WHO: Government Complacency, Funding Shortfalls Contributed to Indonesia's Polio Outbreak

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September 12 2005

Government complacency and a funding drop fueled a recent polio outbreak that has sickened 225 people in Indonesia and raised fears of an epidemic in the vast archipelago, the World Health Organization said Wednesday.

The outbreak, first reported in April, has also been driven by public ignorance about the disease and a government policy in recent years to hand more authority to poorly equipped regional agencies. "The government was resting on the security that it had gotten rid of polio as all governments do after polio disappears," said Dr. David Heymann, who heads up World Health Organization's worldwide polio eradication campaign.

"What happens when that occurs is that routine programs take over from where campaigns left off," he said. "Those routine programs are not as well-funded as campaigns. They are not as easy to operate as are campaigns. Therefore protection rates from polio vaccines decreased." Reported cases have steadily increased in the latest outbreak, mostly on the country's main island of Java, and the country of 210 million people now has the world's highest new case rate.

UNICEF and other experts have warned of a potential epidemic if the virus is not contained ahead of the rainy season that starts in October. The polio outbreak, Indonesia's first in 10 years, has prompted authorities to vaccinate as many as 6.5 million children. But health officials acknowledged earlier this month that they missed a million children whose parents stayed away following erroneous media reports that the vaccine caused the death of some children.

The rumors mirrored those that spread across Nigeria in 2003, where polio vaccinations were suspended for several months after radical Islamic preachers told parents they were dangerous and part of a U.S. plot against Muslims. Islamic leaders in Indonesia - the world's most populous Muslim nation - have done their part to put to rest any rumors, but some parents were worried.

"The public perception of the importance of vaccination has also diminished," said David Hipgrave of UNICEF. "The family of one of the babies with polio lived 100 or 200 meters (yards) from a health clinic and yet they remained unprotected. People we talk to they say they thought polio had gone away." Another 24 million will be targeted in a nationwide campaign starting Aug. 30. WHO and other U.N. agencies are working with the Ministry of Health to counter misconceptions about the vaccine.

Polio spreads when unvaccinated people come into contact with the feces of those with the virus, often through water. It usually attacks the nervous system in children under 5, causing paralysis, muscular atrophy, deformation and sometimes death, although only about one in 200 of those infected ever develop symptoms.

Chocolate's not a Health Food

The truth is bittersweet: Something in cocoa beans may be good for your heart, but - sigh - that's still no reason to load up on chocolate bars or brownies. The health potential is real. Cocoa beans have natural compounds called flavanols, and a growing pile of scientific research suggests they do good things to blood vessels.

Dolly Sullivan, 60, is a believer. She eats two or three squares of Dove dark chocolate daily and talked her mother into switching from coffee to cocoa. "I'm a chocoholic. I can't walk by a chocolate store," said Sullivan, who lives in Warwick, Rhode Island. "I've always enjoyed chocolate, but now I have a reason to eat it." Customers at Neuhaus, a Belgian chocolate shop in Washington's Union Station, like thinking the dark stuff might be healthy, said manager Clementine Loeman.

"That way, they don't feel guilty," Loeman said, adding that chocolate was sometimes considered medicinal when the company began as a pharmacy 148 years ago. Despite the enthusiasm, flavanols are missing from much of the chocolate on store shelves today. Flavanols make chocolate and cocoa taste bitter, and confectioners have spent years trying to perfect ways to remove the pungent flavor.

"Most chocolate, in fact, isn't flavanol-rich," said Norm Hollenberg, a radiology professor and flavanol expert at Harvard Medical School. "But all chocolate is rich in fat and calories. Chocolate is a delight. It can and should be part of a prudent diet. That means you limit what you take." Flavanols are found in other foods, such as red wine, grapes, apples and green tea, although cocoa beans are a particularly rich source. They are so tiny, they cannot be seen, even under a microscope. To find them, it takes sophisticated machinery that seems more appropriate for NASA than a chocolate company's laboratories.

Mars Inc. developed the technology to visualize flavanols on a computer screen. Says Harold Schmitz, the company's chief science officer: "Now we understand cocoa well enough to start to do new things with it." The company is starting with CocoaVia granola bars, made with a special cocoa powder that retains most of the flavanols. The bars also have plant sterols, which have been shown to help lower cholesterol.

For now, the 80-calorie, 23-gram snack bars are sold only on the Internet. The bars have a satisfyingly rich chocolate flavor, along with a slight but distinct bitter taste.

Mars says its Dove dark chocolates - a 1.3 ounce (36.85 grams) bar is 200 calories - also contain flavanols. Researchers are excited by the potential of flavanols to ward off vascular disease, which can cause heart attacks, strokes, diabetes, dementia and hypertension.

Vascular diseases are linked to the artery's inability to make a simple but fundamental chemical called nitric oxide. Flavanols appear to reverse that problem.

"The pharmaceutical industry has spent tens, probably hundreds of millions of dollars in search of a chemical that would reverse that abnormality," Hollenberg said. "And God gave us flavanol-rich cocoa, which does that. So the excitement is real."

Hollenberg studied Central America's Kuna Indians, island dwellers near Panama who make their own locally grown, flavanol-rich cocoa. The Kuna drink a lot of cocoa, and they don't have high blood pressure - except for those who move to the mainland and start drinking commercial cocoa that's flavanol-poor.

Testing the link between flavanols and improved blood flow, Hollenberg fed cocoa with and without flavanols to a study group in the United States and discovered that flavanols seemed to improve blood flow throughout the body.

Another researcher, nutrition professor Carl Keen at the University of California, Davis, has found that flavanols had an aspirin-like effect on blood, among other findings. Mars contributed to Hollenberg's and Keen's research and countless other projects. The company has collaborated on more than 80 studies.

The company announced last month that its scientists have figured out how to make synthetic flavanols and that major pharmaceutical companies are interested in developing the compounds for prescription drugs.

The Straight Dope on Cannabis-Inspired Meds

While the medical marijuana debate rages on, drug companies race to leverage the power of pot

Last spring Canada became the first and only country to approve a drug called Sativex to treat the chronic pain endured by most of the 2.5 million people with multiple sclerosis.

The announcement caused, quite a buzz. Sativex is a whole-plant extract of high-grade Cannabis sativa, a.k.a. marijuana, and is the first prescription drug to contain all 60-plus of the plant's cannabinoids, those compounds that include the psychoactive chemical THC. Although the drug packs a pain-numbing punch, its mouth-spray formulation slows its release into the body, thus diminishing those consciousness-altering side effects associated with smoking marijuana.

Despite a U.S. Supreme Court decision in June to uphold the ban on medical marijuana, drug companies are not discouraged. In fact, Sativex is just one of nearly two dozen new pharmaceutical compounds inspired by the herb. Last year the Society for Neuroscience conference featured almost 200 papers on cannabinoids; a decade ago there were exactly zero.

And 22 pharmaceutical companies, including giants Pfizer and GlaxoSmith-Kline, helped fund last year's meeting of the International Cannabinoid Research Society. In 1992 not a single drug company attended, according to executive director Richard Musty. "Now," he says, "they're showing up and madly taking notes."

The newfound interest stems from a flurry of discoveries in the early 1990s that showed that the body is littered with cannabinoid receptors. In fact, we have more of them in the brain than most other types, which may explain why they regulate such a vast array of functions-appetite, pain, memory, mood.

Luckily for us, such multitasking paves the way for drugs to treat everything from obesity and migraines to cancer and Parkinson's disease. Below, a small sampling of the goods.

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