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5 THINGS TO (NOW

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5 THINGS TO KNOW

AEl]UITt]I RIIR

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02

SRoADtR

PtRSPfOVt5 l/rc

I..l.fi.drr drur

Kt[tR

TOP 5

Ill DIVIIOP

D

ttA$s

I{G NATION5

Dmrh roll: 4 millior/yeor

POl,ro

$o$t hit:

tuErmlbiori{r

2

1

Mqcrt.,, r,rdid, R,/i6l d r, ]1tqndnisran

Htv/AIDS \!orst hit: s,,r 5(/,dro,rlttit\I.

?.HrV/AlDs Deorh

t|1t (1o.i!1bcdn

3.

t{

ro

3 milion/yeor

ARtA

D€olh1ol:l 5miliof/yem

or"Aririnq.

4.

D]ARRlIOI,\

Dcorh

roll 2.2 milion/ytur

tuE:0m

BtrCAUSE \\TE -{RE CI ,OS !]'I O L'Rr\DICATING IT/ Si.ce r988. tlie WIIO, IiNICEF and t|e Rotary FoundaLion have led a i{orldwidc clTon to eradicale lolio. 2t) ] ears snrc. this gitt tionr the 2oLh certuN tothe 21si'xrs madc, the Anericas, lurope rDCl36 othcr counhies hale been decla.ed pol ficc. Iflvc strccced, il willo!! bethe secord tnlc rnanlind has sDccesslul\ e..rdicateda diseas. sincc lgTg

slictory

orersrDallpor. Butpolio can oDl] bceradicated once

.n ,,.1r ,lir rr

is establjshcd.

I i-rt.

,auooot \apuf,r...iur

A.t count!-thal

lets their vacciDatroD

cfforts slid. eDds up threatenirg the prcvious irnnruni\'as any ore uDr:Lccinrtcd child caD lead to a nelvpocli€t ofdisease. \llieD Nigcria haltcd irs poli.) vaccinitjon p.ogrannne in 2oo3 duc to Nidespread nunours that the mccin. coDtained lhe AlDs lirus andwaspart ofafosi SAt.mber rl ricio(s WesterD constiracy to sterilize Nluslun girls. 18 previorisly folio fr'ce counlrjes had poLio outbreak traccabl. to Nigeria. Donor iDterest is lagging and the 20 !ea. lorgcarnprigD to emdicatepolio is shosingsiil sof serious fatjgue. Polio pr.v.ntjon is incrediblr tedious, re.tuiriDs 1o doscs ol chilled racci es space.l Drcnths airart: a fiagile t|ocess easilv disrupted b] misinfohr.d religious z€alots,renophobicmoth.rs and corruft clinic officials who lct lacciD.s gro$

wa.n aud

useless becausc

ih.v pocketed lhe lreezer

BECA(JSI,] IT"S DI'SI'ROYING -{N ENTIITF] CON I INl:lNI/ AIDS is cssentiall\ a set otirfectioDs that rffects tlrc hnman inrn)une s!steni oDce it is damag.d b] HI\: (human irnniurodefi ciencv \irus). No disease |as inslired rs n ch impassioncd celebrjL) h.tnd-nanrgins as AIDS. for unlike pol io aod

malaria,,UDS has Dot lcftthc cliie nor theglitlerrti uDtouched. Thc rcd AIDS ribbon. created to short solidaity with HIV l)osilive per,ple, has becoDe a

trendy fashion accessorv Lhe r99os symlnrl of coDu.ssion lbr all tashioDable crNes. Holl)nrood hrs ever made hit novies likc REIT, glarnonrising 11IV positive peorlc as h.roes.nd conde rniDs preiudicial attitudcs iow. s Lbeni. Yet, the nedia overexposurc has not been enough to chaDge the sitlation for the toor 90% ol the 40 Diilljon HIV infcctcd pcople I ile

limited

h delelopiDs

BR0,\DlR

in.c.urale

inJbrnratjoD rbout,^lDS procntion, dre |ish cost ol niedicrtioDs aDd hnitcd |eah| ca.e infiastructuEs. {lDS is lit.ralh d.cinralinA lan}ilies, iDdusties, am1i.s, schools rnd the cjyil senice in sub-sahamn

African nations !hich hosts 70% of HIY tositrvc

| .,-. \i '\',ir

l.\,-r .rJ|

,'lrt gr^rt'

n

Alricn to lall rs rNch as r.2% polcar. As leAions o1 learhers. lierithcarc \'orlos, parenls and soldiers die tu th.ir trnn., Africa s abilitl to b.eak ort of

povcfty.nd stlile A.o\{s

03

couDtries aDd ha\c

access to treatnient becausc of

PtRlPttTlvt5 th(

daDJ.eroush thin.

hpnltht.tr i:.tt

(t

rchydrorion

{lt

5 rl]ErRtut05ll Dturh roii: Z ml ton/F(]r

5rro

N

lD TB

me

djirg

I 4

3

CLINIC,\I I]trPRISSIO\ \rorst hit !rlnoLUn

c,\N( laR worst hitr {,5,..t lnrl/.lrs/J d/i{.4;,rrrd,!/

,/t

Hlr' ti

TT'S STILL INVISIBLI] AND [IlSUNltl,]RS l OOD/ llra!,jne Naking ut to find 13I.](]AT]ST.]

all iour lorc for lifc inerplicabh dtubed arvay. P.oplc

',-,. rt; 1ir |,l,.tr- ,r 'r n, , lo.. ir'.r,..t F'l ,g ,.gl.,rrl .!,!-, ,,, r, - , i,

I

,'

lll,rfAIISE IT'S PRIi\JllN L\Bl.l,r/ nren as far back as 16()c) ts C.. ar.icnt Grccks and Egyptian doctoshad aLread! discolrjtd that oDccyour bodv ]icld.d that ugl) rnislLapeJr lunrour, dcath $'as closc. Crnc.r starts off i{ith iust .r change i. on. singlc

o

howrour gencti.

n'eeks rt a iime. llai

frierds. clr u.co.hollablv an.l fccl worthless lor tir derr€ssi\cs ftiplar disordcr) na! sn'iDg liom Lhe blackesl of rnoods to ivild

nhe talc€ and ag.ing ccll h repair sistem tace .rll $,ith a coclitail ol extcrnal agents ( cludirg

cxccssiv.ncss. E\trene cases ca. lilerall) wast. a$'ay

crrcinogens lilie.adialion. asbcstos, arscnic aDd

fhm not cating, mutilrtethernsehes ind r5% ofth.m e\e.nr.lll connnit icide. lveryone llas lhei. slock th€or! abour rrh) clinical dcrrssioD is risjns (rich maD s er !j, inrDrahnity, an cmoti{Dally enptv consumeist cnltLrR. elc.l a.d notall arc $lDatlietic toNa swhatsoneli es looks like.hildish bchaliou,. F!.n in ri.i nrtions rne.l.l illness slill.aDi.s a so.i.l stigma. Buiscientists hale lirnlr est.rblishcd

ofura].c]l. And thcD dependiDg

comtmicrlts oftobacco),

a

malignaDt tumour is thus

bon. Shockniglv, tobacco u!e is t|. snrglc nrcst ,tLdbntrblc laDd )et prevertable) ca!se ofcanccr 5C)% olsnrok.rs arc killedbl lLrDg c.rnce., nrakinsit tlie to! killer olallcanccN. Lr richer lations, tobrcco use. alcohol use, nnd being olcncight o. obese are

trnnat

causes

c{ent rn

olcancer. Though canccr is to sone

unpredjctaLJle a.d indiscdninxte killer,

\illb. thc sccond intcrnati{Drl he:Lllli buden alier h.art

3(]% of cancer deatlN co!ld lare been rrcy.Dtcd. Anyonc rich and toor- crn lo$er Lheir risk fa.toF l.,r c.rncer significantlv b,v choosing to liYe thnl clean, 'boiDJl lite doclors lo\c to prcscribe brt so fe$.lilie to heed: re8ular er.r.isc, gctiing raccinrted, !o smokiDg or drinLj.p,, e.tjng norc fruits and

djse.sc. Dcfrcssi.D is comrnon iD dereloling naliors as \!ell cxccft with no local prrlance to diagnose it

lcgctables, eating less lat, suga. and salt rDd sl.thcdng oD strD-block iIlou cannot stal ort of its

be sinrpltblushcd asidc as h'Nins a \.eali (chha nind" s r/rc,r /tr9 snrat rro), haling "too

lile Hong

that nrnjor cliDical dcprcssioi is atreatable biological

bnh

gcrctic inclinatiini that sonebodt crnnot nerelt sia! out of. It.an also b. triggered b! drrstic life cliaDses o. harsh liviDg co!diiioDs. disorder,

a

AccordiDg kr the W110.

largcst

so

bl 2o2o.

it

it nra)

,r ,1.

too

nrr.h

.'r.lll ,. '.,././ /r',a'^r ,,tIo s trtflnrrdisd). It

.,t \''lr"t.i,l't

srrnniAskies.in,ld lilerrlh

(Zimbabrvc

04

BR0ADtR

PtR5PttTVlS l/rc

'l\-in

/r.d///'(,nr Nsr!,

'l"l.r' save vout lifc. (, -or

Kong or Bangk{rk? lackirg your bngs tbr

I

5 cARt)I()\r,\sctII AR DTSF.ASt'. woBt hit: srn Sdhardr,1fi n a. h. Oi r i hh.t t

Fact

n t

or Fiction? Photoshopped advertising and size zero models are causing people to hate their looks! NOI

N 'l I l Ii

\lOS'f EXTREilItr CASES/ \'aniiy is a ferpe(ual hurDan problem and fca pcoplc l

pa.Licularb $onen, are conpletclv plcascd with t|eir lool(s. Lve$one at sone ponrt has obscsscd about an unfo.tunrte pimple or tbc 5kg they ca.not s€eri to shed. Nluch ofthc blame so ta. has been l.rid on the BII,C,\USN I T'S STILL THE I,EADINC CAUSL

Ul l,L\IIl \\(lRI D\\lDl- H^l 'p'd lia crusted wjth salt. Doublc bacon cheeseburgers drippirlg witli beeffat. A lcallv bis icy mug olcoke. A Djght on thc couc| waLching old .e Nrs. So nd likc a drcam? Untbrlunalely, ar erjoyablchish salt, hiit| fat, high sugarsedertan lifestjlchas cDded up in lelhal nightrnares for nillioDs i{hohavedied liom ca.diovascular disease. Rcgrctflrllv, your lirsl heart attaclt or stroke is usuallv the only svmptom or warniDs tou get that tells you loor blood vessels arc gcttjDg too clogged up wiLh tattr deposits. Victims can bc yoLtng or old. rjch o. poor - yon arc at

hig|

dsk as lolg as tou use alot oftobacco, cat unhealthib

and a.e generally physically inactile. Repo.tedly, tatq deposits nay eicn bc found in childrcn as t.ruDg as ro and the deposits kccp mouDinrg silentLy through theyears ntil a criticalnrass is reached. Shockinslv thc skiDny are not exenrpt: even superbly fit marathon runners like Jim liis hare died fion hcaft attacks a late nttribtrted to familyhistory, his old two pack a day habit and hish cholestool levels. Il current treDds go oD as the,v arc, by 2.)15, an estinuted 2(r millioD peopl. will hrvc died Irom heart attacks or strokes. China aheady laces Lhe hearf b rdcn of

fotcntially losinit $558 billior ni rutional inconre oler the n€xt ro yerrs as more Chinese adopt Wester style living ud eatiDg and succumb to heart diserse. strcke and diabet.s. at

05

slamourcus fas|ion and media nrdustries forpushins an in oeasingly sldnnl iderl typified by the enti.c cast

Ctl and Bererl! /1ills gopro 2.o. Bcautilirl models and actresses havc th.ir.y.ry stin discolouratioD aDd little folds of fat meLiculousll ofCossrp

Photoshopped outpixcl bypixel.1l is no $.onder tliat e\€n modcls and actrcss€s th emseh,es dietobsessiveh aDd

fall trey to nu rerous eating clisoders to lit into eve the) caDot attain - staN likc Lindsav

an ideai

Inhan, Jenniter,\iston, Nicole tuchic, Kicra Knightle!

drrr

'lri Ln B.r.il,.,\.h.,r'\r ,r',s.rir,it.,,.,i

,-

rate siDce tliejr first nrcdia aff.ahnces.

But thc most exheme cases ofbody loathiDg cannot be blanred on the

nedir s $'orshif of sizc zcrc waifs

but on psi,chologicrl disor de$ iike obscssirc comfDlsi\"

disorderorflrwed Deurotransnitt.N. Suftirers ol Bodl

Dtsnorphia Disorder (BDD) D til.te themselves, Eo for excessive plastic surgcrt' (lile Michael Jackson) Dot out ofa d.sirc to be beaulilill but out ofa desire to l{xrk

nornal. BDD sullerers are obsesse.l with how unbeljevabl) ugly and defomed thcy arc cvcD thoLrsh Lhey are nomal or even attractilc looking. lheir

si"rlp ' ... r1:'.r^r'\vir\ir ,.'itj FJo,,.r:Iur defect theiIphlsical app.arance rcnder Lhem unable 1...1r"1'

lu'.Lr..i^a,,-Iui,,olF,.,

-\-,r,-

LI1L

Thoug| often seen as a womaD s ilhess, BDD affccts both Dren and women equally aDd s ffcros arc ext.enelvhish dskcandidat.s for suicide It

ER0ADtR PERSPttTIVtS

t/r. heolrhcarr 6src

'1

By 2015-

e$e{s frcdict that

out

of$

mega-

citics,27 rvill be nr the develc,pilrg \otld: sLrch horitiDg dail), cotlditiotls will be ibc nomr forthe nuiority ofthc wo drvholack the resourccs to escape from or inprove upon their urban envi.onnent.

\\o.se still. ,,,!t d$clopinll $o.ld .il1 dx cllr15 h,\. n ilimgll td,'pl.(l lh. $o.st c\crsscs ol . tll)ictl trb ,

lil-cslr lc \rilh ',("!c of lh. sofbislic.tcd sulporl sr sl.nrs ri(h pcoplc usc 1,, trcdiate ils .llil ts. The top fire causes of dcath in the delcloPed

!o

dindesce dinsordera.ehea diseasc, stf okc, pulmonary disease, respiratory infec ons and Lung canccr. Lting at tle bottom of th. top ten list sits sricide. Such urban Dialaise is rsually attdbuted to cedriD hallnarks ol t)-pical urban lile: snroknis,

alcoholism, slressful desk-bound office work, recreational dNs use, rnultiple scx partneN, livins done,

a

srowiDs dependence hish nr caLories

on processcd foods that are

btrt low in nutritioDal value. For nost Russians,the arival ofPereslrcika sai{ an upsurye iD prostitution and drug abuse mtes, blorvirg the nurnber of AIDS paticnis

to 7 million in a country $'hose annual

healt| budset onLy covcrs the cost of treatnert for 5oo.If a risk anal-vst in New York desires to

tuN her lile

prcssure) around, shc can still pe$onal trainer, medical i

toh

to her

Today, more than 8(l% oftobacco dcaths arc fron developing countries aDd

traditionally rich world p.oblems like morbid obcsii*, diabetes andcardiovascLtlar

ir

,,,

globalisatio.. For irstaDce, health rcsearch

and aspire towards a typical Amcican lifes\.le high h fat and susar buL low irr exercisc. Sirce the arrilal of the tirst XlcDonalds in Nlosco! in 1991 rDd in Bejjing in 1992, obesity has corne hard in irard with the libcrnlisation of ihcs. fonner connnaDd ecoDonics. Fei! city m.)ors xre wilhrg to lay do$'n laws that Lake a$'ay belovcd Marlboros and fries fro Lhen voleB. Nc$'YorLs Nlichacl Bloonberg is

to pay for cxpensive nedicines as opposed to the poor and neec!. Out of thc 1556 new drugs ma.ketcd bet\eeen r975 aDd 2oo'1,

anerception: he ised cigarcttc tdes a d banned smokirs fron all rvorkplaces a d .cstrrrrrnls in 2.)(]2 aD.l hter. banD.dtMns fat from restaumnts ir12()06.

ihinli lhrt the drunrl;c nP\ta surs.: oi-$callh radr from r .cntrLr! olceononiic slol)alistt;on h.s .csultcd in an rqurl ur)srrd sut ge in k\.ls of !tL)brl hc.llh. Nluch ink has been spillcd on t|e bcnefits of the frec narket and fair

t.i d e, catolliDg the cxponential rdvancemcDt of scientific nurovation, the development of infrastnrctln€ aDd the b.oad sains in Life expcctarc)' $.e have made over

(aDd blood

health foo.t store and yogaguN. BL't lvhat messures can a waitress in Bansltok (or downlom BrcokllD for that matter) take?

,

diseascs hale risen from Malaysii to Mexjco. L.Dicall)', poor nations tliat used to deal lvith underntrtrition now lure tc) deal with obesity as they grow wcalthie.

Iiul lhc p.olerhirl clephrDt in ll,c ro,'n, so studionrlr ignorcd br s{, Dranr politi(ians it lhrt lh. Prolit nrni!( s;ll al1\.ts.ns,,.c that ro nr.rliet is irnll ticc .,r(l lridc .ulcs iil ahvars l-rvorr the ri(b xnd r)o$c.ful Nho (.rft them. Withirr derelopnrs ard even devcloped nalions themselvcs,larye swalhes of poor people renain cut off fron the dividencls ol

i,.r, i. ir riiriilrr,

i,, ,r- ,, r'rl.rl t l:r'r.,rril 08

ER0ADtRPtRSPttTlWS

ine

pioities

.tre still orieDted around the

ud

hence

tarsct

lhc maladies of rich paticnts rvho can

affod

alailabili\,ol pdlatc

tunds

only 2r targeLed dcvelopiDg like

nalaia

wo

d discases

an d tub.rctrlosis. l hat thc Bill

and }lelinda Gales Forndrtion irad morc money at its disposal thaD the Wo.ld Heal lh

Organisation

(wllo)

even bcfore Warren

Buffett,S largcsse is a teslimon] to Nhere the p.iorities iD wo.ld$.ide healthcarc lie.

hilc lo(.1 hcrlLh ilstitulions still b.nr lhc brunt ol-.csponsib;lil] i Nanagins the hcallh ol thcil PeoPlc, i1 is Jalol)rl ilstiturions lhrt mattc't nDc lhrl .\cr. The prospects for globnl

1\

health are

iitftNically tied

ofslobal economic

aDCt

to thc

prcspe.ts

political cqualit!.

Rcfoml of healthcarc is useless wiL|out ihe ref.nn of h-rae flr]es. labour laws. hadc larilfs, domestic subsidics,.iebt reliel and {id floils that.nable all counticsto be fi€e enough 1o prosper ir healrh and aealth independently. From r legal peNfcciile, it is neither WHO nor tlie World Bank i{ho bolds the true centre of power in global healih sovernance bui the Wo.Ld Tradc O.garisation (WIO). Thc $To ove.sees

GATI and TRIPS : two coniroversial nultilateral trade agreemenls that rffect global health. OstcNibly, both agrccments

cncourage healthca.e innovation bv protecting the fropert) rig|ts of pharmaccuticaL conrpanics but what t|ey eDd up donrg is to make patented drugs nore expensirc ald prohibitiDs developing natioDs l|oDr having access to cheap€r

r rrir/i1f:l

ADd $'hile these international trade agreetnents contain measures to protect public health inte.ests, the rules arc so

compler that countrics nust

haYe

representati\€s of considcrablc .xp.rtise in iDternatioDal cconornics arrd taw lo be ible to $adc thFugh that labvri. th yicloriousb a

luxury not all nations poss€ss.

or,auis{tir)Ds likc thc \VlO nnd $'UO $erc formeil \!ilh lhc h; ghcst idc rls abo ul cq u.r l en4xtrlcrDrcnt of rll mcnrl)cr nnl ioDs. it is still thc nrcmbcr nili,m with thc srcatcsr poliri(nl clonr (rnd rhe induslrinl inl(rcsts thel rcprcscnt) * l,o Jtcl\ r(r\ ed first. Pmmftcd by a

'l hough

ch.rllenge mounted by Amcrican trade .epreseDtatives and b.cf froducers, the WTO n ed asainsta Europear Union baD oD beef Dr oduccd \ith growth hornonesin r

997. setting a precedent diat

colld

be used

to strike down future attempts by Dations Lo set ftrod safeta staDdards. To furthcr

(onrplic{te matters, not all politi.il lerdcrs shuc thc saDrc co ricliurs about\Lhat$orks aDd whal does not. whet|e. America funds $,orld health initiatiles depends on the peculiarbcljefs ol jts present adninjstmtion: under George Bush Jr. s bmnd ofrcligious conservatism, onlr abstiDencc bascd AIDS progranmes

I)ct.lor)i!tg DnlioDs struliiil..

hc\) lhonscl\es because gL)l)rlisatioD his been a tstFcdged s\!i).d ibr th..r. Iirstll. the incrcascd nrobililr {'f labou in { liec cco o'Iv lhat has hc\)cd dc\dopi e natioD! prospo prcscDls rD ironi( bio\r tlJ thcir t()

lrcallhcare srstemsr dorlopinit nations like x{exico,Jamaica, P|ilippines. tndia

ArgentiDa's cconomv cut

inlo proliL

margins. SAUR i{as contracted to use a $96 nrillion World Banlt LonD to distribute waler to Senagalese - but till today, most Sengalese siniply cannot afJord thc p.iccs SAUR sets and still usc untrcaicd $'ater for their own nccds- Thc IMF too has been c.iiiciscd for forcingTanzania to privatise itswateras a condition of liavi.g its debts folai\€n. Ofthe €Soo,ooo given to UKthink tankAdam Smidi Institute to prorid. adric.

to the TanzaniaD governmertj more than hJlfofit r!6 spcnt oD making a promotional

undenninirrg a crilical peacekeepins force within the regioD - plunsiDs Africa into

and the US Congrcss.

.\lso, \ridestrcrd .orrrplio nnd colhboratiin hct\rcc'r l1,c elitc atrd thr illi(it od tlrc krcal aDd dobrl lerel har. .\!cerba t e(l the suffcring ofthc I'oor. Ircm lndoDesiato

Russia. expeDsil,e

dorated medicnrcs haYe l)een knowr to resurfacc lato in the black markets of delclopcd nations, haying beeD palmed otr and sold for a handsoDle profit by bribed politiciar$ to t.aDsrational oryaDiscd crimc nehvorkrl. Worse still. collusion nreans thar

counterfeit

aDd thc elTects offake drugs are deadly. Usclcss flacebos mislend patierts nrio bcliNing the.!- are being cu.ed, cause

allordabie generic Dledicnies to dcvclopnrs

nations. While the Indian court olenLrled Novarlis, ovcr.12o,ooo pcopleworldwjde sigDcd a petition req!esting Novartis to

d.op the case: amongst them, ordiDary people tc, the wo.ld s power brokers likc fo.n€r Sxiss PrcsideDt Ruth Drcifirss. South nembeN from thc Etrrol)€an ParljameDt

Il-$c xre not mo\cd sinpl) bt thc Doral call to rlle\iatc thc snficridjls ofconmron huDaDit\. thcn $c shoukl at lc{st realisc that lhc ncgalivc

e\tcrnrlitics

ol econoDic

globalis.lion $ ill nndemiDe its ve{ o$ n lbuDdatioDs. Ho$'ph$ically hcalthy the wliole i{orld is nr the end reflects how economicalh hcalthv it can be and how norally hcalthy it rcallyis. \\c n,us( not

hn an bcallh lo rrl rnother p.iratc go'di a presqaa. ibr thosc $'1n) :rrc nlreadl ri(h. hale and heart!: priced out ofthr reach ofthosc sho ne(I it DDst. Hcalthcarc should be lept as iDclusivc and non niera.chical as possible. The resporsibilitr of healthcare does nol lall under the puNie{. of researchers, scientists, tradc bodies, politicians aDd $'calthy thilanlhropists rcducc

aloDe. Wc can

a1l

do much nrore to ma\imise

the bcncfits and rnininise the harn of

comtlicaliors and enable i iNses to nutatc and become stroDger. sophisticatcd fakc

globalhation in oorown small ways.

drugs that contain enough i.accs of the rcal

Allhunan lives, no nutter whcrcihevare

iryredients to l)ass lab tests but notenough

lired, are worth thc samc. A unifomrl) hale and hcariv $'orld rnay be an inpossible dram but surelv. thatone truth is enough lo nalie the drean woftii rfight?lt

bcDcfits mostl!, Europear water companjes aDd consukanls. ]n 2oo2. SueT tenninrted

to clu! have caused a resurgence of far

its water and sewerage seFices to Bucnos

polio a|d ArDS.

Aires when the

pharmaceutical corporatjoD Novartis chailenge.l Lidia's Patent Acts La$' to streD'atlien their nonoDolr on existins

Af.ican Archbishop Dcsrnond Tutu and

cc,nsuned iD developing n.tions are

maioritt of World Bank loms for xrtcr fi om 2oo3 to 2(]o8 have requircd developirg natioDs to priyatise water a move that

nrdividuals likc Bono and the Cates ar€ raisins firnds. delilering mediciDes and addressing unlai. laivs. ln soo7, S$'iss

predjcts that br 2(]15, HIV/AIITS wilL haye decimaicd thc South African Defence rorce,

hard \rork. Se(on d1), acccpting

iDternrtir)nrl (orpo..lc ;nlrrcsls mo.r thaD thcir !hl;o'r's hrrlth. Thc

aDd DoctoN Ulithout Borders ard

as the Indian Seneric drus industry is the \dorld s biggest produc'er and exportcr of

prostiiution. dmg tmlllcking rDd Dow, the production and sale ofpirated nedicines. WHO estimates up to 25% of mcdicincs

acceptiDg tcrDrs that nrar bcncl-il

OIfan

0oorcst. slobalisatiois bcncfits arc ,n,l ol-rcr(h as ldrg as intcrnrtioo.l ;nt(NcntioD does Dot Aivc thc , i sigDifi(aDt boosl out oi thcirc\istinJa quriiDrn c. Dccades of weali gorernnients, corrupt despots and perpetLral $'adar. plague states like Conso aDd Ansola, i{hilc their healthcare systenN limf along i{ith death ard diseasc unchecked. The UN

oltheirn.rst

nterDrtionrl help also r.r.s

support tor artore involi€d in thefightfor proper heJthcarc. T nsnatioDal NGOS like

dcalt a serious blos' lo the heaLth ofthepoor

skilcd healthcare worke$ to .icher Dations like the United Lrrgdom who ca! afford to prolide better renunemtion for thcir i

social networks can provide enotioDal, infornational, llnarcial and €ven politicat

druss. A Yictory for Novartis would have

illicit trade thai i{orsens health goes uDpoliccd and unDunished be it

and GhaDa arc losing thrcles

But globalisation DrcaDs thar ro pcrson aDal couDt.l Dccds ro llght aldrc. Thcprtscnce of strongtansnational

dangcrous. drug resisLant strains of

nore

nulaia,

finrn.irl m.lrd.rn.f 09 8R0nD$ PtRSPttllvt! ilre hedlth.dre issre

ON 2ND THOUGHT

Rethink Big Pharma How sick arc our phannaceutical corporations? Ry Joselin Bau

"Big Pharma uses the poor as human guinea pigs" aas Tle

childreD durnu a sererc rneningitis outbrenk. Nigertan

ConstdniGdr.ltncrrisht all aloDg? Did the inpossibb

parents 1{crc never \larned xbolltthe potential side

UN|ORTUNATELY SI II.L TRUE/

I'r,nr.,.r R".

Fl

So

!\'e,/J d.Jr, Rr.tl f"r,.

nutnblc upon a coDspirac! t|at tcflected resonances fron reallifc? Do dastardlv and e\il Dhannrceutical companies puncc or deielopi g nations, icstitu their

A8O1]T

TIlt

WR TIR

efiecls and dsks (braiD damasc, loss of hea.nr8, paralvsis and deaih) of the drug and its Luapproved status andtheirlerb.l approval was given rndcrthe

'r_d .. ,'1.,Lll l l' dr.rBv

',,1

L,rl ' ,-.rl':l

child.cn. Clinical protocol was not followed and

expe.imental mcdicires on rhe poor aDd the oppressed? While thesc dNg companies do lot plots on pregD,nt neccssail) rcsort lo 'nurdcrous whistle blo{€rs. .ecenl uluavclhre ofdNs scandals

co rpleiely abaD.iored when more children slarted dying. Doctors who objected rrerc swiftly dismissed fton the lrial whilc conplicjt local doctoN created

seem to jndicatc that the) willgo lo opportunistic and sometimes cdminall! negligent lenglhs to proicct their

fakc ctliics approval documeDts that Pnzerlatcrnsed to justiry ihe er"ednents to ihe FDA {the U.S. Food

market sharesit]r no interest in the long tcnn herltll of thcir test subiecls.

nl)d Drus Adnjristration that oveNees drLISsafelvj. Troyar was cveDtuallr shown to callse liver damag€

the mosi notorious nnd quotcd extmple ol suc| cinin..L behaliour is the 1996 Pfizer dlus tridl inflicted on desperntely ill Niserian children and their

n st of an epidenric. The Pfizcr cxperinentil antibiotic, Trovan. $'as iln cD to

trDknowing parents in thc

l0

BR0A0[R PTRsP{O

and rleler gaincd approval jn t|e United States nnd was baDned in Europe - abig blo$ to Pfizcr $'ho $'as

\4ut was nore unethical ivrs the lact thai Pfizer advertised its . rpa-'r.prr J . I'1r..'ri ,, n .ffn - Jr.J .n il,: ir .

hopins for uolher blockbuster dNg.

thal position till this da].

Vtl tlt heilth.ate

issue

WATCH TH

s

ch caaDrdes of Dralfeasance nr delelopins couDt.ies happen so easil) because sonetines the poor do not '.r,o" r.1 o.r'"r ,r,Lr.' 1 -J" \ r'.i 1i,1.',drnr^dn B

the local irNtitutc for children s health and c,n r4o . r.r'd....r 484'1L4,$, an i rolrt-. .u r,r. .r.h--i1r

$hat lheir doctors \rant. Deleloping nations have lar lo non existent o\ersight wire! it cornes to regLrlalo'y check ald balanccs. Conscnt fonns, ifther arc oflercd {i all, arc rarclyhaDslated into the locnl le.nacular. 'nrcre are also .o l€ga1 averues to guarantee an) nronctn,l co.ue salion lbr lheir prrticitation nor lhe co.tinued l.eatnent or mc'.ticrl follolt np rlrer Lhe €.'d ol the trial. ADd at thc s!Dr. timc. it is sLill ilcr€dibly easr to find r plcDtiful Dunrbo of palients

an eificacious treatDlent for

for

ch

tials rs thcythink that tlese clinicaltests

will bcth. bcst chance i]ret ha\€ aI qualiN liealth care

for thc rcst of Lheir Li\'€s. And the trials caD bc conducled sL,ch lhal lheyrenderthe q icklndposiii!e

J) tuom diauhoei. Ihis lice seNn i{as documentcd as

dirnhoea and no mcDtion

iv.ts nade of the serum's trarsgeDic orignN nor

\?s

inforned conseni obtaincd. Thc control group

was

rlso giveD

a

l.ss clTcctiYe glucose solution to make the

r.,, u, .F'p.rmorerri.ndt:. l\u{p}.,1;.r.i. r. tle long te coNequences thatthese children Lt.t ril;rb-..,.r- ui$-.t.,r1.,s" nrr1dh),ar8

tcar

a.d jnEestiDg such protciDs. Otrc unfortuDate cirNequence has ldrgtcrm rcr.cussions where these Dations aDd pcoplc sometinres reltrs€ new immunisations, rheir fear beirg that it is the ilhite mcn coning ro ldll rhem asain. hr- sun. n;,1r1. i ,'

1.

siri

p

p\c.tior.

results that drug conpanies Dccd to gct fast apprclal.

tuF

Iror era.iple, up to 99% ofclinicaltrials iD China can

that rvill rarelv be repcat.d? Unfortunalely these examples mavbeih€ tiDDins Doint oflutu.e scardals l. ' T' . c-^LrJ- rr.' la i_ I tnJn -\pFrin,rrlrliJr' .

besto$'positive rcsults trl)on treal ent. lro ically, p{ticnts in dcvcloping nations also nake better lab rats bccause tbey rar€l] talie nedjcines for thcir illnesses and the.efore are jr abcttcr statc to pro\€ thal wLat

kn

ts happeD is froDr thc drus.

booning becnuse

'

c,I

lhe erpardins .lemaDd iD druss,

,,rurl\irun,.h-l'\.lup-J{oid nations

as

\yell. Consider thc fact

{rrh^r , devp or rg t|at drug t alsare

rrpi.tlt' nicreasins nr Durnbe$ acrossihe idorld G.atrted there arc cthical guidelines aod codes thrt safcgrard to frote.t]Fople ilr ciinicil procedures, like thc LrN CoDvenlio olthe Rights ofa Child andthc Nuremberg Code. Tlie Nurembcry code arose in lhe

.tftermath of the horrific hunran €xDerinrents condtrcted d ing \-odd \\'hr II and is.rearl to pmtect hunar subjccts f.om injuN. disabilitv or death. Yet thesc cthical protocols are essentialll toothless and

casily circtmlertted by liraDcial grc'e.l. Thc U.S. Goverrrnrent iD wantirg to ensllre tb. safct\ of tbe druss sol.t for childrcn prcvide an urtbreseen incentiye at the same

tinc. Pharmaccutical

companies are grven

sjx moDihs of pai.nt protection or rnaritel excLusi\it!

whcn SLrcL

th€ylohntarib test dmgs.,n childreD. incentiyes oriv eDco rase thc

l- li|Jur"l

lr' ,I \'

eramdc of childrcn beins

$.rying

h end

ol

1ro"F- li I oin"

piss also occlrcd iD l.inra. Peru. This tnne the child.en we,c r, 1^. .-i-i'rl lrial of .',-r ti..lr r',.4 nd-.. semn con I aini.g svntheiic proteiDs not atprovcd tor Lrsed as guiDea

'p li|! :r .'n' p.' u l'- r J B' .i' , or gr, wi, " '.r health coDccrrs about cXI rice. ine U.S. based conrtan!, Vcnhia, decided to etpernnent iD a

as

the

drtrs industry cxpands. NIost of the rorld's larsest fhannacexticnl compa ies have established a presence in India {here it is estnnated close t{r two rnillion people \rill take parl in clinical t als. Regnlatory bodjcs a.c somelirnes part olthe prcblem as wcll. FDA.pprclal p.ocedures do not sohe the proltcn eit|er. l h€ r:DA is notorious for its caunous afproa..h Lo appr.rvjrg drugs for the local Durkct.ltt, corryenientll these regulations stop ai the border.

Theydo not rcquirc notification i{hen resea.ch talies place olcrscas. Rcquirenrents lhat co rpanies p.ove .\ ',- \,' r ', pr rn Jr ,8. i r .'lF un r.:n.l . -,, r, .vcn siarting lests on hunans are not applicablc to

p.r..ond'.raroIs:,1 u tL Sr t).\\aar Nc.ccis one set ofacceptable isks for patients at |one and anotlier setforthosc abroad.In llre mid r99os, control

J.rt's^fHa 1l.tpdp corurt

es

Fgrdn $"rn-r.:r

.1,'.l"r,

"

Nere denied anti.etrovi.al drugs despite

[restern doctors ltnowing that the &argis {ou]d reduce tie .ate of iDfection in iheir babics by two thirds. lnlints needlesslv contractcd HIV$'|ile the doctors nuintaincd thc nrtcs !vand rigou r ol their nedjcal

dclclopirg coLrrlry. lhe f.ials ivere conducted throrgh

ll

I:

ER0ADtR PtRSPffllVt55

th.

h..lrhnr. ir!tp

DRUGTRIATS:

T}]E0AR(5 Dr (2006)

tor0

rhi5

(ordo

ous BB(

do(umenlory direded by Po!l

(enyor obort

how

por ord

' illihrok lndioi Wrirrlr

ore

!rvillingly Difg ued

len

ro

Doctors defended themselves by otrering the speoors argumeDt that thesc patients could not have alTor ded the drus ar\how. Imasnle ilie uproar that rvould have happened ifthese patienis were lronr dcl'eloped nations and had easy access to

sovernnienls too,

trirl applications.

Even watchdoss like the Public

Citizens Health Research Gtuup can do little to policc r r.n pr\!,' rirl r'l\ and -"1. is J.h ir inrrlJlion i' considered proprietary and confidential

litisatirg lairyers

Though the proliferation ofthe nedia and the visilance of NGos have cut down on t|e possibilily of such practices NDning rampant, it does not also help rh,r Local

dms

ir

bending ovcr backivards to conduct research and

companies io

ge! these rlanJr,.tu-.dnr6s:nl\p r'.nLrrr'ie, nr\'nrlrl;m45 trm a blind cye to the exact legalit] of sorne ofthe

wi

at$alsbe corruptlocJl administ.ations that effecti\,ely rubber stnmp such

rcsearch conducted. There

At the end ofthe da,v, mosi NGos still recommend clinical trials, the aryrnent being that more healtli research is better tban noDe, trusting that the spillove. effect lrill lead to beitcr and increascd standards of healrh carc in developins rations. Whilc ihis may be a recessary aDd unavoidable trcnd, $ie sbould be morc awde ofdouble staDdards and mtionalisation ofethical relativism that justifies shoddy treatment and exploitaiion ofthe \ulnemble in the

wo d.lt

"Big Pharma should have its drug patents broken." No/

The fai cats of Big Pbarma luve long bcer

lur lh" r n or upoli.ti. .ri '

goJr,inS d"_idcd rFnd"r".... l-,r "'ploi,.r'n," dFvF-o,.18'", nlri"' JrL thal|cru.l r'-!lF,I ol rl" plirh oII'oord)ing 1,. li' nr: th. \nrld u.Fr fr"r. rls nu"F ma-lFlin3 budsets are seen as wasteful and allesedly intended to corrupt doclors and politicians. While somc of theirbad rcprtation is deseNed, not all ofd1at venon and bile directed towards these big pharnaceutical conipanies necessary apply as they used io irtoday's fast expanding drug mark€t. Trvo nel' actors -

niddle incone coruit.ies aDd the jncreasing\ po$'edul generic druss industr,v - are changins the picturc as we kno$' it, niaking this sir,ral ^i . lul nror".nn!lr\ lhdr r\" rrs r-l p:l ire ofpoor countries agairst drus companies fron the emergnrg and

In rccert years, thc coDtrovers], swirliDg around Big Pharma has mostly ceDtred on iis ficing oflifcsnvins drugs outofthe r.ach ofthe poorandhence, the Jnoral justification of breakng these dnspatents in a bid to get these drugs to the neediest patieDts. But drus companies nay not hold as much pow€r as i,ou think, as govemments can break ard circumvcni theirbusiresses quiie easily. Oler the last decadc,

12 8[0AD[R PtRSPtfllVts tlrc he<

we havc seer d1 increasins

irend of courtnes breakins

drug pat€nts held by dru8 companies and soing with

genericdrugcompaniesinstead. Countriessaythey dr. -.l, .dlll \oTpp l"J lo do o i rha) arr ..vilb lives this wny breaking drug patents can mean savings ofup lo hundreds ofmillions of dollars aDd opening np accessto cheap drugs.

But the lesscr known fact is that these breaking of drlr; plr"ar. t, n"fir more n dd , -i1' omP.nrn ri-' than the desperatc aDd needy countries. Ihe poorest countries already gct their drugs at low or no c".r because offoreign aid subsidies. The result is that richer countdes are using this threat to browbeat firns into handing oler hrse discounis to middle class citizens who can alr€ady afford to pay Brazil,

Ti

rlJnJ.n,l lrdrJ \!'F,ed l'. rao'-mpal r\u)rIL geneic d gs but their governmcnts are wealthy enoush to spend on health ca.e. Even some NGOS $,orry that this trend is self-sen'ing- After all, Brazil cannot be said to be on ihe same level as Rtanda and thereforc should not shirkpaying its fair sharc of

drul disco\€N

thtot.

costs.

issrre

l

The off-quoted argument still applies: the profit incentive is a necessary impet s for inDovation. Without jnnovation and the proteciion ofiniellestual properry rights, there wiil be fewer life-saving drugs in the tuture. The brealiry of drus patents may mearl that more patients will get .lrugs now but it also means that dns fiIru wil bc nore wary of developing dnss

for the tuture. If al their pmlits are goins to come solely tuom rich countries, they will naturally think twice about researching cures for diseases in tbe

developing world, which are aheady woefully neglected.

forced to rethink its traditional way ofbuiness beyo

itslargel' rerti.dll) inlrgalFd approa.l ro dqplofinB. manufacturins and sellins druss- This includes lereraging on rhe srowl , nl hp i 'dd e clds.pq in energins ecoDonies - Indiat market alone is expected

torcach $2obillion in 2015 and China's numbers are expected to be eveD more spectacular. As such, drug companies are startin€ to focus on buildins up local expertise and research in these developins markets. Insrerd olmFr-\ uolars cul .n.r.. rr,e\ are lakjng 'o an interest in local healih care needs. For exanple, Novartis now has res€arch centres in Shanghai and Sinsapore focusing on tropical diseases.

It is also a little erteme to ihink that stripping away

wil solve all problems for the long term. The intellectual ploperty issue never goes away. Matrufacturers of Seneric druSq dre F\olving irom .opy.al\ ro being Bjs Pharma

s

patent rights in poor comh ies

innovaloF rhem:rl!er

dd ar".t rtilc'o

derend thFn

own new dnss {ron copyins. This will becorne nore of an issue as cuttins edge research moves fron the

de\elopcd cou.ltrie' lik" \'!FslFfn Lufopp. ar.aca andJapan to countries thatusedto conduci the less sophisticated back end work of prodrct developneni. However Big Pharu is also showing that it is capable of change. Wiih the patents of nost blockbuster dngs expiring iD ihe ner110 years and thedemolishing of pice controls jn developed nations which will result iD their profits beins halved, Big Pharna has been

13

BR0A0|R

Nor are dlug companies so evil s to disrcsard pressure from NGOS or goverDments, nor so patentiyblind as

to ignore th€ short shrift they are getting from the nedia. GSK already makes no prcfitlrom the drugs .old in poorAfri.ar ndrion.. and offer. tiered pr:.int, for mosi ofthei. drugs, calculated on the country's ability to pay. Even the WHO applauded cSK's decision to donate 5cl million doses of its new flu vaccine to an energency stockpile.

wlile mntr@ersies Ncr Big Phamra s responsibilities and oblisations will still continue to rage, these new shifts of thinking and action suggest that there is hope for the drugs industry after all, such that there's no need to destroy all basis of inteliectual prcperty just

PtRSPtfilVtS the

henllh.nre iss

e

ISSAY MAKIOVIR

ll people are guilty of it. Not just

students. In an internationally televised debate, zooB Presidential Elect John McCain found himself in a tight spot when he was asked to account for the disastrous situations in Iraq and the U.S economy. AEOUTTl]IWRTIR

As an experienced politicjan, NIcCain deftll sidestel)pcd tlie issue, bulir1g hinN'lftin1€ to think aDd hopefully coniDg Lrl $'itli a strongcr aDswerlatcr oD ilr lhe debate As a Gl tDior

i{atchingtlis,l obserlcd how jUccain

was

intcntionallv not answeiingthc questior

(NAQ) posed to him. And then it suddenl!- stmck me as to liow I cotrld begin this is e's Essay Makcover. Surelyitwould be apParent io anybo(lv. anvsh €nt. io directly anslvcr Pmntd othc.s to do rh. sdne, dn{? lo!ntglV IIsiD. those aho do nol. Be conlfbrte.l that

rc tl1c

ute

alL

s.tne

r.c is

Lltimatel! itt

b.ot

Tang

a lnun.ling

a

question poscd to them? Even a basicbut crediblc answer that rdd.esses thc

'luestion would innned iatcly $'iD trost; much less aD insiShtful and Poignant answerthat could lery well carn itnnrediate respeci. !tt, iladdressing t|c questions fosed to us is so nnpoltant, then i{hy are

so

fe$'people doitu it well? Or Pe.haps nore inlerestingll, whv

are so manv peoplcuDable lo aD$ler the questions poscdto thenr?

patuEtafa .l tcacher dt sthool affhousht.

I4

8R0A0tR

PtKPtOl/t5

l/r.lcolllrftr.

issre

We firct have to rccognisc rhat answering questions well is notjust donc for exams. No mattcr what the age, we ill still liDCL thrt a big portion of ou cvcDday lires is spcnt aDsi{oilg qucsii.i. s. We answer questi{rns to gilc insight to t|e l€s! e\perie ced, facilitat. flan.ing, to remain rccorLnt{bl. for ou.ctions, and in the lrocess, become .l.irer and ctearer of our identit! and fnryose in ]i1e. I knos.thrt learniDgnr ans\cr q cstions lvell h as beeD aD inloftrDt skill as it has brought jnniense gro\th in my ch.mder. work lil€. personrl lifc' rnd thc livcs of otl.rs. Flach tiDe I drswer qrcstions, I .ealise that I am listeDing iD ordcr ro fillly understand thc contcfi and holivations behiDd the qucstions poscd to mc. tlr !Dde.standing this.I have learnl to structure, u.l rcstNcturc mt responses. a swe.ing the queNi{cll bl satist),in3 tlie notitation bchiDd tlrc qu€slion. S€eirrg the satisfaction oD stklcDts aDd l.iends'1aces becausc ofwcll an$r.red questions has becone ajovthat I h!v. corn. to find

delisht in.

Snnilad!, ro.. "u 'Ihe'^

t|cr.

are a Ielv icadernic poiDts I necd you to garDcr fro'n whaL I l)ave slrr.ed

There is a purpose behind every GP question asked. lcvclshavc donc rn exc€llelrtjob in mlking tkse notilations hansparcnt. pr€didable

rpprFnl lo all Lhose $ho

kDow $'hrt thcl aE looking out lor At Lh€ certre underivins assumftionsthrl \4e li.sL need to outline and tr.kle in a svsLe ratic flshjdi. Not rddr.ssing ihe brsic.roLnrtioDs (assuniptnms) behnrd n questioD or1]1' oblllscatcs thc ksnc rnd res(its irr r situation wliere your rcadcr is sirnply liustrated bv ! scrig that is discl,sslng €ve thilgbutthc qu.sti.m at hand.I'oLr aDd

thcrcfom

ofDuDl qncstio.s (.ot all)

LLere are

ilill eDlp{thisc \ith this cxf(r'ie.c€ or sinph foolish DcoDlc.

jJyou have tallied to unfoc

scd,o!.

v .mo lional.

shiltl

In this issre, we are goirg to oudirc thc most llequently asked questioDs / arguments thtt rppear in thc 'A'lcvcls. l'hese will be marhed b! sfigic $ords or sho.t lhnses tlut tpicallv signfost \'hattbe issL,e al hand is. By masteing thcsc arguDrcDts, ud ad.lressnrg th.sc \ords in e!er'-.' parag.aph, rou \yill succcssflrllt rns\.r the queslion

tu a logical aDd cohfle.l lislioD, and I ass reyou.bdrgmn.hd.lighlto)ourrerder. Unfortunat.l), thc lisl ca..ot be exhrustive and$'c hrlc onlysp.ce to showlou the three most coDmon argurrelt tlpes aslied. r\sk !our icachcrs for insiitht i!to othe. key ilords sothat the! cair helprou be norc full! frcparcd forthe exa.rs rgproachins

qnes t jons

tlisw.!

rcldresses thc qtrcics I startc(l o1l

\!ilh. MOSt

people

do not ansrver questions wcll simply because thel'remain ignorant of what is reallv being asked. .rr," u,u." aifii"urt is

wheir people do nr fxct uDdcrstand

t|c queslio. posel

to thern but

"r,ul"ng"

let irtcDti(Dally aloid

answe.irig jt. hi the contc{ ofOP, this rcieJlr Lo studenrs who have bccn niad. a$'.rc of these skiils but lctstillcnd rp l!oiding a direct responsc. So

lct

s

st.It t|is aJljcl€

lJ.'

tirst uDderstaDding r\'h! sorn. srude.ls behye this \!a\'.

l5

ER0ADtR

PtRSPttllvtS

tl.lrditl.ar,r iss!.

E55Jiti,i,rjil. I'1,,,,,

Qunera/

liTs

I ialked to So students

siih

the

s

ne

Do nol

e h<><;5e

ozl-Sl)c>n5

Z

o erto better understand whal the], $rrc ihinking. l hese werc all students $'ho liad conpetent to

/y /o-(;ng {<>r {ami/i,,r t <>nlenl .
commerldable lansuase sldlls, had allbee lrainedto sfot aDd add.ess

LrontcDi is \rroDg- Ior jt is

prcfilciD

keI argumenls, bui Iet aere still iailins tlieir essays. Ihe follolenrs will gilcboth teache$ and students som€ stroDg insisht into tieir

lsrcholo$ and beha\iour; thereby sirirg the a sood basis b)' whicb

It still fuzzles nre ltow slrrddrts rctuall) sLudl l,rr this subjcct. lt is Dol llrnl r.rdnrg up

oD

cvrnd o!r pel\0..tncs ard de\elop th. c.ncctjrrgon c lor frlticular topics. Du t C P is also a slills .lrire! !a flr . Thcrc is no svllalrus inloh cd and rherelbrc rbsol telt no gLra.rnlee thatNhatcler it is stud.nts invcst tine ir studling \ill rltuallt bc l cst.d nr thc ex{n$. Ln, t sl l,d.nts do !) an\'$,a\'. lia.r ili \ith the $'.Ly tlie\' sl dy lbr coDtent dfien H2 subjccts, students irrerila|b DrcDntrise to lael .rore sccurc or PFlarel for thc rrans. l|e probl.n ariscs wher tl,el .onrmitto qucstiols iir P.fd ODc based oD rvhrt th.t fc'el is lirnili,rr cont.Dti Dot xt .tll co.sld.r'iDg thlt thel ma! ltirc.hoscn a vcN dilli.uli argument to haixlle. rcirl to

I

io better establish their tundamental

trndcNtanding ol essay qucstions.

S!ccess is thocforc. in tlieir ancL

t|rt

rriI

s,

nr

istik.nh defiDed b\' q urliq

aDd

rohme

o

l e\u

Dr

l)lcs,

il!

rnd forcc ofxrgulLer)1. Slrdcnts clinn out Iraragrr|hs olcontent thilrlti.g thcv are lojng N.ll, $'hcD in 1r(t Ll,er hr!. not clcn beguD lo r.l.lrcss tlic fossibl!

not

cL.r,

comflcx questjon lh.yIa\c chosen.lla.) slrd.nts go rlread witjt lheirqu.stbns rDF{a' d.spitcthc strons Lun.h th.tthq arc not!!$!e ng it. lbr lcar that dire(tl! .ddrcssingthe

!rL.stion or clioosing a.olh.r

ltill

expose eve. mor. things

thel arc igrorlDt of

the studenls I toll.d lrosth all k,und thc cxperience lir.ilirr. Not confident o1 their oM contcnt, ther mcJnoris.d Dotes or bool,s rnd nscd then !s a clul.h So dcspite e'hal Na\ sct ir the queslion, th.l \onld insist o! using l|at content. regrdless ofhoi! thc questidr lvas phrased as ther jell 1lr.! had to banli on the.ont.nt tliev menrorised Selc.iing r GP questior Lhnl \ou crn .rsilltdd.ess hrs vcr) lcss to do Njlh th. subjccl nuLter.rnd morc to do i{iih t|€ comd.\iB ofthe argunenl.There is no Suatantce that

(onlcnt that is fanrilinr to you $ill Decessatit\ come couplcd \tith

a

st.{ishllb.{i.dquestion.The$rongassunr$ionisthatall qu.stionsnr.thesanreaDd ollv differentialed b!.ontcDt. Thtt is fa. irodr lhct|utli, as ile shallsooD sc.

l6

BR0A0tR

PtR5PftTVIS

ri.

ic.11li(d,? iss,r

7'hu /ungth .>{

lhe ?Lzesl;on mallers.

It is a simplc frnrcidc but one that will shed ligbt on choosing questions that rre nore easilv addrcssed. We are illustmting this p.incipLe by intentionall) choosiDs a popular contert topic, the media. Let us first consider the follo$'ing: ShouLd LUe tesulate tl1e tne.lio? This question asks yo! to deal with a basic polaritr. Weshould eitherregrlate thc mcdia ornot regulatethe nredia.

Should ue still This

ne{

t.a

late the nrcdio?

questioo inse.ts an additional 'still" iDtothe questioD. Elrn though lvc still nccd

lo address the.,rigjml polailv, we also nolr nccd to cxplaiD thc assumption t|at we did need to regulate the media in the past. couldthc rcasons ivhether we should/shoLrld not stilldosotoday. ThejDclusion ofthis crtra argument not onlt' nrcrcases the skjlls required to an$ler tlie questioD, it also iDtcrc$nrgly enough, doLrbles Lhe contenl Sorely it is obvious that if a stud.nt picks this question, he not only co rnrits to a mo.e complex a.gunert but also more content that he might not be awa.e ol

Siould

.ue

itill regrldte iie

ShouL.:l

ue

stilL reguLate the

tne(lio rDhen o rapidla changilg uarld rlakes it ineleDant? The quesrion before ha.i gjven Do pamnrete.s for the rcasonsi{hyne should regulatethe nediatoday. This oDehoi{eyer, iDscrls an c!1ra component $hich conuels us to explain liow the preseDt is affectcd, not jlrst bl any reason, but specilicallti a rapidl,v changing

inedia uhen a rapidlrJ chatlsitls

oorld

tnakes it itlcreasinqlu

Notice liow the argumeDt is nrde morc complcx each time I inselt e{ra parameters of

I am not suggesinrg ther€for€ that the shortest questions are :drvals the easiest, but certaniy wo s into the questiorl oriy nrcreascs tlic numbcr

we see thal the insertion ol n1c,re choice

ol rcquirenents the exaniner expects you to deal with. It is the mastery ofrhcsc choice words that enable students to always rd&ess the qrestior.

i/

BR0A0[R PIRSPIO

VtS .ie /redl./r.dr. r:ssu.

ESSAY MAl(EOVER

Quesli<>n Mdst of

1'W.t

t|e time. strdents do not

address the question simply because they do rot truly understand what the

t. Cc,mpttri5,:tn f,ztesli <>nS Tharkfully, thc comparison question is not the most common question tl-Pe. What most students do Dot unde.stand is ihat iD order to run a fair and convircing conparison, we aclually Dccd a great deal ol contcnt. There a.e two main t)])es of conpaisons the 3 variable comPaison aDd the 2 va able compa.ison By far, ihc 2 !d-iaL

..^

, p:,ri"un

i.

..mplpr

Lo

I J ,dr,

.

question is asking for. We have therefore hishlishted tlree of lhe most

The 3 lariable comparisoD is charactedsed by the follo$'ing signposts.

common argument types tbat examiners insert into questions in

ON I Y,

order to give these questions an erlra

\l At\, rroLLL\ , BLS I, r\ ORST. LL\ST. l\lo5l NOTIIINC I\IORE TIIqJ\. All

these wolds suggest the absoluie; i.c. the subject inatLer is

ihc 'best", "oDly"or"most"

ofrvhatever is to b. aryued. Ir order to trovc or disp.ove ihat absolutc we will n€ed Ln dmrv i oLher facto$ that gire us a basis of cornparison, belbre assessing $'hether thev are indeed the best ' or "most '. The problem viih this argtrnient st.uctur! comcs in tlie large anouDt ol cortentihat rcquires variation. Lett takc the following samflc paragraph to sho$'the dyDanics ofthis aryument.

Strong leadership is most essential for successful governance. On a supeticial lerel, the €cononic suc.esr ofd.orltttr! t. ur! dependent a the n.o]1]l libre of the leaderchip as tlrc nltustitu of the Leadet cdtl da lnucll in

dsfl

ng huesrors o/d tiansparent ond non-cotrupt economA For instolte, Rabert Mugabe of Zitnbdlu€ los driuen /rts oDn econonla inlo a ditch bu operanns a.leat\ canlpt econonlu o d cllooins shili! ecatlolnic palic! that ias underm;red ifie srr.'tqtlt aJ his countru s ctlrretrcu and corse(l almost alL itwestment ta pull out. ht lialrI o/.scendms llte thls, ure cdnnorcldin tfioisd d'r, le.rdcrsnip is tne rlost irrpo,ldnr considerdtion irr 1Jrcrcttinq DlarketiLilure. srccess/i/l aouerndn.e ot the entloDty is dependent o11a larye nnqe ofJactarc, inespectife o//rou,.strons the leddership is. Citizens afa ca nuA catteasihJ un.lermnle the prcgress tltdt good led.liirshry nds huilt, IiterQlLlt oretnight Despite the Chikse garctnntenti aitemPl 10 c'os€ .arruPtian a rl e coutage fust,for fid nuny tr&rrrie.s, fie seliisnlv co.ropa orhtu.les o/,nanV locdls ias t)ut the re4tatiotl of the Chiles? e.onoTny dt stdft€. R ecetlt scatltlols oDer food and tau pro.luctian hes shaken consrmer dnd inuesto, conidence intl1e rcliQbilitll o/Cfitrese tr.lu.strr/, undotlg thelrcc€sttul econotr iL bratlditn that Clnna l1os dcnieued so /ir r. Srrona ledde*fir? is delirirelt/ essenlr aI fot a suc.essfuI econonl! but cainat be considercd nbsr cssentol ds ioe ncc.l r. dlso consrder olier essenndl

/d.rors llte ostro,rg dndrtustuorthU citize t!).

Ifyou study tlie pa.agriph carctully, you

wiLl realise that wc

act ally

int rod uced thrcc

ofcontcDt. Most obviously. stlcccsstul Sovermnce-necds to beQ.ied to i toduce De$.areas ofdiscussioD fo. eich point: e.g. successful environmental SoverDance or successlu l govemancc ofpopulation groi{th. areas

l ,vu,s

n,ke.V,

Ptoro cr.[Drr/..a'lsie1d. IlirkrcrrtiveconnnD.r

'n

rB

Bf0ADlR

PiKPffllvf5 the h.dithcitt! issuc

W"il.o\., . I runo i... .hit.rn ,r....

dat , "gilJ\n.o ,. nt-qr.ur ir..1rntrlr' .. l.l halc rcquned us lo re(leftre "st.ong le{.lcrshilt as Dcrtrrps haviDg cler. visior lbr thc counq or !!islonr necessary to makc good decisions. l his laiation of 'stroDg lcad€rshif wouLd ol(ou.se Deed to bc comparcd !ith ot|er tac(orc th{t rre csscntial to success lu I goverDaDce. These othcr factors could include i country's FLrrther pa.agrrphs wo

avajlablc rsources. the p.esence ofregional assistancc /.lissension or eyen the advent of

lifc alt.dng lech

oLog).

piragraph i{ouldrcquir. trs to keep vat,i g these a.eas. finding thmugh a con\in.ing aGunrent $,hether or Dot "strong

toi.ts of.onrpa son lcaderslif isindeed mostessenti.Thcrjsnoneedrorufevmplesforeachlariablcaswehavedone,butof cou.se lour argument \!il1 be all the more conrnrcing if you hale lIe rel€vant oDes. Flach

aDd assessirg

Thc sinrple.2 variable comparisoD is chamctoised

BET'T!]R II{AN, MORE

TII{N,

b] lhe jolLowins sisDposts:

R-A.THER I HAN.

]'here is in this casc no need lo i.troduce othe. fackrs to dralr

jNtn.cd

to comferc th€ t$,r, fictors

aD],

cnmpadsor. You simpll

p(^idcd.

Hosti a ttriar spottig etenrs crcates nnrc prcble,xs thon b.nqriis.

This questjor is

absolltclr

ori)

ustoconpare ip.oblens" ald"beDcfits"in each p agraph. lhere to b ng in other fi(tors $ the ar suncni is alreadv linr iled Lo iddr€ssjnJr

nccds

Do nccd

th.'\norc th.n cl.use.

z. 7'he a/so/ttl. .r71-taenl thistype ofarsumcntjs characterised by

the lbllowiDg signfosts:

ALWAYS, Ntr\TER, E\'ER T]ris is perhals the nost connnon argurncnt in Paper One. cenerally st dents ar. taugbt to disngree with the absolutc statcmcDl as it is an ert.eme strnd rnd thercforc rarclvtrne. Ho$.ever let ne liake oDc imNrt.nl caleal. Absolutes do exist as val csortnne |onored traditidN. Takc for ilstan.e ihe value that ne shoul.l ncvcrlic, or ne should never gne up hopc. Or consid.r the

nditions thrt we should ahrals cclcbrate 5oth weddin8 :nDi\ersa.ies. In cac| ofthese cases, these values/tMditioDs cxisi h our psyche as absolutes that $€ ideaily do not lvanl Lo undennitie or challcngc. Expl.ining lhes€ ideils preseDts opportuDiti.s at

lIe begnr hg ofrn

1r

essav

for grcatd .vahratio. or jn the conclusioD {s

Besidcs this ircatnent

o

itthrongh

oltiine or

dre contert

l the algu nent challenging th. absolutc also

l9

space.

BR0ADfR

PtR5PtOlVtS

ttu

h ltht.rr i\:1.

ca n

a

rcfrcsbiDg point

be don€ by

rie$ing

ISSAY MAl(E(]VER

Considcrthe follorving argume'rt: Does modetn tednlolos! oluaas ntryroDe the qualita

oJ people's

lires2

t}le possible argumeDts we car raise would be that this nay have beeD true olthe llast bui is hos e!e. not true lbr the prcscni or tuture (tnne based analiEis). or wc can anallse tlie questlon \ia a contc\tral analysisj i.e. bellveen dch or poor, east or west or even seeing thh question in the light ofrcligious

n-s,rul rrr.'r's,.p .pbr\4d.nari.J.l.

z. ,4r3ztmunls z.;il h unJer/yin3 a55zzm7/i<>n5 Some arsumcDis

lcedto

be fully addressed simply by

fint

discussing the underlyiDs assunPtion

in the key lrords used to cftend the argun1enl.lt is desimblc if we rot only addrcss these assumptiius but : so vary these assumpiions in er€ry pangraph. Herc arc three of the most conmon oncs and the priDcipal argumenl behind each one. 1.

TOO

ln orderto coDviDce us that there is too much ofsomethins, in excess of$hat is connonly acceptnble. HoDe

ue beconp lao reliant on teclDblaqv

we need to Drovc that t{e have Lone

tualaa?

In this case, $'e need to e\plain what aD acceptable reliance on technolog) is and show how the d has sone overboard in ils dependalce. The conmonly acceprablc lcvcl is unfortunately ver:, subjectivc and is nore easily defined byestablishins alevel thai is p.obably univeNally accepted. i.e. the loss offrccdon,loss ofidenlity,loss ofvalucs. If cardidates can prove how Man s reliance on technolo&v has causcd us to forsake ourlieedom. ideniiti, privacl orvalues, lhen thcy sorld

wo

have cedainLl proved too".

2. SIMPLY, JUS I- MERE Thcsc words suggest that the subiectrnattcr is fisigDificant.In ordertotully addrcssthe question we needto fiNt e\phin wliy p€c,ple assurnethc subjectmtter to be useless or Deslisible. We then need to argue that this is a nisiaken assunrplion andilrat in fact the subiect naner is vcry siSDificant. VaryiDg this thereforc largcly depends lpon nhether we can gcDerate different reasons why pcople xor d "simply" do somcthins. Possible sceDarios include hafins no other choice, beins e\pcdieDt

iDtheir approach to an issue orbcingcareless intheir lreatmeDi of tlie issue. 3. NO LONG[R, STILI-, AN'!']\{ORE This arsum.Dt also connonLy appears in qucstioDs. The assumption behind each one is that an issue $,as in fact

tluc

the past, but is now no longcr hre. The question therefore rcquires

a

student

io vary reasons nhy things were true in the pnn. Take for nNtanc€ th€ tbllo$'ing qucstioD:

Is there still

e

place for

chatit! in the uorkl todau?

the assumption we are naking is that therc $'as indeed a place lbr cha ty in the past, and the candidate is expecicd to lary these reasons in every paragraph. Theywould subscquently need to addressthe argunent whether these reasons in the past arc still lalid today in each paragraph/point thcy raise.

(t

?0

SR0ADtR

PtRSPtOIVIS r/tc

/raltlr.ore issre

A MAITER OF OPIN|Oi\|

Is eating healthily the sole responsibility of the individual?

,\l!()ul tllls

{

to\TL\T/-r1'

r.\ s,.i

'd

It

'.^l\.d

hcmcndouslv as morc societies shilt li om an agarian based culture

Lo

an'r'uponu,.r

an industrialised one. Cedainly, what

!J,F :n'jinu,.r bul: .i

.'.1

.i 'r

l\!\lPl ls/ a)

NO

Conmcrcialisarion and indusrrialisation of food in(lu\lr!: llo l"o r" ,r.J ir

supermarkets as our sole source offood. i{hat gocs

supernarkets rre p.odrced to na\iniise p.ofit, extend shelflife and ilhet cons ner appetitites. Tlis affccts thc lcvcl ofadditircs. nutritidr.Ll value to calodc laluc ratio as i{cll as portioD sizing.

onto our dinDcr tlatcs is also an outcomc of dccisions nade by food corpomtions and farners.

b) New fangled diets: Ne{ diel lads co'ne add go

that has alwals beeD iD our haDds. But as nore ofus

cjty-di{ellers depen.l solely oD restauraDts and

e!e.y year, pronisirg ni.aculous $.eight loss What us€d to be a sinple niatte. of 'eatirg more fruits and legetables ' has evolved into r cacophorlt ofcoDfusion. s obesitv rates sorr aDdthe Dunber ofnc$'discascs muliiply ocn in thc Drost DrodcrD of cities. nLrhitional scieDtists, investigatjleioLrnalists,

.on,"n n, g . r ,^ dn l d:' I B' r.. Jr4 l. .\.t !i ,g in their two cents norlh about ho$' modern day diets ue impacting our bodies.

Doi{cj

to

oncebizrne eatinghabjts are adopted. e.g. rlood ?ype rpi,,1tftirs,Dpi, South Eeach Diet etc. c) Thc orsanic food movcmcnt: Dcdicai.d chcfs lile Alice \\iaters ol C|ez Panisse |ave long championed the caus€ olfoodsproduced $ilhout coDventional pesticides, &tificirl fetiliseN, sermge ", JJ' .' ,l i-.. "\ '-- -'lr'lr]u, I r' ib u. '.. groxth horDroncs or gcnctic modjfication.

si nccd to rctum io that old fashioncddiorn

fics| foods and cx.rcisc nrore" or should wr let thoughts ol $'hether we are ingesLing enough ornega 3 fattr acids. oat bran, fish oil capsules, llcopenes aDd antjorid{Dts consume our ninds? cat

ranclj hent. lunch

PIoro cRtrDIT/ sd/ao d(o&tsd,

d) The bcalrh supplcmcnt industry: Oftcn targetted br journalisLs liiie xlichael Pollan and Maion Nestle, this indust$ has beeD accused of

pronot

g a

pill-filled diet.

l.Tictr a',!dn!. a-bDDr.ns

?l

ER0ADtR PTRSPt(TlVtS

li. ledlllr(,1, Ns!f

AI,LO\ftrD

/

,,rl

rl I ,ri

|J liNlil i ,,:

A Healthclub CEO Answers nllrlti-llrillion clollar inclustry that iidvocatc taking pelsorral rcsponsibiliq| fbr onr:'s health b-"- exercising. IIo1\ lvoulcl they apploach the nholc del)ate on our- mod.m .ijets? A\ co'rcei\ cd b\ Lirn Pei Pei Healthclubs

ar'r: a

+

$r' \

o

tuht's

Is eating healthily the sole lesponsibility ofthc individual?

believe that one must

,r. borh Drrkiril

1

Yosr

e

{irh snrllo

grnrnrg spacr

i!

tlrc

take responsibiliS' for one's health and fitness. and an integral part of that belief is that \vhll \ulr puL rnlo )our DooJ IS

important.

r'1"r.

r'irr''lt philo$pli!of

'"h)

,r'J

I sot itrlo lhe

it

aD.t

-r'''

'r.-

livc lre ll.r' th(Ngliont

\v. advocrt. tliat nr€sse!,c

h.rlth

tlLe wo,1d. and

all our interi,allodal

liliell tr) be!.rr ir r bilin.ed appror(h lo h..lrht Lnnrs cati ! brhnoed muls rlril.

Tlic scrnt regard

.\ercisenrldncJ:iLr.l

trc..ss.s nr thc slaughte,lo s. causcd tlie nreal lo be corlaDin.tcd b) faecal lllnller. Yon litcrallr Eel crrp Nher \o! ertiuDk f{nnl. 1u s!.e n.nl of}ou

{r\s ...f

As r sr...!!lIl .rarc crlruli\ r. h.

rrillbenDlilicl]

b

snresses

liiest\ les

toll. t

ard nro(

cs daih and 8aiirj.g rn cxtra 1l ltg. rs \!ell rs sullerirg mood ${ings rrid li!.r drmage. I could hrie rlso !u\ed hnn th. Nlseqnenl IoLutccn dilicllt lurths he Deeded to losc that \!ei!,lt1l Anlonc.an

5.ooo.rlo

..',..r1

osl.Dsibh innrctrous urd ..ononiicrl ProPosal ol i riren0 rnd qnick tpsize achrall] costs niore llra . pretlr t.nn]. Eut mch rre t|. lri.ls of$me lool

. u l

l

frofit nlrEi!s

1he herlrhohl CIO is

gertirg pl.rtr .l

\lcDonrld s list liiod di{tto pr^e tLal instfoodltrs drrknrg lmericrDs sicl nDd ob.se. I conld hr!. tul.l Ii.r t|rt. rDd s!\ed l,inr i|onr corstrnirg the.rtr'.

lbr llt. hcrlth of(oDsuhcrs shoB by the profit-moliratcd lood iDdusl+ $'rs rl$ highlighL€d in Fi ich Scholossers /'irsr !b.d Ndri.r. ID the slio$, lhe urhlgicnic rnl sloPl))

''. \, |-l\i

n sl 'l

'j1

. "1,

I

whi.h Sprrloch subje.L.d hiDself to a 30 dr)

t. iDdridrrl

SROADte

PtR5PltTVtS

,.'i

lhcir custonrcrs e!1)rnsc lPun intcndcd). UJho c;rn rcsist tli. rLlu.e.il r 5.) c.nt u,Lro -t. r.r...t r...,.,,,j, t!r a good dcal ni tliese bell lig|tcDing tines. The need Lo boost profits aDd p.rd botlolr liDts has

.lri1en solie lood coDiprnies to r!1 .oDr.rs. \\ihjle

s.nr cnt the n! Lrit jonrl .ontcnt oi their tood pbdncts. othcrs .ftificially inll.rt. drcm Nitlr addjlir.s. sonrelines rcsultiDg iD disaslrolrs coDstquences. Jusl l..t rl lh. d.aths caused b\ lb..trn.nt tainted rrillt

rcsPonslilil)

2?

r''"

e1

iif ifoll]r.d,? isrdr

R[IATID SSUTI

t00D

in ChiDa where nrelamine was added to .rtificially raise the prolein collLerll in the rnilli.lts grim ircny indeed, $hensuch asoureofs stenance is rade Loxic due to uDscNpulous corNption and scaDdal

Arihur Agalston that focuscd oD catnrg thc right cariohydrates and fats. Ho$'about t|c Blood TIpe diel deleloped by Beach diet created bv car diologist. Dr.

Daitrrof.tbic physician. Peler

tt1D.li,w

ol t ootl ri.h attacked all Lhe scienlilic advic€ we halebeer g€ltirg abouL lbod throughout the prst 5() )ears. Pollan belie!€s that redrLciDg food jDto DutrieDt conpon€nts is a ftliculous puadism that has hchcd

health supplements iDdustry rnakc milllors oui ofthe latcst Dutlicnt ircnd St Jo|n s Worl. sinsko bilabo, fis| oil pills, mangosteen jujce. so

,4GRIIUITURI MODIRIi L

II

D Adamo which

declared lhal people are fitte. when thei. diets are I reccnilv rcad }lichacl Pollni's

BUS ttSS & rrHtC5

9]RIT11I\

cuslonised to theirspecific blood bpes? trveDbodv knoils rou stiouldjust ext less, nake sure tou hay.

b{hDce.l mcals, aDd kccp moliDgl I-ook at the

t|c h€alr|iest in the $'orld the.t dontlvorwabout sood carbs a.d badcarbs'a d ,Iapancsc $'ho arc

ccrtainlydon t lhinLabout $4rit susli rnatches whicli

the

C00D Mosuhe (he{ks our

There is Do lack ofsucc.ssors for cach passing fad

and supplements end up

becarsc crcatiDg nutdtion fads are necessary to slay profitablc. To leep nry titnels centre successful, I

etlects ol th€ lroducts. And there aresoneprodncts

loro$'I musl constanllr looli out for novel aDd ir I o\' l..r Fr-r' i.e r mr l" Jpl rr-.1.-.'1.- r ir_ t ul o,rn r ,brr..'nJ r--p tl- r" r'ir'3h:-l.\^.r canrot just have aerobics aDd spinnins classcs anlrnorc. lbu nc.d dance|cise. kic.kboxing aod l'oga. -{Dd not snnp\'vo8a bul Hatha loga, ltelga.toga,

Dany products that lout tlienselves xs health foods

haming the h\€s ofthosc who consume them, rnd notjust physically. I kDoN some athletes wlio realjscd toolatc that thc frotein pplements thcy i{crc taking to build op nruscles lrad bccn adulterated !vi(h steroids. as tlie manulactu.ers warted to artificiallv eDhance the $'hich are nerely placebi)s of iimitcd trsc. I ihink PolhD nuy be scareDronscrnrg i{hcn hc condemns

Bikram

health supplcm.Dts I takc rnulti\itamin! nrysellLc)

bored easily ard like to hrre De$'thiDgs to tr,a so thcv

stavc off colds.

I believe

as long as trustwortliy

associations such as t]lelleaLth Supplemerts In.lustry Associatjon of SiDsalore (HSIAS) aDd thc Hcalth Sciences Authoritl (HSA) do thcir job better

safeguards and fiforDration on th.se supflemenls .. rl\" t n. d, d. \\'|t r1;i ior i- I Li16 F 1.pr'i inF

(TCII) becomins more popular these days. it is also hearreninB lo linow that HSA also oversees the .egulation ofTCXI prlducts. Ultimrteb, it's still cvcrl indiiidual's responsibilivto chcck $lut hc consDrnes, as last cases have sholn that dcspitc th..}ec.ks and regulations, nnsafc suplnenrents and dftrgs stiLl managc to tind t|eir lval to the shops to be bought

bv

nsuspectnrgconsun1ers.

I'm also coDcerncd that advcrtiscments ererlnrhere sccmto.quatc hcalib! lning with raDid \€iAhl loss.

Uhatc\cr hafp.ncd to exercisinit and eating sensjbl)? So nrany De\r

faDgled diets have turned such

conlentional wisdo r on its herd. There was that 'lorr

crrbs craze in the earl,v nilleDiuDr. thaDks to thc Allir'" ,li l ll "l ,a ,\ ,ft d t ^tr ' ro ,',r', p ll p -

)oga

ma)be lr tslood ]-vpe roga is Dot too

lar ofll uode.n people cherish thei. comfort, set

lu-

l -\r). , I'

rationally hcalthier

d

nrc. ...-dI

fort|em.IIan)

I' q\Jr '.

do noL like the

healrhyealinil.

Blanirg (or?outjoDs for conspirins to NiD

-., Ltr l.r 'n.'. 1,.

.

.rla

nha

rc

r' r',s i!.,r'rp

that ar. dcdicat.dtolourheakh and Dranvcustomers Lrs nr business. if lood corpo.aiioDs are nraling bad lbod, it's niajnlr because $'e stjll happily pa) lbr bad lood. xlorc people are choosinst{r pay a premnun for chenical-free oryanic rood andfi.. range cattle and po ltrl', and suffofiing rcstaurants likc Chez PaDissc and bxsinesses like Whole Foods. Bis food coryorations liLe Henrz and Krali ultnnateb

who keep

cnrc about where the Diarket js

gonu aD.t if coDsruneN a.e goilg healthy, they will be forced to go thc sarnc rorte.It is your haDd that chooses i{hich rcsiau.ani doo.sto opeD,r'hatto tut in vour sholping calt and when to fut do$n that forl and liftt|ose dumbbells. Wc are nhat we eat and we are also what we pa) for, where we shop aDda']ro xc sufport.It

PIIOTO CREDIT/ PtrrkJr., FLi.L{ Crdrtnd coMnons

ER0ADIR

g

boredon or dificully oi co sistent ex€rcise and

iDtakc of carbohldrates. Then there nas the South

23

vho'rhe U$ ir ml ns from

P[RSP[OIV[! the

het

thItu i:\rt

A8I]l]TI|]IWRTIR

A MAIIER OI OPINION

A Macrobiotic F'armer

etr**,

Macrobiotic farme$: are thevirrst paranoid hea]th nuts or do they have soDrething reasonable to say about t]le way we eat today? ds conceived by Lorraine Lce

Is eating healthily the sole responsibility of the individual? Japanes€ Dhilosopher

ceorge OhsaNa drew

fron Eastern lollr nedicile to creatc lis tersion ofa rraditioml approach to health. Ee dubcd it macrobioti.s,

dcsc.ibing a lifcstyle that iN'olved a sinple,

balanced diet thai pronroted health and longelilv. Snrce Ohs.M bouglit nadobiotics to tlc West in the 195os,

problcmatic portion sizes aside, it's simpb lrightcning to knoiv l'hat soes into your food. Colournrs to nake

Y I

ov t's clearer to me over t s gotten clearer the vears that everyone, evervon i p o r t - d p e ,t i ent t " " S ingaporeans included, need a return to better foods that are completely natural. or cou."" tt'ere a"e

I

it look aitractive, addiiives to make it taste better,

-

preseNaiives and siabilisers to make it last longcr on ihe shelf. Food production caried out by the big food companies is often a science in itselfand we re the lab rats who pay to eat it all- Fron the inorganic to the syntheiic and the nature- enljcal additives, we

have aU manner of things donc to our food like

conorations that sell orgatjc food btrt really, the nuke su.e tou knoi{ what !,oes into vour food is to grorv it yoursclf and that s exactly what I'm doins.

b"r\irrs.thi.l,,inB."qPele,,8.El,inga,d 5rming The baby" car.ots we buy are actually cut lionr ord ir1 .zrr ci-n drrldiptFd nirnlorinF.ouno, to retain tbeir bight orange colour' No reports ol

and food qualiil

l^Ila h^rri-s m" i.lh' ,nr"d wa\. .1 .'"rporil .1.

postrtully atred heali!,

can fool us and how

health problenN have eDerged lrom coDsming babf' can ts tliough onc nNst note that these carrot pjeces

lol I orvers

ol tle

dracrobiotic approact

h.!r

believed that

$c1l

-

beins,

f.od

and

happin€ss, aml that

l.ss

.

proc.ss€d

oac.obioiic diet has more beneficidl efaecls

t!aD

others.

Ma.robiotic foods compdse of ldmented soy prodtrcts, sealveed

.nd $trole srairs, prlses, tegetables, and

fruit that are lo.alll

safest \eav to

hnited tbe efforts of 8ov€rDnents authoitie! are in monitoring $hat haPpens in productioD and markeinlg. Have )ttr really paid

1a\, ,.ffdd)

aDd henlth

that makc you

feeL Like

consuming rnore tlian our body can handle

Pi

it s morc value for,\ou. monev.

Profi t-nrorivated food corpomtions encourage you to consurnc more ivithout realising it because thnt

.eally ncans more noDey for lhern! Packaging and

24

BR0A0tR

r''rripp"d ol rnJnror t"\ir,min'

that lje bcneath ihe skiD. In the lishi ofihe curfent melanine food scare, it is clear that foreign substances added toorrfood incrcasethe strain on our internal organs and there may be a build-up effecl jf$'.1e

aiiention to portion sizes? If )ou paid attention to tlie food you purchased aithe supermalkct, youre also probably buyins more than you Deed becaLtse they

t'+irin o, .:n.a'"1lhrnq Pnrtor'rlu.busi

hF'

]

lro

c. ly,

corporations are meetins consumers' deniand for foods ihat are hjgh in Dutritional lalue which look liesh and wholcsone with prod cts that arc doctored rvith synthetic and sometines toxic substances

PtRSPIOlV$ rfie /rc.rlrlt.dre

dsre

RILAIIDI55U15

Even in lhe case of health supplemcnts aDd traditional Chnrcsc medi.ines, regLrlalion continu€s

to be a problem. lD the US, supplcmcnts ar. considered tbod, no! drLrgs, ard the p.oducers are mostly exempted fton tcstiDg aDd rcgulation unless

ill

formulatcd to nntrcle diges(ile ard i rnunit! tn viuses. Diet foods give y(N a falsc scnsc of coDhol oler your lile even as you participrte ir each new rvave ofdiets that thc food iDdustn .reates.

or the product advcrtiscmcDts coDtain medical clains. L'he Slimro tragedy iD Sirgapore that killcd oDc aoDian and caused lele!ision peftonaljtl ADdrea decruz to trndcrgo a liycr transplani, resDlted in lhe tighte. rcgulation ofsrch p.oducts that are arailablc $ithout

$ith

a ucsc ptio!. The

coDcept of

consumers become se.iotrslJ

Siinr r o pills came labelled as

only

Icoflc doD'tthink these days

about what iloes into their mouths parl because therc's Do tirnc to thnrk

ir

or queslion, and lrlso becar6e th€y re come to accept it as fart and parcel of city living. Ila)be it-s because we re so focused on tiie flrture and oD doiDg things ever srcater speed and elliciency that the

"sliN"

has bccD tluowD

i{hole

outthcsindo$'.

f00D BUS NtSS&

til]t(S

ACRITLlITURI

Ift

M0DtRti

\URI IIl

5

EEE

EE

trffiffi

-'"- = ltFffi 8I]YIN(;NRI;AN

l]000 t{o0orior rh'{k5

our

containing nrtural ertracts but in actual fact

The nuniber r,f last food rcstruraDts or coN€niexee

uho ovBihe f omily {o,np!nie!

contained toxicchemicals that ilere not discovered

siorcs offcing instant w]ripped potato, hotdogs,

lhol mok' your

in prcvious tests. Even noi{ the HealLh Scjence Autlioirt' contirues to !Dcoler Chnr.sc iladitional

ni,hu"\vi$

healt| products like teas, medicinalpills aDdtoDrcs ihat contain toxjc lcvcls ofarsenic or mercurr'' that have Lo be .ecalled or banned in sinsaporc. Thc cosi

and impossibility of testinit everythjng thl:,roughly will meaDthatae connnnc$ havc to take personal rcsponsibilitr in exercisi!g more caution especially for producis wc regularly consuIne. CompLacent Singaporeans shor d do niore rcscarch, not sinrpl! follow trcnds, go bt.' hea.say or expect the goveniment

to cover all grouDds. Labcls can lie. Tenns like

''ruLritional supplenlent'- healtli supplemeDt", "jmmunc sysicn booster" or "naLLrral hare to be

vierved r{ith a hcalth! dosc Rcrliy, pcoplc nccd to wake

of

suspicion.

xr

and realise what corporations a.e doins to us. Food is bis blrsin.ss $'ithbillions ofdollarc nrvolved ind corNuners de

uflrl

I lr1.

1-11 f l\.l,rgl'.y.\t^J""rl

i,rrIrg

ol$ays to get rjch, rather than $'oq'ing tdr nuch abotrt what

s

good for the pe.son consumiDgthe food

atthe end of the productioD chanr. Too oftcn \c arc bonrbarded with claims and even wlien rve tryto eat right or eat beticr, \'c arc just btrynrg irto ne$' mark€ting strategjes corporations have u€atcd. Takc thc dict fads thathave become so hshionable and such big business. From thc Blood TWe Diet to the

r1--

' :'r'df,rst,,rrn' 1rn'.rd ir

in)

island is just nrind bogslirg. wikipeclia prts the numbcr of 7 ll outlcts in SiDgapo.e at.+r9l When

idea

ol

slow lood '.

rcally hasn't

hii

lt

s

Sinitapore the way it s gained

.ecognition in Europe aDd Amcrica.

L. \s,Fr,.rr.r'd..".^n rn.r.iarisr r'r,l I Jrrre irs "ifor..ldborrroF.,n'li* 1b\. 1-n,.'- p L.l,.1iur offoodlWe mustrctum to the land and takecontrol of producing the food rrc eat. Without thc lsc of dangerous lertilisers aDd chenicals,

o.sanic lood

is morc flavouful, environnrentaily Iriendlt and herlthy. E en snull, urbaD Sirgaporchas ahistory of famrnrs wirh local prcduce like poultry, esgs, pork. vegetables and fruits. In 1988 thcrc \rcr. 2,o75 licensed tarms occupynig 2,o37 hectares of laDd, {ith a total output ofsonre 55362 |rillio worth c,f fami produce. Just 2.J ycars on, Singaforeans have gotten snobbish, prcler.ing lood products fron other couDtrics and simflygiling in to nrstant and ready lbods that are tuss free and do noi rcquire assemblyl Wc havc lost our identif* and sense olcontrc,l, fully at tlie tnerc! of whatever thc othcr cornh ics $€nt to

-llL

dnd

h.'dr.'r.,o

n,.

r- Ji.-,4..,piJ-r ,r.

identit] and se|se of productivity through the literal

ilpqrp.Fd I ,I all. o' .h:r.a)ur.r$-iLlrt;i/. u ''live a balaDced lif.stylc '. You can buycon\€nience

d

nts and desserts tron ltalt iroods tine called "South Beach LiriDg ' or buy Right For Your 1\?e- ,

ASllt]TiHfV/R TIR

To nre, t|e c|oice is crvstal cLear. Sav no to the coryorationsl Say Ics to bctt.r food and fewer feaNl(l

''Mone! Saring Pl]cks' of health suppleneDts

25

!d oi/tuorus/lll ll! (!oni(

been a.ound sirce 1989, but

books, shnning progmmmcs and food products

foods like smckbars, frozeD entrees, salads, ccrcals,

rfy

food comes so easily, cluickly aDd nr such abundaDLc,

and weat|€r pattems overseas.I lo. o e am proud to be going back to the land aDd caNjng out ny oM

J.r. ,."r. '1. 1^l r,l',. ! n le.,,o,,er.".li.rB

hco

.r!.[ed vkor

you dont think aboul i{hat r''ou are eating and end !p with liealth problcms and obcsi\ . I'n all for the

Beach Diet, eatirg right

AtlijnJ Diet and the South

snoorhieJ ! rd

ER0lDtR PIR5PICTIV|s

,cst thd lrti.lc sio ld oJfcnd, Latrulnc is stilt .ltcpllt !ttat./1t to the coryaratitns Jnt o great

nunlbct of belaLed

ttu hcaLthLareiss1L

[0tAL vs. GL0BAL

Who Pays for Health? A comparison ofthree h€althcare systems arcundthc lvorld

b]'Elizabcth Kon

Nationalised Healthcare TIIT RR]TISH NATIONAL H!;AI-TII

SYSTEtrT

(NHS)

he NHS offers univcNal, coniprehensn e

,nd fia'e herlth.are to all. Started in 1948, its rin was to otTcr ihe British the freedom fron fear, sp€cificallythe fieedom lrom thccosts ofillhealth. The thinking afterthe rvlrr was that if BritaiD was going

. , .i

"r,d -8,"

Protecl ou

n.n.L' tr.lltini

.

Irainins

ernpLor-ment, thaD it sliould also apply the same principles (o guaranteeing their citizeDs the ights to

ProtGct

health care, and thus usher ir a nrorc just society bascd oD equity and thc rcdistribuljon ofwcalth.

lhis mcasure

so removes thc

siigm ofcha tlby

treating all its patieDts on thcbasis

ofDeed. nol i|c

:Lbiljty lo pay.

and GPs l]rc not auilable on weekends even thoush thcir pry lias r,on. uf by !o% (43% of cn.a money gncD to the NHS sincc 2oo2 has gone

hmilydo.tors

nrto lisher pay) and the runber of doctorc and ruNes

The grumblings about this systen is that i{lile the nodel $'as baclied by Doble rheto.ic, il is siatliDg to

Ialc arisen. Dentishf, orthodontic seniccs andlong Lerm care xre Dol considcrcd part olthe publictrust

loot aDiiquated and inadcquate to the

groups and tcnd to b€

needs of

modem society. Tlie loudest complaiDts have to do with ils bDrcaucratic inflexibiliq, and is i\,. Brilons alrcady do pav \crr little fb. health carc than iD nosl de'eloped natioDs. Free healthcarc cones funded

fron

certraL ta{ation aDd individuals only pay at Drost

d rLrgs, onc of the lowesl Frccntages in lhe i{orld. But the securiq ofa govemnrent fundcd nroropoly is out$'eiglied byits unrcspotlsiveness to patienLs nccds and its slowness in inDovatirg. Too

5% for the cost ol

rr.ry1e, lie.t

ll\

rl

I'r.u,"

"a^d. lurup r''liors

- 7oo-ooo at anyoDctime iD the quetrc. Health care is ratiinied on the urgcncy of clinicai needs, so ltrits

ABOU]

IHI

!'JR]TI

R

167 bjllion was speDt in 2()06 and !98 iD 2olr8 onc fiftli oltsdlain\ yearly erpenditurc, and an rnount bigger than most world econo ies dcspite record flrndiDg during thc fast decade, il still cannot neet dernand and tnr payers at. Dot getling thei. moDey's woth. CaDcer treatnrent is still poor, and hosDital intections have becorne lrightcniDgl,v freqren l, with hospiial wards amazingl! lessthan clern and steilc.

26

BR0ADtR

PtRSPtiTlvtS

costlv.

Tliis n:itionaliscd slstem that employs oler I illjon siaff, stilL has Do integrated l l' s,v''stcm of paljenl rccor.ls. A proiect, costirs billio.s, to consolidate elcctroDic patje t recods will not corne onhne till 20r4. Thc citicisn1 is thrtthrcsins pots ofrnoDclat the svstern has soDe to lir,h er cnsts rather than bettcr

A lieavy handed go\trnnenLal sl stcm also means a lot ofbureaucracy and nicrcmanaging. Doctors aDd nurscs sometines

a.e busy satisi

can vart wideiy ivithin rcsions.

lerf

saoific. patient time

ing

becausc they

ew n:forDN and ta.gets irNtcad

of focusing oD qualitr care. Thc NHS cost cortrol nechanism is considered mostl,''' scDsible even thoush there are still many medicines wit| proven efficacy not alailable ihrough the NIIs. \Mrat docs Dot make sens. to chronically ill patients is not bciDS able io pay for these drugs and hcatmerts thenselvcs. U4leD the' do. thcv xre c.rnsidered a p.ivate patient and hence unablc to retain their frec medical care stahts in dle NHS.

tic ft(ollr.or.r asr.

'1

he consensus js that

B.itai

s

low Levei of private as thesc

The doom and gloom aboutthc NHS

inthc mcdia

spendirg on liealth nay have to chaDge,

maybc.trrious; it is laudcd xbroad aftcr all.

altem{tives Noukl provide more resolrrces for thosc with the greatest DeedaDdnrcrcase cfficicDcv. After all, nr mosi frcc markcisj consumers drive up s. idJ d ,d dri!. , n' p Ll '^r'ra,\i \ '\' il walleis. BuI slch choice is missing nr the Nl lS thoush thegovernmenl is lryirg toproDote niore choicebl gjvirlg people the.iglit to choose hospitals iD flrture. ]\nd finally hospitals will be mandated to publish

I'Icdia rcprcscntation of a bunsled D.ndemic of epic prcl)oltio.s nraysirnplybe nedia lbdder. E.\cepriors rill alwats make the ews but the lhirg to relnemberjs that ther" are prevaleDtjn all healtlicare svstens. The 't

Ditish nuv

be tessinistic about

tlicir

safeb .epor1s, success mtes ofofcmtioDs and otircr

politicians' abilitv io fus| t|rough rcal rcfomr in thc NHS. Hoi{ever, thel should be rcassured th.t the socialist begin.ings ol (hei.

qralit! indicaiors. Paii.nt suNcys \ill dctcmrin. ul) to 4% ofallocated budgets in tirtu e.

heallhcare sysLenr are conside.ed so sac.osanct that all Eritish political parties, p.esent an.l

tutlrrc, \rili al$als fightto rpholdthcrn. at

The Failure of Private Enterprise THB UNII'ED SI'A'I'ES HLqITHCARE MODEL WAIIH TH

he

Aneican healthcare system,

ir

coDt.ast $'ith tlie Bitish natioDaliscd nrdcl, is goiDgthrough a i{orsc oisis.

Its imfloding failure is so nell tublicis.d, it makes B tain s concems seem almost miDiscule and €asilr resolved by .on.t rr: .on Nor o rl' \.r-ri''' "r . ,i tl.. t-n ivealthl nrtioDs iD the ilor'ld that docs noi offcr universal health care, it has nicrcasnrs raDks ofihc

i'

uniDsurcd. 46 million AmcicaDs are.urrentiv uninsurcd or cannot alTord health nrsurance. even durins a decade of overall economic growth ard ..\, n A,np, i. i d.re ,J. r,-n, in; Jn ,, rnl r" ' rs% of GDP on healthcare - already averasnrs $2

.fll

r"r',\ 'r.r,l-\ 'p.-l ^d'rllnrl h..n,rig

decade. He thcarc costs arc siDg so much fastcr than \.agcs and inflation ihat mcdical c.uses are J l\ . r d lyl,i -rtt.\ rlFrq r'r .o, rtr'., i"

".r

' ', tr'nr'l'.1lh .

eye ll i.r

,lr

'

,81.1.,, h-j l..Fn r: .F,,in;

ore iDdividu.rls vulnerabLe

"..

, \.ft'll.J

ard

a{ra tocli&le

dt'l\J.'rrri,g

with govemment support onl) ior Lhe elderlJ" and the very poor. Actual delivery and execution oI heallhcare is unde.taken by private insuers or designe.t around private vohuitary iDsurancc. Ironically, despite the usc ofp vatc cntcry sc to handle nost of jts proccsscs, acc.ss, cfficicncv and

Z

K0ADIR

qualill'ar

I

dcficicDt and a causc ofconstant teeth par.dox of the Ame can heallh sysienr

gnashiDg. Thc

is the failLr.e oipri!ate corporations in providing crmpetilion to brirB down pdces. Worse, thissystem competes on zero sun levels to shift costs to tlie

coDstrner and to

restict choice ud serrices.

Bcst practices arc slori to sfrcad and innovrrior

highly rcsisted. None of t|is. ol corrse, adds any value lo a sich patient iI] the slslem. MIiHAILMOORfS

'lhe s]sieD s iDelTicienct is

a

large coDtribution to

nuraw{I costs. Bloated bureaucracies and hugc admiDjstlatiyc cxpcnscs to do $'it| paper fornrs, claims, conrflicated bill par-ing stsLetns and high Drarketing costs all clog up ihe svstemjs ability Lo rLrn sea lesslr. A dive.s€ and !a.)irg nunber of health care providers also laclt coo.dirrtiol rnd iDcrease the ftrgmertrtion of proce.lures. This.esults loru wait tines for tests or rcpcatcd tcsting bccaNc luticnt's gehefened to doctors unfarniliarrvill them. It is a little i{onder t|an thal Ame.ican palients lead theso.ld in lo r ing to nedic.rl sel|help bool$ and web posti gs to deal with their frustratioD rnd dislrust ivith the svsteDr. A hcalth sr-stcm that rclics so hcavily on i|. protit d veD .onrfrnies to provide whal is essenlially a Dubli. good also increases the ineq!ality olaccess.

PtisPtolvts th.

h.

lth

rr;\\rp

srrc (2004

ffi

H

P85'YI(AROllIIDTl][ i]Y0RrD(200/)

ri t]tuilii

L0[{i-

R15IARI:Hil]I5:

4ltalllTYPt5

0t

HTAI1BTARI SYSTIM5

(A(mdins ro PEs.ors)

rl]r BtvtfttDcI I{00tt

Suc| compaDicschasc{fterpeopLervhoilreadyha!e -l-r ar'r '.n ff^rdrbLr'rr?.'.,J-\'nlh,. LUU \p that node.n nredicin€ can pr.r'idc. Thclosers a.ethe pLL.. .., nL ci lr I 1 ,d r',n." hr I d s brli.i' s $'lio are repeatedl) denied a.c.ss and excluded bcca sc they onlt rdd to insurerj risk. This foint is crnphasised in x1i.Iael Moo.€'s Sicko rere applicaDts are ruthlcssly screcned and rejected on a long list of erclusions. Unfortunatcl!, tliis does not serv€ Lhe people who nrosl need insurancc.

tubo, hofq Korq, 6nor

46 millioD ,{mericars wiLhoutinsunncc also include alarse poftionofthe middle class,Nho havc cnoush

8

io disqLlalit theDsetves fronr gove rment fund.d

oln, Nav

bolond, Spoin

obaDra are debaiiDg reducing costs \trsus iDcrcasins

.o\cmgc io no real conclusior.ls Lhe Anreien systcm Lhen iust doome.l to another erpersive and dishea.Lening stal.matc? Some poiDt to the llig|t of Am€rican nredical rctugees" {s a Decessary cat.tlyst tliat e,ill shock hospital ad.rinistmtoN and insurem into trying harder to fix a tr'oublcd systen. x{aybe this will brnu the $.rwing polilicnl prcssurc for refoml to a hcad as the prospect of losjnil .evenue to lDdia, 'lhailand or singapore is .listasteful €nough toshakc sclerotic Anrerican health-DaiDteDanc€ olganisaiions o,.t ot rlFir'''"n"ild n-u.lr.? r,l 'u|.te lio, rnd transpnrercy. Or not. Wc can onlr woDder hoi! tlie richest cou Lry in the world clcr let itself get into

programm.s and yct not enough pe.s.rnal resources TUt I5l\lr\Rt( M0DIt lIeo rh{ !

re i5 ioiflly

to

ifiord comprehcnsiyc private insurarce. Such are rore likel], than oth.r citizens fron the

people

developed e,orkl to dela) secting mcdical care

wlich

ir

nore erpensive nredical cises later oD. Because tliey clo not have access to r.gular healthcarc aDd preventive se.vjces, this sitxaii^n quiclJt becomcs oDc of life rnd death. SuNets cile onl,v resrlts

the lacl

THI NATIi]NAI INSUR,\

Bism

o

through

o

7c) %

ntore

tha

This also cxacerbates

rr

al.eady conrpromiscd

slst.n $'hcre senices and treatrnenls are and fro\id.d on frofit.ibilit-v beDch markers.

henlrhcrm nodel.

selected

not n€ed. Services .r hcDcc capped or rest.i(ted and fall $.eLl shorL .]1 recomnrcndcd carc.Itdoes not hel! nole ruf

that it is privrte manager's, not doctors or patierts who liavc the final sa," ir makins rcfcrcnce, prescription and treatment decisions. Doctorc arc

incenli\isedb how Duch costs tliel cut, nol on how $el1 or sLrcc.ssfully they t.eat their patients.

lutO1lT0tP0((rrtl0Dft 0ny40ofrheword'i200

& Supply-Side Government

Intervention

HTAITH

tIMODII

rtk

t insurrDce we.e

lliose with irNurancc to die over the Dext yea.s three aller being diagnoscd with colorectal

liltel) llelher ond5, Sv lzorlond

thatthos.sitho

Individual Responsibility

cilen how problematic this systcm is, $'hy have the AneicaDs Dot s$.jtched to a singlc talcr systeni \rhc.c a plblic agencJ or the Sovernnrent t.k.s charg.? ll does not h.h that Arnericrns are s., suspicious of bjg governmcnt intrudiDg irlto their lives lhal suc| sohrtions bandicd onnd do not so verl fariMichael Moore stu ts in socialist countrics oDlygoiDgso fa..

TIIE SINCA] 'ORE IIE;\I,TIICr\RE MODEL zAI np.'r.or .n.. I n.,'n..slenr:i.oniirLenLh -1', .dl,\,i ',:,,i ,,r1,\!,, d.o,Fo \\! n \ I ,F I,F.r ", h, \.n 'l srrj"pul hJ , o l\/ ,,:,.,,,r r,edl h ,, ,rrlrc d!. \cr I consiilered a g.eat success and a modcl for other counhics to follo{. Though Singapore pats only oD.1l1l| to onc sclcDth of \tiat Americans pay elcn

nakinst|eEurcf.aDslookspendthdli

and hasless

careBilers percapital. SiDgaporerns on mosl heallh indicators (liie evectaDcl', infant nortalitlrate, etc)

are herlthier than mant dcveloped nrtioDs. "1, gn\" i, ", ",. rr,d iu.1o""^':r".r^-" total hcalth costs - app.oximalel) 4% of GDP. lndividuals and cmployers pal the rest. Unlike dre heary hnnd that sovcrDDrerts ilield in natioralised healthcare systenrs. ihc SinsaDore Aovernnent has

It is a sign of how nnpr,rLarL t|is crisis is that aDy nr.jor pohtician wantnig to bu rish his national c.edentials nrFt ofler r herlth care plan to $'in the elecLorat. ov$. Currently, Johr Mccain and Ba.a.k

?8

BrT)AlrlR

PflSPt(iWtS

trken the patli of choice and comfetition over cornmand and coDtrol. lntercslingly, as of 198.{ the

Singaporc healthca.e slsten followed thc British nodel closcly, i{ith nedical costs linanced through

tl 'h. lttunr. issrt

trxes and

se N

ices provided

.lt anomiDalcharge. But

wjlh henlihcar€ costs escalatiDg, the govcmmcnt decidedto reforn the system into onc that srs more flexjble rDd sustajnablc for ihc long tcrnr. The National Health Plan was coDcciled and the result is the 3M modcl of hcalthcare drat we see today. t hese

relorms introduc.d in

t|e

r{al tr conlrolljng health

r99osj have gone a Long

c:r.e costs.

Singa!o.e uses medicalsalinss accouDts Mcdisav..

\l-Jitur'Ll-.^,'_1. I"rnr. ."r'. the elemeDts of nldiridual rcsponsibility and governnent s pport. Th.sc accounts are ta\ hee,

N- : hi'l

.',,11

thcv .arn jDtcrcst and aretopped op withmardatorl

fron lhe i djlnluals patcheqtre and co tributions. Individuals caD takc out

dcductions

enrployer mon€y to pay for approred categorics of mcdical treatnents aDd procedures aDd cvcn for nrore expensire treatmeDts snch as chcrnotherapy or HIV dmgs. The accouDtsalso pr!\ide an nrsulancesafetl Dct to strppoft lori income eamers aDd the poor. P.ople ar€ req!i.ed to sare to rneetthei. om medjcal e\Fnses in the tuture and Dot relv too hea\ily oD thc

3o.4.r,rnan l'b':l

't h€) are also expe.ted to pay morc whcD

r

rl

h

-r\

i.i

l,-1 Lr InIiJ|,.,.-8

.

tbci d.rnand

- i [ .a r... \LJ\|. .'r,r p.

F

coDsumttion arc th.refore ke!L in check b) dcmandins personal accountability. Such sivings

i!

costs fiees up the golcrDrncDt to

thatiiis mostlv poorer ciL izens who Rap the beDefits of sxch goverrr €nt subsjdies. These clieapcr healthcare options also force pri\'{t. hcalthcar. provjders to be rnore conpetiti\c in their pricnrg. Thc

goyerDnient encourages snch coDUctiiivcncss bt cornpellilgihc pnblication ofdciail.d tdce lists so d b gic consumcrs morc intbmration to nralte beLte. dccisioDs s'hen ihe! go co rpirison shopphg. The p. ornrances ol hospitals are also contiDuall) bedch.,irked agrinst other internxtioDalhosfitals lo maintair hjgh standr s ofhealthcarc. Lifonution Lechnologv is also to bc haDcsscd to b ng about

, '.? f. r' , .:.' \ , 'ai

Slstem$'ill coDsolid.tc.lectrcnic,nedical rec.,rds across thc nhole svsled.

il. a inb 1., Lu , Lt l .. l'1 ,:'-. . ., r ,9 iL,o|.inn.-l "luu .'.1.'L,'l!. lr', l. s. a .19

'|\F

the ivo.ld. SiDgaporeMcdicinc, a rnulti agency i tiative, xrs lauDchcd in 2oo3 totake adlanlage ol this

oppotuity

and to posiiio n Singapore as a

leadhg

., 'rilI L',,C Lednt:onrlocrltl--!rdL\ -!- run. T|e besl Singapore liospitals already iral many |ospilals in the developed $'orl.1

aDd

athalfth.

cost.

A! such- the consistent quali\ and vakrc ofSnrgal)or. healthcare is crsily a dra$'for Dr.dic.l toDrists. Silgaporc ainN to atimct 1 nillion nredical lourhls by2(l12,. group thal colld bewodh $TbiLljoD aloDe.

c ,' a,r' ii.," !' r' i., b'.' li. -.lru, ..

"r

,

prc\cntile

adranlages uni.tue to r snall nation statc. SiDgaforc

prosunines (promotioD of hcalthr eaft rs habils, sports aDd heaith club subsidies to encou.age an activc lifc) or nnfroving erNironnert lactors like the

lns a srull aDd relatively vouns populatio!, politi..l stabilitl that cnablcd sncc.ssivc gov.rnnrflrls lo intrcducc timcl! and suptofiinil hcalthcare regulalion, an(l heaithca.e irfrastNctLre ihat hrs close prorinrit) to one aDotlier. Part of Singapore s srccess is also that grorvtli of thc Singaporc's econon] has actralll outpaccd irlcrcascs in healtli care inflatioD. B t this slst.m is an iling .t

spend tli€ noDey else$'here that focuscs on care

raFr ro,

o'.o-JC:o,."i \-.','l l,-rrl',

^lp^-l r(^,. c..pntidt, LU.ir.,rn L

,.er1

rnl

ri ^,

comes in Lhe lomi of supply-sicle policies that rcgulat.

the nurnber ofhospjtal beds, doctors aDd the use of higli-cost technolo$ . Thcsc Drcasurcs guards aita insl

tlat Ias to be based high volunre to be Drofltable, and ar over reliaDce

t|e c|allenges

or€rlv-long hosfital sta)s,.are

a crossrcads as SingaDorc faccs

oD

contiDucd cost contanr merrl s'hjle haying

on e\l)ensive 't he

b)

Lo deal

ol

with

rr', sr,Jr,rlpir\,rF,, ,., ot r. ; i,.pupll rur' and increasinillr e\pensive Diedical tecliDology.

lec| olo$.

gole.nneDt .lso lieeps basic healthor. atrordable bsmisins public hospitals (rdcccaps ar. fla.ed

su

or all services and rroccdurcs).nd sover.nient o tpatient clinics. Even this is not a lree lunch that

Sinilaporc needs to be e\eD nore frrseeins and Dnnblc

in order to balan(e the elenmts of govcrnmcDi suppoft, persoDal responsilility and frnat.

..r.',F-l ir;L 'e^,sr'\.ri'_i,.Jf',"F, in oduced ir 2ooo 1o rnrke eveD norc suc

to be

?9

BR0A0tR

PtRlPtt]lvts theiedlti.drc i$uc

IUTTUREWAICH

cHRONrc FATTGUE SYNDR0ME

(CFS)

Havc you cver felt loDs'd.awn physical or mental exhaustioD coupled with w espread pain and aches that restcould not cvcn relieve? First named in 1956, nyalgic ercephalomlclitishas been unslnpatheticilly dubbed r uppie ll u . Slffercrs have been accused of simply n'aDting attention, being hypochondIiac or nalinserirs, rvhich is ro wonder, for it can bc fairly easy to fakc CFS syndromes to gel llnancial or emotional bcDcfits. CFS sutrerers argue that sir| so nan, people belieliDs that they a.e f,l
.b u\rL ules sho Lr-\ill'se Jld

1

o.t 'l,e,r.unJiriur'.

Not getting the sane amount ofsupport other sick

ai|i8hcr -]€t anotlier controversial illness

people gct unfortunately puts Cl.S sufterers

risk for defrcssioD ABOUTTHI\vRITIR

whose sulTercrs arc mislabeled as not wanting to

out

ofit".

tnap

It

CILIiRRITY SUFFERERS/Lauren HillenbraDd, author of Scabiscuit"; olaf Bodden, soccer player

ATIENTToN DEHOT DIS0RDER (ADD) lve used tojust punish hi?eractivc childreD relio could not sit still in class but now, persistcnt patterDs of irnpulsivcDess atrd inattention can be diagnoscd as

ADD or ADHD (Attention Deficit Hyperactility Disorder). Thoush there is

a

st.ong genetic and gender

component to ADHD (it occurs twice

as

conmonly in

bu's Li n in g:r1.,. adu \ c-r' dr\r Lp .up n! neclurisms with nedication and couDselins. Sone cducators aDd parents though a.e hcsitant to label inattcntile clildren so readiLy as ADD sulTerers for fear ofharmnrg thejr self-esteem or giling thern an excuse for brcttish misbehaviour. Sone neurologjsts, ho ever, have blasted ADHD as a fraud perpet.ated b)' psychiatrists and pharmaceutical corporations to milk anxjous parents of their noney. Thc church of Scicntolog) atrd its most prominent spokesnanTon Cruise in farticular luve lashed out ailainst ADHD medication Riialin and r\dderall as being no better than street dnrgs. It

CELtrIIRI'IY SUFFERERS/Robin Williams, walt Disney, John Lennon, Clier

SelfPorh dil COr']RICHT/ Sinion Pak nronas flirkr ctuative CorrDN

30

BR0A0tR

PtRSPlOWS t'hp

hrolt'hrtrt

issut

OBSESSIVE (OMPULSIVE DISORDER

Heroes&Villains

DocnDrentins onr fi(kle

.

"

aDd

rith

pedectionistic, people

w)rld's cLeFclungnra prrrcptnnrs

thosc'

qurlitites mat not neccessarill snffcr fron OCD but ocPD lobsessile-comfulsivc pcrsonality disord.r).

$rlut s.famtcs

soDrconc idro is mcrcly iastidious il orn

{r ,r \q.l o, Dr,\Jtl .^\.,s.i^r .^r.^nprl..o-. uv' l. ' r, . '\.'..\"r-ur'\e.n,at1,F u, ' 'i,'-

emotionally distlessinit and caose impaiDneDt in lis r€lationships. OCD sufterers rnay obsess over certair inapprcp.iate thoughts or compulsively repcat c.ftain rcts like srvitchtug offlights at a c.rtain fixcd iimc.

iiDiDg up all thcir cloihcs in tmfect position and taking only a ccrtail .umber ofsteps to reach n destinition. Theseacts are us!ally aimed at p.eventing some unrelaled d.eaded erellt tliat th€r believe \rill liappen iftheir self-imroscd Nlcs aE not folloi{ed.It

Clll-llllRI]I SUFItrRERS/ Cameron rliaz (cleannLg doorknobsl. Da\id Becha.r rs!nmetNl. LeoDa.do di Cap o (no steppirs on cracks h the pavemerts)

D

gFlo.'.

frofilnrg dala llom slud)jr)g ca cercells lorfree to the '''. ndl:on I rF. r' l, ' n'rn ,r.il. ll,i, 1..'"si\-

donation is of g.eat benefit to the b.illiaDt bui underinnded encer .esea.cliers Nho do not havc acccss

to the truckloads of eafcDsivc irfomratioD GSK has amasscd. qnics may scofi thai all Bis Phann. is doins is relyins on smaller companies and acndemics to dc) pioneering $o.li betr,.e s$.oopi!g back oDto the sceDe lo spjn offnew and profitable products thrt leverage upon their ilork. Still, jfthe outcome is tl t lons-ai{aited cu.e for caDcer. should cSK Dot desenc soDc financial retums for hclpiDs to bdns it about? ft

\iILL\IN /

lhe lnte ret is a treantre t.ove of social leLworks rateriDg to erery

bo)s fir1d it especially shamcflrl to confcss it.

erest, Do rnatter liow nnDxlaDe

disordeN as n glamourous ljtesttle clioice.athe. thaD a lelhal disease. X{}s!ace grlup Pr! Nation's r,ooo ^m aDorcxics arc odd Diembers .leclarc's that Do r.corcriDs allo$'ed to jonr bccausc it Nins our notivation . Faccbook groups 'Yes, I lrale an eati.it disoder. No,

It is nowoDdcrthc prcsshailcd UK'stbrnrer prnne minisler69 year old Joh

PrescoLl as b.nye when he coDfessecl to the

BBCthat he had been bulinicforteD vears, and nost chroricaliy du nshisrearsnrotricc. Snfferers lite Prtss.ott.l.,rl! s|.w tlrnr sometim.s pcoplc rcsor-i io catins disorders

it\

taistcd i{ay ofgainilg conlrol over thejr lives

during tines ofgreatdistress ancl powerlessDess.

tt

Cl.lLl.lttRll Y SUl.lliRliRS/ Karcn Ca{enter, Paula ]\bdul,linccss DiaDa, Calista Flockhcaf, Elton John

3l

i

or srotesqle - aDd pro-ana (],ro aDorcia) and pm mia 0ro buhnia) lvebsites c€rtainlv Dake lle .ur. Faccbook, llr'-'Spacc rnd Blogiter have bee uncerernoniously linled to groups exlolins eatiDs

conefron all ethnicr+oups, all ases - and rnore ofthem are nale thar $'e thinkbccaus.

as a

'n,.ur.,dtl., I,. \,,, IrrB \.i'l.r

ny fenule celebritieshalc com. out

ofthe closet to admii thcj snffcrd from cit|cr bllimia, aDorcxia or bngc .ating t|at cating disorders |a!ebecome a stranse Dosimodero badite ofpride. lhough srereoLyped as a youDgwhitegi.l s disease, ffere$ ma)

d.f!t]

IIl,lRO / Don't dismiss Big Phamayct forhaving no heart. ID JuDc this vcar, GlaxoSDrithKlinc ((;SK)

Pro-Ana Sites

EAIING DISORDERS So

GlaxoSmithl{ine

ER0ADtR

notyour problern. and "Cet lhinordie triing'sLun up besl the deliant. selfrighteous attitl es oftliis cu.ious grou! of ertrerne dieters. X{enbe.s share infornation oD ho$'to hjde tlieir habits fiom familr, conpete iI weight loss coDtcsts, swap i{ar storics of closc shav.s nith dcat| .nd s.el solace in i.raites ol

slinn] gi s Io. thinspiratjo .

Relentless self

destmction is noi{ no more thnr a lifestyle c|oice.

PtRSPfUlVi5

il.lt.dldtcdrc dsur

(t

RTBOOI YOUR MIND

The Future of Health Going by t]le medical breakthroughs we have seen over the past 5 yea$, The future is not too

bleat for healthcare.

witl

tlle Internet and brealithroughs in material technolosr,

of mankind (at least for those who can afford it) looks reasonably

NAN(}TE(HNOLOGY'S WONDERS SMALL SIZE, RIG IMPACT / Surgery

healtly.

tl1e

future

By Nadja Mah

is

essentially about using tools to rip open the hunan body and patch up prcblems - aD invasive, aen mrde

sohition that results in complications and a longer healing process. However nanotechnologypronises

io reduce the

size of surgical tools so radically that suryerycatrbe done interDaliy, bypassing the need io cut the body up unnecessarily. Scientists fron the Universiiy of Texas and Rice University have

di..overedhowtolr-,1li'Fr

.rr'r{

-,orrld1,

sI

ncigirbournrg tissue. In initial er?eriments, scientists

implanted carbon nanolnbes so minuscle ihat 7s,ooo of them lined side by side would be tbe width J lurnar hr.r -,lir".rl) inro liv"r tumouh rr

"l

l"bbiLs. The rabbits were then er?osed to radio waves

and the nanotubes pmduced heat, destroying the ttrmotrr directly. A new Datlo sjzed endoscope will also allow doctors to discover even the smallest aDd

WHERT] DOES MY HEART BEAT NOW?/ Its nam€ is a nouthftrl - the Chmniclc Implanrable FlaemodyDamic Mo. il or. But wliat it does is simple and life saving: it is a 2417 heart monitor inplanted

most elusive tumours. By using light from a sinsle optical fibre through a probe about the width ofa human hair, the endoscope can navigate the most delicate areas of ihe human body like the middle ear or ventricles in the brain, resultiDs in less tissue dn,l damag" lron p\ce,.ivp ana.sll,.sia.

the IDternet to their dociors the moment ihcir heafts get into irouble- With the Chronicie IHM, doctoN

\anorF'l,nulo$ hJ"dl.opro'idFdaldndvso u io l

via th€ world Wide web - heart rate, body

to health problens caused by contaminated water.

tenperaiure, fluid lelels

"!matF

in

lo

pdlienl whi.h .eids

a mns.JSc M-ciFss y

@n monitor their patient's condition

About r.7 million deaths take place in the world due to poor waier hygiene- ScieDtists

{ion

the

vi:

fron anlNhere

most significantly the diastolic and systolic pressures of the heart. aDd

Unive ity used

Anothe. major breathrough for lung transplaDt

DaDopaticles to exert an electrostalic atLract ion onto

patients has been tlie iDvention of the BioLuDgby a

of South Australia have succcssfull)' toxiDs. Once dirty water is flushed through a AEOUTTl]IWRTIR

ARTIFICIAL ORGANS AND IMPLANTS

filter

with the nanopanicles, the toxins attach themselves ro h. pani.le zIdJtsl lrippFo:n IhFijhFr.leavng behind clcan, potable wate. - and a significantly cheaper, less enersy consumins method of $'ater

puificatioD.

rt

Michisan professor of surgery. The artificiai lung

paiie 's heart to manage oxygen and fow h"ouglo'r rlpbod).Sin'1 rhFLleri.F

works with a

blood

depends on tbe heaft rather than some neclianical device to pump blood, patients do not have to be

hooked p to

32

BR0ADIR PIRSPIOIVIS t/ze

ledlticdre

rssue

a machine in hospital and are frce to

lTHIRMID(AtAND HIALTt]TARI ERIA(THR()LIGH\

PATIENT

IO

PATIENI SUPPORI GROUPS

Dl{. Pr{tItrNT! lr.D. / When cycn docloN chcck Iiikipedia on thc sl) lo lin.l our Drore up to clatc inlirnation aborn nredicinei von c.r. bet that t|. lhe aveftg. taticDl \!ith an lDtcnot connectidr h.s also becoDr.

il,

r

l.rL

,ft

a,

wEtL "''-"-" L;

",li.,,ur '{rr|g t,, , .ti., 1rr,,r,,.

passji c d iagnosis or tack

o

l detaild

.xfl.

ThaDks 1o printouts tioDr n€$,sgrouts.

lR0r\1lllt 5tA

. ar ioDs.

I'om

humh

A!nr

or rcreo(he6

nrrili,,il lists

!lethom of nrtcr.ationai Drcdi.al $,ebsitcs oDline, prtjents arc b. . d ilg togctlrd l o l.rke char3c of lheir own hcrllh and establishing their oi{n surporl g(tr'psj researdr projccls, lobbvnrs dd\rs. latabascs, llood tnd tjs cbr.ks ancl regishies As peoplc groi{ ore awrrc ol lrealtlicarc rcso!.cc! onlir., t|ev are morc aggressivel! rcs.fuchirs

poynsflhrhd re iophone to

n bro n ord

viere 06e

lo. Dedical $rccess stoies wit| n contact list of doctors rnd cu red prtients to nr i.

i{ill b. b.urre lJ]' this t.lienr toTrticDl .royement Dr Weil of thc nn.)efsel) popuiar sil€ lrleil.conr drcarrs ofsomcdrr seeils an o.llne heahngrcgjslJ\' $hercl)aii.nlsca!sc c|

]\sl

jLrsl get

thcm

rl

e

practical Nisdom

ough rhejr da*csl d.t) s.

Dr'

\{'eil.

ONIBTOl]DTYPI

lcrlthll.rp .enuils

nntofrnre

a 1i

c.

mi$ e$ol omprry

b

oodrypg ro 0 by remov ns rhe

$gormole(ules o1didore

stARtIS'SLJRGIRY W]TH

IVIl]NITs

oarsmf

ln ?008,

poliert

rcmoyed o

kidney throush llie

lely bu|or, eviry

o neory

nsbh sro.Ihis remokob e firnrlirrk rd p'o@d!re w6 on/y po$lble

rhrouqh AGS

rynem of moqners

cHricK

o!rrlde

oul'

\lorked

He{lthmrt. uLr!.l,edliiD&p.or.i

t_ 8R0ADR PtR5PttTlVtS

t/r. /r1////r(dr.

r$r.

!

p ored

obdomen rlror

'lre loseih {irh

orhcr

mogmt droded rorinysrgi(l roo

33

md min

Zyme0!6i is wo'kif! oi

fn|liclv

to thc d.y.lot)ing i{orld $,bere poortl

wo*s

le{hnolosy rhor wi I ionven ol

aDd

n ice that will be .rl nxrst

ko

mlx ups, medl(ol

aDd lo$.op.ratnrg (osts, se

ihe me b oorlrype rhor

bonks

discasc .ontrol efforts. (loojlle.org Irs granred Ilcrlthllip S,l5o.ooo to heb its cfforrs since its

I

is

of oll pmpie. Io rove rhe ptrsrio shortogc thor blood

nrlo Nalpcd data lhaL uublichcrlrh \aorlters, mcdicat researchers aDd tIe public can nsr to Lrrckthc lat.sr

xlailallc ne$s sourccs

RUrrlHtMAtt

10

lverybody ovu rype 0bood

suppoltcd herlthcare slstcms have lundic.pped

Brsed oD

forsiid

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