Nobody Funds an Abstraction

By G. Emily Ghods-Esfahani | Friday, February 10, 2006

BOOK REVIEW

The Monster at Our Door
Mike Davis
New Press, 2005

Sublimity may be the climax of human sorrow. Through generations of pandemics, we look back at history in awe, as one run of death after another sweeps through one civilization after another, consuming each: smallpox in classical Rome, Black Death in medieval Europe, tuberculosis in industrial slums and ghettos and, immediately, AIDS. And yet, since the beginning of human history, no pestilence has massacred more of mankind than the 1918 influenza pandemic that whispered itself into the malnourished corpse of Europe, Asia, Africa, and North America.

Humanity took a knee.

Mike Davis, the author of The Monster at Our Door , fears another convulsion of pandemic flu; this one more horrifying and deadly than the calamity of 1918. Avian flu, should it arrive with enough virulence and transmissibility, will, he concludes, wipe out one billion of our fellow human beings.

In his book, or perhaps more accurately, prophecy, Davis argues that pandemic Avian Influenza is not only inevitable, it is already lifting civilization’s door off its hinges. The author’s tortured lamentations and contortions might have done better to simply state the science, rather than beat on his ideological drum. But Davis not only sees health crises, he sees bad people. More or less the usual suspects: spectral Republicans, “profitable” pharmaceuticals (the quotes are the author’s own; the concept of profits, it seems, can only be understood ironically by Mr. Davis), and other favored arch-enemies of the chattering class, or as it was once put, the “nattering nabobs of negativism” (a little irony right back at cha).

Sadly, Michael Moore and Cindy Sheehan have already been there and done that, assuredly without the science, but to greater effect and renown. It’s standing room only on this stage.

In this regard, Davis seems intellectually unorganized and only marginally persuasive. Still, there is the science and the very real threat of Avian Flu; keeping an eye on the real dilemma will help us separate the meaningful wheat from the ideological chaff.

Avian influenza (given the esoteric code, H5N1) is an impending virus which cyclically circulates between geese, quail, ducks, poultry and, more recently, human beings and swine (ironic?). Naturally and asymptomatically, the virus brews in the intestinal tracts of geese where it vigorously divides, making contact with other birds as it is passed on through fecal excretions.

Due to random mutations in its genetic blueprint and an evolutionary pace that surpasses that of human’s by many-fold, the virus has wildly dispersed into five hundred novel strains that repetitiously exchange and share genetic material within a huge gene pool. The larger the gene pool, the higher the chance that the virus can evolve into a super-bug.

As Avian Flu mutated, its dandelion-spoke structure changed and it began to recognize human cells. Before 1997, the species barrier from bird to human was thought to be insurmountable. In 1997, six people died of Avian Flu in Hong Kong. An anomaly was slowly becoming a reality.

Flu epidemics typically emerge in China and Southeast Asia where birds and swine live in close, crowded quarters. The Pigs swim in the fecal matter of the water fowl. In so doing, the swine becomes a host to the virus, which flourishes in a larger more varied gene pool.

The pig is, as it were, the elusive missing link in the viral vault across the species barrier from fowl to humans. Within the pig, the virus recognizes both avian and human cells through its cell-surface receptors. Here, influenza makes the species jump that Mr. Davis claims now threatens all humankind.

In swine, the avian virus has the potential to genetically recombine with the human virus to produce an Avian-Human flu hybrid. This feared super-bug will have the lethal virulence of Avian Flu while harboring Human Flu’s gene for airborne communicability.

In the past decade, Avian Flu in poultry has come and gone, occasionally leaping over the species barrier to infect humans—but then it retreats, dispersing and fading from the human-to-virus theatre of battle. Local, national and international authorities handled the emergence of each epidemic abysmally. From a public health perspective, everything that could go wrong went wrong.

Despite concealed epidemics, despite the viral resistance to the antiviral used to treat Avian Flu, despite an ineffective Avian Flu vaccine, despite a shoddy national and international flu surveillance network, despite the commercial release of infected poultry onto Asian dinner tables, Avian influenza receded peacefully, leaving less than one hundred people dead.

Davis himself confesses that these were “mild outcomes,” and microbiology expert Dorothy Crawford tells us, “the high level of partial immunity remaining in the community ensures that antigenic drift [evolutionary mutations] will not cause a pandemic.”

And the conditions surrounding the pandemic of 1918 hardly parallel those of today: World War One provided the ideal breeding ground for the virus with its squalid trench warfare and overcrowded encampments; there were no antibiotics to fight off the deadly secondary infections that accompanied the flu pandemic; malnutrition and slums were common to both the third world and the western industrialized world; viruses were not even discovered, as such, until fifteen years later.

Certainly, 1918 was a horrific year for public health. Equally certain is the fact that the current state of Avian influenza does not warrant the disruptive panic advocated by the hysterical press. It’s been recycled to the point that you recognize such outbursts as no more than reused boilerplate. Laurie Garrett, the renowned public health journalist, is featured on the cover of Davis’ crass book: “start pestering your politicians, demanding they do […] something, before pandemic influenza claims millions of lives.”

Davis does not draw the obvious distinction between the conditions of the 1918 pandemic and our 2006 world, opting instead to fly his finger at “Big Pharma” and the Bush administration.

Davis maintains that emergent diseases are shaped by “concentrated urban poverty [and] the neglect of vaccine development by a pharmaceutical industry that finds infectious diseases ‘unprofitable’ …”

Exhibiting a postmodern streak, Mr. Davis wraps the word “unprofitable” in quotes, leading the reader to wonder what Davis finds so ironic about corporations determined to make a profit. That’s kind of the point. One of those “profitable” corporations, Roche Pharmaceuticals, manufactures the best defense against Avian Influenza, Tamiflu. A five-day course of two pills a day costs eighty to ninety dollars. Sounds reasonable enough.

Davis even offers a good-guy/bad-guy narrative. He imagines a Mexican Stand-off wherein public health calls out, “give us the vaccine” and the pharmas reply “no vaccine unless accompanied by ridiculous revenue flows”—stated less cryptically, Davis believes the pharmaceuticals are holding the vaccine hostage and will only release it upon the conveyance of a hefty ransom, that is, a hefty “profit.” The moral: evil Pharma smites the innocent well-meaning good guys because of this whole “profit” thing.

Perhaps the most flagrant accusation Davis makes concerns the pharmaceuticals policy on antibiotic research. To Davis, pharmaceuticals do not invest in antibiotic development because antibiotics will cure the disease, and from a market standpoint, there is nothing more “unprofitable” than that.

Next on his black-hat list is, predictably, our current President, George Bush. Mixing his cause and indignation like an alchemist, he assails G. W. Bush (and his administration) on everything from “abstinence education” to moral degeneration, at one point scurrilously accusing the President of bribery. In revolutionary mode, Davis speaks of the current administration as a “regime.” He chastises President Bush for, as Davis says, the “mortgaging off” of American lives; he claims that under Bush, “Soldiers first. Children last” will be the treatment protocol when it comes to Avian Flu.

He criticizes Project Bioshield —a federally funded research project that concentrates on bio-terror diseases like Ebola, Anthrax and smallpox—as a ploy that is “obviously [aimed] to woo young science entrepreneurs and their startup firms to the Republican party.” This is rich stuff. Even so, I doubt that even the senior senator from Massachusetts will bite into this.

Unfortunately, not only does Davis lose sight of his thesis, but he mischievously makes saving lives into a dogged partisan issue. In the last third of his book, the closest Davis comes to discussing the threat of Avian flu is his milquetoast, albeit morally righteous, stance on, that’s right, the Vietnam War. “Most egregiously, the United States—the country with the greatest historical moral obligation to Vietnam—has failed to provide that poor nation with the resources to monitor or contain the outbreak.”

It is certainly true that the issue of resources and funding is at the practical core of the Avian Flu dilemma. In the 1980s, public health went private as market forces emerged to dominate our economically and technologically integrated world. As a result, government spending on many services, including health, (across the world, not just in America) suffered drastic cuts.

In public health the big talk is dominated by the rhetoric of whose cause is the scariest? Thus, day to day, such crises and causes sound scarier and scarier. Soon, a new vocabulary will become necessary in the hucksterism associated with achieving money and media face time. Not to diminish the very real threat of Avian Flu, but does anyone remember the SARS scare (Severe Acute Respiratory Syndrome)?

Davis, in his habitually politicized book, argues the preeminent social status of Avian Flu. But it doesn’t take an astute economist to figure it out. By affording Avian Flu celebrity status, the Department of Health and Human Services, amongst more mundane social outlets like Oprah and Eye Witness News at 7, will divert resources and time from other threats and causes that are currently—not potentially—killing Americans.

According to the United Nations Health Agency, 85 people have died from Avian Influenza world wide, as of January 31.

In one day, tuberculosis, cancer, diabetes, AIDS, and malaria will each kill more people than Avian Flu has killed in ten years.

We are now faced with an ethical question over how our cultural, scientific and financial resources will be distributed among the many health threats we face. Certainly, Avian Flu should be high on the list. To accomplish this feat, the rhetoric will escalate—as of yet, there are not enough dead bodies to match the Davis’ rhetoric, and public health advocates know it.

As Albert Camus succinctly stated, nobody mourns an abstraction: “a dead man has no substance unless one has actually seen him dead; a hundred million corpses broadcast through history are no more than a puff of smoke in the imagination.” No one needs to tell this to Mike Davis. Where he sees smoke he screams fire.

Nobody Funds an Abstraction

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