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3/2: The Liberal Years.

America: the Land of Scientific Progress.
When Starr brings up the private vs. public research funding issues, I can’t help but wonder whether modern Medicine would have been what it is today if it weren’t for the interest of private sponsors in medical research. Would issues of advancement have been superseded by the importance of access and primary?
All the scientific breakthroughs Paul Starr mentions make the liberal years a good time to be an American scientist and an even better time to be a scientist interested in medical research.  America as a “leader for the free world” was living up to its promise.
The Polio Epic Battle.
Starr recounts succinctly the winning battle America had waged against Poliomyelitis. My first reaction was:”ah! That’s why Americans believe that almost anything can be cure.” I would like to contrast this with Egypt’s battle against Bilharziasis. As an endemic disease known to Egyptian as far back as the Pharaonic times, Bilharziasis had claimed many Egyptian lives and reduced the quality of life of many more. Organized efforts in treating the disease where usually Colonial in nature. True cure came with injections with Antimonium Tartaratum (tartar emetic) with mass injection programs in the mid 1960’s. The miracle oral drug, Praziquantel, did not become available except years later. These cures came as the result of research and development in other more advanced countries. The Egyptians had a sense of powerlessness against death and disease. When Hepatitis C, at epidemic proportions, was linked to use of tartar emetic ‘unclean’ injections, it fueled the general helpless attitude of the Egyptian population. It seemed as though as soon as you beat a disease, another--fiercer--one appears. This attitude, of course, came mixed with the right amount of fatalism to make it seem like the belief of a pious, not powerless, people.
The danger in this attitude lies in the fact that people who do not sufficiently believe in science cannot be mobilized to fund science. In modern Egypt, you can see a few “run for the cure” pink-ribbon (or hijab!) campaigns a l’americain, but these are merely organized social functions where the elite and upper-middle class convene and educate amongst themselves.
Of course, if appealing to rationality and common sense does not work, playing on the emotional strings of the Egyptians pays off well. As in the case of Hospital 57357, a pediatric cancer hospital funded entirely through donations and fundraising. The fundraisers created huge marketing campaigns featuring pediatric cancer patients, and the people donated to ease their suffering. These efforts are commendable, needless to say,  but the problem is with no financial support for local research oriented towards local community needs, it might not be too far in the future that patended drugs and medications become just unaffordable in Egypt on a large scale--and then charity will not suffice I am afraid. 

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