have not gone into much detail about TB itself. Now seems like the perfect time to do so.
According to the World Health Organization, also called the WHO, “Tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.” At the beginning of 2007, approximately 2 billion people, especially in Asia, were infected with the TB bacilli, which is the microbes that cause TB. That consisted about 1/3 of the world’s population. One out of every ten of those people infected in the TB bacilli will become sick with the active form of the virus. The patients who do not receive treatment generally infect approximately ten to fifteen people per year. Those who have HIV are at an even higher risk of contracting this infectious disease. Even scarier, in 2005, 1.6 million people died from TB. This is approximately 4400 deaths per day. Undeniably, Tuberculosis is a worldwide pandemic.
What’s next? Scientists are working hard to develop a cure. However, according to the WHO, “Multidrug-resistant TB (MDR-TB) is a form of TB that does not respond to the standard treatments using first-line drugs. MDR-TB is present in virtually all countries recently surveyed by WHO and its partners.” Despite this discouraging fact, the WHO continues to work towards meeting its goal of reducing the prevalence of and deaths due to TB by half by 2015. In order to fight this, these leaders are following a plan called The Global Plan to Stop TB. “The strategy emphasizes the need for proper health systems and the importance of effective primary health care to address the TB epidemic.”
According to the World Health Organization, also called the WHO, “Tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.” At the beginning of 2007, approximately 2 billion people, especially in Asia, were infected with the TB bacilli, which is the microbes that cause TB. That consisted about 1/3 of the world’s population. One out of every ten of those people infected in the TB bacilli will become sick with the active form of the virus. The patients who do not receive treatment generally infect approximately ten to fifteen people per year. Those who have HIV are at an even higher risk of contracting this infectious disease. Even scarier, in 2005, 1.6 million people died from TB. This is approximately 4400 deaths per day. Undeniably, Tuberculosis is a worldwide pandemic.
What’s next? Scientists are working hard to develop a cure. However, according to the WHO, “Multidrug-resistant TB (MDR-TB) is a form of TB that does not respond to the standard treatments using first-line drugs. MDR-TB is present in virtually all countries recently surveyed by WHO and its partners.” Despite this discouraging fact, the WHO continues to work towards meeting its goal of reducing the prevalence of and deaths due to TB by half by 2015. In order to fight this, these leaders are following a plan called The Global Plan to Stop TB. “The strategy emphasizes the need for proper health systems and the importance of effective primary health care to address the TB epidemic.”
Monday, January 12, 2009
When Prison Fails
Aren’t prisons supposed to protect people from the criminals? Well, this does not appear to be the case in a San Diego juvenile detention facility. An 18 year old man, a prisoner, is supposed to be infected with TB. During his stay, he potentially infected over 300 people.
This is not the first time a person has passed on TB while being an inmate in a local jail. Rajesh Nikam, a man convicted of an attempt to culpable homicide, actually died of TB during his sentence. Though he was transferred to a better facility to manage his disease, who knows how many people he infected.
Being in jail simply makes matters worse. Prisoners are often confined to cramped spaces and are kept in close proximity to each other for very, very long periods of time. Similarly, jails are not known for their hygiene. This makes it even easier to spread the disease.
Thankfully, generally, most of the people who are exposed to this disease do not become infected. Nevertheless, it raises many questions. What would have happened if a prisoner does infected many people? Would he be sentenced to life? Who is at fault? Is it the prisoner? What about the prison itself? Shouldn’t they have maintained better supervision over the health of the inmates?
Thursday, January 8, 2009
TB for the Poor
While TB is not often the topic of discussion in many richer countries, it is for the poorer ones. In Tajikistan the death toll from TB has continued to rise over the years. Despite this general agreement that Tajikistan’s present plague is TB, no one can reach a consensus as to what the actual percentage of the population is contaminated. The WHO, the World Health Organization, claims that there were 204 cases per 100,000 people of people infected with TB in 2006 alone. On the other hand, the Tajik health ministry claims that there were only 75 new cases in 2006. Whether the actual toll is 204/100,000 people or 75, who knows. What we do know is any of those numbers is too high, especially because richer countries do not seem to have such high numbers.
One of the main reasons why TB is so common in areas like Tajikistan is because this country is poor. Impoverished countries have few of the necessary resources to control the outbreaks. There is poor sanitation, few drugs, not enough clean food and poor health care standards. In fact, the Who claims that the Tajik government spends less than $100 per person on healthcare. Making problems even worse, few civilians have the opportunity to become educated about the disease. Consequently, few are aware of the ways in which the disease is spread. This means that the vicious cycle continues. There is little hope, unless something drastic happens to change their predicament.
For more info, go to http://news.bbc.co.uk/2/hi/asia-pacific/7773139.stm
Wednesday, January 7, 2009
The Preliminaries
The effects, whether they be assets or nuisances, of globalization often waddle their way into the discussions of many. Regardless of whether or not globalization is actually good for the globe has yet to be proven, the fact remains: globalization changes the standards.
Zakaria, the author of “The Rise of the Rest,” explains how the US has had to adjust to the changes brought upon by globalization. He stresses that the reason for which the US is so glum is because “Americans see that a new world is coming into being, but fear it is one being shaped in distant lands and by foreign people.” The fear of no longer being the center is ever scarier now that it is no longer just about being the best of the local community, but the entire globe. He also explains that with globalization, everything travel more quickly. Events, like news and wars, are “amplified, echoed, and disseminated.” Everything changes because of globalization.
Mahubabani, the author of “The Case Against the West,” believes the West has not handled its responsibility as a global leader appropriately. He believes that “the West assumes that it is the source of the solutions to the world’s key problems. In fact, however, the West is also a major source of these problems.” Although Mahbubani acknowledges that the West has been the global leader for quite some time, it fails to understand its role in globalization.
Similarly, Tony Judt, the author of “What Have We Learned, If Anything?” insists that the US’s stance in global affairs has provided this country with the power to readjust the ethics behind torture. With globalization changing the impact of terrorism, many leaders in the US, especially, have tried to justify the use of torture. For example, Charles Schumer, a Democrat, believes that “few people…[believe] that torture should never ever be used.” Thus, because of globalization, principles, like that regarding torture, need to be adjusted.
This leads to another topic of discussion. If the standards for principles like terrorism have changed, what about that for infectious diseases? What about TB? What makes TB such a health threat is that it is not only contagious, but it spreads through the air. So when infected individuals cough, sneeze, spit or even just talk, they're spreading the bacteria. Other people become infected when they breathe in the now airborne bacteria. As more and more people start to travel, the spread of Tuberculosis should lead to new ethical questions. Should people who spread the disease be held accountable for their actions? Are they criminals? Should they be tried with 1st degree murder? What steps should we take to prevent the spread? The list of questions goes on. Already the effects are seen across the globe. In Quebec, a man was put into jail for refusing to get treatment.
Zakaria, the author of “The Rise of the Rest,” explains how the US has had to adjust to the changes brought upon by globalization. He stresses that the reason for which the US is so glum is because “Americans see that a new world is coming into being, but fear it is one being shaped in distant lands and by foreign people.” The fear of no longer being the center is ever scarier now that it is no longer just about being the best of the local community, but the entire globe. He also explains that with globalization, everything travel more quickly. Events, like news and wars, are “amplified, echoed, and disseminated.” Everything changes because of globalization.
Mahubabani, the author of “The Case Against the West,” believes the West has not handled its responsibility as a global leader appropriately. He believes that “the West assumes that it is the source of the solutions to the world’s key problems. In fact, however, the West is also a major source of these problems.” Although Mahbubani acknowledges that the West has been the global leader for quite some time, it fails to understand its role in globalization.
Similarly, Tony Judt, the author of “What Have We Learned, If Anything?” insists that the US’s stance in global affairs has provided this country with the power to readjust the ethics behind torture. With globalization changing the impact of terrorism, many leaders in the US, especially, have tried to justify the use of torture. For example, Charles Schumer, a Democrat, believes that “few people…[believe] that torture should never ever be used.” Thus, because of globalization, principles, like that regarding torture, need to be adjusted.
This leads to another topic of discussion. If the standards for principles like terrorism have changed, what about that for infectious diseases? What about TB? What makes TB such a health threat is that it is not only contagious, but it spreads through the air. So when infected individuals cough, sneeze, spit or even just talk, they're spreading the bacteria. Other people become infected when they breathe in the now airborne bacteria. As more and more people start to travel, the spread of Tuberculosis should lead to new ethical questions. Should people who spread the disease be held accountable for their actions? Are they criminals? Should they be tried with 1st degree murder? What steps should we take to prevent the spread? The list of questions goes on. Already the effects are seen across the globe. In Quebec, a man was put into jail for refusing to get treatment.
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