Notebook: Dallas Edition

Once again, getting out of town has provided me with the chance to jot down some ideas on recent news. This time, we're in Dallas, Texas.

The Numbers

In the early days of the AIDS epidemic in the United States gay men were emerging from not years or decades, but centuries of discrimination and persecution. AIDS was often cited by scary religious types  as devine retribution, or in the secular understanding, as a "natural" outcome of "unnatural" sexual behavior. In this environment, it's not hard to understand the urge to exaggerate the numbers. The argument that this isn't just us (gay men), but could in short order be you (heterosexuals) has a certain power.

Today, however, this tactic has resulted in the long established and accepted belief, largely supported by the obvious truth it carries in Africa, that the disease is biding its time before it races through the general population. But Africa is a very special case where multiple concurrent partnerships are responsible for the widespread dissimination of the virus. Yet still better data and a greater understanding of the whys and wherefores of dissimination at the population level is only now working its way into the popular understanding of HIV/AIDS.

And so once again, after first being noted in India, the numbers are being revised downward [Yahoo! link may expire] worldwide by the large AIDS organizations. What does it mean to revise downward the number of people living with this disease? First and foremost, it means a re-prioritization of health needs and the resources allocated thereto. In the pantheon of preventable diseases, cancer and heart disease kill more people than HIV. And emerging threats, such as MRSA, are proliferating in the United States and abroad, and also apparently kill more people than AIDS.

[Edit: Hugh over on the Intactivism Pages points out the very important fact that lower numbers throw the circumcision/HIV mathematical models into very grave doubt.]

"Territorial Jealousy"

In a related AFP article, a global lung health conference taking place in South Africa reports that  organizations working on different diseases compete -- and not in a good way. The astounding idea that two groups working on public health issues would exhibit "a lack of mutual trust and territorial jealousy" is really hard for me to take in. But a quick reflection on the driver of any public health campaign, i.e. resources aka money, in a place of dire poverty doesn't seem so astounding after all. Enter the circumcisers.

Within a given disease, differing approaches clearly compete for the available resources. The mad scram for money exists wherever there's ... well, money. That is to say, also in healthcare, public health policy making and implementation, wherever ... . Circumcision without regard to its appropriateness or effectiveness may be developing into just one more offering in the school cafeteria of HIV/AIDS.

Stem cell from foreskins

Yesterday, National Public Radio in the Untied States reported that stem cells can be created by introducing only four specific genes into a skin cell using a virus as a vehicle. The scientists tell us  that this is extraordinary because "from the foreskin of a newborn child" we can make limitless numbers of stem cells for actual practical applications for disease control and cures. Yes, they said that. Let it be known that another market may be developing to continue driving gratuitous circumcisions of unconsenting infants. From one speculative ethical issue, i.e. embryonic stem cells, to a well-established ethical issue, i.e. circumcisions without consent, a morally confused America meanders.

Now, the inevitable question is: Can they take a skin cell from an infant foreskin, make a stem cell, and then grow a new foreskin for restorers? And would conscientious restorers accept such a restoration in light of the ethical problems? Fortunately, the skin cell likely can come from other areas of the body.

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Comments

[Hugh7]

Simultaneous with the US foreskin-to-multipurpose cell discovery came a Japanese facial-skin-to-multipurpose cell discovery. (It'll be harder to get hold of unattached foreskins in Japan.) This one has had more publicity (at least outside the US), because they had the wit to turn it into heart cells, which beat, making good television. So there's no need to use foreskins for this purpose.

[Adrienne]

Now really...besides embryos, what better tissue is there for growing cells than the unaged and genetically least compromised, fresh, new baby foreskin? Will the research companies resist the temptation to promote circumcision to make sure they have a steady supply? Oh, I guess there's no need to worry. Plenty of parents are all too eager to free their babies from this unnecesary "appendage". Now they can feel even better about it since they are contributing to the greater good of society.