Sophie Hall was out with a group of friends at a night club in London in early April. It was 1 a.m. and they were still having fun before she noticed a fight breaking out next to her. Then she became overwhelmed by the smell of petrol and her face felt like it was on fire. The next thing she could remember was being stripped of her clothes and transported to the hospital for treatment for an acid attack.

Sophie was one of twenty people who were victims of the acid attack at the Mangle nightclub. The attack was not an isolated incident, but part of the larger epidemic of gang- and drug-related acid attacks that have increased in London in recent years.

According to data from the London police released in March, acid attacks from 2015-2016 increased by 74 percent. There has been a 30 percent rise in England overall. The problem has gotten so serious that London police officers have been issued acid treatment kits to allow officers to give immediate on-scene treatment to victims.

Acid attack epidemics are nothing new for the city. During the Victorian era it was common for women to throw corrosive acid on men who had “crossed them in love” as revenge. However, in the UK today most corrosive acid attacks involve men. Gang wars are believed to be the primary cause.

There are a variety of reasons why acid attacks may be popular for gang members. For example, there’s the relative cheapness of purchasing and concealing the substance. A liter of 95 percent sulfuric acid only costs £6.50 (about $8.50) and can be easily concealed from police. Furthermore the rise in acid attacks also coincides with efforts by lawmakers to deter possession of knives and guns.

Simon Harding, a Criminologist at Middlesex University, believes that the frequency of acid attacks has risen because they’re more difficult to prosecute and see more lenient repercussions, pointing out: “If you throw [acid] in someone’s face, it’s going to affect their eyes and eyesight so you have a high chance of getting away with it.” He went on to say: “Acid is likely to attract a ‘[Grievous Bodily Harm] with intent’ charge while using a knife is more likely to lead to the attacker being charged with attempted murder.”

In recent weeks, acid was used to target food delivery workers for popular services such as UberEats and Deliveroo. Jabed Hussain, 32, was one of five delivery bikers who were attacked during a 90-minute acid attack spree on July 16 in East London. In response, Hussain and other busy drivers blocked a central street in London during rush hour to protest the lack of safety. Hussain told reporters: “I’m just shocked, using acid to steal a bike? What’s a bike worth? My life is worth more than that.”

Representatives from the British government are currently meeting with police officers and the office of Home Secretary to discuss banning some kinds of acid, but have encountered difficulties because variations of the chemical are found in household goods. One MP, Stephen Timms, has recommended making it illegal to carry such noxious chemicals without justification. Violating that law would lead to penalties more on par with people caught with guns or knives. But while it may deter the number of acid attacks, it could inspire criminals to search for new, more dangerous weapons to use.

James Levinson

James Levinson is an Editorial intern at Law Street Media and a native of the greater New York City Region. He is currently a rising junior at George Washington University where he is pursuing a B.A in Political Communications and Economics. Contact James at staff@LawStreetMedia.com

The post What You Need to Know About the Rise of Acid Attacks in London appeared first on Law Street.

With 1 million confirmed cases, Russia is experiencing an HIV/AIDS epidemic, and it seems like no one knows how to handle it. The response from the Russian government is conservative and prejudiced, and puts blame on the affected people for lacking morals.

Rising Epidemic

According to a UNAIDS report from July 2016, Eastern Europe and central Asia make up the only region in the world where AIDS continues to rise rapidly. More than 80 percent of new cases in that region were in Russia. Even though the majority of cases affect key populations, such as drug users and gay men, it also spreads quickly through the rest of the population, especially heterosexual women, because condoms are somewhat difficult to come by.

“Condoms have practically been banned because they lead to people having sex, and sex is risky,” said Dr. Orlova-Morozova, head of Moscow Regional Hospital’s AIDS department, to ABC. The hospital currently has 38,000 patients with HIV or AIDS. He said that there is not enough money for medicine, so they have to choose who to treat and turn away many.

Rejected by Society

This view on HIV/AIDS is so conservative and biased it is hard to believe. A poster on the hospital wall where Dr. Orlova-Morozova works says: “The majority of cases of HIV/AIDS are due to the weaknesses and improper behavior on behalf of the infected person.” People who are HIV positive often lose their jobs, their friends, and are pushed out from society.

Under President Putin’s rule, life in Russia has shifted back toward a moral standard that was commonplace during the Soviet Union era, and religious leaders have a lot of influence. The approach commonly adopted is ‘Family, fidelity and faith.’ According to LaSky, an outreach organization for gay men in Moscow, there was a “scientific” paper at a recent AIDS convention that was called “How prayer can cure HIV.”

The government has banned sex education in schools and it is punishable by law to even mention sex or AIDS to children under 15 years of age if you’re a teacher. It is estimated that over half of the HIV cases in Russia are spread via intravenous drug use. But despite the fact that methadone treatment is the most successful way of treating drug addiction according to WHO, methadone therapy has been illegal since Putin came to power. There is also no way to hand out sterile needles.

Distrust of the Government

The hospitals can’t even help everyone they would want to–people with foreign citizenships living in Russia are not entitled to free medical help. A man that ABC talked to, called Sasha, was born in Uzbekistan but lived in Moscow when he discovered he was HIV positive. To get free care he would have to go back home, where homosexuality is illegal. He can’t even work to make his own money for treatment, since he would have to prove he’s HIV-free to get a job in Russia.

Social worker Maksim Malyshev thinks it is the government’s attitude that is the problem.

In my view, the problem of HIV infection in Russia exists because the people whose job it is to find ways of preventing HIV in Russia are doing a crap job. They are living in some kind of fantasy world of their own, and they have no desire to listen about science-based methods and to the specialists who are working on this problem.

Evgeny Sorokoumov, project manager for LaSky, agrees, saying, “Putin wants to show the world that our country is strong. No one needs us. We can just die.”

The UNAIDS report concludes by stating that changes in behavior, comprehensive sex education, and distribution of condoms are important measures to prevent any further spread of HIV. But in Russia’s case, it seems to be the will that is lacking, not just the way.

Emma Von Zeipel

Emma Von Zeipel is a staff writer at Law Street Media. She is originally from one of the islands of Stockholm, Sweden. After working for Democratic Voice of Burma in Thailand, she ended up in New York City. She has a BA in journalism from Stockholm University and is passionate about human rights, good books, horses, and European chocolate. Contact Emma at EVonZeipel@LawStreetMedia.com.

The post Russia Faces AIDS Epidemic, Government Blames Moral Lapses appeared first on Law Street.

America’s addiction to opioids and heroin have reached epidemic levels. Right now, 78 people die per day from use and overdose of such drugs, forcing the conversation of governors and party leaders to address a strategy that involves treatment of addiction in conjunction with punishment for use and possession of illicit drugs.

The shift in focus as it pertains to treatment rather than solely punishment is something that politicians from the likes of Bernie Sanders to Mitch McConnell can get behind–further highlighting the fact that current solutions and implementations are not working. Read on to learn more about the growing epidemic, brainstormed strategies and example case studies, and what the 2016 presidential candidates are saying America can expect in the future.

Heroin Growth Across the U.S.

The United States represents 5 percent of the world’s population, yet utilizes 80 percent of its opioids, which are known to be the gateway to heroin use. The death toll, reported in 2014, had reached the staggering level of 47,055/year.

No population is immune from the epidemic. Figures show a consistent upward trend from urban and inner-city communities to rural areas in the same fashion. The use and subsequent dependency on legal opioid painkillers has contributed to the growing problem. Workplace accidents and injuries, cyclical familial use, post-surgery procedures, and experimentation with drugs available in the home all serve as contributing factors to the outbreak of heroin use and overdoses in the United States.

States and Municipalities Take the Lead

One prevalent public health worry is that some heroin users use in public. You can find examples readily in the news–in Philadelphia, a man on public transportation during rush hour injected heroin into his hand in full view of all other individuals on the bus. A couple traveling from Indiana who had stopped at a Cincinnati McDonald’s collapsed in front of their children from an overdose. In Cambridge, Massachusetts, a church closed its public bathrooms after several individuals overdosed in those facilities. Drug users are utilizing parks, restaurant bathrooms, hospitals, libraries, vehicles, city transit, churches, and other public places to shoot up, and in turn, are losing consciousness or dying in those public places.

Due to the increasing display of overdoses coupled with the cheap and extremely accessible nature of heroin, states, local authorities, and local organizations are being forced to take action in an effort to battle the widespread heroin use.

Taking Action: Vermont

Governor Peter Shumlin (D) of Vermont took the first step in admitting that Vermont was not equipped to handle the outbreak and consequences of heroin, stating, “I found we were doing almost everything wrong.”

Initially, Vermont began its fight by addressing non-violent offenders, who were provided with an opportunity to enter into a treatment facility instead of serving jail time. Not only did this policy change reduce the number of individuals incarcerated for non-violent drug crimes, but also addressed the need for treatment and long term solutions over punishment. The facilities work with courts and provide the requisite treatment along with ensuring appropriate steps for assimilation back into society and on-going care.

Further, Vermont has taken steps to protect individuals seeking medical assistance from prosecution from possession or intent to sell. Finally, it was the first state to legalize the over-the-counter sale of naloxone–a drug used to “reverse overdoses” and effectively save lives.

However, Schumlin is not naive to believe that the battle will not come with some difficulty. He has already addressed the shortage in supply for doctors and qualified medical personnel and is working diligently to help treat those on waiting lists. Most importantly, Schumlin recognizes the need to more rationally and safely administer prescription drugs, such as OxyContin, which often serve as the gateway to heroin when prescriptions become too difficult to obtain and OxyContin becomes scarce.

Big Steps: Ithaca, New York

While most states share in the challenges faced by Vermont, politicians are taking different approaches to fight the heroin epidemic. Most controversially, the idea of supervised injection facilities has surfaced under the direction of Mayor Svante Myrick of Ithaca, New York. A supervised injection facility would allow an individual to use heroin while monitored by a nurse or caretaker without getting arrested.

This type of facility would, without a doubt, be met with public policy, political, and judicial opposition and doubt, but Myrick stands by his initiative. Abandoned by a drug-addicted father as a young child, Myrick noted, “I have watched for 20 years this system that just doesn’t work. We can’t wait anymore for the federal government. We have people shooting up in alleys. In bathroom stalls. And too many of them are dying.”

Myrick’s facility would utilize a holistic approach and view heroin addiction as a public health issue rather than a criminal justice issue. His rationale reflects a growing belief among the younger American generation that the War on Drugs, dubbed as such by President Richard Nixon in 1971, is a drastic failure.

However, critics are wary. They see the strategy as encouraging people to continue using drugs rather than seeking treatment to free themselves from addiction. Myrick does not disagree, but recognizes the need for new solutions and is working with local prosecutors and police to gain support and insight into his proposed solution. Elected District Attorney, Gwen Wilkinson initially opposed the idea, but has seen the possible benefit and stated, “What brought me around was the realization that this wouldn’t make it more likely that people will use drugs. What it would do is make it less likely that people will die in restaurant bathrooms.”

Myrick’s plan is to ask the New York Health Department to declare the heroin epidemic a state crisis, which would allow for him to take certain steps on a local level without the approval of state legislature. Governor Andrew Cuomo has failed to make any statement regarding such a facility, but has supported needle exchange programs and additional funding for treatment and preventative care in the past.

His inspiration was Canada’s supervised injection site dubbed “Insite,” which opened in Vancouver in 2003. Dr. Patricia Daly, Chief Medical Health Officer at Vancouver Coastal Health operates the facility and has shared that the site has approximately 800 visitors daily, 10-20 of whom overdose each week, but the facility has experienced zero deaths. The number of deaths in the surrounding neighborhoods has dropped by 35 percent and in 2011, Insite gained an unexpected ally in the Canadian Supreme Court who noted the facility’s success in saving lives “with no discernable negative impact.”

Myrick has other plans as well. Under his direction, low-level drug offenders would be sent to treatment, rather than jail and the creation of a drug policy and youth apprenticeship program would provide alternatives for drugs to young people.

While the answer has shifted away from solely jailing drug abusers, the major concern about such a facility is the lack of consequences for drug abusers and its inability to treat and change behavior. Even those opposed to a supervised injection site usually recognize the need for new solutions.

What the 2016 Presidential Candidates Have to Say about the Heroin Epidemic

While many of the 2016 Presidential candidates probably did not expect to be asked questions about the growing heroin epidemic, their presences in places such as New Hampshire, a state hit hard with heroin-related deaths and overdoses, has forced them to take a stance.

Presidential candidate Hillary Clinton unveiled a $10 billion plan to combat and contain substance abuse across the nation. The Democratic candidate is on board to shift focus from pure punishment to treatment, devising federal-state collaboration programs that would allow for states to receive grant money from the federal government in order to boost treatment availability, preventative care, and incarceration alternatives. Tym Rourke, the chair of the New Hampshire Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment and Recovery shared with the Clinton campaign about the lack of adequate resources and infrastructure to tackle the epidemic. Clinton’s focus on federal-state partnerships would aim to provide the support and resources that many states, like New Hampshire, are experiencing. She is the first candidate to unveil a comprehensive proposal to fight the epidemic.

(Former) Republican candidate, Chris Christie, ran ads highlighting the importance of life and the need to help addicts on a road to recovery. Additionally, he signed a series of bills into New Jersey law that focused on heroin and opioid abuse, requiring the state to:

Put in place a requirement that substance abuse centers submit performance reports; extended immunity to emergency responders and needle-exchange program employees who administer the anti-opioid drug Narcan; and mandated that state agencies provide mental health and substance abuse services to inmates in state prisons.

Another former candidate, Jeb Bush, recognized the value of input from facilities that provide treatment and care for heroin users and announced he was working with such locations in an effort to develop a plan that would address the real issues faced by treatment centers.

Democratic candidate Bernie Sanders has pushed for a decrease in the cost of naloxone, which can serve to reverse the effects of heroin and is most often used to treat an overdose when possible. The expansion of access to such medicine would allow responders and law enforcement to react more efficiently and effectively when witnessing an overdose.

Presidential candidates are identifying the amount of heroin use and heroin-related deaths as a devastating occurrence in the United States and are taking measures to diminish the number of people affected and the number of overdoses and deaths tied to the drug.

Conclusion

It is evident from the local action taking place, as well as the national campaign exposure pertaining to the use of heroin, that leaders within the United States view this problem as an epidemic. The focus of leadership, coupled with the variety of implementations and solutions surfacing into place make one thing starkly clear–a heroin epidemic is taking place in our backyard and the possible solutions are a far cry from additional punishment or prolonged jail time. This time, the ultimate resolution has shifted and it reflects treatment. As the epidemic continues to grow and claim lives, we must wait and see what the election unfolds or work with our communities to put together plausible efforts to minimize the dangers and effects of heroin on our communities. Until then, we depend on state and local leadership and law enforcement to implement actions and procedures that will decrease the number of people dying on a daily basis from heroin overdoses.

Resources

Business Insider: One State Has Shaped the National Debate on Heroin Addiction

The New York Times: Heroin Epidemic Increasingly Seeps Into Public View

New York Post: Upstate New York Mayor Wants Place Where Addicts Can Inject Heroin Safely

The New York Times: How the Epidemic of Drug Overdose Deaths Ripples Across America

The Guardian: Hillary Clinton Proposes $10bn Plan to Combat Substance Abuse ‘Epidemic’

The Guardian: Heroin Crisis: Presidential Candidates Forced to Confront Issue on Campaign Trail

Ajla Glavasevic

Ajla Glavasevic is a first-generation Bosnian full of spunk, sass, and humor. She graduated from SUNY Buffalo with a Bachelor of Science in Finance and received her J.D. from the University of Cincinnati College of Law. Ajla is currently a licensed attorney in Pennsylvania and when she isn’t lawyering and writing, the former Team USA Women’s Bobsled athlete (2014-2015 National Team) likes to stay active and travel. Contact Ajla at Staff@LawStreetMedia.com.

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Flakka, or gravel as it is also known thanks to its composition of small crystals, is a new drug sweeping across the nation. The epidemic originated in South Florida in 2014 and now has been linked to many deaths, arrests, and overdoses throughout the country. The synthetic drug is first produced in China and sometimes Pakistan, before being shipped to the United States. From here, it is sold on the streets for a very low price as compared to other popular drugs with similar reactions, such as cocaine and bath salts, the latter of which infamously caused chaos a few years ago.

Deadly delusions: The drug flakka is growing in popularity http://t.co/HMbbZ7GS5M @DEANEWS pic.twitter.com/5lBVSaY5wo

— WORLD News Group (@WORLD_mag) June 10, 2015

What exactly is flakka? It is usually made from Alpha-PVP, which is a synthetic type of cathinone, a stimulant that is made from the Khat plant. This plant grows in the Middle East and Somalia, and its leaves are often chewed to achieve a slight high. The chemical cathinone can be so strong that it sometimes delivers harsher effects than crystal meth. Flakka is already very dangerous to take alone, but if a user were to take more than a single dose or to combine it with other drugs, then there could be disastrous results. It was also reported that this drug can be extra harmful because it doesn’t always arrive pure, and so it sometimes is laced with other deadly drugs, which would only intensify the effects on the user.

The use of flakka in the United States is strongest in South Florida, where it is believed to have first emerged. South Florida is sometimes known as a haven for drug users given how easy it is to access substances in this area since so many are imported there. Cases involving this powerful drug have also been reported in many other states, such as Ohio, Texas, and Tennessee. Flakka has reportedly led to 27 deaths in the past eight months alone in Broward County, Florida. There also three or four hospitalizations a day in this county because of the drug.

The name is derived from the Spanish term “la flaca,” which is slang for a beautiful, slender woman. Authorities believe that the drug is shipped by boat to South America and then it is brought to Florida through the Caribbean. Given Florida’s extensive coastline, authorities are having extreme difficulty trying to pinpoint where exactly the drug enters the country. Many law enforcement agencies have joined the search for flakka traffickers, dealers, and users.

Flakka can be taken in many different ways, including snorting, ingesting, smoking, injecting, or vaping it using electronic cigarettes. Experts say that the the slightest difference in the amount taken can lead to drastic results. Flakka can induce a wide variety of symptoms on its users, some of which can cause death or severe damage to the body, such as hyperthemia, which is why people often take off their clothes when they are high on the drug. It can also induce paranoia, making users think that they are being chased, or giving them the illusion that they have super strength. Doctors have also stated that it can cause irreparable brain damage or stroke-like symptoms. Some users have even suffered kidney failure and will likely have to be on dialysis for the rest of their lives.

This drug has been linked to a wide variety of odd arrests and brutal incidents throughout the country. NBC Miami has reported many different arrests related to flakka, such as one mom who made headlines for abandoning her one-year-old daughter after smoking it. Multiple instances of people running around naked claiming they were being chased have been reported, or there was the case of one man who tried to have sex with a tree after taking the drug. One man tried to break into a police department because he thought that the mob was after him, while another man was impaled by a fence when he tried to climb over it to get to the police precinct because he thought he was being chased.

This drug has proven to be incredibly dangerous and has taken the country by storm, as it has led to countless overdoses, a plethora of injuries, many bizarre crimes, and numerous deaths. It is cheap to buy compared to other narcotics, although it is so potent that it can induce an extreme level of insanity in its users shortly after being consumed. Educating the public on just how detrimental an effect this drug can have is the top priority of police and drug prevention agencies alike. Police in Florida have even begun dispensing flakka-detection kits to officers, sending drug-detection dogs to mail offices, and also training officers on how to look for signs of mania.

Toni Keddell

Toni Keddell is a member of the University of Maryland Class of 2017 and a Law Street Media Fellow for the Summer of 2015. Contact Toni at staff@LawStreetMedia.com.

The post Introducing Flakka: The New Cocaine appeared first on Law Street.

Mankind’s greatest enemy is not war or hunger but infectious disease. Throughout history it has cost countless deaths, and even in the twenty-first century our defenses against it remain limited. Above all, it is the threat of outbreak that unsettles us so; it is not just suffering and death, but fear. Whether it’s the Black Plague, Cholera, Spanish Influenza, H1N1, or Ebola, disease is a dark cloud looming over our lives.

Most of the microscopic killers with which we contend have been transmitted to us through animals. In the early ages of settled agriculture, close contact with domesticated chickens, pigs, cows, and others exposed humans to pathogens to which their immune systems had no previous exposure and consequently minimal means by which to combat them. There are two primary behavioral patterns of diseases. Some ascribe to the category of “chronic.” In this case, as geographer and ornithologist Jared Diamond explains, “…the disease may take a very long time to kill its victim; the victim remains alive as a reservoir of microbes to infect other[s]…” The other category is “epidemic.” In this case, Diamond continues, there might be no cases for a while, followed by a large number in an affected area, and then none for a while more. Such behavior is a consequence of the intensity of the disease’s manifestation; it strikes with such force that it basically burns itself out because the potential hosts all either die or become immune.

“Epidemic” is a widely feared term. Rather than consider the fact that they can and have been occurring on very small scales throughout human history, many people associate epidemic with things like the Black Plague in Europe, Smallpox in the New World, or a global zombie apocalypse. Since people naturally fear most what they do not understand, insufficient knowledge of disease vectors and behavior results in widespread fear and panic.

Ebola is a relatively late arrival on the scene. Originally suspected to be yellow fever, it was discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Samples extracted from an ill nun who had been working in the region came to doctors and scientists in an Antwerp, Belgium laboratory. They eventually discerned that the infection behaved differently from what would be expected of the original diagnosis. After sending samples to the Center for Disease Control in Atlanta, their conclusions were confirmed and a new disease had been discovered. Shortly thereafter, another outbreak occurred relatively far away in Sudan. While knowledge of the initial source and starting location of the disease is still vague, it was determined that it had spread via unsterilized syringes and contact with bodies during funerals. Therefore a lack of knowledge of the nature of the disease lent itself to its spread.

Ebola in large dropped off the radar screen until the recent epidemic began in West Africa. Going hand in hand with lack of knowledge of the disease are incomprehensive and underdeveloped means of addressing it. On a recent edition of Global Public Square, the insightful international news show hosted by CNN’s Fareed Zakaria, international relations PhD Chelsea Clinton declared that the disease is spreading exponentially, necessitating exponential containment measures. This is very difficult to achieve, due to the poor technological and economic infrastructures of the region. As Dr. Paul Farmer — another guest on Zakaria’s show — expanded, the Liberian healthcare system is also very weak. Liberian Foreign Minister Augustine Ngafuan detailed how Liberians have deeply ingrained burial practices that involve close contact with bodies; this is an important aspect of cultural values in the region and not easily relinquished in the face of something that foreign experts, much less locals, barely understand.

A Liberian village, courtesy of jbdodane via Flickr.

Globalization and increased interconnectedness between individuals, societies, and locations has exacerbated the rate at which diseases spread. Many Americans cried out when infected aid workers were brought home to be treated. Appropriate measures were taken in this instance, with sanitary transportation vehicles bringing the patients to the Emory hospital in Georgia. Due to its affiliation with the CDC, this is one of the few facilities truly equipped to accommodate infectious diseases of this nature. Both those patients recovered, though they would likely have died if they were forced to remain in Africa. The situation was handled intelligently and effectively, without resounding negative consequences. Yet the outcry and fear demonstrates people’s lack of knowledge and tolerance of the unknown and perceived dangers. This was in fact the first occasion in which Ebola was present on American soil.

The situation changed with the death of Thomas Duncan. Having arrived from Liberia in late September, Duncan provided a new first by being the first patient diagnosed with Ebola in the United States. His illness was unknown during his transit, and so new fears arose as to the likelihood of Ebola crossing the ocean with traveler hosts. Now in a complete state of fear, Americans want more and more action taken in defense of the nation’s health, yet do not know what those measures ought to be because we do not know enough about the disease. Many airports have begun taking travelers’ temperatures. The CDC initially cited 101.4 degrees as the point at which one must be quarantined, but lowered it after some supposedly ill people were cleared. This demonstrates the uncertainty of the disease’s nature; in what ways does Ebola affect a person’s body temperature? At what point in their illness are they contagious? Is a body temperature an effective indicator of this? These questions have yet to be answered for the disease of whose existence we have known for less than 40 years.

Specialists clean up a Hazmat area, courtesy of sandcastlematt via Flickr.

The second set of problems that are causing fear are the alleged breaches of protocol that have enabled several other people to catch the disease in the United States. The Dallas hospital in which Duncan died was not equipped to handle this disease and consequently could not treat him effectively. Furthermore, the staff did not have the proper training insofar as interacting with Ebola, and this has been cited as the reason why nurse Nina Pham, who was treating him, became ill as well. A recent video surfaced wherein a patient is being transferred from one vehicle to another by four workers in “hazmat,” or hazardous material, uniforms. A fifth person, dubbed “clipboard man,” stands with them completely unprotected. Finally, CDC Director Dr. Tom Frieden has come under fire for making statements and then retracting them. Pennsylvania Republican Congressman Tom Marino has even called for him to step down. We have quickly forgotten, though, that in the early 1990s Frieden was instrumental in developing awareness and programs to combat a rising Tuberculosis epidemic in New York City. In addition to other stellar career highlights, Frieden is a highly capable leader experienced in engaging these concerns.

We are too wrapped up in fear of the unknown to do anything but demand immediate results. Ebola is a newcomer on the scene and will take some time to understand effectively. As we continue to discern our relationships with our surrounding environments, we do know that ebola is not nearly as contagious as other diseases. It requires direct contact with bodily fluids of infected patients. As we continue to learn how it works, and how our actions, societies, and cultures interact with it, we will become more effective at addressing it. In the meantime, we annually face airborne foes which are far more dangerous and contagious; do not forget to get your flu shot in the coming weeks.

Franklin R. Halprin

Franklin R. Halprin holds an MA in History & Environmental Politics from Rutgers University where he studied human-environmental relationships and settlement patterns in the nineteenth century Southwest. His research focuses on the influences of social and cultural factors on the development of environmental policy. Contact Frank at staff@LawStreetMedia.com.

The post Ebola and America’s Fears appeared first on Law Street.

It seems like all anyone can talk about anymore is Ebola. Especially now that the first case of Ebola has been found in the United States, in Dallas, and the first case transmitted outside Africa reported in Madrid, people seem to be freaking out. One big concern has been that Ebola is going to become an issue in the U.S., which I just want to start by saying is unfounded and unrealistic. The public health infrastructure in the U.S., as well as our ability to isolate the disease make it incredibly unlikely that it becomes an epidemic. You’re still significantly more likely to die of the flu, or a car accident than even go near someone who has Ebola. As of press time, Thomas Eric Duncan — the man in Dallas who had contracted Ebola — has passed away of the disease, and while our thoughts and sympathy are with his family, this development does not change the risk factors in the U.S.

People are losing their minds over it. Seriously, check out #EbolaQandA on Twitter. It makes me terrified — not of Ebola, but at the extent to which our American education system appears to have failed people when it comes to very, very basic concepts of health and geography. Now Ebola is an incredibly important world issue right now, and combating it absolutely deserves our attention, vigilance, and support. That being said, we all need to take a deep breath over here in the U.S., and stop listening to misinformation and conspiracy theories, because this is getting silly. Here’s a helpful flowchart for anyone who’s concerned about the spread of Ebola in America.

Worried about Ebola? Here's a flowchart just for you! #diseases #outbreak #EbolaOutbreak #notenoughwine pic.twitter.com/U6uvQd8MKf

— Melody Butler (@MelodyButler) August 2, 2014

There have been many proposals to try to keep the United States from having Ebola-infected people cross over our borders. One of the most extreme is a “travel ban” aimed at West African countries with high infection rates.

This sounds like a good idea in theory, it really does. But in reality, it’s not something the U.S. will do, or should do. First of all, the best way to make sure that the United States does not experience problems with Ebola is to stop the epidemic. And if we restrict our access and communication with the affected region, it’s just going to get worse. When there’s not a huge risk of Ebola reaching any sort of epidemic levels in the United States, it doesn’t make sense to impede our relief efforts with a ban. A travel ban could mean that relief workers have a harder time going in, or refuse to go at all because they worry that they might not be able to get back.

Also, instituting a travel ban could make it more likely that someone with a case of Ebola makes it into the U.S. If we have a ban in place for countries heavily infected like Sierra Leone, Guinea, and Liberia, people are going to find a way around it. They could go to Senegal, or any other nearby nation where travel is not restricted. Because of the ban they may be incentivized to lie about whether or not they’ve been in contact with an infected person in hopes of not being prevented from getting on a plane. Right now we’re able to track people and examine them at the airport and upon arrival, and we’re going to strengthen our tools for that. We shouldn’t incentivize anything that makes it harder for us to do that.

I’m not an expert in public health; I don’t know what will happen with this epidemic. But what I do know is that panicking is going to do nothing. Educate yourself. Donate to the relief effort. Don’t feed the frenzy. This crisis needs a pragmatic approach, not a reactionary one.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Keep Calm and Carry On: You Don’t Have Ebola appeared first on Law Street.

The recent Ebola outbreak is plaguing thousands across West Africa with illness and even death. In the modern age of science, it seems incomprehensible that there is not yet a vaccine for Ebola. Though the virus is an urgent health concern, pharmaceutical companies have few incentives to develop drugs to combat the disease. Read on to learn what happens when economic incentives do not align with public health needs, and what better solutions may exist for drug development.

What is the status of the Ebola outbreak and vaccine?

Ebola virus disease is characterized by fever, intense weakness, and muscle pain, leading to more severe symptoms. Ebola was initially transmitted by animals and is now spreading between humans through contact with bodily fluids. The outbreak was first detected in Guinea, by which time it had already spread to Liberia, Sierra Leone, Senegal, and Nigeria. A separate outbreak occurred in the Democratic Republic of Congo, which is believed to be unrelated to the outbreak in West Africa. The virus has primarily infected villages where there is extreme poverty and insufficient medical care to combat the spread of the virus.

Statistics

Mortality rates for the Ebola virus are well over 50 percent. Since March, Ebola has killed more than 1,500 people, making it the deadliest outbreak of the virus in human history. The World Health Organization estimates that the Ebola outbreak could affect 20,000 within the next nine months, and that roughly half a billion dollars is needed to stop the spread. Watch the video below for more information on the outbreak:

Vaccines

Ebola first appeared in 1976, yet nearly 40 years later no approved vaccination exists. In part this is due to the nature of the virus. Since incidents of Ebola are rare and occur in remote villages, it is difficult for scientists to effectively obtain samples and study the disease. Scientists cannot predict when an Ebola outbreak will occur, and even during a typical outbreak there are rarely enough people for a vaccine trial.

Since the outbreak, scientists are furiously working on an Ebola vaccine, and requests for approval are being fast-tracked. In the United States, the National Institutes of Health partnered with GlaxoSmithKline to develop a vaccine. The potential vaccine tested very well on primates, but the trial on humans only began on September 1. Initial data from the trial will not be available until late 2014. A number of other prototype vaccines are being worked on across the world.

Other Treatments

ZMapp was the experimental drug given to two Americans who contracted Ebola this year. While vaccines are designed to prevent future infections, ZMapp was designed to treat an existing Ebola infection. Both Americans who took the drug recovered, but the company that manufactured ZMapp has exhausted its supply.

What is the drug development process like?

Developing a new drug or vaccine is an extremely long process due to stringent regulation. Candidates for a new drug to treat a disease range anywhere from 5,000 to 10,000 chemical compounds. Of these compounds, roughly 250 will show promise enough to warrant further tests on mice or other animals. On average, ten of these will then qualify for tests on humans. Since certain outbreaks, such as Ebola, do not lend themselves to have vaccines ethically tested on humans, the United States does provide a way for the drugs to be approved on animal tests alone.

Pre-clinical and clinical development for a new drug takes between 12 to 15 years, though the Ebola vaccine should come much sooner. Pre-clinical development includes testing the various chemical entities and meeting all regulations for use. Three sets of clinical trials are then conducted on humans. Clinical phases include trials on healthy humans to test for the safety of the drug. Testing then moves to those who are ill to see if the treatment is successful. If successful, the drug is submitted for further approval by the Food and Drug Administration. Other countries have similar regulatory bodies to the FDA. Internationally, the World Health Organization oversees which drugs can be used to combat a crisis like Ebola. Learn more details about the development process by watching the video below:

The problem is not that scientists lack the capability to create an Ebola vaccine, but rather that the economics of drug development do not entice companies to develop such a vaccine. Pharmaceutical companies estimate the cost of the entire process of developing a new drug to range from hundreds of millions to billions of dollars. Many times the drugs are not successful, in which case the companies have spent a huge amount of money and have no profit-making product. A Forbes analysis estimates that 95 percent of experimental drugs tested ultimately fail. Only one in five that reach the clinical trial phase are approved.

Given the low rate of success for potential drugs and the huge amounts of money that can be spent on research and development of drugs, cost plays a huge factor. In the United States, basic discovery research is funded primarily by government and philanthropic organizations. Development in later stages is funded mostly by pharmaceutical companies or venture capitalists.

Why do some see funding as a problem?

Funding for areas that support public health is a tricky issue. Since pharmaceutical companies are looking to make a profit, they have an incentive to make drugs that a large number of people will take and be on for a long time. Most research and development for these companies target diseases that affect wealthy people in primarily Western countries.

Targeting wealthier clients leads to a severe underinvestment in certain kinds of drugs. Diseases of poverty cannot compete for investment from financial companies looking for big return. Ebola infects relatively few and primarily affects the poor. Ebola is similar to diseases like malaria and tuberculosis, which kill two million people each year but still receive little attention from pharmaceutical companies. Watch the video below for more on the economics of drug development:

Neglected Tropical Diseases, a set of 17 diseases including Dengue Fever and Chagas Disease, affect more than one billion people each year and kill half a million. Most of these diseases could be completely eradicated, but the drugs are not widely available. One study found that of the more than 1,500 drugs that came to market between 1975 and 2004, only ten were aimed at these diseases.

Even though developing countries may experience an outbreak of a disease, the demand for new drugs is limited. In rural villages in Africa, many reject clinical drugs for diseases such as Malaria and Tuberculosis. Instead, they favor spiritual healers and herbal remedies.

What is being done to promote drug research of neglected diseases?

The Office of Orphan Products Development (OOPD) in the FDA was designed to advance development of products that could be used to diagnose or treat rare diseases affecting fewer than 200,000 people. Orphan diseases do not traditionally receive much attention from pharmaceutical companies. The program provides a tax credit of up to 50 percent for research and development of drugs for rare diseases. When these drugs do become available, however, there is still no guarantee that patients will be able to afford them.

Since 1983 the OOPD program successfully enabled the development and marketing of more than 400 drugs and products. In the ten years prior, only ten of these products came to the market. Learn more about the OOPD with the video below:

Additionally, in 2007 the FDA created a voucher program to encourage research for neglected diseases. If a company receives approval for a drug for neglected diseases, it will receive a priority review voucher to speed up the review time for another application. Only four of these vouchers have been awarded so far.

Are there better ways to fund drug research?

Some argue that researching very rare diseases is not worth the time, and that instead research should be focused on more prevalent diseases. Companies will naturally invest in research for the most pressing concerns that offer the greatest opportunity for profit. Drug development for rare diseases should not be encouraged since the diseases occur so infrequently. Others argue research for rare diseases is essential to public health. The case of Ebola shows that even rare diseases can have a disastrous world impact.

Bioterrorism

Beyond public health, knowledge about the workings of any serious virus or disease is important to combat threats of bioterrorism. Concerns of bioterrorism are what led to Ebola research in the past. Serious threats of bioterrorism force the government to partner with research institutions to learn more about rare diseases. In March, the University of Texas and three other organizations received $26 million from the National Institutes of Health to find a cure for Ebola and the Marburg virus in case they were ever used for a bioterrorist attack. Other groups partnered with the Department of Defense to find an injectable drug treatment for Ebola.

Prizes

Prizes and grants are seen as ways to incentivize companies to develop drugs for diseases they might otherwise ignore. Financial incentives would encourage speedy development for an Ebola vaccine. The World Health Organization has looked into building a prize fund, where a centralized fund would reward drug manufacturers for reaching certain research goals. These tactics are more cost effective for the government, since they only have to pay if the product actually works. By creating grants for specific drugs, the government can pull research into neglected areas. Most prizes and grants, however, are not offered until a severe outbreak occurs, by which time many people are already in need of drugs.

Partnerships

Others point to room for greater partnerships between various entities for drug development. The greatest area for partnerships is between development groups and pharmaceutical companies. For instance, if a company pays to research and develop a product, the government could pay the company for the right to the product and could then promote the product itself without worrying about profit. In another case, GlaxoSmithKline and Save the Children arranged for someone from the charity to be on GSK’s research and development board, so the groups can share expertise and resources.

The Ebola outbreak indicates areas in which our current drug development model is lacking. People are dying because no Ebola vaccine exists. When pharmaceutical companies search only for profits, drugs for rare diseases go neglected. By expanding partnerships and offering greater prizes and financial incentives, the government can encourage drug research for these otherwise neglected diseases.

Resources

Primary

WHO: Ebola Virus Disease

FDA: Developing Products for Rare Diseases

CDC: Experimental Treatments and Vaccines for Ebola

Additional 

CNN: Ebola Outbreak: Is it Time to Test Experimental Vaccines?

Vector: De-risking Drug Development

Guardian: Funding Drug Development for Diseases of Poverty

Reuters: Scant Funds, Rare Outbreaks Leave Ebola Drug Pipeline Slim

Explorable: Research Grant Funding

Vox: We Have the Science to Build an Ebola Vaccine

American Society for Microbiology: Ebola Virus Pathogenesis

NBC: No Market: Scientists Struggle to Make Ebola Vaccines

Wall Street Journal: Two Start-Ups Aim to Change Economics of Vaccine Production

NPR: Would a Prize Help Speed Up Development of Ebola Treatments?

Harvard Global Health Review: Funding Orphan Drugs

LA Times: U.S. Speeds Up Human Clinical Trials

Washington Post: Why the Drug Industry Hasn’t Come Up with an Ebola Cure

New Yorker: Ebolanomics

Alexandra Stembaugh

Alexandra Stembaugh graduated from the University of Notre Dame studying Economics and English. She plans to go on to law school in the future. Her interests include economic policy, criminal justice, and political dramas. Contact Alexandra at staff@LawStreetMedia.com.

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