Diseases and Cures Travel the Globe

Relatives and teachers need to keep up with findings about diseases in order to protect children. On the other hand, older students can begin to see career opportunities for themselves in medical and medical-related fields, including in the area of bioethics.

Tropical Diseases

Africa is breaking the grip of tropical diseases thanks to a coalition of aid agencies, pharmaceutical companies, and charities that formed Uniting to Combat Neglected Tropical Diseases (NTDS). Health programs in individual countries and radio programs where experts and patients answer questions about treatments and dispel misconceptions also do their part.
     In Sierra Leone, for example, a country once ravished by Ebola, health workers visit villages once a year to provide everyone at risk with drugs for four diseases:

• Elephantiases (lymphatic filariasis). Microscopic worms infest the body and cause extreme irreversible swelling and damage.
• River blindness (onchocerciasis). Blindness caused by black fly bites and worms infecting the body.
• Snail fever (schistosomiasis). Parasitic worm infection that destroys kidneys and the liver.
• (Helminths) Roundworms in soil cause infections that stunt growth and physical development.

By treating all family members with all four drugs at once, Sierra Leone saves money on multiple visits and prevents families from passing diseases to one another.

     Mosquitoes continue to be the ones that transmit malaria, dengue fever, and Zika in tropical areas. In warm, wet weather, they mature faster and become infectious sooner. But even in warm, dry conditions, they find ways to survive underground in storm drains and sewers. In Singapore on a small scale, Trendwatching.com reports innovative pots, decorated with paint infused with the non-toxic mosquito repellent, permethrin, are used to kill mosquitoes trying to survive in water collected in plant pots. (Use keywords, mosquitoes, malaria, dengue, and Zika, to find earlier posts on these subjects.)

Polio

News that polio is staging a comeback in some parts of the world recalls disturbing memories from my childhood. Paralysis from polio required President Franklin Roosevelt to wear leg braces, a neighbor to live in an iron lung, and a playmate to compensate for her withered left arm. When Jonas Salk's polio vaccine became available in the 1960s, we all rushed to take it on sugar cubes.
     Normally, the polio vaccine that carries a live, weakened virus breeds in the recipient's intestines and enters the bloodstream to cause a lifelong protective immune response. But occasionally, once in every 17 million vaccinations, the weakened virus mutates and causes a new strain that can live in poop for six to eight weeks following an innoculation. In countries that lack clean water, adequate toilets, and treatment for sewage, polio is transmitted by drinking water carrying the mutated virus. That seems to be what has happened to cause cases of polio in Papua New Guinea, Afghanistan, Pakistan, and Nigeria.

HIV/AIDS and STDs

Ever since the International AIDS Society (IAS) established a 90-90-90 goal in 2014, countries have aimed to make sure 90% of their population knows they have the disease, 90% of those are taking antiretroviral drugs (ARVs), and virus levels in 90% taking ARVs are negligible. Worldwide, only a 75-79-81 goal is reached.
      In less developed countries, HIV is combated by circumcising male foreskins to remove HIV-breeding cells and by paying school tuition for girls who are less susceptible to exchanging sex for food and other benefits, if they have employable skills. In all countries, HIV prevention responds to a combination of two ARVs, tenofovir and emtricitabine found in Truvada. Prevention still depends on those at risk coming forward and governments willing to help pay for treatment.
     After being raised and educated in Europe, Dr. Agnes Binagwano began returning to Rwanda with suitcases filled with medical supplies. Working with the government, she began an HIV program and trained health workers to visit villagers in their homes. To build trust for Rwanda's health care program, villagers chose the health workers who care for them.Once the country with the worst child mortality rate, 97% of Rwanda's infants now are vaccinated. The country where genocide killed nearly one million in 1994 also has the University of Global Health Equity in Kigali, rural health centers, and a nationwide health insurance program.
     Still a problem, ARVs give gay and bisexual men a false impression that these drugs prevent all sexually transmitted diseases (STDs). And birth control pills and other forms of female contraception give heterosexual couples the false impression male partners need not use condoms. Consequently, syphilis, chlamydia, and gonorrhoea infections all are on the rise from unprotected sex. At the same time, testing has been hit by cuts in funding for preventive education, local health departments, and confidential clinics that cater to adolescents.

Gene Editing

Which human cells the CRISPR-Cas9 technique edits and the changes made promise to treat diseases when engineered cells return to a patient's body. While unintended consequences of CRISPR-Cas9 editing to improve agricultural crops are less of a concern, the studies that find some forms of CRISPR-Cas9 editing delete or rearrange strings of DNA, affect non-targeted genes, and might cause cancer in humans motivate the search for technological techniques that produce only intended results.
     Genetic engineering capable of removing hereditary predispositions to cancer would, of course,be valuable. Editing into humans destructive hereditary traits passed along to future generations would not.
     Based on the way viruses can penetrate bacteria cells and destroy their defenses, CRISPR editing also is involved in the search for a way to k(ll superbugs resistant to antibiotics. (Use the keywords, antibiotics and CRISPR, to see earlier posts on these subjects.)

Cellphone Radiation

Research continues to study the danger of cellphone radiation from phones and antennas. Emissions from decaying lithium batteries, which remind me of those from black holes, also seem to indicate possible health risks. Keep an eye on findings about brain damage and memory loss from long term studies of new 5G technology. 

New Beginning for Zambia and Zimbabwe Falters

In the unfortunate country, where a protected lion named Cecil met his fate at the hands of a trophy hunter, voters braved intimidation to elect members of parliament and a new president on July 30, 2018. But violence began tearing up the country days after the election. Not only losing candidates and their supporters protested the less than free and fair election, but winners in the Zanu-PF party and the military also split into competing factions.

     A rise in fuel prices on January 12, 2019 again set off protests, sent soldiers into the streets to kill 8, and blocked internet access until January 16. At the same time, President Mnangagwa departed for Moscow, where he agreed to give the Russian company, Alrosa, access to Zimbabwe's diamond mines.

     After World War II, Great Britain grouped Zimbabwe (then Rhodesia), Zambia (then Northern Rhodesia), and Malawi (then Nyasaland) into the Central African Federation. London's plan made perfect sense economically, but not politically. Located within Northern Rhodesia, valuable exports from the Copper Belt, shared with the Congo's Katanga Province, already traveled south by rail through Rhodesia to ports in South Africa. Rhodesia, named for Cecil Rhodes, whose guns defeated Chief Lobengula of the Ndebele people who inspired the costumes for Black Panther, had a developed agricultural economy with farms capable of feeding the region and generating tobacco and chinchilla pelt exports. Yet to be mined rich deposits of gold and platinum still exist. Migrant workers from Nyasaland were used to working Rhodesia's farms. They would consult their lists of good and bad employers before agreeing where to work.

     The two most prosperous countries in the former federation, Zambia and Zimbabwe, struggle to get back on track. Zambia, one of the African countries that received debt forgiveness in 2005-2006 began spending freely just when copper prices tanked and a new regime increased the number of districts where it could reward leaders with graft. By 2018, Zambia defaulted on a Chinese loan repayment, and immediately Beijing was ready to begin talks to takeover ZESCO, Zambia's electric company, even though President Edgar Lungu claimed the Cabinet would have to approve such a measure. China already owns Zambia's national broadcaster, ZNBC.

     Black majorities in Northern Rhodesia and Nyasaland broke away from white-ruled Rhodesia. Ian Smith, like South Africa's white leaders, clung to power, and, in 1965, he unilaterally declared Rhodesia's independence from Britain. Later, Zimbabwe also would leave the British Commonwealth.To wrest control from Smith, blacks, led by Robert Mugabe's Zanu party, launched a successful civil war in 1972. Mugabe would exercise dictatorial power in Zimbabwe from 1980 until a military coup led by his vice president, Emmerson Mnangagwa, ousted him in 2017.

     Mugabe failed to follow the advice of Nelson Mandela, South Africa's first black president after apartheid. (See Mandela's advice in the earlier post, "How to React When You've Been Wronged."). Doing unto Zimbabwe's white farmers what they had done to blacks, Mugabe's government seized the farms of white owners in 2000. The economic prosperity envisioned by Britain's plan for the Central African Federation disappeared, when whites quickly emigrated. Following the 2017 coup, Mnangagwa left Zimbabwe for a charm offensive designed to lure back white farmers who could feed the estimated 1.1 million to 2.5 million  people starving in his country.

     To avoid a runoff, a president in Zimbabwe needed to win over 50% of the vote. After a delay, 16 different polling stations reported exactly the same number of votes, and Mr. Mnangagwa won a slim 50.8% majority. His Zanu-PF's party candidates also won 145 of the 210 seats in the National Assembly. Rather than support a Zanu-PF leader who overthrew him, Robert Mugabe, who would die at age 95 on September 5, 2019, backed Nelson Chamisa from the Movement for Democratic Change (MDC) party, who received 44.3% of the vote, while the remaining votes were split among 21 presidential candidates. Six died, when the military quelled rioting in the capital, Harare, following the announcement of National Assembly votes. MDC voters, who are concentrated in Zimbabwe's cities, called the election unfair and a fraud. When the Constitutional Court rejected MDC's election challenge, members fled the country to escape violence.

     Most Zimbabweans live in rural areas where they depend on foreign food donations. By distributing food at rallies, the Zanu-PF military and traditional chiefs intimidate villagers to vote "the right way." Before the 2018 election, Catholic Church leaders attempted to counter fear, apathy, and violence used in past elections by recognizing the need to protect voters and by stressing a vote for the common good was a human right. Sister Mercy Shumbamhini took it upon herself to go to the streets to ask citizens what the common good meant to them. They answered: having enough to eat, health services, a job, a clean environment, dignity, good roads, and security. In other words, they wanted what citizens everywhere want.

     Zimbabwe entered a new election cycle starved for food, tourist and export dollars, and business investment to cover unpaid debts to the World Bank and African Development Bank. Initially, Mugabe's incompetent party loyalists, used to collecting bribes in their civil service positions, retained their jobs. But in an effort to demonstrate his determination to stabilize Zimbabwe's faltering economy and gain much needed IMF, British, and Chinese loans, President Mnangagwa replaced cronies with technocrats, including Ncube, his new finance minister.

      Funding still remains in doubt, since post-election violence caused lenders to back away from support for the new government. Inflation has soared. Everyone wants payment in US dollars instead of unbacked, government-printed zollars subject to devaluation. Goods, such as generators and building materials, and staples like sugar, maize, and gasoline, are in short supply as customers purchase everything they can before their money is worth even less.

      A 5G pilot project in rural Zimbabwe stands as a vestige of a once hopeful new beginning. Offering new hope, however, is the Friendship Bench organization founded by Zimbabwe psychiatrist, Dr. Dixon Chibanda. According to an article in TIME magazine (February 18-25, 2019), Dr. Chibanda's organization grew out of his advice to those with mental problems: Visit grandmothers. Friendship Bench trains grandmothers, who have time and a natural tendency to listen and guide, rather than tell people what to do, to use role playing and other behavior therapies. The medical journal, JAMA, published the positive benefits of the Friendship Bench approach.

     

China Stretches a Napoleon-Style Belt

Emperor Xi Jinping gained open-ended power, when China's Communist Party scrapped his two, five-year term limit in February, 2018. He already had launched an ambitious One Belt, One Road (OBOR) Initiative to connect China to Europe and a Maritime Silk Road (MSR) that will join China to Africa. The Silk Road term, not coined until the 19th century by a German, is well suited to the OBOR and MSR initiatives which mimic the ancient variety of land and sea routes that carried silk and other goods, as well as ideas, between Asia, Europe, and Africa. Many have observed, however, that besides a means to facilitate trade, China's port projects could serve as a way to establish worldwide influence and naval bases for China's expanding navy.

     In pinyin, the form of Chinese characters described in Roman letters, the One Belt, One Road Initiative is called yidaiyilu. The worldwide use of English and the U.S. dollar rankles China. Beijing's Academy of Contemporary China and World Studies claims globalization is now causing many words, such as xiongmao, the pinyin word for giant panda, to be recognized outside of China.

     Ever since Romans built the Appian Way, leaders have recognized how transportation binds an empire together. Yet, China's infrastructure projects will test the tight control Beijing now maintains over its citizens' telecommunication and face-to-face contacts with the outside world. Like the Chinese employees who built the railroad in Kenya, those building the new container terminal and nearby oil storage installation at Walvis Bay in Germany's former African territory of Namibia, are sealed off from the local community. They live in a closely monitored compound of barracks imprisoned by a wall topped by electrified barb wire.

     Stretching thousands of miles from Beijing, work on the OBOR and MSR cannot help but require ongoing contacts with local government officials, financial institutions, suppliers, laborers, religions, and academics in the countries the roads pass. Already, the China Democratic League, one of China's eight non-communist parties, submitted a proposal to the advisory body, the National Committee of the Chinese People's Political Consultative Conference, suggesting cultural exchanges along the routes are as important as trade.

      Singapore-based Broadcom's failed hostile bid for the San Diego company, Qualcomm, might, however, signal China's determination to maintain control over vast areas by using high-speed optic fiber communications and Smartphone communication and data exchange. The Committee on Foreign Investment in the United States (CFIUS) cited national security issues to block Broadcom from access to Qualcomm's wireless chips and 5G (fifth generation) high-speed mobile network technology and standards. In April, 2018, the U.S. Commerce Department placed a 7-year ban (now lifted) on sales of chips, all from Qualcomm, to China's ZTE, because the company violated a 2017 agreement not to send telecommunications equipment containing Qualcomm chips to Iran and North Korea. In Australia, (and later in the UK and Sweden) China's Huawei telecom companies remain banned from 5G networks.  Before its US-blocked acquisition of Qualcomm, Broadcom transferred its headquarters from Singapore to San Jose, California, and later purchased Manhattan-based CA Technologies, a chipmaker in the infrastructure software field. In July, 2018, China would block Qualcomm's acquisition of China's NXP semiconductor company.

     Noticeably missing from China's One Belt, One Road initiative was any reference to North Korea. But that was before members of the women's hockey players in North and South Korea agreed to play together in the 2018 winter Olympics; and U.S. President Trump accepted Kim's invitation to meet on June 12, 2018 in Singapore. Suddenly, on March 25, 2018, North Korea's dark green train carried Kim to China for a strategy session prior to the upcoming US-North Korean meeting, from which China was excluded. Subsequently, Beijing agreed to Liaoning province's $88 million plan to build roads on the North Korean side of the Friendship Bridge that connects the two countries at Dandong.

     Whether China's strategy in Africa is considered part of the Maritime Silk Road (MSR) or an extended One Belt-One Road-One Continent strategy, China already has shown interest in the Continent by its trade, military base in Djibouti, the dam its Export-Import Bank built in Uganda, and railroad projects in Zambia, Tanzania, Kenya, Ethiopia, Sudan, and Nigeria. Other current and proposed Chinese port, rail, and airport projects ring Africa in the following countries:

• Seychelles
• Mauritius
• Tunisia
• Tanzania
• Uganda
• Rwanda
• South Sudan
• Mozambique
• Namibia
• Gabon
• Cameroon
• Ghana
• Senegal