Saturday February 11, 2006
Let me take you back to 2005, and one of several Bad Science stories about Susan Clark and her What’s The Alternative column in the Sunday Times. She’s no longer in that post – if you’re lucky we’ll have room to talk about her successor soon – but she stood out on account of her penchant for giving advice on the bigger diseases: MRSA, malaria, that kind of thing.
Anyway, she also liked to recommend that plants whose constituents had recently been discovered to have antibiotic properties should be taken prophylactically, that is, to stop you getting a disease. She suggested, for example, that pau d’arco should be taken by patients to prevent themselves from getting MRSA in hospital, and artemisinin to prevent malaria.
Now my objection to this at the time was, in some ways, a subtle point. Think about how “superbugs”, bacteria resistant to antibiotics, come into existence: they are exposed to antibiotics in lower doses, but killed off incompletely, some survive, and so, by a process of mutation and natural selection, the bacteria evolve to be resistant to the drugs. The bacteria that survive the battle are the ones that are most resistant.
Now I realise evolution may be a problem area for some of you, but this really is an incredibly clever process: for example, once new resistance genes have evolved, bacteria can then share these genes with completely different bacteria nearby. They literally swap genes between each other. This is happening right now, in your body. They are clever, clever little buggers. To prevent resistance to antibiotics, you want to keep your best antibiotics out of farming, and away from pushy patients with viral coughs, to give a couple of examples.
But this kind of thing doesn’t occur to alternative therapists. And the problem is that malaria, for which Clark was recommending artemisinin, prophylactically, without any evidence, to travellers, isn’t a decadent westerners’ playground. Malaria kills more than a million people a year, mostly children. As recently as 2004, in the Lancet, there was hope that artemisinin could be used to eradicate malaria for good, if used carefully to treat people with the disease.
And now, here is the punchline. Just this month the new chief of the World Health Organisation’s malaria programme warned that the growing misuse of artemisinin – which you can still buy from the usual “health food” outlets – could create an incurable strain. The same thing happened with resistance to chloroquine, our magic bullet for malaria in the 1940s, of course: it’s now virtually useless. Dr Arata Kochi from WHO says any drug companies even selling the drug artemisinin alone, instead of with other drugs in the same tablet – which ensures a cleaner kill of the malaria in your blood – will face boycotts of their other products. This kind of threat is almost unheard of.
Now let’s be clear. I’m not saying Clark is a mass murderer, although if anyone followed her advice, clearly they would be contributing to resistance to the drug, as the artemisinin-exposed malaria bugs are sucked out of her travelling readers’ blood by mosquitoes and then deposited into the arms of the picturesque natives. No. Susan Clark is merely a tiny cog of a huge system: and this whole system, of perpetuating and disseminating the beliefs of alternative therapy fantasists, of flattering them that they have a valid perspective and contribution to make, simply because it is commercially and politically expedient to do so, in our decadent, healthy western countries, is dangerous, stupid, shortsighted, and flawed.
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