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April 22, 2007

Food for the Poor - Food for the Rich



You Are What You Grow
By MICHAEL POLLAN
New York Times, April 22 2007

A few years ago, an obesity researcher at the University of Washington named Adam Drewnowski ventured into the supermarket to solve a mystery. He wanted to figure out why it is that the most reliable predictor of obesity in America today is a person’s wealth. For most of history, after all, the poor have typically suffered from a shortage of calories, not a surfeit. So how is it that today the people with the least amount of money to spend on food are the ones most likely to be overweight?
Drewnowski gave himself a hypothetical dollar to spend, using it to purchase as many calories as he possibly could. He discovered that he could buy the most calories per dollar in the middle aisles of the supermarket, among the towering canyons of processed food and soft drink. (In the typical American supermarket, the fresh foods — dairy, meat, fish and produce — line the perimeter walls, while the imperishable packaged goods dominate the center.) Drewnowski found that a dollar could buy 1,200 calories of cookies or potato chips but only 250 calories of carrots. Looking for something to wash down those chips, he discovered that his dollar bought 875 calories of soda but only 170 calories of orange juice.
As a rule, processed foods are more “energy dense” than fresh foods: they contain less water and fiber but more added fat and sugar, which makes them both less filling and more fattening. These particular calories also happen to be the least healthful ones in the marketplace, which is why we call the foods that contain them “junk.” Drewnowski concluded that the rules of the food game in America are organized in such a way that if you are eating on a budget, the most rational economic strategy is to eat badly — and get fat.
This perverse state of affairs is not, as you might think, the inevitable result of the free market. Compared with a bunch of carrots, a package of Twinkies, to take one iconic processed foodlike substance as an example, is a highly complicated, high-tech piece of manufacture, involving no fewer than 39 ingredients, many themselves elaborately manufactured, as well as the packaging and a hefty marketing budget. So how can the supermarket possibly sell a pair of these synthetic cream-filled pseudocakes for less than a bunch of roots?
For the answer, you need look no farther than the farm bill. This resolutely unglamorous and head-hurtingly complicated piece of legislation, which comes around roughly every five years and is about to do so again, sets the rules for the American food system — indeed, to a considerable extent, for the world’s food system. Among other things, it determines which crops will be subsidized and which will not, and in the case of the carrot and the Twinkie, the farm bill as currently written offers a lot more support to the cake than to the root. Like most processed foods, the Twinkie is basically a clever arrangement of carbohydrates and fats teased out of corn, soybeans and wheat — three of the five commodity crops that the farm bill supports, to the tune of some $25 billion a year. (Rice and cotton are the others.) For the last several decades — indeed, for about as long as the American waistline has been ballooning — U.S. agricultural policy has been designed in such a way as to promote the overproduction of these five commodities, especially corn and soy.
That’s because the current farm bill helps commodity farmers by cutting them a check based on how many bushels they can grow, rather than, say, by supporting prices and limiting production, as farm bills once did. The result? A food system awash in added sugars (derived from corn) and added fats (derived mainly from soy), as well as dirt-cheap meat and milk (derived from both). By comparison, the farm bill does almost nothing to support farmers growing fresh produce. A result of these policy choices is on stark display in your supermarket, where the real price of fruits and vegetables between 1985 and 2000 increased by nearly 40 percent while the real price of soft drinks (a k a liquid corn) declined by 23 percent. The reason the least healthful calories in the supermarket are the cheapest is that those are the ones the farm bill encourages farmers to grow.
A public-health researcher from Mars might legitimately wonder why a nation faced with what its surgeon general has called “an epidemic” of obesity would at the same time be in the business of subsidizing the production of high-fructose corn syrup. But such is the perversity of the farm bill: the nation’s agricultural policies operate at cross-purposes with its public-health objectives. And the subsidies are only part of the problem. The farm bill helps determine what sort of food your children will have for lunch in school tomorrow. The school-lunch program began at a time when the public-health problem of America’s children was undernourishment, so feeding surplus agricultural commodities to kids seemed like a win-win strategy. Today the problem is overnutrition, but a school lunch lady trying to prepare healthful fresh food is apt to get dinged by U.S.D.A. inspectors for failing to serve enough calories; if she dishes up a lunch that includes chicken nuggets and Tater Tots, however, the inspector smiles and the reimbursements flow. The farm bill essentially treats our children as a human Disposall for all the unhealthful calories that the farm bill has encouraged American farmers to overproduce.
To speak of the farm bill’s influence on the American food system does not begin to describe its full impact — on the environment, on global poverty, even on immigration. By making it possible for American farmers to sell their crops abroad for considerably less than it costs to grow them, the farm bill helps determine the price of corn in Mexico and the price of cotton in Nigeria and therefore whether farmers in those places will survive or be forced off the land, to migrate to the cities — or to the United States. The flow of immigrants north from Mexico since Nafta is inextricably linked to the flow of American corn in the opposite direction, a flood of subsidized grain that the Mexican government estimates has thrown two million Mexican farmers and other agricultural workers off the land since the mid-90s. (More recently, the ethanol boom has led to a spike in corn prices that has left that country reeling from soaring tortilla prices; linking its corn economy to ours has been an unalloyed disaster for Mexico’s eaters as well as its farmers.) You can’t fully comprehend the pressures driving immigration without comprehending what U.S. agricultural policy is doing to rural agriculture in Mexico.
And though we don’t ordinarily think of the farm bill in these terms, few pieces of legislation have as profound an impact on the American landscape and environment. Americans may tell themselves they don’t have a national land-use policy, that the market by and large decides what happens on private property in America, but that’s not exactly true. The smorgasbord of incentives and disincentives built into the farm bill helps decide what happens on nearly half of the private land in America: whether it will be farmed or left wild, whether it will be managed to maximize productivity (and therefore doused with chemicals) or to promote environmental stewardship. The health of the American soil, the purity of its water, the biodiversity and the very look of its landscape owe in no small part to impenetrable titles, programs and formulae buried deep in the farm bill.
Given all this, you would think the farm-bill debate would engage the nation’s political passions every five years, but that hasn’t been the case. If the quintennial antidrama of the “farm bill debate” holds true to form this year, a handful of farm-state legislators will thrash out the mind-numbing details behind closed doors, with virtually nobody else, either in Congress or in the media, paying much attention. Why? Because most of us assume that, true to its name, the farm bill is about “farming,” an increasingly quaint activity that involves no one we know and in which few of us think we have a stake. This leaves our own representatives free to ignore the farm bill, to treat it as a parochial piece of legislation affecting a handful of their Midwestern colleagues. Since we aren’t paying attention, they pay no political price for trading, or even selling, their farm-bill votes. The fact that the bill is deeply encrusted with incomprehensible jargon and prehensile programs dating back to the 1930s makes it almost impossible for the average legislator to understand the bill should he or she try to, much less the average citizen. It’s doubtful this is an accident.
But there are signs this year will be different. The public-health community has come to recognize it can’t hope to address obesity and diabetes without addressing the farm bill. The environmental community recognizes that as long as we have a farm bill that promotes chemical and feedlot agriculture, clean water will remain a pipe dream. The development community has woken up to the fact that global poverty can’t be fought without confronting the ways the farm bill depresses world crop prices. They got a boost from a 2004 ruling by the World Trade Organization that U.S. cotton subsidies are illegal; most observers think that challenges to similar subsidies for corn, soy, wheat or rice would also prevail.
And then there are the eaters, people like you and me, increasingly concerned, if not restive, about the quality of the food on offer in America. A grass-roots social movement is gathering around food issues today, and while it is still somewhat inchoate, the manifestations are everywhere: in local efforts to get vending machines out of the schools and to improve school lunch; in local campaigns to fight feedlots and to force food companies to better the lives of animals in agriculture; in the spectacular growth of the market for organic food and the revival of local food systems. In great and growing numbers, people are voting with their forks for a different sort of food system. But as powerful as the food consumer is — it was that consumer, after all, who built a $15 billion organic-food industry and more than doubled the number of farmer’s markets in the last few years — voting with our forks can advance reform only so far. It can’t, for example, change the fact that the system is rigged to make the most unhealthful calories in the marketplace the only ones the poor can afford. To change that, people will have to vote with their votes as well — which is to say, they will have to wade into the muddy political waters of agricultural policy.
Doing so starts with the recognition that the “farm bill” is a misnomer; in truth, it is a food bill and so needs to be rewritten with the interests of eaters placed first. Yes, there are eaters who think it in their interest that food just be as cheap as possible, no matter how poor the quality. But there are many more who recognize the real cost of artificially cheap food — to their health, to the land, to the animals, to the public purse. At a minimum, these eaters want a bill that aligns agricultural policy with our public-health and environmental values, one with incentives to produce food cleanly, sustainably and humanely. Eaters want a bill that makes the most healthful calories in the supermarket competitive with the least healthful ones. Eaters want a bill that feeds schoolchildren fresh food from local farms rather than processed surplus commodities from far away. Enlightened eaters also recognize their dependence on farmers, which is why they would support a bill that guarantees the people who raise our food not subsidies but fair prices. Why? Because they prefer to live in a country that can still produce its own food and doesn’t hurt the world’s farmers by dumping its surplus crops on their markets.
The devil is in the details, no doubt. Simply eliminating support for farmers won’t solve these problems; overproduction has afflicted agriculture since long before modern subsidies. It will take some imaginative policy making to figure out how to encourage farmers to focus on taking care of the land rather than all-out production, on growing real food for eaters rather than industrial raw materials for food processors and on rebuilding local food economies, which the current farm bill hobbles. But the guiding principle behind an eater’s farm bill could not be more straightforward: it’s one that changes the rules of the game so as to promote the quality of our food (and farming) over and above its quantity.
Such changes are radical only by the standards of past farm bills, which have faithfully reflected the priorities of the agribusiness interests that wrote them. One of these years, the eaters of America are going to demand a place at the table, and we will have the political debate over food policy we need and deserve. This could prove to be that year: the year when the farm bill became a food bill, and the eaters at last had their say.
Michael Pollan, a contributing writer, is the Knight professor of journalism at the University of California, Berkeley. His most recent book is “The Omnivore’s Dilemma.”


April 19, 2007

April 16, 2007

Poem du jour

Burial Rites
by Philip Levine

Everyone comes back here to die
as I will soon. The place feels right
since it’s half dead to begin with.
Even on a rare morning of rain,
like this morning, with the low sky
hoarding its riches except for
a few mock tears, the hard ground
accepts nothing. Six years ago
I buried my mother’s ashes
beside a young lilac that’s now
taller than I, and stuck the stub
of a rosebush into her dirt,
where like everything else not
human it thrives. The small blossoms
never unfurl; whatever they know
they keep to themselves until
a morning rain or a night wind
pares the petals down to nothing.
Even the neighbor cat who shits
daily on the paths and then hides
deep in the jungle of the weeds
refuses to purr. Whatever’s here
is just here, and nowhere else,
so it’s right to end up beside
the woman who bore me, to shovel
into the dirt whatever’s left
and leave only a name for some-
one who wants it. Think of it,
my name, no longer a portion
of me, no longer inflated
or bruised, no longer stewing
in a rich compost of memory
or the simpler one of bone shards,
dirt, kitty litter, wood ashes,
the roots of the eucalyptus
I planted in ’73,
a tiny me taking nothing,
giving nothing, and free at last.

April 15, 2007

Update: Where in the World I've Been


"http://www.world66.com/community/mymaps/worldmap?visited=CAUSBSARAZBYBEEEFRGEDEHUIEITLVLTNLRUESUAUKVATRKRTMAUINZA"

Probably, the tiniest ever update - I went to the Bahamas for a 4-day tour!
Mah-veh-lous... Pictures to follow soon!

Bizzarre Urinals / Toilets











....

















April 14, 2007

Carribean sea



Photos by Valera Meylis

April 11, 2007

Iraq - population tagging





American troops in Iraq resorted to tagging the population with the indelible laundry markers - men get it on their necks, women - on their hands.

Bahama Mama












The beautiful Westin Our Lucaya Hotel, the top floor overlooking the ocean :)
Photos by Valera Meylis

April 9, 2007

Poem du jour

Looking Forward
by Billy Collins

Whenever I stare into the future,
the low, blue hills of the future,
shading my eyes with one hand,

I no longer see a city of opals
with a sunny river running through it
or a dark city of coal and gutters.

Nor do I see children
donning their apocalyptic goggles
and hiding in doorways.

All I see is me attending your burial
or you attending mine,
depending on who gets to go first.

There is a light rain.
A figure under an umbrella
is reading from a thick book with a black cover.

And a passing cemetery worker
has cut the engine to his backhoe
and is taking a drink from a bottle of water.


April 8, 2007

NYT Readability

Click to see a larger image

Today the New York Times published a readability chart, in which it compares the corporate executive compensation reports with other reading materials. According to that chart, readers of British The Times and Guardian could easily read an academic paper. While NYT-reading Americans would need to go to school for four-five more years to accomplish a similar feat. TV Guide junkies and Bible readers (which is a very nice grouping in itself) may need up to 10(!) years to get to that level...
I am now assured even more that the New York Times has been dumbing down its pages deliberately to make it more readable for hoi polloi, which is where the stock market wants them to be. I do not disagree with that policy, as one would be much better off meeting the public from above as opposed to losing it altogether. But I may have to start looking for a less readable newspaper :) with fewer ads, fewer Sunday coupons and better movie and book critique, ok maybe with an expert level Sudoku every day to exercise the logic machinery in my aging brain.


April 7, 2007

Zoo


By DENNIS LIM
''ZOO,'' the new film by the Seattle director Robinson Devor, arrived at this year's Sundance Film Festival better known as ''the horse sex documentary.'' But as festival audiences discovered, this description, while not incorrect, was also misleading. The film revisits the true story of a man who died in July 2005 after a sexual encounter with a horse in rural Washington State but does so with a lyricism startlingly at odds with the sensational content.
''This topic is not something people want to think about,'' Mr. Devor said in an interview at Sundance, summing up both the challenge of marketing the film and the reason he and his writing partner, Charles Mudede, were compelled to make it.
Speaking at the premiere Mr. Mudede called ''Zoo'' a ''thought experiment.'' He added, ''If someone can go there physically, I can go there mentally.''
Contemplating an unorthodox merging of man and beast, ''Zoo'' (which is set to open in New York on April 25) is itself an exotic hybrid: a fact-based film combining audio testimony with speculative re-enactments that feature a mix of actors and actual subjects. (The title is the subcultural term for a zoophile, a person whose affinity for animals sometimes extends to the carnal.)
''Zoo'' obliquely recreates the events of the fateful night that caused a media frenzy in the Seattle area two summers ago. Shortly after being dropped off at an emergency room in Enumclaw, Wash., a 45-year-old Boeing engineer named Kenneth Pinyan -- known in the film only by his Internet handle, Mr. Hands -- died of internal injuries resulting from a perforated colon. The police investigation led to a farm and turned up videotapes and DVDs that showed several men engaging in sexual acts with the resident Arabian stallions. Bestiality was not illegal in Washington at the time, but in response to the Pinyan incident the State Senate voted last year to criminalize it.
Mr. Devor and Mr. Mudede, a columnist for the Seattle weekly The Stranger, noticed a disturbing uniformity in news coverage and public opinion surrounding the case.
''There seemed to be two responses: repulsion or laughter,'' Mr. Mudede said. ''People didn't want to have any connection or identification with these men. Early on Rob and I said to each other, 'We're going to revive their humanity.' ''
''Zoo'' strives to liberate Mr. Hands from his posthumous fate as tabloid punch line. It allows the friends of the dead man a means for disclosure and dares to find, in their candid accounts of their desires and the hidden worlds where they were fulfilled, something strangely beautiful and even recognizable.
''It was fascinating that there was a community of close friends, that there were basic human interactions happening alongside things that seemed completely alien,'' Mr. Mudede said. ''Zoo'' minimizes its freak show aspect by emphasizing the coexistence of the mundane and the bizarre, a strategy it shares with the pair's 2005 Sundance entry, ''Police Beat,'' an enigmatic reverie inspired by Mr. Mudede's crime-blotter column. What emerges here is a sad, even tender portrait of a group of men who met from time to time at a farm, where they would drink slushy cocktails, watch some television and repair to the barn to have sex with horses.
The film's nonzoophile perspective is provided by Jenny Edwards, the founder of a local rescue organization called Hope for Horses, who helped investigate potential animal abuse in the Enumclaw case. ''I don't yet quite know how I feel about that,'' she says in the film, referring to the intense feelings that zoophiles claim to have for animals, ''but I'm right at the edge of being able to understand it.''
''Zoo'' invites the viewer out onto that ledge of near comprehension. That it does so with neither squeamishness nor prurience owes much to Mr. Devor's sidelong approach, one that was born of necessity. The story's central figure was dead, and his family wanted nothing to do with the film. Only one of the three zoophiles interviewed agreed to appear in the re-enactments. All are identified simply by their online names: Coyote, H and the Happy Horseman.
''I'm glad we weren't able to depend on the talking-head approach,'' Mr. Devor said. Mr. Mudede concurred. ''It was a chance to really make a film instead of a '60 Minutes'-style documentary,'' he said.
Driving for the first time into Enumclaw, a town at the base of snow-capped Mount Rainier, the filmmakers immediately grasped the cinematic potential. ''Talk about a mythic place,'' Mr. Devor said. ''This happened in the shadow of a volcano, in these verdant fields. You had beautiful animals, private gatherings, secret societies.''
''Zoo'' makes the most of its Edenic setting. Sean Kirby's Super-16 cinematography reinforces the sense of a prelapsarian idyll, with lush images of rhododendrons in bloom, Mount Rainier perfectly framed in a picture window, men walking through the woods at night in dreamy slow motion.
Unabashed aesthetes, Mr. Devor and Mr. Mudede are anomalies in the grungy landscape of American indie film. Given the off-putting subject matter ''Zoo'' might even be accused of using beauty as a salve, as some reviewers grumbled at Sundance.
Responding to this critique Mr. Mudede said: ''I don't think the aesthetic element is deceiving. It's not that we're making something difficult more accessible through beauty. That's exactly the situation in which these men experienced their friendship.''
But he added, laughing, ''I admit if this had happened on an ugly pig farm we wouldn't have made the film.''
Mr. Devor said it was tricky trying to communicate the movie he had in mind to his wary subjects: ''They would be like, 'What do you mean impressionistic images?' ''
As it happened, it was a zoo, as the participants call themselves, who initiated contact, sending an e-mail message to Mr. Mudede in response to an article he had written about the case. ''I think there was a desperate need to talk,'' Mr. Mudede said.
Coyote, the only zoo who appears in the film, said in a recent e-mail interview that he came to trust Mr. Devor after meeting him a few times. ''I felt in my gut he was not going to make an exploitive type of movie,'' he wrote.
Despite an instinctive suspicion of publicity, it was evidently important to the zoos that their stories be heard. H, the farmhand who was the host of the get-togethers, called Mr. Devor in mid-December after ''Zoo'' had been selected for Sundance and consented to an audio interview (leaving Mr. Devor just a few weeks to frantically re-edit the film).
Coyote, for his part, remains conflicted about his involvement. ''I do not think a higher profile is good at all,'' he said. ''We have no torch to bear or cause to defend. We just want to be.''
According to Mr. Devor the biggest challenge was not getting the zoos to talk but finding a location to shoot the film.
''We went to every single horse farm within two hours of Seattle and came up empty,'' he said. ''Owners would say things like: 'We have Microsoft picnics here. They're going to think it happened in my barn.' '' He finally found a sympathetic farmer in Canada, who helped pull some strings with a landowner in Washington.
The overwhelming aversion to zoophilia is bound up in established taboos and moral codes. The debate, if it would come to that, tends to concern the welfare of the animal and the murky issue of consent. The men in ''Zoo'' attest to the fulfilling completeness of zoophile relationships and claim not to resort to coercion. On the latter count they have an unlikely ally in Rush Limbaugh, who can be heard in the film weighing in on Mr. Pinyan's death: ''How in the world could this happen without consent?''
But the apparent arousal of the horses is beside the point for many animal advocates, including Ms. Edwards. ''Horses have an incredible sense memory and are unbelievably willing to learn,'' she said in an e-mail message. ''They want to do what is asked of them. But I'm not convinced they want to have sex with us.''
Mr. Devor interviewed the zoos and is more inclined to term the sex consensual. He spoke to them one-on-one, in hotel rooms, and his subjects sometimes illustrated their points by showing him homemade pornography. ''It was in my face, really graphic stuff,'' he said. ''It's a strange way to get to know someone.'' But some of what he saw did change his outlook.
The sex in ''Zoo'' is merely glimpsed and barely discernible in a few seconds of a video that the police had confiscated and that was circulated on the Internet after Mr. Pinyan's death.
''The film is extreme more in its formalism than in terms of graphic content,'' said Mark Urman, an executive producer of ''Zoo'' and the head of theatrical releasing at ThinkFilm, which is distributing it. ''One really worries if there's a significant population looking for the tabloid version.''
But Mr. Devor has detected among audiences a curiosity, if not an appetite, to see more. ''So many people have said to me there's not enough sex,'' he said. ''I think there's a need to see the mechanics.''
Those viewers should be careful what they wish for. ''Maybe we can find some things to put on the DVD,'' Mr. Devor said.

April 6, 2007

Jeanne d'Egypt



The presumed remains of Jeanne d'Arc turned out to be those of an Egyptian mummy.

April 5, 2007

Poem du jour

You Said You Would Write
by Billy Collins

Two strong coffees
and an hour of unfocused staring,

and now the hour rolls round
to put on some clothes

and then to take them off again
and return to bed.

Later, it will be time
to stride down the driveway

and wait by the iron mailbox
on its solid wooden post

for the truck to round
the corner – red, white and blue.

Time even, if he is late,
to hop up and straddle

this dark metal postal horse
by the side of the road,

time to lean forward,
jockey of romance

in my imaginary silks –
a red and black hexagon –

full of hope, whip in hand,
mad for the stamp, the blue curve of your pen.


April 1, 2007

NYT Cancer: Feeding the Cancer Machine

Op-Ed Contributor
Feeding the Cancer Machine
By SHANNON BROWNLEE
Annapolis, Md.

HAVE you ever wondered why hospitals offer free cancer screening tests? You’ve heard the ads on radio, and seen them in newspapers, urging you to come to your local hospital for a free Pap smear, mammogram or prostate cancer blood test.
Hospitals would like you to think they are doing this out of the goodness of their hearts, that free cancer screening is a public service intended solely to improve your health. But there may be another motive at work here: providing free screening brings in new cancer patients, and cancer generates profits.
Has the profit motive gotten in the way of finding a cure for cancer or better treatment? Could it be that at least some of the $100 billion we spend each year on detecting and treating this disease is used not to improve the health of patients, but rather to prop up hospital finances?
Cancer makes money for hospitals in a couple of ways. First, it’s a disease of aging, and that means the majority of people who get it are covered by Medicare, which always pays its bills. Second, many treatments for cancer patients are particularly profitable, especially compared to those for other diseases.
Hospitals generally make money on surgery to remove cancer. Then there are all the imaging tests, like CT scans and M.R.I.’s, which are also well reimbursed by Medicare and other payers. The more cancer patients a hospital can attract, the faster it can recoup capital investments in imaging machines.
Another big source of profit is cancer drugs. Worldwide, we spend about $35 billion a year on chemotherapy and other drugs related to cancer treatment. Hospitals make money on drugs by purchasing wholesale and charging insurers full price. Cancer doctors also purchase drugs wholesale, making as much as two-thirds of their income on the “chemotherapy concession,” in which they sell and administer chemotherapy drugs in their offices.
Hospitals and doctors need to make money, of course, but the high profit margin in cancer has created a situation where providers have every reason to screen more people and treat those who are diagnosed with cancer more aggressively — and few incentives to hold back, even if that’s what the patient might prefer. Recognizing this, Medicare reduced its reimbursements for chemotherapy in 2005, but even with those changes, cancer remains an enormous economic engine in our health care system.
Sure, aggressive treatment is reducing mortality and improving the quality of life for some patients. Sometimes it even cures. But for many others, the cancer machine offers only marginal benefits at best, and providers push screening and aggressive treatment in part because they have nothing else to give, but also because it’s profitable. How much of the money we spend on unnecessary or futile cancer treatment might be put to better use searching for real advances?

Shannon Brownlee, a senior fellow at the New America Foundation, is the author of the forthcoming “Overtreated: Why Too Much Medicine Is Making Americans Sicker and Poorer.”


NYT Cancer: Patents over patients

Patents Over Patients
By RALPH W. MOSS
State College, Pa.

WE could make faster progress against cancer by changing the way drugs are developed. In the current system, if a promising compound can’t be patented, it is highly unlikely ever to make it to market — no matter how well it performs in the laboratory. The development of new cancer drugs is crippled as a result.
The reason for this problem is that bringing a new drug to market is extremely expensive. In 2001, the estimated cost was $802 million; today it is approximately $1 billion. To ensure a healthy return on such staggering investments, drug companies seek to formulate new drugs in a way that guarantees watertight patents. In the meantime, cancer patients miss out on treatments that may be highly effective and less expensive to boot.
In 2004, Johns Hopkins researchers discovered that an off-the-shelf compound called 3-bromopyruvate could arrest the growth of liver cancer in rats. The results were dramatic; moreover, the investigators estimated that the cost to treat patients would be around 70 cents per day. Yet, three years later, no major drug company has shown interest in developing this drug for human use.
Early this year, another readily available industrial chemical, dichloroacetate, was found by researchers at the University of Alberta to shrink tumors in laboratory animals by up to 75 percent. However, as a university news release explained, dichloroacetate is not patentable, and the lead researcher is concerned that it may be difficult to find funding from private investors to test the chemical. So the university is soliciting public donations to finance a clinical trial.
The hormone melatonin, sold as an inexpensive food supplement in the United States, has repeatedly been shown to slow the growth of various cancers when used in conjunction with conventional treatments. Paolo Lissoni, an Italian oncologist, helped write more than 100 articles about this hormone and conducted numerous clinical trials. But when I visited him at his hospital in Monza in 2003, he was in deep despair over the pharmaceutical industry’s total lack of interest in his treatment approach. He has published nothing on the topic since then.
Potential anticancer drugs should be judged on their scientific merit, not on their patentability. One solution might be for the government to enlarge the Food and Drug Administration’s “orphan drug” program, which subsidizes the development of drugs for rare diseases. The definition of orphan drug could be expanded to include unpatentable agents that are scorned as unprofitable by pharmaceutical companies.
We need to foster a research and development environment in which anticancer activity is the main criterion for new drug development.

Ralph W. Moss writes a weekly online newsletter about cancer.


NYT: Cancer

April 1, 2007
Op-Ed Contributor
To Break the Disease, Break the Mold
By SUSAN LOVE
Los Angeles

WITH the cancer recurrences of Elizabeth Edwards and Tony Snow the question arises: Why does this still happen? As is often the case, the answer isn’t very satisfying: not all cancers are alike, early detection doesn’t always work and treatments are still far from perfect.
But there’s another problem: we keep focusing on doing the same thing better rather than trying something new. It is as if we are wearing blinders that let us see only one path and not the alternatives.
If you look at most cancer research journals you will see that our focus remains on finding smaller cancers, doing less surgery and radiation and developing new drugs to add to the old ones in an attempt to treat the cancers we detect. This approach — finding the enemy, and then slashing, burning and poisoning it — hasn’t changed since I was a resident in training 30 years ago. We have certainly refined it over the years — two publications just came out that recommended expanding the use of M.R.I. scans in women who have breast cancer or are at risk for it — but, as in this situation where the additional exam only identified 3 percent more cancers, each progressive development leads to a smaller increment in benefit.
Why do we lack new approaches? One of the key problems is the way research on cancer is carried out. In the past it was common for clinicians to observe their patients, come up with a hypothesis regarding diagnosis or treatment and then head to the lab to test it out. For instance, in 1983, two Australian clinicians — one was a pathologist, the other a gastroenterologist — observed bacteria in stomach biopsies and went on to prove that ulcers were caused not by acid, as had been assumed, but by a bacterial infection. Ulcer researchers, who had spent their careers studying gastric acid, thought the idea was absurd but much to their amazement it turned out to be true.
The curious clinician is becoming increasingly rare. Medicine and science have become so complicated that it is almost impossible for one person to be an expert at both. Researchers tend to take a discovery from the lab and apply it to patients; the reverse trip is more and more uncommon. More often than not, someone makes an interesting discovery in the lab and then tries to find a clinical application. There is little chance, much less financing, for the wild idea that might prove revolutionary.
This situation is not helped by the incentives we give to young cancer researchers but not to experienced clinicians who want to test a hypothesis developed over years of treating patients. It is difficult indeed to obtain a grant to do research if you haven’t spent your career in the laboratory. As the baby boomer generation of doctors approaches retirement, we should harness their experience and wild ideas by offering training in science or partnering them with younger research colleagues. Otherwise we risk inventing and discovering without reference to actually helping cancer patients.
Another aspect of the problem is our peer review system for financing research. It works well at eliminating poor investments, but it squelches innovation and fosters the old boy network. Organizations that give out “innovator” and “pioneer” awards claim to want to support new ideas but end up giving money to better ways of doing the same thing. And our academic and research institutions reward projects with clearly defined objectives that have a good chance of quickly leading to publications and tenure. If you have a wild idea or a completely new paradigm, forget about it.
Cancer of the cervix is one of the few cancers where we have been able to break the mold. We have moved from the Pap smear, which merely discovers abnormal cells, to a vaccine that can prevent the resulting cancer by protecting women against the virus strains that cause it.
At a breast cancer conference in San Antonio last December, a leading cancer researcher, James Holland, presented evidence suggesting that breast cancer may also have viral associations. A wild idea indeed; however, rather than being greeted with enthusiasm by the attending scientists and members of the press it was dismissed. Might there be something to it? We’ll probably never know.
We need a new approach to fight this war and we need the money to do it, but, most of all, we need wild ideas to get us out of the rut of doing the same thing better.

Susan Love is the president and medical director of the Dr. Susan Love Research Foundation.