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Dear Jonathan,

I will give you a large quantity of alcohol if you would please promise to never again publish photos of flesh-eating worms, parasites, burrowing ticks, etc., particularly when accompanied by medical images of such living in someone's brain. Would you at least put them after the jump if you're posting during lunch?

With No Small Measure of Throw-up in My Mouth,


P.S. You owe me the sandwich I am now not able to eat.

Posted by Ralph | June 27, 2008 1:09 PM

Keep publishing the pictures, Jonathan. As long as our neighbors have these horrible diseases, we need to see them. God, I want science back in American public policy so bad.

Posted by Fnarf | June 27, 2008 1:13 PM

Bravo, Jonathan. I do wonder why the Gates Foundation isn't focusing more attention to its own backyard.

Posted by laterite | June 27, 2008 1:38 PM

Mr. Gates, who is going to feed all these people you save from deadly disease? I mean, I appreciate what you do, but hunger is already a severe problem in so many places. And if you can save them from starving, who will feed their children? Maybe birth control is an area you can work on as well.

Posted by Vince | June 27, 2008 2:21 PM

Jesus fucking christ.

Thanks for that.

Posted by Matthew | June 27, 2008 2:21 PM

Hey, I remember that House episode too!

Posted by K | June 27, 2008 2:30 PM


Two points to consider:
1. Not everyone with these infections dies. In fact, most live--just with less energy and intellect. Treat them, particularly as children, and you end up with more from the same amount of eating.

2. Increasing survival to adulthood--most of these illnesses disproportionately affect children--can actually decrease birthrates and population growth. It's a paradox I described a while ago.


And sorry Ralph. When I read this article in PLoS NTD, I was really shocked.
Think about this: A decent percentage of the people that picked the lettuce, harvested the grain, baked the bread in a factory and slaughtered the animals in your sandwich--castigated as illegal immigrants by the dominant political party in the country--probably had tapeworm eggs growing in them.

This whole situation enrages me.

Posted by Jonathan Golob | June 27, 2008 2:32 PM

how do i get screened for these worms?

Posted by Bellevue Ave | June 27, 2008 2:41 PM

Well, as someone who works in this area, I don't agree with your assumptions.

First, if Bill G spent his entire Foundation holdings on research, it would be less than our annual budget for scientific research.

Secondly, costs for programs in the US are dramatically higher than for those in the poorest countries that are hit the hardest = e.g. Africa - and thus you get more bang for the buck overseas.

Thirdly, he's focussed on deliverables, much less than the underlying research which the Government should be paying for.

We do actually have human trials of vaccines for malaria and other such things, but they are trials, and we are still trying to figure out the safety, cost, delivery, and other factors at this time.

Want a miracle? Pray to the FSM.

Posted by Will in Seattle | June 27, 2008 2:56 PM

Oh Will--

Let's say that the Gates Foundation funds a study to nail down the percentage of Americans with these neglected tropical diseases--a carefully done, comprehensive study.

This study comes back showing that an astonishing percentage of Americans, US citizens, have diseases more associated with impoverished tropical countries.

Wouldn't pharma take notice? The NIH? Wouldn't new drugs be rapidly developed to treat this vast new market? It would be an American market, treated totally differently than say drugs targeted for Sub-Saharan Africa. A drug target useful only for problems in poor countries is far less attractive than a drug target that can also be used to treat Americans.

This small investment in a prevalence study--hell, you don't even need to spring for a more complicated incidence study--would probably do more to develop new anti-parasitics than anything else.

Posted by Jonathan Golob | June 27, 2008 3:07 PM

Some quick thoughts...

First, I don't know how sexy this research is to the various biomed disciplines. I'd consider it quite sexy and I know some epidemiologists and pathobiologists who would too. But, part of the sex appeal is the financing. Money would most likely have to come from the NIH which would have to justify spending money on this rather than on breast cancer or heart disease or diabetes or... and people already whine so much about paying taxes. Not that it can't be done. The HIV budget, for example, got fatter over time and lots of biomed folk made careers on research in the field (heck an NIH AIDS training grant kept me in ramen noodles for a few years). So, yes, it's all politics - the politics of getting people to want to spend the money (which, practically, means spending the money on this rather than something else).

Posted by umvue | June 27, 2008 3:13 PM

If you wanted bang for your buck on malaria, you wouldn't fund vaccine trials, you'd negotiate a deal on a hundred million mosquito nets. I'll bet you could find someone to make them for a quarter apiece with an order that large.

Posted by Fnarf | June 27, 2008 3:16 PM


Not only that, but health care for poor people can also increase the income of poor families.

Posted by keshmeshi | June 27, 2008 3:27 PM

Pharma would only care if they could make big dollars on it.

Migrant farmworkers usually don't have big dollars.

So, the short answer is ... no, they won't care.

Seriously, the reason why people don't get TB in the US and Canada has a lot more to do with how rich they are and how much Big Pharma makes by treating it here instead of other places.

Posted by Will in Seattle | June 27, 2008 3:31 PM

Yes, Yes let's save all the humans from parasites and diseases. So they can grow up to join the military or rebel group and kill each other with weapons of mass destruction ( guns ).
Paradox my ass. If you are going to save these people from diseases you better have an education and a job also waiting for them. Otherwise us first-world nations get a few hours of news entertainment watching genocide happen in Africa on cable or satellite.

Posted by robot2501 | June 28, 2008 9:37 AM

Say "YES" to War on Iraq by Dan Savage Oct. 2002

"War may be bad for children and other living things, but there are times when peace is worse for children and other living things, and this is one of those times."

"The War on Iraq will make it clear to our friends and enemies in the Middle East (and elsewhere) that we mean business: Free your people, reform your societies, liberalize, and democratize... or we're going to come over there, remove you from power, free your people, and reform your societies for ourselves."

Washington Post June 27, 2008

"Bomb Kills Marines, Iraqi Tribal Leaders
At Least 40 Die in Two Separate Attacks"

Posted by danfansarewarmongersupporters | June 28, 2008 9:51 AM

Yep, deeply immoral.

And nobody cares. Didn't you get the memo? Ronald Reagan, circa 1981. Something about it being okay to stop giving a damn about anybody but yourself.

You're not one of those fancy elitists, are you?

Wanna buy a monkey?

Posted by CP | June 28, 2008 10:28 AM

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