Nurses wearing protective suits escort a man infected with the ebola virus to a hospital in Monrovia, Liberia, 25 August. Photo: Getty
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Why releasing untested ebola drugs was the right thing to do

Drug trials rarely tell the whole story as many drugs have side effects that emerge only after deployment in the population at large. Yet unexpected effects can sometimes be surprisingly good.

Scientists do the best they can, but no drug is properly tested until it is fully deployed. And sometimes the result is better than anyone could have hoped.

In all the hand-wringing over whether it was right to release untested drugs to treat ebola victims, an important truth has gone largely unreported: even when completed, drug trials rarely tell the whole story. Many drugs have side effects that emerge only after deployment in the population at large. If you want proof, look at the millions of reports of adverse effects on the US Food and Drug Administration’s new OpenFDA website.

It’s worth noting, however, that unexpected effects can sometimes be surprisingly good. Take BCG. The Bacillus Calmette-Guérin vaccination was designed to protect against tuberculosis but it does far more. It stimulates an immune reaction against bladder cancer, for instance – the vaccine, delivered directly into the bladder, is now a standard treatment for this disease. It has also been used to fight multiple sclerosis and diabetes. No one knows exactly why this immunity-boosting effect takes place.

Other vaccines also have unexpected protective effects. Studies have shown that, when deployed in Africa, the measles vaccine cuts deaths from diseases other than measles by a third. The way it stimulates the immune system seems to enhance the body’s defence against infections. As a result, pneumonia, sepsis and diarrhoea – the most common causes of death in developing countries – are reduced by vaccinating against a completely unrelated disease.

We have known this for a while. In the early 20th century a physician logged the survival rates of children when vaccination was introduced to Sweden. Even though tuberculosis mostly kills older children, the vaccination had an effect on babies, too: those who had received it stood a much higher chance of reaching their first birthday. Follow-up trials in the US and UK in the 1940s and 1950s suggested that BCG-vaccinated children had a 25 per cent lower death rate from diseases unconnected to tuberculosis.

More recent studies have shown that vaccines for both smallpox and BCG can reduce susceptibility to lymphoma, leukaemia and asthma. Some researchers suggest that the rise in allergies and asthma in developed countries might be linked to the phasing out of the BCG vaccines.

There are still improvements to be made. This year, the World Health Organisation (WHO) has announced that it is looking into tweaking the sequence in which certain vaccines are administered in developing countries, after a team of experts concluded that the way they interact might be having an adverse effect on girls’ health.

It is not the first time that gender-specific effects have been noted after vaccination. In 1992, WHO withdrew a high-dose measles vaccine that had been shown to increase girls’ susceptibility to infection. No one is advocating that we drop any vaccinations – they save far more lives than they put at risk. But just changing the order in which they are given might help them save even more lives.

In the messy world of pharmaceuticals, nothing is ever certain. Whatever the outcome, releasing the untested ebola drugs was the right thing to do. In a crisis, we sometimes have to jump and hope for the best. Or maybe even better. 

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 20 August 2014 issue of the New Statesman, What the Beatles did for Britain

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Justin Trudeau points the way forward for European politics

Is the charismatic Canadian Prime Minister modelling the party of the future?

Six months after Canadian election day, Justin Trudeau’s Liberal party continues to bask in the glow of victory. With 44 per cent of support in the polls, the Liberals are the most popular party amongst every single demographic – men and women, young and old, and people of all educational backgrounds. 

While most European mainstream parties only dream of such approval, this is actually a small dip for the Liberals. They were enjoying almost 50 per cent support in the polls up until budget day on 21 March. Even after announcing $29.4 billion in deficit spending, Canadians overall viewed the budget favourably – only 34 per cent said they would vote to defeat it.

Progressives around the world are suddenly intrigued by Canadian politics. Why is Justin Trudeau so successful?

Of course it helps that the new Prime Minister is young, handsome and loves pandas (who doesn’t?) But it’s also true that he was leader of the Liberals for a year and half before the election. He brought with him an initial surge in support for the party. But he also oversaw its steady decline in the lead up to last year’s election – leadership is important, but clearly it isn’t the only factor behind the Liberals’ success today.

Context matters

As disappointing as it is for Europeans seeking to unpack Canadian secrets, the truth is that a large part of the Liberals’ success was also down to the former Prime Minister Stephen Harper’s extreme unpopularity by election time.

Throughout almost ten years in power, Harper shifted Canada markedly to the right. His Conservative government did not just alter policies; it started changing the rules of the democratic game. While centre-right governments in Europe may be implementing policies that progressives dislike, they are nonetheless operating within the constraints of democratic systems (for the most part; Hungary and Poland are exceptions).

Which is why the first weeks of the election campaign were dominated by an ‘Anybody But Harper’ sentiment, benefitting both the Liberals and the left-wing New Democratic Party (NDP). The NDP was even leading the polls for a while, inviting pundits to consider the possibility of a hung parliament.

But eight days before election day, the Liberals began to pull ahead.

The most important reason – and why they continue to be so popular today – is that they were able to own the mantle of ‘change’. They were the only party to promise running a (small) deficit and invest heavily in infrastructure. Notably absent was abstract discourse about tackling inequality. Trudeau’s plan was about fairness for the middle class, promoting social justice and economic growth.

Democratic reform was also a core feature of the Liberal campaign, which the party has maintained in government – Trudeau appointed a new Minister of Democratic Institutions and promised a change in the voting system before the next election.

The change has also been in style, however. Justin Trudeau is rebranding Canada as an open, progressive, plural society. Even though this was Canada’s reputation pre-Harper, it is not as simple as turning back the clock.

In a world increasingly taken by populist rhetoric on immigration – not just by politicians like Donald Trump, Nigel Farage, Marine Le Pen and other right-wingers, but also increasingly by mainstream politicians of right and left – Justin Trudeau has been unashamedly proclaiming the benefits of living in a diverse, plural society. He repeatedly calls himself a feminist, in the hope that one day “it is met with a shrug” rather than a social media explosion. Live-streamed Global Town Halls are one part of a renewed openness with the media. Progressive politicians in Europe would do well to take note.

Questioning the role of political parties today

Another interesting development is that the Liberal party is implicitly questioning the point of parties today. It recently abolished fee-paying, card-carrying party members. While this has been met with some criticism regarding the party’s structure and integrity, with commentators worried that “it’s the equivalent of turning your party into one giant Facebook page: Click ‘Like’ and you’re in the club,” it seems this is the point.

Colin Horgan, one of Trudeau’s former speechwriters, explains that Facebook is “literally a treasure trove for political parties”. All kinds of information becomes available – for free; supporters become easier to contact.

It was something the Liberals were already hinting at two years ago when they introduced a ‘supporters’ category to make the party appear more open. Liberal president Anna Gainey also used the word “movement” to describe what the Liberals hope to be.

And yes, they are trying to win over millennials. Which proved to be a good strategy, as a new study shows that Canadians aged 18-25 were a key reason why the Liberals won a majority. Young voter turnout was up by 12 per cent from the last election in 2011; among this age group, 45 per cent voted for the Liberals.

Some interesting questions for European progressives to consider. Of course, some of the newer political parties in Europe have already been experimenting with looser membership structures and less hierarchical ways of engaging, like Podemos’ ‘circles’ in Spain and the Five Star Movement’s ‘liquid democracy’ in Italy.

The British centre-left may be hesitant after its recent fiasco. Labour opened up its leadership primary to ‘supporters’ and ended up with a polarising leader who is extremely popular amongst members, but unpopular amongst the British public. But it would be wrong to assume that the process was to blame.

The better comparison is perhaps to Emmanuel Macron, France’s young economy minister who recently launched his own movement ‘En Marche !’ Moving beyond the traditional party structure, he is attempting to unite ‘right’ and ‘left’ by inspiring French people with an optimistic vision of the future. Time will tell whether this works to engage people in the longer term, or at least until next year’s presidential election.

In any case, European parties could start by asking themselves: What kind of political parties are they? What is the point of them?

Most importantly: What do they want people to think is the point of them?

Ultimately, the Canadian Liberals’ model of success rests on three main pillars:

  1. They unambiguously promote and defend a progressive, open, plural vision of society.
  2. They have a coherent economic plan focused on social justice and economic growth which, most importantly, they are trusted to deliver.
  3. They understand that society has changed – people are more interconnected than ever, relationships are less hierarchical and networks exist online – and they are adapting a once rigid party structure into a looser, open movement to reflect that.

*And as a bonus, a young, charismatic leader doesn’t hurt either.

Claudia Chwalisz is a Senior Policy Researcher at Policy Network, a Crook Public Service Fellow at the University of Sheffield and author of The Populist Signal: Why Politics and Democracy Need to Change