As I've written before, circumcision is gaining currency as an effective means of preventing HIV. Data published in last week's Lancet suggests that circumcision cuts the risk of HIV infection by up to 65%, more even than the previous estimates.

The World Health Organization is hosting a conference in early March to make recommendations on implementing circumcision for preventing AIDS. But judging from comments here and elsewhere, it's going to be a tough sell.

Experts have warned that unsafe circumcision can endanger lives. A new study, published in the March issue of the Annals of Epidemiology, adds that in some African countries, circumcised boys are two to three times more likely to be infected with HIV. This may be because circumcision is often done with unsterilized equipment and can pass on infected blood from one child to another.

Posted by Apoorva Mandavilli at 02:57 PM | Permalink | Comments (0)

Something strange--and embarassing--has happened in India.

For the past few weeks, Novartis has been fighting a lawsuit in India that could affect the availability of cheap drugs worldwide. The lawsuit challenges India's decision to interpret WTO rules and only honor patents on drugs that are entirely new, not just derivatives or variations of existing drugs.

This clause allows Indian companies to make cheap copies that they then sell all over the world. The case is still being heard, although high-profile voices, including nonprofit group MSF (Doctors Without Borders) and Henry Waxman, chair of the influential US House Committee on Oversight and Government Reform, have asked Novartis to drop the suit. More than 250,000 people have signed the MSF petition.

In the meantime, the Indian government had asked a high-level committee, including R.A. Mashelkar, who retired last year as Director General of India's Council of Scientific and Industrial Research and is arguably one of the most respected Indian scientists, to look into the patent issue. After nearly two years' deliberations, the committee produced a report on the law that is favorable to Novartis.

But get this: an Indian newspaper discovered that the crucial bits of the report were plagiarized from a paper published by a think tank in the UK and funded by INTERPAT, an association of pharma companies whose members include Novartis. Mashelkar says he didn't know about the plagiarism and has withdrawn the report, asking for three months to review it. I buy that he didn't know about the plagiarism and that it might have crept in when the "draft was being worked on by a sub-group" but the larger issue is the potentially biased source of the original conclusions.

The government hasn't yet said whether it will accept the revised report, but any way you slice it, this is a deeply embarassing incident for Indian science. Earlier this month, Nature challenged Indian scientists to speak up and help shape policies. This is an inauspicious start indeed.

Posted by Apoorva Mandavilli at 05:59 PM | Permalink | Comments (1)

Our former intern Emily Waltz points out that Scientific American's March issue has given Francis Collins and Anna Barker, who lead the Cancer Genome Atlas initiative, several pages to, as Emily puts it, "make their case" for the project.

The cancer genome atlas, which is supposed to catalog all the mutations found in human cancers, is ambitious in scope--it's expected to cost about $1 billion over the next decade. Just the pilot phase, which began a year ago, has a tab of $100 million. That's no small sum when individual researchers are feeling the pinch of tightening budgets.

Emily is understandbly skeptical. Her reporting of the project last year uncovered serious practical hurdles facing the project, including the lack of enough tumor samples with the required informed consent. Privately, many scientists also complain that this is a vanity project and is unlikely to do much beyond run up masses of data.

As if in direct response to that criticism, Collins and Barker say, "Piles of data are, of course, not worth much without evidence that comprehensive knowledge of cancer's molecular origins can actually make a difference in the care of people."

Collins and Barker are right to note that drugs like Gleevec, which is what scientists like to call a "rational drug," can result from identifying the molecular origins of a cancer. But the article isn't really clear on how the project is likely to deliver those drugs--at least, not enough to make it worth the hefty price tag.

Posted by Apoorva Mandavilli at 03:08 PM | Permalink | Comments (0)

The prominent Chinese AIDS activist Gao Yaojie, whom I blogged about previously, left Beijing yesterday to receive an award in Washington DC for her work exposing blood-selling schemes that infected tens of thousands. Chinese authorities had released her from house arrest, suggesting that they respond to international media coverage and diplomatic pressure.

But what about AIDS activists who are not so internationally famous? How are they faring? To find out, I called up Nicholas Bequelin, a Hong-Kong based researcher at Human Rights Watch, which in 2003 published a report on human rights and AIDS in China.

“Essentially all the independent HIV aids activists in China operate under fairly difficult conditions,” says Bequelin, “We still see the harassment of individuals and grassroots activists.”

NGOs (nongovernmental organizations) in China have few legal protections from authorities wary of initiatives operating outside of the government framework. That’s not the most effective way to fight a virus that at current rates of transmission could infect 10 million people in China by 2010, according to estimates by the United Nations.

“I think international experience shows clearly that NGOs are the most effective groups to deal with high risk populations—sex workers, injection drug users, gay men, truck drivers—to reach them you need to have organizations that are grass roots,” says Bequelin.

As an example, consider the strong link between AIDS activism and the gay rights movement in the United States. Yet in China, the government only decriminalized homosexuality ten years ago and only six years ago removed it from a state list of mental disorders. In many parts of the country, people with HIV/AIDS are still stigmatized.

Over the last several years, China has improved its approach to AIDS treatment and prevention, for instance, increasing spending and applying for funds from the Global Fund to Fight Aids, Tuberculosis and Malaria. Yet the country still has a long way to go.

The 2003 report from Human Rights watch extensively documents the harassment and surveillance of groups that combat HIV/AIDS. Much of that is still going on, says Beqeuelin, who provided two examples:

1. Wan Yanhai, the director China’s leading AIDS NGO, Aizhixing, was reportedly coerced into canceling a conference on HIV-AIDS and human rights. The conference, “Blood Safety, AIDS and Legal Human Rights” was to have taken place in Beijing in November, 2006. But Yanhai called off the conference after being detained by Beijing security personnel for two days.

2. In Tianjin, police harassment has curtailed advocacy and awareness projects in clubs and other places where gay people meet. In July 2006, the police arrested clients at a male bath house and confiscated all the condoms supplied by Tianjin’s Family Planning Association, according to reports from Aizhixing. A month later police again raided the club. “Everything has disappeared in the city,” says Bequelin, “There are no activities in terms of prevention and awareness for gay men.”

Even Yaojie has said she is wary of being too outspoken during her trip to the United States.

The 1980's AIDS activist slogan "Silence=Death" was powerful for a reason- this is a virus that thrives on silence.

*****
By some estimates, a billion people watched the Academy awards last Sunday—and surprisingly that could provide a boost to efforts to publicize the fate of individuals infected with HIV through tainted blood in China. The documentary “The Blood of Yingzhou District" won the award for best documentary short subject. The film, produced by the China AIDS Media Project follows the life of a child orphaned by the blood scandal. The film will be playing in mid-March here in DC and I’ll be blogging about it later.

Posted by Charlotte Schubert at 11:15 AM | Permalink | Comments (0)

Seafood lovers, pregnant women and lobbyists for the fishing industry heard some startling news this week from a study in The Lancet.

Offspring of women who ate a lot of seafood during pregnancy scored higher on tests of verbal and social ability than offspring of women who at little or none—despite concerns about high mercury levels in seafood. Even the study’s authors were surprised.

The take-home message of the study may seem positive, but it comes with ominous undertones: “The benefits of eating seafood outweigh the risks.” Somehow, I'm not fully comforted.

What the study did not address was how the seafood-reared children would have fared if their mothers had eaten mercury-free fish—a thing about as rare as coelacanth caviar. It’s a tough question, but it’s worth asking — given that mercury at the concentrations found in many fish is likely harmful to fetal development, as The National Academy of Sciences has concluded.

The new study didn’t take the bite out of mercury — it just suggests that omega-3 fatty acids and other substances in seafood are really good for the developing nervous system. The findings will certainly put pressure on US regulatory agencies to change their advisories limiting fish intake for vulnerable populations. Pregnant women in the study had to eat more than the level advised by the agencies, 340 grams per week, for the beneficial effect.

So what is fish lover to do — believe this one study and start chowing down on tuna fish sandwiches? Carefully parse lists of fish species with high and low mercury content, or just eat a lot of omega-3 containing flax seed?

There’s only one sure way to make things simpler — and safer. And that is to get rid of mercury in our waterways.

The Bush administration is notoriously backward on this front. The US Environmental Protection Agency — the same agency that issues advisories on fish consumption — has ruled that coal-fired power power plants have almost 20 years to cut their emissions by 70 percent. That stands in contrast to an overturned Clinton-era ruling calling for a 90 percent reduction by 2008.

The EPA has received hundreds of thousands of letters protesting the Bush-era ruling — so a single study from The Lancet is unlikely to change anything. But those letters show how strongly people feel that there should be only benefit, but no risk, to eating a basic food item.

Posted by Charlotte Schubert at 08:48 PM | Permalink | Comments (1)

My graduate advisor, like many scientists, was not known for his touchy-feely approach to mentorship. But he did occasionally dispense nuggets of advice in the form of a joke. He came out with this one—perhaps told in many laboratories—in response to my frustration at getting equivocal results from experiments that I thought were obvious:

A man who had lost some change on the street at night was frustrated because he could not seem to retrieve it. His friend, wanting to help, asked, “Why do you keep looking in this one place?” The man replied, “Because that is where the light is shining.”

How many scientists keep looking where the light is shining? What do they miss when they fail to explore what’s in the darkness?

I can think of no better example of people searching little-known areas—and striking gold—than one featured in our February issue by Erika Check. In her story “Gut Warfare,” Check describes how, after difficult experiments, HIV researchers have come to view immune cells in the gut as key to the pathogenesis of the virus.

Just a few years ago almost all HIV researchers focused their studies on immune cells in the blood, but the topic of HIV in the gut is now all the buzz at HIV meetings. The findings have the potential to change how HIV is treated and have already shifted the emphasis in vaccine development to mucosal surfaces.

When I first covered this advance as the news and views editor in 2004, I was struck by the fact that some of the earliest evidence for it emerged in the 1990s including a 1998 study in Science. Why did it take so many years for the subject to become the next hot thing in HIV research? Why did so many HIV scientists seem to ignore the early clues?

I don’t know the answer. But in all fairness, the advance required extremely challenging experiments—gut biopsies taken from individuals shortly after HIV infection.

I’ve heard researchers in many fields complain about mindsets that impede progress and restrict grant funding for fresh ideas. Does too much competition make people jump on the same fashionable but obvious project, pummeling each other in the light? I’m not sure what it is, but I do know that as a graduate student, I had a strong practical interest in getting published and getting out of school.

What are some of the untapped areas in your field? Have you seen certain ideas, perhaps easier ones, prevail for long periods of time—while truer answers languished in some hard-to-find dark crevice?

Posted by Charlotte Schubert at 10:08 AM | Permalink | Comments (0)

I love sleep. I need at least 7 hours to feel human and when I'm sleep-deprived, it's just so much harder to make sense of what the news articles I'm trying to edit are all about. And I'm not alone in feeling this way.

There's no doubt that sleep is good. Not getting enough sleep can make you, among other things, cranky, forgetful and obese. Scientists are now saying that if you can add on a regular midday nap, say 30 minutes three times a week, you can cut your risk of heart disease by 37%.

This might explain why heart disease is lower in countries where people take siestas, say the scientists, who followed 23,681 Greek men and women ages 20 to 86 for about six years. They published their results in this week's Archives of Internal Medicine.

I think it might also have something to do with the famous low-fat diet in Mediterranean countries. In India, where I'm from, people also take midday naps--something to do with escaping the sun's grueling rays for at least a couple of hours. India has one of the highest rates of heart disease in the world.

But hey, why look a gift horse in the mouth? This is all the encouragement I've ever needed. I asked today if I could nap at work every day. You know, for my health.

My boss Juan Carlos Lopez, Nature Medicine's chief editor, hails from Mexico and spent many years in Spain. Naturally, he fully supports the concept of a midday nap — in theory.

JC, as we call him around here, says he sometimes takes a nap on the weekends, but no more than 15 minutes. "If it's more than 15 minutes, it screws up my whole day," he says.

Suportive boss that he is, he says I can try it if I want, but my colleagues will probably yell in my ear, or something equally pleasant, and wake me up.

Sigh. I guess my daily siesta will have to remain a dream.

Posted by Apoorva Mandavilli at 04:41 PM | Permalink | Comments (2)

So Harvard has gone and elected itself a woman president, the first in the university's 370-year history. That means half of all Ivy league universities now have women at the helm, which is a remarkable statistic.

A few weeks ago, scientists got a little excited that Nobel Laureate Tom Cech and neurobiologist Steven Hyman were being considered for Harvard president. But Drew Gilpin Faust, a historian, became the odds-on favorite after Cech withdrew his name from the race, saying he was choosing to stay on as president of the Howard Hughes Medical Institute. And who can blame him? The Harvard job, as Larry Summers knows well, is no cake walk.

I'm a bit wary that Faust's appointment will be bandied about as proof that Harvard has addressed its problems with creating equal opportunities for women. But perhaps scientists still have reason to rejoice. The New York Times reports today that:

Asked Sunday whether her appointment signified the end of sex inequities at the university, Dr. Faust said: “Of course not. There is a lot of work still to be done, especially in the sciences.”

Will Drew Gilpin Faust take Harvard's gender inequities to task?

Posted by Apoorva Mandavilli at 01:48 PM | Permalink | Comments (0)

China may be eager to claim a top spot in the international scientific community, but before it can move forward, it must first face up to its past.

Just last week, it seems that government authorities prevented a prominent AIDS activist, Gao Yaojie, from traveling from her apartment in Zhengzhou to Beijing for a visa to attend an awards ceremony in the United States. She is slated to be honored this March by the Vital Voices Global Partnership, a nonprofit group with Hillary Clinton on its board.

Yaojie is well-known for uncovering the unsafe blood donation practices in Henan province in the 1990s that ultimately infected more than tens of thousands of individuals with HIV. In state-run facilities, blood from multiple donors was mixed together before being infused back into the donors' bloodstream—a practice that continued for years as Henan officials attempted to cover it up .

For her tireless effort to expose the scandal, Yaojie, a 79-year-old physician, endured government harassment and surveillance. According to some reports, the current effort to keep her quiet stems from a wish to avoid embarrassing Li Keqiang, the former governor and party chief of Henan, who is rumored to be in line for the presidency.

No official seems to have been punished for his role in the plasma trade, according to reporting by the Economist. Victims of the scandal have been promised drugs and reparations by the government, but it’s also unclear how that effort is progressing.

China recently lifted some of its restrictions on foreign reporters, in advance of the Olympic Games. Hopefully some will be able to use the opportunity to dig deeper into the legacy of this government-sanctioned and silenced disaster.

Posted by Charlotte Schubert at 08:43 AM | Permalink | Comments (0)

The most popular news item on Yahoo yesterday was a Reuters article about a potential new cancer drug. Intrigued, I read the article but couldn't understand why it was news.

The article is a cutesy account of how the researcher, Katherine Schaefer, had mistakenly added massive amounts of a PPAR-gamma modulator to a cancer cell line and killed them. That apparently led Schaefer to test this substance as a cancer drug in various other cancer cell lines and in mice.

As most biologists can tell you, almost anything added in massive amounts will kill cells. It's fortunate that this one does seem promising, but let's be realistic. So far, it seems effective in mice, which are a far, far cry from humans. Even if everything works well, a less than 10% chance, it will be at least 15 years before a drug version sees the light of day.

This particular article was published in the International Journal of Cancer--and not in the fictitious International Cancer Research as the Reuters article said--but a quick PubMed search reveals that Schaefer first published a link between PPAR-gamma and cancer in 2005. So even that aspect wasn't new.

Although scientists do often hype their findings, Schaefer herself seems perfectly reasonable. When I told her I was surpised her paper had been covered so widely, she said, "You and me both." Apparently, this was the work of an energetic PR person at her university who, I must say, deserves to be congratulated. She spun the story admirably well as a tale of lucky accidents, a wire service journalist bit and bingo! I could say something here about the dangers of over-hyping science, but I'll restrain myself.

At least the publicity has already had one good outcome. Schaeffer says she's had emails from people she hasn't heard from in 15 years or more. Happy accident indeed!

Posted by Apoorva Mandavilli at 03:44 PM | Permalink | Comments (2)

On Wednesday, a Senate committee passed a bill that would make it illegal to discriminate against people on the basis of their genes.

This is an important step: as we know more and more about the genetic variations that predispose people to certain diseases, it will become important to make sure the information doesn't get misused in any way. The law would stop insurance companies from denying coverage to someone with a high-risk gene, for example.

That's a long way off, however. The Senate has twice passed a similar measure unanimously, but it stalled both times in the House of Representatives. With a Democrat-controlled Congress, the outcome could be different. If it is, the law might also enocurage more people to get tested. Polls show that about 85% of people think their information would get misused--not exactly a strong incentive to get tested.

Even when people are willing to be tested, predictive screens open up a whole new can of worms--what to do with that information? Should people take certain extreme preventive measures, such as radical mastectomies if they carry high-risk breast cancer mutations? Should insurance companies pay for those treatments?

My friend and fellow journalism school alum Joanna Rudnick is making a personal and powerful documentary about these very issues.

Posted by Apoorva Mandavilli at 06:34 PM | Permalink | Comments (0)

This week’s New England Journal of Medicine carried a small, but alarming, report on those ever-so-calming substances lavender and tea tree oil.

The researchers noticed that three boys who were 4, 7 and 10 years old — so all prepubescent — developed gynecomastia. That’s jargon for enlarged breasts. Apparently, more than half of boys will show some signs of this during puberty but never before.

The first things doctors look for when something like this happens is exposure to the hormone estrogen. None of the boys had been exposed to any known estrogen source — no drugs, birth control pills or soy products. But two of the boys had been using products with lavender oil and one both lavender and tea tree oil. Once they stopped using the products, their breasts returned to normal.

Based on further experiments, the doctors are saying that these oils mimic the effects of estrogen and may be triggering hormone imbalances. Given the popularity of lavender-scented soap and skin lotions, shampoos and styling products, this seems to me to be big news. Okay, it’s three boys and some in vitro data, but it’s also published in a reputable journal and deserves investigation.

This seems to be just the beginning of a long and scary saga. What about women that may carry risk genes for estrogen-sensitive cancers? What about young girls? What about the rest of us? Should I throw away my lavender roller and tea tree oil body wash?

Posted by Apoorva Mandavilli at 06:22 PM | Permalink | Comments (1)