Friday, September 23, 2005

False Promises and Quackery (What else is new?)

President Abdul Kalam is promising an HIV/AIDS vaccine in India in the next three years:

Anti-HIV/AIDS vaccine will be available in the country within the next three years and its clinical trial is on, President A P J Abdul Kalam said on Friday. "Hopefully in three years, it will be available in the market," he told a conclave on 'HIV/AIDS: A uniformed intervention', organised by Assam Rifles Wives Welfare Association.

I hate empty promises like this one. If it were really possible to guarantee that, why aren't any researchers in the field saying so? As far as I know, there is no effective HIV/AIDS vaccine. Any vaccines that are being tested are being tested because it isn't known whether they work. It's really counterproductive to presume that a trial in progress is going to have a positive result.

In general, I'm not so terribly excited about Abdul Kalam. He may have been a good rocket scientist and engineer in his day, but a lot of what he comes up with these days regarding the status of science and technology in India is pretty nutty. When do we get a new Indian President?

Secondly, I'm really not thrilled about the idea that Indian medical schools are going to be incorporating homeopathic medicine into the M.B.B.S. curriculum in the next few years.

I know lots of people subscribe to things like Ayurveda, but it always makes me cringe when people talk about treating cancer with random concoctions, scented candles, and prayer. If folks want to do Ayurveda, fine. There is something to the placebo effect (if you actually believe it). But when the doctors themselves don't know the difference, their patients are really in trouble.

Fortunately, many in the medical community in India are criticizing the proposal.

15 Comments:

Blogger pennathur said...

Amardeep,

Here is the link to the speech
http://www.presidentofindia.nic.in/scripts/eventslatest1.jsp?id=987
and an abbreviated link as well in case the 1st one doesn't work.
http://tinyurl.com/d9df4

I am surprised that you find his ideas "nutty". Is there something in particular you are referring to?

4:52 PM  
Anonymous Anonymous said...

I think the image of Ayurveda with 'scented candles n prayer' is very misleading.

6:47 PM  
Blogger Suvendra Nath Dutta said...

It would not be totally accurate to think of him as a great rocket scientist. He was, regardless of what his detractors say, a great manager of the ISRO. Although the first two SLV's failed, the success of the SLV-III was pretty impressive. Same with his development of Agni and so on.

Also having spoken to several medical friends in India (ok Kolkata), this introduction of nonsense, excuse me, homeopathy and so on, should be seen in the Indian and not the US context. Everyone knows, that if you are really sick, you go see a real doctor. But if you not really sick, merely hypochondria-ic, then you see whomever you happen think is for the moment. I wouldn't worry about this, Indian medical schools (at least the government run ones) still produce the best doctors in the world.

8:19 PM  
Blogger pennathur said...

Suvendra,
Kalam is highly regarded by his colleagues and the 100s of engineers he has mentored. His approach to managing large projects has been far ahead of its time. After the pioneering duo of Dhawan, and Prakash who in turn got the space sector going with inspiration from Sarabhai, Kalam showed the execution skills and set up India's first multi layered and multi link supply chain. One reason why India has done so well in IT and ITES is because the sector does not require such a supply chain; and which the manufacturing sector in India has never managed to grow and develop. The critics of Kalam are either mendacious (like Bidwai who accused him of wanting to promote eugenics) or ignorant (like MV Ramana whose understanding of such complex issues is wafer thin).

Amardeep,
The person responsible for wanting to mess around with the medical sector in India is a member of the other political family from Tamizh Nadu, "Dr." Anbumani Ramdoss son of the successful casteist leader Dr.Ramdoss. Fruther Anbumani has decided in his infinite wisdom that the government must take over the Medical Council of India so that he can probably tinker around with medical education. It beats me how a greenhorn with almost no clinical experience thinks himself fit to advise India's doctors on medical education. But since the Congress is beholden to all varieties of opportunists we wont hear much about this.

10:36 PM  
Blogger pennathur said...

Amardeep,

Sorry. One more comment. Political terms in India run for five years. Kalam was sworn in 2002 and has another two years before he is due for re-election. I would like to see him appointed for life or at least be re-elected for another couple of terms. He is quite simply the best President India has had. Earlier, Presidents delivered fine homilies (intellectuals as they were). And then we had KR Narayanan a Scotch n' Soda Socialist who stopped learning after he graduated from LSE in 1947. Read Kalam's I-Day speech. That shd have been delivered at the UN Gen.Assy. You can spend hours at his site. There are 100s of pages of his presentations and speeches, not one of them is banal or commonplace.

10:50 PM  
Blogger Rohin said...

About the medicine:

First, I think I should draw attention to the fact that homeopathy and holistic or alternative medicine are not one and the same. Homeopathy refers specifically to the quackery of giving people water - the Lancet recently wrote a timely article urging GPs to stop referring patients in the UK to homeopathists as it's completely useless (but placebo is a powerful thing).

Now, w/r India. I find this story odd as India already has a well-established Ayurvedic curriculum taught at many reputable schools around the country. I'm not sure of the details of this proposal, but I find it unlikely that there will be any large scale changes to Indian medical schools, which are amongst the best in the world.

I am also an outspoken critic of a lot of alternative therapies, but I do respect the right of the patient to choose. As long as everything exists side-by-side I'm happy. I have no problem with allopaths taking courses in acupuncture or Ayurveda (I must agree with anonymous, Ayurveda has a lot of good stuff to offer), but the core five years at medschool should be grounded in science.

Here in the UK, as physicians we're not even expected to have a rudimentary knowledge of alternative therapy, but we should know what's available.

Oh lastly Amardeep (and anyone else interested) I have finally started my blog! Hurrah!

11:21 PM  
Blogger Amardeep said...

Pennathur,

Ok, ok, the word "nutty" was too strong and too facetious. I was feeling a bit grouchy yesterday (long week and so on).

But my frustration with Kalam's promise still stands: he shouldn't be promising a working vaccine. It's irresponsible for anyone in a position of authority to make such a claim. It might be ok to say, "I am sure a vaccine will eventually emerge in our own country." But in my view it is not ok to say "I am sure in 3 to 5 years time, an anti-HIV vaccine will emerge in our own country."

I read the rest of the speech (thanks for the link), and I'm impressed that he is speaking in fairly technical and precise terms throughout. It's helpful to know, for instance, which vaccine trials he's referring to (Adeno-Associated Virus; one can go and look it up and try and verify). It also helps quite a bit that he alludes to the uncomfortable social issue behind the speech he's giving to the Assam Rifles Wives' Association: the fact that their husbands are going HIV positive at an alarming rate. (Must have been a bit awkward to even attend this event, given that.)

But there is one general characteristic of Kalam's in evidence here as well as elsewhere, which makes me less than enthusiastic: he does seem to be relentlessly optimistic about technology and science. Take this Republic Day speech. In the "Progress" section, he goes on about high tech innovations for a full four paragraphs before briefly mentioning HIV/AIDS. The priorities seem to be a bit out of whack.

In general, having a highly educated, professionally accomplished person in the President's Office is better than having an illiterate political hack.
It's certainly helpful to have someone who offers ideas and a challenging (if overly utopian) vision of where India might go. And I am not one of those leftists who believes that India's technological contributions should be thrown out in favor of all social welfare, all the time (in fact, India's growth as a technology center is inspiring).

But if Kalam's emphasis is all on advanced warfare and space exploration, that is a cause for concern. It needs a little more balance...

7:44 AM  
Blogger pennathur said...

Amardeep,
Kalam has not been a scientist and is more of an engineer. He does not believe in distributing resources but in creating mechanisms that will ensure little scope for 'super-normal' profits or 'monopoly rents'. Remember his open disagreement with Bill Gates on closed source? Kalam is believed to be quite a Linux freak. He sees the pursuit of science and technological prowess benefiting much more than India's warmaking abilities. Check out his addresses to State legilslatures where he offers solutions for environmental degradation, education, health care, the disabled, and employment. He is certainly a nationalist/patriot (will never understand the difference) and is anchored not in the post-1947 India of socialism and non-alignment but in the 'eternal India' of Ambedkar, Patel and Nehru. Definitely not Gandhian or Tagorian.

12:28 PM  
Blogger anandsharma said...

As constitutional Head of state,President of India having priorities of his own,other than those of the cabinet,is a little unusual.What he states about HIV/AIDS vaccine appear to be his personal views.I agree that persons in responsible positions should make promises which are realistic,especially when he happens to adorn the chair of President of India.

12:50 PM  
Blogger pennathur said...

Anand,
It seems that you haven't read Kalam's speech that Amardeep and I are discussing. The rediff.com report is a definite quote out of context and leaves out so much that Kalam's concerns, principles and advice have remained unknown. The President is not a rubber stamp and must act of his own accord if the situation demands it. Of course this can lead to disastrous consequences as it did when KRN gave Sonia indefinite time to prove her "majority" in 1999. If the Cabinet is taking up issues that are not serious or ignoring serious ones the President must act in the only way he can by directly talking to the people. The Constitution and practices of governance are not set in stone.

4:19 PM  
Blogger Vikram said...

Kalam is an optimistic visionary who consistently prods people in his sphere to attain seemingly unreachable goals. His HIV vaccine comments arguably crossed the line, but it springs from that can-do spirit--he's no quack.

Thanks,

Vikram

hindu.blogspot.com

4:36 PM  
Anonymous Kanya said...

I don't know enough about Kalam to comment on that part of your post Amardeep, but I would argue with lumping Ayurveda with quackery as other respondents have also noted. In the case of cancer treatment (since our family is unfortunately dealing with this issue right now), the "scientific" allopathic approach is to shoot you up with the strongest drugs, kill everything in sight, and then wait and watch to see if the system will boot up again and bring the good stuff back. It's true that we might not have an alternative yet, but as an approach to healing, this leaves much to be desired. In terms of diagnosis, some kinds of failures or morphing of body cells, could be a sign of any one of thirteen different diseases, hence there is no precise way to treat them. It's hit and try--literally. I am not an armpit crystal granola type of person, and I respect doctors and modern medicine, but its severe limitations as a system in the face of certain diseases really needs to be talked about as well. In those cases, it is well see that Ayurveda treats the body more holistically, more respectfully, and hey if they don't have a cure for cancer, neither do the allopaths.

10:13 PM  
Blogger anandsharma said...

Pennathur,
I have gone through the speech of President Kalam delivered at Shillong on 23rd sept.(thanx for the link).I respect Kalam for his many qualities and idealism;but somehow, when he raises unrealistic expectations which we know are not likely to be fulfilled,it leaves many question marks about him.

7:03 AM  
Blogger kuffir said...

pennathur says kalam is the best president ever...i wish he'd follow the advice he renders others and look up the histories of the other presidents before he draws such sweeping conclusions...in my view kalam is an extremely likeable person, he has all the right qualities to be called so ..honesty,probity etc., but what he lacks is an understanding of the institutions and issues surrounding politics as practised in india..the president is required to play a very crucial role when it comes to situations such as the 'sonia incident' referred to in this debate. his understanding of the constitution needs to be more firsthand than gained from a simple reading of the books on it. most times, what kalam says at public fora seems totally out of sync with what the public expects him to say. i can think of only one practicable proposal that he has championed which makes any real sense- the pura scheme/project which envisages bringing the amenities of the big city to hubs situated in clusters of villages. it could create jobs, stem migration and make rural life much easier.
i agree with amardeep on kalam- he's not very exciting.

2:17 PM  
Anonymous Anonymous said...

When all else fails try Ayurveda. It will succeed where all else fails. My own life's experience has proven this! Glory to the Sages and Rishis of India. Glory to Bhagavan Dhanvantari. In Ayurvda they have provided us with a way of life, not only a system of medicine. Between yoga and ayurveda, in the right hands, miracles are routine!

6:38 PM  

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