Miliband's confession: better late than never?

Has our Foreign Secretary finally grown a pair...? In what could be described as an extraordinary speech, given in a city still reeling from their most recent terrorist atrocity, David Miliband has delivered what could be seen as a crushing blow to the neoconservative ideology around which the War on Terror (brought to you by Fox and Halliburton) was built - he even went as far as admitting that the use of the phrase 'War on Terror' may have 'caused more harm than good.' He expands on this idea in an article published in today's Guardian newspaper, warning against seeing different struggles around the world as a

binary struggle between moderates and extremists, or good and evil...

A senior British government minister refuting the use of inflammatory language, taking an historically sensitive, nuanced stance on international relations, repudiating a militaristic approach to countering terrorism in favour of dialogue - surely this is no bad thing? Maybe so, but I used the phrase 'could be' twice in my first paragraph advisedly.

Firstly, there's the question of timing. In a sense Miliband's comments come at a very good time, and indeed were made in an apt location too. As a strategy to encourage India not to escalate tensions in the aftermath of the Mumbai attacks, this speech was undoubtedly sound. Given the massacre in Gaza too, where more than 1,000 people have now been killed as a result of Israel's offensive, Miliband's position could be seen as a brave reminder to Israel that there will never be a military solution to the Palestine conflict.

But maybe it's all somewhat akin to shooting fish in a barrel. Declaring the futility of the War on Terror (WoT) some seven years after its inception, having played a lead role therein, does appear rather odd, until you consider another quirk of timing. As the architect of the WoT prepares to leave office next week, it becomes a simpler matter to denounce the central tenet of his foreign policy. Indeed, it becomes a matter of political expediency given the incoming President's well-publicised opposition to the 2003 invasion of Iraq and his reportedly more considered stance on engaging with the so-called enemy.

This is not to detract from the substance of what Miliband said and wrote - taken together the speech and article are the arguably the most level-headed comment on international affairs any British official's made in years. It's just that one's left wondering where the world would be if the UK had discovered its concern for human rights, its instence on

championing the rule of law, not subordinating it,

its welcome use of reason, whether the world would be a different place. Whether if, instead of supporting the wrongheaded US-lead invasion of Iraq, we could have prevented it from happening. Maybe, instead of continuing to supply Israel with military equipment which it's now using to massacre hundreds of Palestinian civilians as well as Hama militants, we could have held Israel to account over its obligations under numerous UN Resolutions and insisted on dialogue. Possibly, rather than appeasing a Pakistani regime for fear of losing their support in the fight against al-Qaida, we could have insisted that it did more to prevent cross-border terrorism such as that seen in Mumbai.

But then again, if we are to wish away the last eight years, we may as well re-write history, as TA Frank did in an excellent piece in yesterday's Guardian. As I think I've said before, would that it were so...

Demonstration for peace in Gaza

Much has already been written about the escalation of violence in the Middle East, and yet this blogger is sure none of it can capture the horror of being caught up in the cycle of rocket attacks and retaliatory military action. What we know is this: at the end of last year, Israel decided it was time to respond to Hamas' cross-border rocket attacks, which had increased in intensity over the previous year or so. The world stood with baited breath to discover the extent of the Israeli reaction, and over the last three weeks most observers' worst fears have been realised and supassed.

Let's get one thing clear up front. There is no justification for launching rockets into civilian territory as Hamas and its operatives had done for some time. Living in Israeli border towns became a story of coping with the threat of (until recently) sporadic but deadly Qassam weapons. The latest barrage of rocket fire was used by Israel's military to justify air strikes and ground operations aimed at what they claimed were legitimate terrorist targets - at first glance, a justified response to being under fire, one might suggest. However, what has followed has been nothing short of a disproportionate, brutal, indiscriminate attempt to wipe out Hamas and the (democratically elected) party's infrastructure to rule the Gaza strip; what's more this comes against the background of a bitter economic blockade imposed upon the Palestinian people for over 18 months. Although there's no room for a comprehensive history lesson here, let's talk context and background.

Hamas' democratic election over the more moderate Fatah movement in Gaza in 2006, and Hamas' eventual seizing of power after a bitter internal struggle with their rival faction, caused Israel to impose sweeping economic blockade of Gaza. This reduced Gaza to a basket-case territory, with most people depending on food aid just to survive, fuel and electricity reduced to a bare minimum, even medical supplies and other imports restricted. This effective stranglehold on life in Gaza, together with the building of an illegal wall on the border, ramped up tensions and Hamas responded with rocket attacks. Despite what you may hear from UK/US media outlets, these attacks were sporadic and spectacularly inaccurate - it's estimated less than 20 Israeli civilians have died from such attacks.

Not that a single death should be tolerated, but if any retaliation was coming the way of Gaza there was an obligation on Israel to ensure a proportionate response, one targeting militant infrastructure and not civilian targets. Instead we've had over three weeks of horrific civilian casualties. Jonathan Fryer, in his ever-succinct style, showed just how Israel's military have impacted upon ordinary Gazans - I warn the reader that the images posted on Jonathan's blog are not for the faint hearted, and yet urge you to take a deep breath and look anyway. It is time we stopped shielding ourselves from the true cost of war, from the truly shameful consequences of leaping into armed conflict without care or concern for who is being hit.

Undoubtedly Israel will cite the rocket attacks as their reason for invading Gaza. No doubt either that Hamas will claim that the blockade, not to mention 60 years of occupation and marginalisation in turn lead to the rocket attacks. What neither side appears to acknowledge is that in ratcheting up the antagonistic rhetoric, by insisting on a recourse to arms and not talks, each party is guilty of provoking an overreacting in equal measure - the cycle of violence is unrelenting. From a distance one could easily infer equivalence between Palestine's cause and that of Israel. So why were there tens of thousands present in London's Hyde Park this past Saturday, attending a demonstration of support for Gaza organised by the Stop the War Coalition and partners? I was amongst the protesters demanding that Israel immediately halt its devastating war, which has already claimed over 800 lives. Why does this cause deserve support?

Perhaps it's the asymmetry, with the might of the one of the world's most powerful armies pitched against a militia armed with crude armaments; the astonishing contrast between Israelis living in immaculate homes with manicured lawns living within shelling distance of impoverished Palestinians forced to eek out an existence on virtually nothing; the shameful support the US and the EU continue to provide Israel, implicit or often outright, weighed against the ghastly silence in the face of Palestinian suffering under inhumane economic torture. Then again, perhaps it's the ongoing occupation of Palestinian land, in clear contravention of United Nations resolutions too numerous to mention. Maybe we simply cannot stomach the thought of hundreds of dead children, shorn of the most basic human right so poignantly enunciated by Michael Rosen in his poem about Palestinian children of war - the right not to be dead.

The right not to be dead. Read the poem. Go figure...

Campaign to stop quackery for 'treating' AIDS and malaria

Following on from some serious discussions with such legends of the blogosphere as Ben Goldacre, gimpy, jaycueaitch and others (aka after a chat over some beers in a London inn...), I decided to write the following 'open letter' that I intend to forward to charities, NGOs, United Nations, anyone that may have an interest in preventing the use of 'alternative medicine' in the 'treatment' of AIDS and malaria. This arises from recent exposes of dangerous practices in Africa, detailed in the letter below. Before you read on, please note that the idea is that you, kind blogger/reader, also take a copy of the letter, edited as deemed appropriate, and pass in on to an organisation of your choice. And then blog about it, write comments here, and generally feel smug about trying to make a difference etc. Anyway, here's the letter:

Dear [name of NGO/Charity/organisation, better still a named Officer thereof],

I am writing to raise the issue of so-called ‘alternative medicine’ in [Africa/India/region of interest], and in particular the potentially fatal marketing strategies employed by practitioners of homeopathy, nutritionism and related therapies.

As covered comprehensively in recent issues of The Guardian newspaper (for example here and here), the notorious pill salesman Matthias Rath has been exposed as a charlatan selling vitamin tablets to those suffering with terminal illnesses including malaria and AIDS. He is not alone; as covered in detail in several investigative weblogs (for instance, see here , here , and here), there are many clinics offering homeopathy and vitamin supplementation to desperate patients in Botswana, Ghana and elsewhere in Africa. It is worth clarifying that although there is some (albeit disputed) evidence that multivitamins may slow disease progression in AIDS (1), there is no evidence to support the use of such supplements as large-scale interventions (2) and there is even less cause to revert to homeopathy. Note that homeopathic ‘remedies,’ which contain no active ingredient , simply do not work any better than placebo; arguably harmless when administered to treat a cold, but potentially lethal when given in place of proven anti-retroviral drugs and/or effective malarial prophylaxis.

It is this latter phenomenon that is most concerning; specifically, the advice to use alternative therapies instead of, and not as well as, proven evidence-based interventions may be costing lives. In [my/our] opinion your vital organisation is in a very strong position to counter these dangerous practices by ensuring that the public in the regions in which you operate are fully informed.

[I/we] would like to know if your organisation has encountered purveyors of such ‘alternative medicines,’ and if so, what action you have taken to ensure that sugar pills and vitamin supplements do not replace proven treatments. It is in the communities mentioned above that direct action is required. There is a very real possibility that lives are being needlessly lost today as a result of unproven, effectively empty pills being promoted ahead of proven drugs. This tragic scenario must be averted immediately, which is why [I/we] are asking for your help.

[I/we] acknowledge that many anti-retrovirals are expensive, hard to obtain and may have significant side-effects; nonetheless they remain the most effective barrier to AIDS disease progression. Ditto malarial prophylactics; unpleasant side effects aside, together with mosquito nets they form a vital defence against a disease that still kills one million people a year [http://www.cdc.gov/malaria/impact/index.htm]. Please try and respond to the questions below where possible; the reputation and presence of your organisation is of utmost importance in spreading the message that vitamins and homeopathy cannot treat life-threatening conditions.

1) Has your organisation had to deal with clinics/services selling/prescribing homeopathic remedies targeting either malaria or AIDS?

a. If yes, please give details

2) Does your organisation have a policy designed to prevent such services from spreading, or to educate members of the public against the use of unproven remedies for life-threatening disease?

a. Again, please provide details

3) Are there any governmental, non-governmental or local authorities or individuals that may benefit from being better informed about the dangers of using homeopathy and.or vitamin supplements in malaria and AIDS?

a. If yes, please either pass on their contact details to [me/us], or pass on this letter to them and send [me/us] a copy of any subsequent correspondence.

[I/we] appreciate you taking the time to read this letter, and I hope that you share in my/our concern over the serious danger the use of homeopathy and vitamin pills, particularly in place of conventional treatment, represents. I look forward to hearing you response on this matter of urgency.

With warm regards,

Yours etc,

References:

1) Fawzi WW, Msamanga GI, Spiegelman D, et al. A randomized trial of multivitamin supplements and HIV disease progression and mortality. N Engl J Med 2004;351:23-32

2) Marston B, De Cock KM, Multivitamins, nutrition, and antiretroviral therapy for HIV disease in Africa. N Engl J Med. 2004 Jul 1;351(1):78-80

Tips on sendiing the letter? Obviously, delete the red text as needed - the "we" is included mainly if you wish to gather many signatures, say from faculty or just from other people, and send the letter as a collective. I'd also suggest removing the hyperlinks if you plan to send the letter by snail-mail, which is something I'd strongly urge - perhaps in tandem with an electronic copy, for maximum impact.

Please send the letter to any and all charities, NGOs, medical organisations, professors, bin men, AIDS patients... basically anyone who you think would be an appropriate recipient. And please, just to fuel my ego, please leave a comment here once you have - you don't have to acknowledge in the letter where it came from (I'd rather you didn't actually, to avoid accusations of a vexatious campaign), but I'd like to know whether this lands on the desk of even one influential organisation.

Malaria and AIDS cannot be treated with sugar pills - we must, must do our utmost to prevent the loss of life this practice could cause. Join in, send the letter, do your bit!

EDITED: letter shortened (2nd edit, link to guardian stories altered too) according to suggestions on badscience forum, please let me know any other changes you think need to be made!!

On the politics of a crash

Five percent of the population with the highest incomes... recieved approximately one-third of all personal income.

Corporate weakness inherent in... holding companies and investment trusts. It would be hard to imagine a corporate system better designed to accentuate a deflationary spiral.

A bad banking structure - it would be hard to imagine a better arrangement for magnifying the effects of fear.

This is not an analysis of the current economic climate in the USA and the UK. These aren't the words of a contemporary John Maynard Keynes or John Kenneth Galbraith - they're the words of Galbraith himself, describing the underlying reasons why The Wall Street Crash of 1929 lead inevitably to the Great Depression of the early 1930s. Every generation has the right to make mistakes, it's just depressing (pardon the pun) when a little background reading, a little acknowledgement of similar events past could have allowed us to avoid the same old tired mistakes of the 1920s.

As the elastic thinker documents here, we are truly enetering a new era, with economic history being made with every forced banking merger and every nationalisation of a private mortgage lender. No more cries of 'hands off!' from the denizens if the financial services industry; begging bowl in hand, bankers, both commercial and investment, reach for the State to suckle on its teat for much-needed respite from crashing share prices and the collapsing money markets.

No need to recount here how this latest credit crucnch-derived, sub-prime driven crises came about - ours is not to question why and so on - but let's think about what happens next. Whether the $700bn rescue package currently before Congress relieves the pressure on banks (at the time of writing the measures have failed in the House of Representatives), whether taxpayers' money saves Northern Rock and Bradford and Bingley, one thing seems to be certain - the days of GDP relying on the de-regulated, unmolested, bonus-driven City-based finance industry are numbered. Early indications are that markets either side of the Atlantic are underwhelmed by these unprecedented manoeuvres, as shares continue to slide. How on Earth banks can hold a gun to a nation's head and complain when it comes back with the best it can afford is both beyond me and the topic for another day.

Galbraith's contention is that a stock market crash only leads to a general depression if the economy is heavily dependent on consumer spending reliant on bouyant dividends, and if income inequality means that the wealthy few thus control vast swathes of economic activity. For years following the Great Depression, even during major stock market shocks, these condtitions weren't prevalant. What's frightening now is that we seem to have returned to the pre-1929 conditions - we can only watch this space in suspended horror as to where this crash will lead, but it is up to those with progressive ideals and economic knowhow to prepare to fill the void left by the death of unfettered capitalism.