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TODAY Friday 24 October 1997 Each weekday. Conn Nugent on what's new in the world, on the site.

 

TODAY IN THE WORLD: Meanwhile, Back at the Infirmary...

If there's one thing you learn by poring over public opinion data, it's that most Americans regard toxic threats to health as the most important of all environmental problems. We tend to be concerned about "pollution" (a word which covers a range of phenomena) that contaminates air and water and spreads diseases. It's not that people don't care about nature conservation per se -- there's wide support for protected areas. It's just that any problem of ecosystem degradation or loss of biodiversity is made more compelling if it can be described in terms of the listener's family's physical well-being.

Despite some excellent work by the Center for Health and the Global Environment at Harvard Medical School, the connection between climate change and threats to health is infrequently drawn in American popular media. One reason for that, perhaps, is that most of the foreseeable problems are involved with diseases that people identify with the tropics; out of sight, out of mind. That dengue fever has a toehold on the Gulf Coast, or that American cases of malaria have risen sharply, is either not known or is simply regarded as insufficiently threatening. People do have a sense that chopping down trees in the rainforest can unleash killer viruses -- which is a more sophisticated appreciation of ecological epidemiology than anybody had fifty years ago -- but medical investigators haven't yet documented enough frighteningly airtight examples of direct causation.

It was in that context yesterday that I read the news about tuberculosis. The big environment story in the newspapers, of course, was the announcement of President Clinton's plan on greenhouse gas emissions. But back on page A13 of The New York Times there was an article from the Associated Press that might have attracted more green attention on a slower news day. "A study of 50,000 patients in 35 nations has found that a third of the countries have a form of tuberculosis resistant to the standard drugs, the World Health Organization said today...'This study shows definitely, and for the first time, what we most feared but could not previously prove: our world again faces the specter of incurable tuberculosis,' said Dr. Michael Iseman, tuberculosis chief at the National Jewish Medical and Research Center in Denver, who reviewed the study."

What's happening is that people with the TB bacillus take drugs which they stop taking "when they feel better or run out of money." But the drugs work only if they're continued for six to eight months; dropping them mid-therapy allows the bacillus to mutate so that one or more of the drugs becomes ineffective. "Acquired drug resistance," the study calls it. The new tough TB spreads quickly, of course, through coughing and sneezing, and now many poor parts of the world are overwhelmed with a new and tough enemy, who can be fought only with skill, time, and money. In the Indian state of Delhi, 13% of all tuberculosis patients are now classified as "multidrug resistant."

Can this bleak development be described as an "environmental" phenomenon? If you stretch the word environmental so that it embraces all manner of monkeying around with natural systems, including the human immune system, I suppose so. But the revival of tuberculosis, and the mutations of the TB bacillus, do share some of the key characteristics of what could be a spate of environmentally-induced epidemics in the future. For one thing, international disease transmission in the era of cheap jumbo jet travel is a strikingly faster phenomenon than early 20th Century epidemiology was accustomed to. A tropical virus that breaks out of a disturbed rainforest ecosystem could indeed spread quickly around the globe, just as HIV appears to have done, just as the new mutant TB surely will do. And second, there is a definite co-evolution between environmental degradation and resistances developed by disease carriers. Change the climate, grow swamps, breed mosquitoes, spray swamps with pesticides, promote pesticide-resistant mosquitoes, dose humans with antibiotics, promote antibiotic-resistant pathogens, etc. As Bill Clinton (and Al Gore) seeks to educate the American public on the downsides of global warming, some furrowed brows about climate change and children's health are surely in order.

 

TODAY ON THE SITE

Go to The Grove. I mean that you should give yourself a free subscription to "The Grove," Lib Tree's bi-weekly cyber-newsletter. In the most recent edition, Donella Meadows and her friends in the Balaton Group conduct an online conversation about international trade, free and otherwise.

 

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10/23: "Heading Down the Right Path"
10/22: Markets and Medium-Greens
10/21: The Silver Republic and the People's Republic
10/20: Duck!
10/17: The Energy Non-Crisis
10/16: Drillbit Diplomacy
10/15: We Love You, Hiroshi Okuda
10/14: Good Deals at Showroom and Pump
10/10: Clinton Waffles!
10/09: Can Therapy Help the Songbirds?

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