The production of consumption: addressing the impact of mining on tuberculosis

Mining for coal, diamond, gold and other minerals has been associated with some of the greatest disasters in occupational history, with recent mine collapses in Chile, West Virginia, and China capturing headlines. The environmental impact of mining, along with the use of gold and “conflict diamonds” to fund proxy armies, has also been the subject of novels and documentaries.

But from a public health perspective, the dangers of mines are not isolated to dramatic explosions, trapped miners and guerilla wars; the epidemiology of mining, in fact, suggests that the occupation carries with it a unique set of secondary effects on the rest of the population. In this week’s post, we look at the evidence suggesting that mining amplifies infectious disease epidemics (especially tuberculosis, TB) on a regional and worldwide scale. We look at how the use of statistics and simulation models can enable us to investigate the broad effects of mining on a wider population, as well as compare alternative policy options to control the epidemic effects of mining on TB.

Three decades of HIV …and still learning

On June 5, 1981, five cases of Pneumocystis carinii pneumonia were reported among young men in Los Angeles, in what was to become the first account of AIDS. The pandemic that transformed Earth now marks its thirtieth anniversary this month. And while much attention is appropriately being paid to declarations made about the Millennium Development Goals and reports on the broad state of the disease in different continents (see the mortality graphs below), it’s easy to forget some of the critical lessons we’ve learned over the years from this unparalleled pandemic. In this week’s blog post, we’ll revisit some of the historical lessons we’ve learned HIV: from the redefinition of the behaviorist model of health promotion, to the detailed tax records of the pharmaceutical industry.

Settling the controversy on Haiti’s cholera epidemic

While Japan’s recent earthquake and tsunami have appropriately captured the world’s attention, an earthquake that took over a year ago has continued to produce devastation in another hemisphere. Haiti’s earthquake of January 2010 shattered the country’s already-weak water and sewage infrastructure, and in October 2010, cholera (a bacterial illness spread by contaminated water) was reported in the country for the first time in more than 100 years. Within weeks, the disease had been identified in every one of Haiti’s provinces; by the end of the year, more than 150,000 cases and 3,500 deaths had been reported. Although the cholera epidemic has fallen from public view, the epidemic continues to rage on.

There’s been increasing controversy about what to do in response to the persisting epidemic. Should we distribute vaccines, even though the epidemic has already started? Are antibiotics useful, even though the classical medical textbooks say that hydration alone should be sufficient to avert death? Are clean water provisions sufficient? And, of course, how much money do we need for all of this?