2006 in Review: Medicine and Health

by Leigh Pomeroy

To cover every significant milestone in medicine and health that has gone down in 2006 would take a multi-page treatise. Instead, we will try to cover THE BIG PICTURE, deal with some anomalies, and throw in a little commentary when (at least by our definition) appropriate.

Medical breakthroughs happen on a daily basis, and the U.S. is certainly among the world leaders in advancing medical research and technology. But we're not going to deal with the high-tech stuff, for while it's great — Minnesota is one of the leading states in this area — the real changes to human survival and longevity occur in public health and policy. To begin:

This year new rotavirus vaccines have gained widespread government approvals. According to the Centers for Disease Control and Prevention (CDC),

Rotavirus is the most common cause of severe gastroenteritis (vomiting and diarrhea) in infants and young children in the United States.... In the first five years of life, four of five children in the United States will develop rotavirus disease, one in seven will require a clinic or emergency room visit, one in 78 will require hospitalization, and... one in 200,000 [will] die from rotavirus diarrhea.

And this is just in the U.S. Worldwide, it kills 600,000 children annually. The new vaccines "could cut child deaths by nearly 4 million by 2025" (Science and Development Network).

Also a major step forward is President Bush's late-in-the-year declaration of war against malaria. According to the CDC, "each year 350-500 million cases of malaria occur worldwide, and over one million people die, most of them young children in sub-Saharan Africa." Malaria is a preventable and treatable disease, as has been proven in areas of the U.S. and other wealthy nations where the disease once was prevalent.

Economist Jeffrey Sachs "estimates that combating malaria globally would cost $3 billion annually, or $3 per person in the richest Western countries" (Boston Globe). That's about what the U.S. pays for one and a half weeks of maintaining its presence in Iraq.

Put in perspective, if $3 billion saves just 600,000 lives, that effort costs about $5,000 per life — not a small investment. Yet if the very liberal estimate of 7,000 insurgents are captured or killed in Iraq each month at a cost of about $2 billion a week, that comes to over $500,000 per insurgent. It doesn't take a Ph.D. in economics to figure which is the best investment.

Even if Mr. Bush's promise to deal with malaria is greater than his and Congress's political ability to help fund a solution, the fact that he has brought the disease front and center to the American people is a huge step forward.

Progress continues to be made against AIDS. The cost of treatment has dropped from $10,000 to $140-300 per person per year since 2000 (Global Business Coalition on HIV/AIDS). Nevertheless, as many as 4.3 million people became infected with HIV and the total number of AIDS orphans now exceeds 15 million (Avert).

As well as AIDS and malaria there are other preventable scourges that affect people, particularly children directly or indirectly, worldwide. These include polio, tuberculosis, cervical cancer, female genital mutilation and tobacco-caused diseases (World Health Organization). Add to these war, famine, the lack of clean drinking water and pollution, and it seems humankind is its own worst enemy.

Most of the above are virtually unheard of in the U.S., but we can add our own unique diseases attributable to a prosperous society, such as those caused by alcohol, unhealthy eating habits, stress and a sedentary lifestyle.

Meanwhile in Minnesota, one of our top medical research and care facilities has had to divert costly resources toward protecting itself from a pie-in-the-sky scheme by a small, financially troubled railroad to become a major coal shipper in the U.S. with the assistance of good old American pork-barrel politics. The proposed DM&E expansion is health-related in more than one way, as increased coal train traffic through the communities along the proposed route raises a red flag among those concerned about environmental and safety issues.

Speaking of Minnesota, the elections of 2006 were somewhat of a watershed as candidates not only got away with advocating universal health insurance (UHI) but may have gained votes by doing so. And hardly ever did the other side use the terms "socialist" or "communist" to debase UHI, realizing perhaps in their capitalistic heart of hearts that a universal system offers certain economic advantages that our current so-called "free market" system does not. (For example, administrative costs for Medicare, which is guaranteed universal health insurance for the nation's seniors, is under 5%, while administrative costs for private policies are at least five times that.)

Not only did pro-universalists like Keith Ellison and Tim Walz get elected, but a former health care Grinch, Governor Tim Pawlenty, having seen the results of the election, actually reversed himself.

As I write this around 2:00 in the afternoon on Christmas Eve day I look out the window and see absolutely nothing white. The house next door is light blue, the air conditioner and the flower stalks and the leaves on the ground and the lawn are all shades of brown, and there are slivers of green sprouting up from the latter. There is a coniferous bush that is also green. But no white.

2006 might be designated as the year when the world's most prolific producer of greenhouse gases finally awoke to the fact that it might be the principal cause of the greatest health challenge yet to humankind: global warming. And while too many in this country's ruling elite are still decidedly asleep on this issue, others of us are making plans about how to save the day.