David Dobbs's Library tagged no_tag →  View Popular

The second major issue that requires scientific reform is group selection, a theory that explains how groups can become well adapted to their environments in the same sense that individuals do. The theory of group selection began with Darwin and involves a simple set of issues that anyone can understand. Yet, it remains endlessly controversial. Next year marks the 35th anniversary of my first publication on group selection and I'm confident that the controversy will continue for decades more unless something is done. That "something" is a truth and reconciliation process, similar to the resolution of political conflicts that otherwise might continue forever. The idea that a scientific controversy might require a truth and reconciliation process similar to a political controversy speaks volumes about science as a fallible and culturally influenced process.

My

Migration of Doctors and Nurses from Developing to Developed Countries

Is the "brain drain" of doctors and nurses from poor to rich countries hurting health care in those developing lands? Is the massive inflow of donor dollars to pay for HIV/AIDS treatment in poor countries diverting resources away from other health concerns in those already underserved places?

He's a breath of fresh air," said Amir Attaran, a biologist and lawyer at the University of Ottawa who has accused the W.H.O., the World Bank and the Global Fund to Fight Aids, TB and Malaria of squandering millions on old, useless drugs.

"You need to talk tough," he added. "There has been absolute incoherence on fundamental issues."

Dr. Attaran, a longtime W.H.O. critic, also praised Dr. Kochi for being one of the first at the agency to realize that AIDS could be treated in Africa with standard regimens of cheap drugs and simple blood tests, instead of Western-level care costing tens of thousands of dollars a year.

In the 90 days before his deadline expired, Dr. Kochi met with generic drug-makers, many of whom are trying to shift from duplicating Western drugs to researching new ones. He told them, he said, that they would face a public relations fiasco if they made malaria worse.

Caroline Jansen, a member of the family that owns Dafra Pharma, a Belgian company that supplies about 25 percent of Africa's private market for malaria drugs, said her company had agreed to stop selling monotherapy and was developing pills mixing artemisinin with lumefantrine, amodiaquine and other drugs.

The war on malaria — in theory more winnable than the war on AIDS because a cure exists — is instead being lost, Dr. Kochi says. In the 1960's, malaria was considered potentially eradicable: DDT and chloroquine, a synthetic form of quinine, had been invented, and much of the tropics were under colonial rulers who, whatever their other faults, were good at killing mosquitoes.

Since then, DDT has been withdrawn because of its environmental damage, chloroquine and its successor, Fansidar, have become all but useless and the health systems in most of Africa and parts of Asia and Latin America have collapsed.