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OMAIR AHMAD
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Omair Ahmad is a Delhi-based writer. His last book was Kingdom at the Centre of the World: Journeys into Bhutan (Aleph, 2013).

“Wrong-headed approach to science and health”

At the time of writing this column, almost 900 people have died in India in the last month and a half due to Swine Flu, a disease caused by the H1N1virus. Of course, if you listen to some of our politicians, you would have little idea what to do about it. While the Union Health Ministry has asked people not to panic, but to be careful, this tells people very little. And many people who are told not to panic usually do. It does not help that our politicians end up saying all sorts of ill-informed statements. Mamata Banerjee, the Chief Minister of West Bengal, has stated that mosquitoes may be spreading the disease, while the Mayor of Mumbai, Snehal Ambekar informed the population that it is a heart disease and the cure for it is to plant trees.

It is easy to laugh at the sheer idiocy of such comments, but an unscientific approach to health may have deeply negative effects in poor countries where people are distrustful of the government. Thabo Mbeki, as President of South Africa (1999 to 2008), denied the causation of HIV leading to AIDS, and famously appointed a Health Minister who believed in herbal and other unproven remedies, severely compromising the response of the country to a massive health crisis. In a situation where the world is rightly distrustful of pharmaceutical companies keeping prices artificially high (please, please see Dylan Mohan Gray's excellent documentary, Fire in the Blood, on how the U.S. pharmaceutical companies blocked cheaper drugs to fight the HIV/AIDS pandemic in Africa, until India broke the consensus. Since then, we have agreed to terms that may not allow us to do so again), world leaders that undermine the faith of their populations in well-tested responses effectively open the way to suicide by lack of care. In the recent Ebola virus outbreak in West Africa, one of the terrible reasons that many people did not seek treatment early was because the citizens did not believe or trust their government due to corruption, lack of transparency or accountability. The consequences were fatal.

Swine flu is far less contagious or deadly as the Ebola virus. Basically, it is a seasonal virus that has been observed in swine populations from the 1930s, and causes the following symptoms in pigs, "fever, depression, coughing (barking), discharge from the nose or eyes, sneezing, breathing difficulties, eye redness or inflammation, and going off feed," according to the U.S. based Center for Disease Control. Like all viruses — in fact like all living beings— the virus has constantly adapted and evolved over the years. In 2009, the first transfer of the virus from pigs to humans happened (virus transfer both ways, by the way, we give our diseases to animals as often as they give diseases to us; to a virus we are just a different habitat from our animal cousins) in Mexico, leading to a pandemic.45 to 80 million people were affected in 71 countries during that outbreak, of which an estimated 9,000 to 18,000 people may have died because of the illness between April 2009 to August 2010.

A less lethal virus will breed in your body (making you ill, but not terminally so), and will spread from you to the person you cough on, who will also get a little ill, and so on.

A few things should be pretty apparent about these numbers. Firstly, the virus killed a very few number of people affected (around 2%). This is not a lethal virus. Secondly, it spread very fast and very far. This is tied into the first point. A more deadly virus, such as Ebola, has difficulty spreading because it kills its hosts too quickly — although the density and increasing interconnectedness of humanity are making that difficult to manage. A less lethal virus will breed in your body (making you ill, but not terminally so), and will spread from you to the person you cough on, who will also get a little ill, and so on. The third issue is that the numbers are very broad. Bear in mind that these numbers come from the Centers for Disease Control and Prevention in the U.S. (the initial swine flu pandemic affected the U.S. first and foremost) whose estimated 2014 budget was $11 billion (approximately Rs 600 billion, or Rs 60,000 crores) while the Indian health budget used in 2014 was about $4 billion (Rs240 billion) — bear in mind that the total U.S. health budget was $920 billion more than 200 times ours in total. Despite the high amounts spent, the estimate is vague primarily because the chances of successfully diagnosing an infection are between 10 to 70%.

So here goes: we have a disease whose symptoms are exactly like those of the common flu — a cold, cough, fever, diarrhoea, headache or any combination of these. The chances of diagnosing it are low. The cost of diagnosing it is Rs 5,000 approximately, which is two-third of the average monthly wage of an Indian — the vast majority of whom do not have health insurance. On top of that, they are not being properly informed by our politicians. If you want to understand why India is not a great power, why it struggles to grow, and why its poor struggle to rise — this is a perfect example of one of the reasons why.

 
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