Public health vs biodefense vs lying

You'd think increased concern about bioterror would translate into better overall public health. It only stands to reason that heightened awareness, larger research budgets, and a heightened sense of urgency would be beneficial. Unfortunately, it isn't that simple.

At Effect Measure, public health scientist Revere explains how the DHS biodefense model is undermining the public health system. I encourage everyone to read Revere's essay in full. You won't find a comparable perspective anywhere else in the progressive blogosphere.

In other depressing public health news, the Washington Post caught an anonymous Bush administration official lying about research findings on the effectiveness of needle exchange for HIV prevention.

The administration claims that the evidence for the effectiveness of needle exchange is shaky. An official who requested anonymity directed us to a number of researchers who have allegedly cast doubt on the pro-exchange consensus. One of them is Steffanie A. Strathdee of the University of California at San Diego; when we contacted her, she responded that her research "supports the expansion of needle exchange programs, not the opposite." Another researcher cited by the administration is Martin T. Schechter of the University of British Columbia; he wrote us that "Our research here in Vancouver has been repeatedly used to cast doubt on needle exchange programs. I believe this is a clear misinterpretation of the facts." Yet a third researcher cited by the administration is Julie Bruneau at the University of Montreal; she told us that "in the vast majority of cases needle exchange programs drive HIV incidence lower." We asked Dr. Bruneau whether she favored needle exchanges in countries such as Russia or Thailand. "Yes, sure," she responded. [WaPo; 02/27/05]

Fontana Labs writes:

Maybe I'm missing something, but this looks pretty bad. It looks like they're lying about the research in a way that will kill a lot of people. Or (haha) allow them to die. Reckless disregard, for some small political gain or ideological line-toeling. How much contempt can be summoned? It won't be enough.

[Cross-posted with Pandagon.]

Background

US drug warriors have been cynically misrepresenting the findings of Schecter and Bruneau for years. In 1997 Schechter published a study showing that participants in the Vancouver needle exchange had a higher rate of HIV infection than users who didn't participate. In 1988 and 1995 Bruneau found similar results among Montreal addicts.

The researchers drew two conclusions from these findings: 1) Don't confute correlation and causation. Addicts who patronize needle exchanges are at a might higher baseline risk of HIV infection than intravenous drug users at large. 2) Vancouver and Montreal need to supply more needles per addict to cope with an influx of IV cocaine users who may inject up to 40 times a day.

The scientists have been fighting an uphill battle to counter the misrepresentation of their data ever since.

Further reading

Strathdee SA, Vlahov D.The effectiveness of needle exchange programs:
A review of the science and policy.AIDScience.2001;1(16).

Schechter MT.Science, Ideology, and Needle Exchange Programs. Ann. Am Acad Poli Soc Sci. 2002;582:94-101.

Comments

[Anjali]

Thanks for this post, and the links.

I felt a knot in my stomach when i read last year that my medical school has put so much money into biodefense microbio research, as the school is located in a city with some of the worst national health indicators. Completely misplaced priorities.