Studying Liver Diseases in Bangladesh
Thursday, 21 May 2009
A Hepatitis Study Group in Bangladesh ran an advertisement last Tuesday, ostensibly, to create awareness, informing the reading public about the prevalence of various liver diseases in the country and what people could do to protect themselves effectively. Although the thrust, as usual, was predominantly on selling vaccines, the Association for the Study of the Liver, this time round, also included some down-to-earth information like the importance of safe food and water in the prevention of hepatitis A and E. Given that such primary health aspects often get under-emphasised or omitted altogether by ethics-less, commercially aggressive, medical interventionists, the study group might earn some credit for simply mentioning these mundane points.
As for the blood and body-fluid-borne B and C varieties, the group underlined the deadliness of the types by evoking the AIDS spectre: both are transmitted through the same routes as AIDS, that is, through unprotected carnal activity and use of contaminated syringes and body fluids. Claiming that one in 12 persons worldwide suffers from some kind of hepatitis, the ad straight away recommends that all age groups should go for vaccination against type B, while children should additionally be inoculated against type A. For type C hepatitis, which is yet to have a vaccine designed against it, caution is the only prevention, said the study group.
It may be mentioned here that people in general had become wary of such costly vaccination services ever since it started a decade or so ago with the allegedly 'controversial trial of hepatitis B vaccine' through some schools in Bangladesh. Towards the beginning of the programme, a symposium on liver diseases was organised in Dhaka and experts then said that 7.5 per cent of the population in this country carried the hepatitis B virus and that 20,000 of them died of it every year. The study group considered this prevalence serious enough to merit countrywide immunisation against the disease. Cynical critics however considered the danger more contrived than real. This, they claimed, could not be equated with the cluster of child killers that continue to demand the attention of the global health authorities for universal immunisation.
The most cost-effective approach to addressing liver diseases would be to go for preventive measures through information, education and communication about the role of safe water, safe food and proper sanitation. Besides, most terminal cirrhosis of the liver in this region is said to be caused by poor- quality diet, particularly the intake of fungus-spoilt grain, aflatoxin, in the main. Instead of peddling questionable vaccines that do not provide lifetime immunity, it would therefore be more appropriate to ensure that standards of hygiene are maintained in public and private practices of food preparation and consumption and the provision of safe water and sanitation is guaranteed.
Healthcare activists working for relevant and affordable medical interventions in poverty-ridden Bangladesh think the proliferation of 'vaccination points' has more to do with profits and free experiments with human guinea pigs than people's health and well-being. Bangladesh is supposedly a goldmine for microbiological research as here the niceties of 'informed consent of volunteers for clinical trials' are unnecessary and even seeded professionals can be co-opted for the purpose. There are plenty of human guinea pigs available, and thanks to the apathy of the scientific community, the commercial interests of giant companies get nicely served. Policy makers must wake up this potential of the global medical industry to flout the ethics of research and get away with it. It is not in the interest of the commercial giants that sponsor most research to bother about the actual health needs of the people at large.
As for the blood and body-fluid-borne B and C varieties, the group underlined the deadliness of the types by evoking the AIDS spectre: both are transmitted through the same routes as AIDS, that is, through unprotected carnal activity and use of contaminated syringes and body fluids. Claiming that one in 12 persons worldwide suffers from some kind of hepatitis, the ad straight away recommends that all age groups should go for vaccination against type B, while children should additionally be inoculated against type A. For type C hepatitis, which is yet to have a vaccine designed against it, caution is the only prevention, said the study group.
It may be mentioned here that people in general had become wary of such costly vaccination services ever since it started a decade or so ago with the allegedly 'controversial trial of hepatitis B vaccine' through some schools in Bangladesh. Towards the beginning of the programme, a symposium on liver diseases was organised in Dhaka and experts then said that 7.5 per cent of the population in this country carried the hepatitis B virus and that 20,000 of them died of it every year. The study group considered this prevalence serious enough to merit countrywide immunisation against the disease. Cynical critics however considered the danger more contrived than real. This, they claimed, could not be equated with the cluster of child killers that continue to demand the attention of the global health authorities for universal immunisation.
The most cost-effective approach to addressing liver diseases would be to go for preventive measures through information, education and communication about the role of safe water, safe food and proper sanitation. Besides, most terminal cirrhosis of the liver in this region is said to be caused by poor- quality diet, particularly the intake of fungus-spoilt grain, aflatoxin, in the main. Instead of peddling questionable vaccines that do not provide lifetime immunity, it would therefore be more appropriate to ensure that standards of hygiene are maintained in public and private practices of food preparation and consumption and the provision of safe water and sanitation is guaranteed.
Healthcare activists working for relevant and affordable medical interventions in poverty-ridden Bangladesh think the proliferation of 'vaccination points' has more to do with profits and free experiments with human guinea pigs than people's health and well-being. Bangladesh is supposedly a goldmine for microbiological research as here the niceties of 'informed consent of volunteers for clinical trials' are unnecessary and even seeded professionals can be co-opted for the purpose. There are plenty of human guinea pigs available, and thanks to the apathy of the scientific community, the commercial interests of giant companies get nicely served. Policy makers must wake up this potential of the global medical industry to flout the ethics of research and get away with it. It is not in the interest of the commercial giants that sponsor most research to bother about the actual health needs of the people at large.