5 Things To (Now

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5 THINGS TO (NOW

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5 THINGS TO KNOW

AEl]UITt]I RIIR

02 SRoADtR PtRSPfOVt5 l/rc I..l.fi.drr drur


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TOP 5 Kt[tR D ttA$s
Ill DIVIIOP I{G NATION5

Dmrh roll: 4 millior/yeor


tuErmlbiori{r
1 2
POl,ro Htv/AIDS ?.HrV/AlDs
$o$t hit: Mqcrt.,, r,rdid, R,/i6l d r, ]1tqndnisran \!orst hit: s,,r 5(/,dro,rlttit\I. t|1t (1o.i!1bcdn
Deorh ro 3 milion/yeor

3. t{ ARtA
D€olh1ol:l 5miliof/yem

or"Aririnq.

4. D]ARRlIOI,\
Dcorh roll 2.2 milion/ytur
tuE:0m rchydrorion {lt

BtrCAUSE \\TE -{RE CI ,OS !]'I O L'Rr\DICATING BECA(JSI,] IT"S DI'SI'ROYING -{N ENTIITF] 5 rl]ErRtut05ll
IT/ Si.ce r988. tlie WIIO, IiNICEF and t|e Rotary CON I INl:lNI/ AIDS is cssentiall\ a set otirfectioDs Dturh roii: Z ml ton/F(]r

FoundaLion have led a i{orldwidc clTon to eradicale that rffects tlrc hnman inrn)une s!steni oDce it is
lolio. 2t) ] ears snrc. this gitt tionr the 2oLh certuN damag.d b] HI\: (human irnniurodefi ciencv \irus). 5rro N lD TB me djirg
tothe 21si'xrs madc, the Anericas, lurope rDCl36 No disease |as inslired rs n ch impassioncd
othcr counhies hale been decla.ed pol ficc. Iflvc celebrjL) h.tnd-nanrgins as AIDS. for unlike pol io aod
strccced, il willo!! bethe secord tnlc rnanlind has malaria,,UDS has Dot lcftthc cliie nor theglitlerrti
sDccesslul\ e..rdicateda diseas. sincc lgTg slictory uDtouched. Thc rcd AIDS ribbon. created to short
orersrDallpor. Butpolio can oDl] bceradicated once solidaity with HIV l)osilive per,ple, has becoDe a
.n ,,.1r ,lir rr I i-rt. ,auooot \apuf,r...iur trendy fashion accessorv Lhe r99os symlnrl of
is establjshcd. A.t count!-thal lets their vacciDatroD coDu.ssion lbr all tashioDable crNes. Holl)nrood
cfforts slid. eDds up threatenirg the prcvious hrs ever made hit novies likc REIT, glarnonrising
irnnruni\'as any ore uDr:Lccinrtcd child caD lead to 11IV positive peorlc as h.roes.nd conde rniDs
a nelvpocli€t ofdisease. \llieD Nigcria haltcd irs poli.) preiudicial attitudcs iow. s Lbeni. Yet, the nedia
vaccinitjon p.ogrannne in 2oo3 duc to Nidespread overexposurc has not been enough to chaDge the
nunours that the mccin. coDtained lhe AlDs lirus sitlation for the toor 90% ol the 40 Diilljon HIV
andwaspart ofafosi SAt.mber rl ricio(s WesterD infcctcd pcople I ile h delelopiDs couDtries aDd ha\c
constiracy to sterilize Nluslun girls. 18 previorisly limited access to treatnient becausc of in.c.urale
folio fr'ce counlrjes had poLio outbreak traccabl. to inJbrnratjoD rbout,^lDS procntion, dre |ish cost ol
Nigeria. Donor iDterest is lagging and the 20 !ea. niedicrtioDs aDd hnitcd |eah| ca.e infiastructuEs.
lorgcarnprigD to emdicatepolio is shosingsiil sof {lDS is lit.ralh d.cinralinA lan}ilies, iDdusties,
serious fatjgue. Polio pr.v.ntjon is incrediblr tedious, am1i.s, schools rnd the cjyil senice in sub-sahamn
re.tuiriDs 1o doscs ol chilled racci es space.l African nations !hich hosts 70% of HIY tositrvc
Drcnths airart: a fiagile t|ocess easilv disrupted b] | .,-. \i '\',ir l.\,-r .rJ| ,'lrt gr^rt' n
misinfohr.d religious z€alots,renophobicmoth.rs Alricn to lall rs rNch as r.2% polcar. As leAions o1
and corruft clinic officials who lct lacciD.s gro$ learhers. lierithcarc \'orlos, parenls and soldiers
wa.n aud useless becausc ih.v pocketed lhe lreezer die tu th.ir trnn., Africa s abilitl to b.eak ort of
povcfty.nd stlile A.o\{s daDJ.eroush thin. (t

03 BR0,\DlR PtRlPttTlvt5 th( hpnltht.tr i:.tt


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3 4
CLINIC,\I I]trPRISSIO\ c,\N( laR
\rorst hit !rlnoLUn worst hitr {,5,..t lnrl/.lrs/J d/i{.4;,rrrd,!/

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ti ,'

TT'S STILL INVISIBLI] AND


13I.](]AT]ST.] lll,rfAIISE IT'S PRIi\JllN L\Bl.l,r/ nren as far
[IlSUNltl,]RS l OOD/ llra!,jne Naking ut to find back as 16()c) ts C.. ar.icnt Grccks and Egyptian
all iour lorc for lifc inerplicabh dtubed arvay. P.oplc doctoshad aLread! discolrjtd that oDccyour bodv
',-,. rt; 1ir |,l,.tr- ,r 'r n, , lo.. ir'.r,..t I ]icld.d that ugl) rnislLapeJr lunrour, dcath $'as closc.
F-
'l ,g ,.gl.,rrl .!,!-, ,,, r, - , i, Crnc.r starts off i{ith iust .r change i. on. singlc
frierds. clr u.co.hollablv an.l fccl worthless lor ofura].c]l. And thcD dependiDg o howrour gencti.
tir derr€ssi\cs ftiplar disordcr)
n'eeks rt a iime. llai nhe talc€ and ag.ing ccll h repair sistem tace .rll
na! sn'iDg liom Lhe blackesl of rnoods to ivild $,ith a coclitail ol extcrnal agents ( cludirg
cxccssiv.ncss. E\trene cases ca. lilerall) wast. a$'ay crrcinogens lilie.adialion. asbcstos, arscnic aDd
fhm not cating, mutilrtethernsehes ind r5% ofth.m comtmicrlts oftobacco), a malignaDt tumour is thus
e\e.nr.lll connnit icide. lveryone llas lhei. slock bon. Shockniglv, tobacco u!e is t|. snrglc nrcst
th€or! abour rrh) clinical dcrrssioD is risjns (rich ,tLdbntrblc laDd )et prevertable) ca!se ofcanccr
maD s er !j, inrDrahnity, an cmoti{Dally enptv 5C)% olsnrok.rs arc killedbl lLrDg c.rnce., nrakinsit
consumeist cnltLrR. elc.l a.d notall arc $lDatlietic tlie to! killer olallcanccN. Lr richer lations, tobrcco
toNa swhatsoneli es looks like.hildish bchaliou,. use. alcohol use, nnd being olcncight o. obese are
F!.n in ri.i nrtions rne.l.l illness slill.aDi.s a trnnat causes olcancer. Though canccr is to sone
so.i.l stigma. Buiscientists hale lirnlr est.rblishcd c{ent rn unpredjctaLJle a.d indiscdninxte killer,
that nrnjor cliDical dcprcssioi is atreatable biological 3(]% of cancer deatlN co!ld lare been rrcy.Dtcd.
bnh disorder, gcrctic inclinatiini that sonebodt
a Anyonc rich and toor- crn lo$er Lheir risk fa.toF
crnnot nerelt sia! out of. It.an also b. triggered l.,r c.rncer significantlv b,v choosing to liYe thnl clean,
b! drrstic life cliaDses o. harsh liviDg co!diiioDs. 'boiDJl lite doclors lo\c to prcscribe brt so fe$.lilie
AccordiDg kr the W110. bl 2o2o.\illb. thc sccond
it to heed: re8ular er.r.isc, gctiing raccinrted, !o
largcst intcrnati{Drl he:Lllli buden alier h.art smokiDg or drinLj.p,, e.tjng norc fruits and
djse.sc. Dcfrcssi.D is comrnon iD dereloling naliors lcgctables, eating less lat, suga. and salt rDd
as \!ell cxccft with no local prrlance to diagnose it sl.thcdng oD strD-block iIlou cannot stal ort of its
so be sinrpltblushcd asidc as h'Nins a \.eali
it nra) .,t \''lr"t.i,l't 'l\-in -or 'l"l.r'
nind" (chha s r/rc,r /tr9 snrat rro), haling "too lile Hong Kong or Bangk{rk? lackirg your bngs tbr
,r ,1. .'r.lll ,. '.,././ /r',a'^r ,,tIo srrnniAskies.in,ld lilerrlh save vout lifc. (,
too nrr.h (Zimbabrvc s trtflnrrdisd). It

04 BR0ADtR PtR5PttTVlS l/rc /r.d///'(,nr Nsr!,


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cARt)I()\r,\sctII AR DTSF.ASt'.
woBt hit: srn Sdhardr,1fi n a. h. Oi r i hh.t
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Fact
or Fiction?
Photoshopped advertising and
size zero models are causing
people to hate their looks!

NOI l N 'l I l Ii
\lOS'f EXTREilItr CASES/ \'aniiy
is a ferpe(ual hurDan problem and fca pcoplc
pa.Licularb $onen, are conpletclv plcascd with t|eir
lool(s. Lve$one at sone ponrt has obscsscd about an
unfo.tunrte pimple or tbc 5kg they ca.not s€eri to
shed. Nluch ofthc blame so ta. has been l.rid on the
slamourcus fas|ion and media nrdustries forpushins
BII,C,\USN I T'S STILL THE I,EADINC CAUSL an in oeasingly sldnnl iderl typified by the enti.c cast

Ul l,L\IIl \\(lRI D\\lDl- H^l 'p'd lia ofCossrp Ctl and Bererl! /1ills gopro 2.o. Bcautilirl
crusted wjth salt. Doublc bacon cheeseburgers models and actresses havc th.ir.y.ry stin
drippirlg witli beeffat. A lcallv bis icy mug olcoke. discolouratioD aDd little folds of fat meLiculousll
A Djght on thc couc| waLching old .e Nrs. So nd Photoshopped outpixcl bypixel.1l is no $.onder tliat
likc a drcam? Untbrlunalely, ar erjoyablchish salt, e\€n modcls and actrcss€s th emseh,es dietobsessiveh
hiit| fat, high sugarsedertan lifestjlchas cDded up aDd fall trey to nu rerous eating clisoders to lit into
in lelhal nightrnares for nillioDs i{hohavedied liom an ideai eve the) caDot attain - staN likc Lindsav
ca.diovascular disease. Rcgrctflrllv, your lirsl heart Inhan, Jenniter,\iston, Nicole tuchic, Kicra Knightle!
attaclt or stroke is usuallv the only svmptom or drrr
'lri Ln B.r.il,.,\.h.,r'\r ,r',s.rir,it.,,.,i ,-
warniDs tou get that tells you loor blood vessels arc rate siDce tliejr first nrcdia aff.ahnces.
gcttjDg too clogged up wiLh tattr deposits. Victims
can bc yoLtng or old. rjch o. poor - yon arc at hig| But thc most exheme cases ofbody loathiDg cannot
dsk as lolg as tou use alot oftobacco, cat unhealthib be blanred on the nedir s $'orshif of sizc zcrc waifs
and a.e generally physically inactile. Repo.tedly, but on psi,chologicrl disor de$ iike obscssirc comfDlsi\"

tatq deposits nay eicn bc found in childrcn as t.ruDg disorderorflrwed Deurotransnitt.N. Suftirers ol Bodl
as ro and the deposits kccp mouDinrg silentLy through Dtsnorphia Disorder (BDD) D til.te themselves, Eo
theyears ntil a criticalnrass is reached. Shockinslv for excessive plastic surgcrt' (lile Michael Jackson) Dot
thc skiDny are not exenrpt: even superbly fit marathon out ofa d.sirc to be beaulilill but out ofa desire to l{xrk
runners like Jim liis hare died fion hcaft attacks nornal. BDD sullerers are obsesse.l with how
a late nttribtrted to familyhistory, his old two pack unbeljevabl) ugly and defomed thcy arc cvcD thoLrsh
a day habit and hish cholestool levels. Il current Lhey are nomal or even attractilc looking. lheir
treDds go oD as the,v arc, by 2.)15, an estinuted 2(r si"rlp ' ... r1:'.r^r'\vir\ir ,.'itj FJo,,.r:Iur
1...1r"1'
millioD peopl. will hrvc died Irom heart attacks or defect theiIphlsical app.arance rcnder Lhem unable
strokes. China aheady laces Lhe hearf b rdcn of lu'.Lr..i^a,,-Iui,,olF,., -\-,r,- LI1L
Thoug| often seen as a womaD s ilhess, BDD affccts
fotcntially losinit $558 billior ni rutional inconre
oler the n€xt ro yerrs as more Chinese adopt both Dren and women equally aDd s ffcros arc
Wester style living ud eatiDg and succumb to heart ext.enelvhish dskcandidat.s for suicide It
diserse. strcke and diabet.s. at

05 ER0ADtR PERSPttTIVtS t/r. heolrhcarr 6src


'1
By 2015- e$e{s frcdict that out of$ mega- diseascs hale risen from Malaysii to globalisatio.. For irstaDce, health rcsearch
citics,27 rvill be nr the develc,pilrg \otld: Mexjco. L.Dicall)', poor nations tliat used pioities .tre still orieDted around the
sLrch horitiDg dail), cotlditiotls will be ibc to deal lvith underntrtrition now lure tc) alailabili\,ol pdlatc tunds ud hence tarsct
nomr forthe nuiority ofthc wo drvholack deal with obesity as they grow wcalthie. lhc maladies of rich paticnts rvho can affod
the resourccs to escape from or inprove and aspire towards a typical Amcican to pay for cxpensive nedicines as opposed
upon their urban envi.onnent. lifes\.le high h fat and susar buL low irr to the poor and neec!. Out of thc 1556 new
exercisc. Sirce the arrilal of the tirst drugs ma.ketcd bet\eeen r975 aDd 2oo'1,
\\o.se still. ,,,!t d$clopinll $o.ld XlcDonalds in Nlosco! in 1991 rDd in only 2r targeLed dcvelopiDg wo d discases
.il1 dx cllr15 h,\. n ilimgll td,'pl.(l Bejjing in 1992, obesity has corne hard in like nalaia an d tub.rctrlosis. l hat thc Bill

lh. $o.st c\crsscs ol . tll)ictl trb , irard with the libcrnlisation of ihcs. fonner and }lelinda Gales Forndrtion irad morc
lil-cslr lc \rilh ',("!c of lh. connnaDd ecoDonics. Fei! city m.)ors xre money at its disposal thaD the Wo.ld Heal lh
sofbislic.tcd sulporl sr sl.nrs ri(h wilhrg to lay do$'n laws that Lake a$'ay Organisation (wllo) even bcfore Warren
pcoplc usc 1,, trcdiate ils .llil ts. The belovcd Marlboros and fries fro Lhen Buffett,S largcsse is a teslimon] to Nhere
top fire causes of dcath in the delcloPed voleB. Nc$'YorLs Nlichacl Bloonberg is the p.iorities iD wo.ld$.ide healthcarc lie.
!o dindesce dinsordera.ehea diseasc, anerception: he ised cigarcttc tdes a d
stf okc, pulmonary disease, respiratory banned smokirs fron all rvorkplaces a d 1\ hilc lo(.1 hcrlLh ilstitulions still
infec ons and Lung canccr. Lting at tle .cstrrrrrnls in 2.)(]2 aD.l hter. banD.dtMns b.nr lhc brunt ol-.csponsib;lil] i
bottom of th. top ten list sits sricide. Such fat from restaumnts ir12()06. Nanagins the hcallh ol thcil PeoPlc,
urban Dialaise is rsually attdbuted to cedriD i1 is Jalol)rl ilstiturions lhrt mattc't
hallnarks ol t)-pical urban lile: snroknis, nDc lhrl .\cr. The prospects for globnl
alcoholism, slressful desk-bound office ihinli lhrt the drunrl;c nP\ta surs.: health are iitftNically tied to thc prcspe.ts
work, recreational dNs use, rnultiple scx oi-$callh radr from r .cntrLr! ol- ofslobal economic aDCt political cqualit!.
partneN, livins done, a srowiDs dependence ceononiic slol)alistt;on h.s .csultcd Rcfoml of healthcarc is useless wiL|out ihe
on processcd foods that are hish nr caLories in an rqurl ur)srrd sut ge in k\.ls of ref.nn of h-rae flr]es. labour laws. hadc
btrt low in nutritioDal value. For nost !tL)brl hc.llh. Nluch ink has been spillcd larilfs, domestic subsidics,.iebt reliel and
Russians,the arival ofPereslrcika sai{ an on t|e bcnefits of the frec narket and fair {id floils that.nable all counticsto be fi€e
upsurye iD prostitution and drug abuse t.i d e, catolliDg the cxponential enough 1o prosper ir healrh and aealth
mtes, blorvirg the nurnber of AIDS paticnis rdvancemcDt of scientific nurovation, the independently. From r legal peNfcciile, it
to 7 million in a country $'hose annual development of infrastnrctln€ aDd the b.oad is neither WHO nor tlie World Bank i{ho
healt| budset onLy covcrs the cost of sains in Life expcctarc)' $.e have made over bolds the true centre of power in global
treatnert for 5oo.If a risk anal-vst in New healih sovernance bui the Wo.Ld Tradc
York desires to tuN her lile (aDd blood O.garisation (WIO). Thc $To ove.sees
prcssure) around, shc can still toh to her Iiul lhc p.olerhirl clephrDt in ll,c GATI and TRIPS : two coniroversial
pe$onal trainer, medical i ro,'n, so studionrlr ignorcd br s{, nultilateral trade agreemenls that rffect
health foo.t store and yogaguN. BL't lvhat Dranr politi(ians it lhrt lh. Prolit global health. OstcNibly, both agrccments
messures can a waitress in Bansltok (or nrni!( s;ll al1\.ts.ns,,.c that ro cncourage healthca.e innovation bv
downlom BrcokllD for that matter) take? nr.rliet is irnll ticc .,r(l lridc .ulcs protecting the fropert) rig|ts of
iil ahvars l-rvorr the ri(b xnd pharmaccuticaL conrpanics but what t|ey
Today, more than 8(l% oftobacco dcaths r)o$c.ful Nho (.rft them. Withirr eDd up donrg is to make patented drugs
arc fron developing countries aDd derelopnrs ard even devcloped nalions nore expensirc ald prohibitiDs developing
traditionally rich world p.oblems like themselvcs,larye swalhes of poor people natioDs l|oDr having access to cheap€r
morbid obcsii*, diabetes andcardiovascLtlar renain cut off fron the dividencls ol
, ir ,,, i,, ,r- ,, r'rl.rl t l:r'r.,rril i,.r, i. ir riiriilrr, r rrir/i1f:l
08 ER0ADtRPtRSPttTlWS ine
ADd $'hile these international trade ArgentiDa's cconomv cut inlo proliL But globalisation DrcaDs thar ro
agreetnents contain measures to protect margins. SAUR i{as contracted to use a pcrson aDal couDt.l Dccds ro llght
public health inte.ests, the rules arc so $96 nrillion World Banlt LonD to distribute aldrc. Thcprtscnce of strongtansnational
compler that countrics nust haYe waler to Senagalese - but till today, most social networks can provide enotioDal,
representati\€s of considcrablc .xp.rtise in Sengalese siniply cannot afJord thc p.iccs infornational, llnarcial and €ven politicat
iDternatioDal cconornics arrd taw lo be ible SAUR sets and still usc untrcaicd $'ater for support tor artore involi€d in thefightfor
to $adc thFugh that labvri. th yicloriousb their own nccds- Thc IMF too has been proper heJthcarc. T nsnatioDal NGOS like
a luxury not all nations poss€ss. c.iiiciscd for forcingTanzania to privatise OIfan aDd DoctoN Ulithout Borders ard
itswateras a condition of liavi.g its debts nrdividuals likc Bono and the Cates ar€
'l hough or,auis{tir)Ds likc thc \VlO folai\€n. Ofthe €Soo,ooo given to UKthink raisins firnds. delilering mediciDes and
nnd $'UO $erc formeil \!ilh lhc tankAdam Smidi Institute to prorid. adric. addressing unlai. laivs. ln soo7, S$'iss
h; ghcst idc rls abo ul cq u.r l to the TanzaniaD governmertj more than pharmaceutical corporatjoD Novartis
en4xtrlcrDrcnt of rll mcnrl)cr nnl ioDs. hJlfofit r!6 spcnt oD making a promotional chailenge.l Lidia's Patent Acts La$' to
it is still thc nrcmbcr nili,m with thc streD'atlien their nonoDolr on existins
srcatcsr poliri(nl clonr (rnd rhe druss. A Yictory for Novartis would have
induslrinl inl(rcsts thel rcprcscnt) dcalt a serious blos' lo the heaLth ofthepoor
* l,o Jtcl\ r(r\ ed first. Pmmftcd by a 0oorcst. slobalisatiois bcncfits arc as the Indian Seneric drus industry is the
ch.rllenge mounted by Amcrican trade ,n,l ol-rcr(h as ldrg as intcrnrtioo.l \dorld s biggest produc'er and exportcr of
.epreseDtatives and b.cf froducers, the ;nt(NcntioD does Dot Aivc thc , i allordabie generic Dledicnies to dcvclopnrs
WTO n ed asainsta Europear Union baD sigDifi(aDt boosl out oi thcirc\istinJa nations. While the Indian court olenLrled
oD beef Dr oduccd \ith growth hornonesin quriiDrn c. Dccades of weali gorernnients, Novarlis, ovcr.12o,ooo pcopleworldwjde
r 997. setting a precedent diat colld be used corrupt despots and perpetLral $'adar. sigDcd a petition req!esting Novartis to
to strike down future attempts by Dations plague states like Conso aDd Ansola, i{hilc d.op the case: amongst them, ordiDary
Lo set ftrod safeta staDdards. To furthcr their healthcare systenN limf along i{ith people tc, the wo.ld s power brokers likc
(onrplic{te matters, not all politi.il death ard diseasc unchecked. The UN fo.n€r Sxiss PrcsideDt Ruth Drcifirss. South
lerdcrs shuc thc saDrc co ricliurs predjcts that br 2(]15, HIV/AIITS wilL haye Af.ican Archbishop Dcsrnond Tutu and
about\Lhat$orks aDd whal does not. decimaicd thc South African Defence rorce, nembeN from thc Etrrol)€an ParljameDt
whet|e. America funds $,orld health undenninirrg a crilical peacekeepins force and the US Congrcss.
initiatiles depends on the peculiarbcljefs within the regioD - plunsiDs Africa into
ol jts present adninjstmtion: under George Il-$c xre not mo\cd sinpl) bt thc
Bush Jr. s bmnd ofrcligious conservatism, Doral call to rlle\iatc thc snficridjls
onlr abstiDencc bascd AIDS progranmes .\lso, \ridestrcrd .orrrplio nnd ofconmron huDaDit\. thcn $c shoukl
colhboratiin hct\rcc'r l1,c elitc atrd at lc{st realisc that lhc ncgalivc
thr illi(it od tlrc krcal aDd dobrl lerel e\tcrnrlitics ol econoDic
I)ct.lor)i!tg DnlioDs struliiil..hc\) t() har. .\!cerba t e(l the suffcring ofthc globalis.lion $ ill nndemiDe its ve{
lhonscl\es because gL)l)rlisatioD his I'oor. Ircm lndoDesiato Russia. expeDsil,e o$ n lbuDdatioDs. Ho$'ph$ically hcalthy
been a tstFcdged s\!i).d ibr th..r. dorated medicnrcs haYe l)een knowr to the wliole i{orld is nr the end reflects how
Iirstll. the incrcascd nrobililr {'f resurfacc lato in the black markets of economicalh hcalthv it can be and how
labou in { liec cco o'Iv lhat has delclopcd nations, haying beeD palmed otr norally hcalthy it rcallyis. \\c n,us( not
hc\)cd dc\dopi e natioD! prospo and sold for a handsoDle profit by bribed rcducc hn an bcallh lo rrl rnother
prcscDls rD ironi( bio\r tlJ thcir politiciar$ to t.aDsrational oryaDiscd crimc p.iratc go'di a presqaa. ibr thosc $'1n)
lrcallhcare srstemsr dorlopinit nations nehvorkrl. Worse still. collusion nreans thar :rrc nlreadl ri(h. hale and heart!:
like x{exico,Jamaica, P|ilippines. tndia illicit trade thai i{orsens health goes priced out ofthr reach ofthosc sho
and GhaDa arc losing thrcles oltheirn.rst uDpoliccd and unDunished be it ne(I it DDst. Hcalthcarc should be lept
skilcd healthcare worke$ to .icher Dations prostiiution. dmg tmlllcking rDd Dow, the as iDclusivc and non niera.chical as
like the United Lrrgdom who ca! afford production and sale ofpirated nedicines. possible. The resporsibilitr of healthcare
to prolide better renunemtion for thcir WHO estimates up to 25% of mcdicincs does nol lall under the puNie{. of
hard \rork. Se(on d1), acccpting cc,nsuned iD developing n.tions are researchers, scientists, tradc bodies,
i nterDrtionrl help also r.r.s counterfeitaDd thc elTects offake drugs are politicians aDd $'calthy thilanlhropists
acceptiDg tcrDrs that nrar bcncl-il deadly. Usclcss flacebos mislend patierts aloDe. Wc can a1l do much nrore to ma\imise
iDternrtir)nrl (orpo..lc ;nlrrcsls nrio bcliNing the.!- are being cu.ed, cause the bcncfits and rnininise the harn of
mo.r thaD thcir !hl;o'r's hrrlth. Thc comtlicaliors and enable i iNses to nutatc globalhation in oorown small ways.
maioritt of World Bank loms for xrtcr fi om and become stroDger. sophisticatcd fakc
2oo3 to 2(]o8 have requircd developirg drugs that contain enough i.accs of the rcal Allhunan lives, no nutter whcrcihevare
natioDs to priyatise water a move that iryredients to l)ass lab tests but notenough lired, are worth thc samc. A unifomrl) hale
bcDcfits mostl!, Europear water companjes to clu! have caused a resurgence of far nore and hcariv $'orld rnay be an inpossible
aDd consukanls. ]n 2oo2. SueT tenninrted dangcrous. drug resisLant strains of nulaia, dram but surelv. thatone truth is enough
its water and sewerage seFices to Bucnos polio a|d ArDS. lo nalie the drean woftii rfight?lt
Aires when the finrn.irl m.lrd.rn.f

09 8R0nD$ PtRSPttllvt! ilre hedlth.dre issre


ON 2ND THOUGHT

Rethink Big Pharma


How sick arc our phannaceutical corporations? Ry Joselin Bau

"Big Pharma uses the


poor as human guinea pigs"
UN|ORTUNATELY SI II.L TRUE/ So aas Tle childreD durnu a sererc rneningitis outbrenk. Nigertan
ConstdniGdr.ltncrrisht all aloDg? Did the inpossibb parents 1{crc never \larned xbolltthe potential side
I'r,nr.,.r R". Fl !\'e,/J d.Jr, Rr.tl f"r,. efiecls and dsks (braiD damasc, loss of hea.nr8,
nutnblc upon a coDspirac! t|at tcflected resonances paralvsis and deaih) of the drug and its Luapproved
fron reallifc? Do dastardlv and e\il Dhannrceutical status andtheirlerb.l approval was given rndcrthe
companies puncc or deielopi g nations, icstitu their 'r_d .. ,'1.,Lll l l' dr.rBv ',,1 L,rl ' ,-.rl':l
expe.imental mcdicires on rhe poor aDd the child.cn. Clinical protocol was not followed and
oppressed? While thesc dNg companies do lot co rpleiely abaD.iored when more children slarted
neccssail) rcsort lo plots on pregD,nt dying. Doctors who objected rrerc swiftly dismissed
'nurdcrous
whistle blo{€rs. .ecenl uluavclhre ofdNs scandals fton the lrial whilc conplicjt local doctoN created
seem to jndicatc that the) willgo lo opportunistic and fakc ctliics approval documeDts that Pnzerlatcrnsed
sometimes cdminall! negligent lenglhs to proicct their to justiry ihe er"ednents to ihe FDA {the U.S. Food
market sharesit]r no interest in the long tcnn herltll nl)d Drus Adnjristration that oveNees drLISsafelvj.
of thcir test subiecls. Troyar was cveDtuallr shown to callse liver damag€
and rleler gaincd approval jn t|e United States nnd
the mosi notorious nnd quotcd extmple ol suc| was baDned in Europe - abig blo$ to Pfizcr $'ho $'as
A8O1]T TIlt WR TIR
\4ut was nore
cinin..L behaliour is the 1996 Pfizer dlus tridl inflicted hopins for uolher blockbuster dNg.
on desperntely ill Niserian children and their unethical ivrs the lact thai Pfizer advertised its
trDknowing parents in thc n st of an epidenric. The . rpa-'r.prr J . I'1r..'ri ,, n .ffn - Jr.J .n il,: ir .

Pfizcr cxperinentil antibiotic, Trovan. $'as iln cD to thal position till this da].

l0 BR0A0[R PTRsP{O Vtl tlt heilth.ate issue


WATCH TH I:
s ch caaDrdes of Dralfeasance nr delelopins couDt.ies the local irNtitutc for children s health and c,n r4o
happen so easil) because sonetines the poor do not . r.r'd....r 484'1L4,$, an i rolrt-. .u r,r. .r.h--i1r
J)
'.r,o" r.1 o.r'"r ,r,Lr.' 1 -J" \ r'.i 1i,1.',drnr^dn tuom diauhoei. Ihis lice seNn i{as documentcd as
B
$hat lheir doctors \rant. Deleloping nations have lar an eificacious treatDlent for dirnhoea and no mcDtion
lo non existent o\ersight wire! it cornes to regLrlalo'y iv.ts nade of the serum's trarsgeDic orignN nor \?s
check ald balanccs. Conscnt fonns, ifther arc oflercd inforned conseni obtaincd. Thc control group was DRUGTRIATS:
{i all, arc rarclyhaDslated into the locnl le.nacular. rlso giveD a l.ss clTcctiYe glucose solution to make the T}]E0AR(5 Dr (2006)
'nrcre are also .o l€ga1 averues to guarantee an) r.,, u, .F'p.rmorerri.ndt:. l\u{p}.,1;.r.i. r. tor0 rhi5 (ordo ous BB(
nronctn,l co.ue salion lbr lheir prrticitation nor tcartle long te coNequences thatthese children do(umenlory direded by Po!l
lhe co.tinued l.eatnent or mc'.ticrl follolt np rlrer Lt.t ril;rb-..,.r- ui$-.t.,r1.,s" nrr1dh),ar8 (enyor obort how por ord
Lhe €.'d ol the trial. ADd at thc s!Dr. timc. it is sLill a.d jnEestiDg such protciDs. Otrc unfortuDate ' illihrok lndioi Wrirrlr ore

ilcr€dibly easr to find r plcDtiful Dunrbo of palients cirNequence has ldrgtcrm rcr.cussions where these !rvillingly Difg ued ro len
for ch tials rs thcythink that tlese clinicaltests Dations aDd pcoplc sometinres reltrs€ new
will bcth. bcst chance i]ret ha\€ aI qualiN liealth care immunisations, rheir fear beirg that it is the ilhite
for thc rcst of Lheir Li\'€s. And the trials caD bc mcn coning ro ldll rhem asain.
conducled sL,ch lhal lheyrenderthe q icklndposiii!e
results that drug conpanies Dccd to gct fast apprclal. tuF hr- sun. n;,1r1. i ,' 1. siri p p\c.tior.
Iror era.iple, up to 99% ofclinicaltrials iD China can that rvill rarelv be repcat.d? Unfortunalely these
besto$'positive rcsults trl)on treal ent. lro ically, examples mavbeih€ tiDDins Doint oflutu.e scardals
p{ticnts in dcvcloping nations also nake better lab l. ' T' . c-^LrJ- rr.' la i_ I tnJn -\pFrin,rrlrliJr' .
'
rats bccause tbey rar€l] talie nedjcines for thcir booning becnuse c,I lhe erpardins .lemaDd iD druss,
illnesses and the.efore are jr abcttcr statc to pro\€ ,,rurl\irun,.h-l'\.lup-J{oid {rrh^r , devp or rg
thal wLat kn ts happeD is froDr thc drus. nations as \yell. Consider thc fact t|at drug t alsare
rrpi.tlt' nicreasins nr Durnbe$ acrossihe idorld as the
G.atrted there arc cthical guidelines aod codes thrt drtrs industry cxpands. NIost of the rorld's larsest
safcgrard to frote.t]Fople ilr ciinicil procedures, like fhannacexticnl compa ies have established a presence
thc LrN CoDvenlio olthe Rights ofa Child andthc in India {here it is estnnated close t{r two rnillion
Nuremberg Code. Tlie Nurembcry code arose in lhe people \rill take parl in clinical t als.
.tftermath of the horrific hunran €xDerinrents
condtrcted d ing \-odd \\'hr II and is.rearl to pmtect Regnlatory bodjcs a.c somelirnes part olthe prcblem
hunar subjccts f.om injuN. disabilitv or death. Yet as wcll. FDA.pprclal p.ocedures do not sohe the
thesc cthical protocols are essentialll toothless and proltcn eit|er. l h€ r:DA is notorious for its caunous
casily circtmlertted by liraDcial grc'e.l. Thc U.S. afproa..h Lo appr.rvjrg drugs for the local Durkct.ltt,
Goverrrnrent iD wantirg to ensllre tb. safct\ of tbe corryenientll these regulations stop ai the border.
druss sol.t for childrcn prcvide an urtbreseen incentiye Theydo not rcquirc notification i{hen resea.ch talies
at the same tinc. Pharmaccutical companies are grven place olcrscas. Rcquirenrents lhat co rpanies p.ove
sjx moDihs of pai.nt protection or rnaritel excLusi\it! .\ ',- \,' r ', pr rn Jr ,8. i r .'lF un r.:n.l . -,, r,
whcn th€ylohntarib test dmgs.,n childreD. .vcn siarting lests on hunans are not applicablc to
p.r..ond'.raroIs:,1 u tL Sr t).\\aar Nc.ccis
SLrcL incentiyes oriv eDco rase thc $.rying h end ol one set ofacceptable isks for patients at |one and
l- li|Jur"l lr' ,I \' 1ro"F- li I oin" anotlier setforthosc abroad.In llre mid r99os, control
eramdc of childrcn beins piss also
Lrsed as guiDea J.rt's^fHa 1l.tpdp Fgrdn $"rn-r.:r .1,'.l"r,
occlrcd iD l.inra. Peru. This tnne the child.en we,c corurt es Nere denied anti.etrovi.al drugs despite
"
r, 1^. .-i-i'rl lrial of .',-r ti..lr r',.4 nd-.. [restern doctors ltnowing that the &argis {ou]d reduce
semn con I aini.g svntheiic proteiDs not atprovcd tor tie .ate of iDfection in iheir babics by two thirds.
'p li|! :r .'n' p.' u l'- r J B' .i' , or gr, wi, lnlints needlesslv contractcd HIV$'|ile the doctors
'.r "
health coDccrrs about cXI rice. ine U.S. based nuintaincd thc nrtcs !vand rigou r ol their nedjcal
conrtan!, Vcnhia, decided to etpernnent iD a
dclclopirg coLrrlry. lhe f.ials ivere conducted throrgh

ll ER0ADtR PtRSPffllVt55 th. h..lrhnr. ir!tp


Doctors defended themselves by otrering the speoors dms trirl applications. Even watchdoss like the Public
argumeDt that thesc patients could not have alTor ded Citizens Health Research Gtuup can do little to policc
the drus ar\how. Imasnle ilie uproar that rvould have r r.n pr\!,' rirl r'l\ and -"1. is J.h ir inrrlJlion i'
happened ifthese patienis were lronr dcl'eloped nations considered proprietary and confidential
and had easy access to litisatirg lairyers
At the end ofthe da,v, mosi NGos still recommend
Though the proliferation ofthe nedia and the visilance clinical trials, the aryrnent being that more healtli
of NGos have cut down on t|e possibilily of such research is better tban noDe, trusting that the spillove.
practices NDning rampant, it does not also help rh,r effect lrill lead to beitcr and increascd standards of
Local sovernnienls too, ir bending ovcr backivards to healrh carc in developins rations. Whilc ihis may be
ge! these companies io conduct research and a recessary aDd unavoidable trcnd, $ie sbould be morc

rlanJr,.tu-.dnr6s:nl\p r'.nLrrr'ie, nr\'nrlrl;m45 awde ofdouble staDdards and mtionalisation ofethical


trm a blind cye to the exact legalit] of sorne ofthe relativism that justifies shoddy treatment and
rcsearch conducted. There wi
at$alsbe corruptlocJl exploitaiion ofthe \ulnemble in the wo d.lt
administ.ations that effecti\,ely rubber stnmp such

"Big Pharma should have


its drug patents broken."
No/ The fai cats of Big Pbarma luve long bcer we havc seer d1 increasins irend of courtnes breakins
d"_idcd lur lh" r n or upoli.ti. .ri ' goJr,inS drug pat€nts held by dru8 companies and soing with
rFnd"r".... l-,r "'ploi,.r'n," dFvF-o,.18'", nlri"' genericdrugcompaniesinstead. Countriessaythey
JrL thal|cru.l r'-!lF,I ol rl" plirh oII'oord)ing dr. -.l, .dlll \oTpp l"J lo do o i rha) arr ..vilb
1,. li' nr: th. \nrld u.Fr fr"r. rls nu"F ma-lFlin3
lives this wny breaking drug patents can mean
budsets are seen as wasteful and allesedly intended savings ofup lo hundreds ofmillions of dollars aDd
to corrupt doclors and politicians. While somc of opening np accessto cheap drugs.
theirbad rcprtation is deseNed, not all ofd1at venon
and bile directed towards these big pharnaceutical But the lesscr known fact is that these breaking of
conipanies necessary apply as they used io irtoday's drlr; plr"ar. t, n"fir more n dd , -i1' omP.nrn ri-'
fast expanding drug mark€t. Trvo nel' actors - than the desperatc aDd needy countries. Ihe poorest
emergnrg and niddle incone coruit.ies aDd the countries already gct their drugs at low or no c".r
jncreasing\ po$'edul generic druss industr,v - are because offoreign aid subsidies. The result is that
changins the picturc as we kno$' it, niaking this richer countdes are using this threat to browbeat
sir,ral ^i . lul nror".nn!lr\ lhdr r\" rrs r-l p:l ire firns into handing oler hrse discounis to middle
ofpoor countries agairst drus companies fron the class citizens who can alr€ady afford to pay Brazil,
Ti rlJnJ.n,l lrdrJ \!'F,ed l'. rao'-mpal r\u)rIL
geneic d gs but their governmcnts are wealthy
In rccert years, thc coDtrovers], swirliDg around Big enoush to spend on health ca.e. Even some NGOS
Pharma has mostly ceDtred on iis ficing oflifc- $,orry that this trend is self-sen'ing- After all, Brazil
snvins drugs outofthe r.ach ofthe poorandhence, cannot be said to be on ihe same level as Rtanda
the Jnoral justification of breakng these dnspatents and thereforc should not shirkpaying its fair sharc
in a bid to get these drugs to the neediest patieDts. of drul disco\€N costs.
But drus companies nay not hold as much pow€r as
i,ou think, as govemments can break ard circumvcni
theirbusiresses quiie easily. Oler the last decadc,

12 8[0AD[R PtRSPtfllVts tlrc he< thtot. issrre

l
The off-quoted argument still applies: the profit forced to rethink its traditional way ofbuiness beyo
incentive is a necessary impet s for inDovation. itslargel' rerti.dll) inlrgalFd approa.l ro dqplofinB.
Without jnnovation and the proteciion ofiniellestual manufacturins and sellins druss- This includes
properry rights, there wiil be fewer life-saving drugs lereraging on rhe srowl , nl hp i 'dd e clds.pq in
in the tuture. The brealiry of drus patents may mearl energins ecoDonies - Indiat market alone is expected
that more patients will get .lrugs now but it also means torcach $2obillion in 2015 and China's numbers are
that dns fiIru wil bc nore wary of developing dnss expected to be eveD more spectacular. As such, drug
for the tuture. If al their pmlits are goins to come companies are startin€ to focus on buildins up local
solely tuom rich countries, they will naturally think expertise and research in these developins markets.
twice about researching cures for diseases in tbe Insrerd olmFr-\ uolars cul .n.r.. rr,e\ are lakjng
'o
developing world, which are aheady woefully an interest in local healih care needs. For exanple,
neglected. Novartis now has res€arch centres in Shanghai and
Sinsapore focusing on tropical diseases.
It is also a little erteme to ihink that stripping away
Bjs Pharma s wil solve
patent rights in poor comh ies Nor are dlug companies so evil s to disrcsard pressure
all problems for the long term. The intellectual from NGOS or goverDments, nor so patentiyblind as
ploperty issue never goes away. Matrufacturers of to ignore th€ short shrift they are getting from the
Seneric druSq dre F\olving irom .opy.al\ ro being nedia. GSK already makes no prcfitlrom the drugs
innovaloF rhem:rl!er dd ar".t rtilc'o derend thFn .old in poorAfri.ar ndrion.. and offer. tiered pr:.int,
own new dnss {ron copyins. This will becorne nore for mosi ofthei. drugs, calculated on the country's
of an issue as cuttins edge research moves fron the ability to pay. Even the WHO applauded cSK's
de\elopcd cou.ltrie' lik" \'!FslFfn Lufopp. ar.aca decision to donate 5cl million doses of its new flu
andJapan to countries thatusedto conduci the less vaccine to an energency stockpile.
sophisticated back end work of prodrct developneni.
wlile mntr@ersies Ncr Big Phamra s responsibilities
However Big Pharu is also showing that it is capable and oblisations will still continue to rage, these new
of change. Wiih the patents of nost blockbuster dngs shifts of thinking and action suggest that there is hope
expiring iD ihe ner110 years and thedemolishing of for the drugs industry after all, such that there's no
pice controls jn developed nations which will result need to destroy all basis of inteliectual prcperty just
iD their profits beins halved, Big Pharna has been

13 BR0A0|R PtRSPtfilVtS the henllh.nre iss e


ISSAY MAKIOVIR

ll people are guilty of it. Not just


students.
In an internationally televised debate, zooB
Presidential Elect John McCain found himself
in a tight spot when he was asked to account
for the disastrous situations in Iraq and the U.S economy.
AEOUTTl]IWRTIR
As an experienced politicjan, NIcCain deftll sidestel)pcd tlie issue, bulir1g hinN'lftin1€
to think aDd hopefully coniDg Lrl $'itli a strongcr aDswerlatcr oD ilr lhe debate As a Gl
tDior i{atchingtlis,l obserlcd how jUccain was intcntionallv not answeiingthc questior
(NAQ) posed to him. And then it suddenl!- stmck me as to liow I cotrld begin this is e's
Essay Makcover. Surelyitwould be apParent io anybo(lv. anvsh €nt. io directly anslvcr
Pmntd othc.s to do rh.
a question poscd to them? Even a basicbut crediblc answer that rdd.esses thc
sdne, dn{? lo!ntglV 'luestion
would innned iatcly $'iD trost; much less aD insiShtful and Poignant answerthat could
IIsiD. those aho do
nol. Be conlfbrte.l that lery well carn itnnrediate respeci. !tt, iladdressing t|c questions fosed to us is so
rc ute alL Lltimatel! itt nnpoltant, then i{hy are so fe$'people doitu it well? Or Pe.haps nore inlerestingll, whv
tl1c s.tne b.ot Tang
are so manv peoplcuDable lo aD$ler the questions poscdto thenr?
r.c is a lnun.ling
patuEtafa .l tcacher
dt sthool affhousht.

I4 8R0A0tR PtKPtOl/t5 l/r.lcolllrftr. issre


We firct have to rccognisc rhat answering questions well is notjust donc for
exams. No mattcr what the age, we ill still liDCL thrt a big portion of ou cvcDday lires
is spcnt aDsi{oilg qucsii.i. s. We answer questi{rns to gilc insight to t|e l€s! e\perie ced,
facilitat. flan.ing, to remain rccorLnt{bl. for ou.ctions, and in the lrocess, become
.l.irer and ctearer of our identit! and fnryose in ]i1e.

I knos.thrt learniDgnr ans\cr q cstions lvell h as beeD aD inloftrDt skill as it has brought
jnniense gro\th in my ch.mder. work lil€. personrl lifc' rnd thc livcs of otl.rs. Flach
tiDe I drswer qrcstions, I .ealise that I am listeDing iD ordcr ro fillly understand
thc contcfi and holivations behiDd the qucstions poscd to mc. tlr !Dde.standing
this.I have learnl to structure, u.l rcstNcturc mt responses. a swe.ing the queNi{cll bl
satist),in3 tlie notitation bchiDd tlrc qu€slion. S€eirrg the satisfaction oD stklcDts aDd
l.iends'1aces becausc ofwcll an$r.red questions has becone ajovthat I h!v. corn. to find
delisht in.

Snnilad!, t|cr. are a Ielv icadernic poiDts I necd you to garDcr fro'n whaL I l)ave slrr.ed

ro.. There is a purpose behind every GP question asked.


"u
'Ihe'^ lcvclshavc donc rn exc€llelrtjob in mlking tkse notilations hansparcnt. pr€didable
aDd thcrcfom rpprFnl lo all Lhose $ho
kDow $'hrt thcl aE looking out lor At Lh€ certre
ofDuDl qncstio.s (.ot all) underivins assumftionsthrl \4e li.sL need to outline
LLere are
and tr.kle in a svsLe ratic flshjdi. Not rddr.ssing ihe brsic.roLnrtioDs (assuniptnms)
behnrd n questioD or1]1' oblllscatcs thc ksnc rnd res(its irr r situation wliere your rcadcr
is sirnply liustrated bv ! scrig that is discl,sslng €ve thilgbutthc qu.sti.m at hand.I'oLr
ilill eDlp{thisc \ith this cxf(r'ie.c€ jJyou have tallied to unfoc scd,o!. v .mo lional. shiltl
or sinph foolish DcoDlc.

In this issre, we are goirg to oudirc thc most llequently asked questioDs /
arguments thtt rppear in thc 'A'lcvcls. l'hese will be marhed b! sfigic $ords or
sho.t lhnses tlut tpicallv signfost \'hattbe issL,e al hand is. By masteing thcsc arguDrcDts,
ud ad.lressnrg th.sc \ords in e!er'-.' parag.aph, rou \yill succcssflrllt rns\.r the queslion
tu a logical aDd cohfle.l lislioD, and I ass reyou.bdrgmn.hd.lighlto)ourrerder.
Unfortunat.l), thc lisl ca..ot be exhrustive and$'c hrlc onlysp.ce to showlou the three
most coDmon argurrelt tlpes aslied. r\sk !our icachcrs for insiitht i!to othe. key ilords
sothat the! cair helprou be norc full! frcparcd forthe exa.rs

rgproachins qnes t jons tlisw.! rcldresses thc qtrcics I startc(l o1l \!ilh. MOSt people
do not ansrver questions wcll simply because thel'remain
ignorant of what is reallv being asked. .rr," u,u." aifii"urt
"r,ul"ng"
is wheir people do nr fxct uDdcrstand t|c queslio. posel to thern but let irtcDti(Dally aloid
answe.irig jt. hi the contc{ ofOP, this rcieJlr Lo studenrs who have bccn niad. a$'.rc of
these skiils but lctstillcnd rp l!oiding a direct responsc.

So lct s st.It t|is aJljcl€ lJ.' tirst uDderstaDding r\'h! sorn. srude.ls behye this \!a\'.

l5 ER0ADtR PtRSPttllvtS tl.lrditl.ar,r iss!.


E55Jiti,i,rjil. I'1,,,,,

Qunera/ liTs
I ialked to So students siih the s ne Do nol e h<><;5e ozl-Sl)c>n5
Z
prcfilciD o erto better understand
whal the], $rrc ihinking. l hese werc
/y /o-(;ng {<>r {ami/i,,r t <>nlenl .<rea;
all students $'ho liad conpetent to It still fuzzles nre ltow slrrddrts rctuall) sLudl l,rr this subjcct. lt is Dol llrnl r.rdnrg up oD
commerldable lansuase sldlls, had LrontcDi is \rroDg- Ior jt is c cvrnd o!r pel\0..tncs ard de\elop th. c.ncctjrrgon
rcirl to
allbee lrainedto sfot aDd add.ess lor frlticular topics. Du t C P is also a slills .lrire! !a flr . Thcrc is no svllalrus inloh cd and
keI argumenls, bui Iet aere still rherelbrc rbsol telt no gLra.rnlee thatNhatcler it is stud.nts invcst tine ir studling \ill
iailins tlieir essays. Ihe follolenrs rltuallt bc l cst.d nr thc ex{n$. Ln, t sl l,d.nts do !) an\'$,a\'. lia.r ili \ith the $'.Ly tlie\' sl dy I

will gilcboth teache$ and students lbr coDtent dfien H2 subjccts, students irrerila|b DrcDntrise to lael .rore sccurc or PFlarel
som€ stroDg insisht into tieir for thc rrans. l|e probl.n ariscs wher tl,el .onrmitto qucstiols iir P.fd ODc based oD
lsrcholo$ and beha\iour; thereby rvhrt th.t fc'el is lirnili,rr cont.Dti Dot xt .tll co.sld.r'iDg thlt thel ma! ltirc.hoscn a vcN
sirirg the a sood basis b)' whicb dilli.uli argument to haixlle.
io better establish their tundamental
trndcNtanding ol essay qucstions. S!ccess is thocforc. in tlieir rriI s, nr istik.nh defiDed b\' q urliq aDd rohme o l e\u Dr l)lcs,
ancL not cL.r, il!
rnd forcc ofxrgulLer)1. Slrdcnts clinn out Iraragrr|hs olcontent thilrlti.g
t|rt thcv are lojng N.ll, $'hcD in 1r(t Ll,er hr!. not clcn beguD lo r.l.lrcss tlic fossibl!
comflcx questjon lh.yIa\c chosen.lla.) slrd.nts go rlread witjt lheirqu.stbns rDF{a'
d.spitcthc strons Lun.h th.tthq arc not!!$!e ng it. lbr lcar that dire(tl! .ddrcssingthe
!rL.stion or clioosing a.olh.r ltill expose eve. mor. things thel arc igrorlDt of

the studenls I toll.d lrosth all k,und thc cxperience lir.ilirr. Not confident o1 their oM
contcnt, ther mcJnoris.d Dotes or bool,s rnd nscd then !s a clul.h So dcspite e'hal Na\
sct ir the queslion, th.l \onld insist o! using l|at content. regrdless ofhoi! thc questidr
lvas phrased as ther jell 1lr.! had to banli on the.ont.nt tliev menrorised

Selc.iing r GP questior Lhnl \ou crn .rsilltdd.ess hrs vcr) lcss to do Njlh th. subjccl
nuLter.rnd morc to do i{iih t|€ comd.\iB ofthe argunenl.There is no Suatantce that
(onlcnt that is fanrilinr to you $ill Decessatit\ come couplcd \tith a
st.{ishllb.{i.dquestion.The$rongassunr$ionisthatall qu.stionsnr.thesanreaDd
ollv differentialed b!.ontcDt. Thtt is fa. irodr lhct|utli, as ile shallsooD sc.

l6 BR0A0tR PtR5PftTVIS ri. ic.11li(d,? iss,r


7'hu /ungth .>{ lhe ?Lzesl;on mallers.
It is a simplc frnrcidc but one that will shed ligbt on choosing questions that rre nore
easilv addrcssed. We are illustmting this p.incipLe by intentionall) choosiDs a popular
contert topic, the media. Let us first consider the follo$'ing:

ShouLd LUe tesulate tl1e tne.lio?


This question asks yo! to deal with a basic polaritr.
Weshould eitherregrlate thc mcdia ornot regulatethe nredia.

Should ue still t.a late the nrcdio?


This ne{ questioo inse.ts an additional 'still" iDtothe questioD. Elrn though lvc still nccd
lo address the.,rigjml polailv, we also nolr nccd to cxplaiD thc assumption t|at we did
need to regulate the media in the past. couldthc rcasons ivhether we should/shoLrld not
stilldosotoday. ThejDclusion ofthis crtra argument not onlt' nrcrcases the skjlls required
to an$ler tlie questioD, it also iDtcrc$nrgly enough, doLrbles Lhe contenl Sorely it is obvious
that if a stud.nt picks this question, he not only co rnrits to a mo.e complex a.gunert but
also more content that he might not be awa.e ol

Siould .ue itill regrldte iie


tne(lio rDhen o rapidla changilg uarld rlakes it ineleDant?
The quesrion before ha.i gjven Do pamnrete.s for the rcasonsi{hyne should regulatethe
nediatoday. This oDehoi{eyer, iDscrls an c!1ra component $hich conuels us to explain
liow the preseDt is affectcd, not jlrst bl any reason, but specilicallti a rapidl,v changing

ShouL.:l ue stilL reguLate the inedia uhen a rapidlrJ chatlsitls oorld tnakes it itlcreasinqlu

Notice liow the argumeDt is nrde morc complcx each time I inselt e{ra parameters of

I am not suggesinrg ther€for€ that the shortest questions are :drvals the easiest, but certaniy
wo s into the questiorl oriy nrcreascs tlic numbcr
we see thal the insertion ol n1c,re choice
ol rcquirenents the exaniner expects you to deal with. It is the mastery ofrhcsc choice
words that enable students to always rd&ess the qrestior.

i/ BR0A0[R PIRSPIO VtS .ie /redl./r.dr. r:ssu.


ESSAY MAl(EOVER

t. Cc,mpttri5,:tn f,ztesli <>nS


Quesli<>n 1'W.t Tharkfully, thc comparison question is not the most common question tl-Pe.
What most students do Dot unde.stand is ihat iD order to run a fair and convircing
Mdst of t|e time. strdents do not conparison, we aclually Dccd a great deal ol contcnt. There a.e two main t)])es of
address the question simply because conpaisons the 3 variable comPaison aDd the 2 va able compa.ison By far, ihc 2
they do rot truly understand what the !d-iaL ..^ , p:,ri"un i. ..mplpr Lo I J ,dr, .

question is asking for. We have


therefore hishlishted tlree of lhe most The 3 lariable comparisoD is charactedsed by the follo$'ing signposts.
common argument types tbat
examiners insert into questions in \l At\, rroLLL\ , BLS I, r\ ORST. LL\ST. l\lo5l
ON I Y,
order to give these questions an erlra NOTIIINC I\IORE TIIqJ\.

All these wolds suggest the absoluie; i.c. the subject inatLer is ihc 'best", "oDly"or"most"
ofrvhatever is to b. aryued. Ir order to trovc or disp.ove ihat absolutc we will n€ed Ln
dmrv i oLher facto$ that gire us a basis of cornparison, belbre assessing $'hether thev
are indeed the best ' or "most '. The problem viih this argtrnient st.uctur! comcs in tlie
large anouDt ol cortentihat rcquires variation. Lett takc the following samflc paragraph
to sho$'the dyDanics ofthis aryument.

Strong leadership is most essential for successful governance.

On a supeticial lerel, the €cononic suc.esr ofd.orltttr! t. ur! dependent a


the n.o]1]l libre of the leaderchip as tlrc nltustitu of the Leadet cdtl da lnucll in
dsfl ng huesrors o/d tiansparent ond non-cotrupt economA For instolte,
Rabert Mugabe of Zitnbdlu€ los driuen /rts oDn econonla inlo a ditch bu
operanns a.leat\ canlpt econonlu o d cllooins shili! ecatlolnic palic! that
ias underm;red ifie srr.'tqtlt aJ his countru s ctlrretrcu and corse(l almost alL
itwestment ta pull out. ht lialrI o/.scendms llte thls, ure cdnnorcldin tfioisd d'r,
le.rdcrsnip is tne rlost irrpo,ldnr considerdtion irr 1Jrcrcttinq DlarketiLilure.
srccess/i/l aouerndn.e ot the entloDty is dependent o11a larye nnqe ofJactarc,
inespectife o//rou,.strons the leddership is. Citizens afa ca nuA catteasihJ
un.lermnle the prcgress tltdt good led.liirshry nds huilt, IiterQlLlt oretnight
Despite the Chikse garctnntenti aitemPl 10 c'os€ .arruPtian a rl e coutage
fust,for fid nuny tr&rrrie.s, fie seliisnlv co.ropa orhtu.les o/,nanV locdls ias
t)ut the re4tatiotl of the Chiles? e.onoTny dt stdft€. R ecetlt scatltlols oDer food
and tau pro.luctian hes shaken consrmer dnd inuesto, conidence intl1e rcliQbilitll
o/Cfitrese tr.lu.strr/, undotlg thelrcc€sttul econotr iL bratlditn that Clnna l1os
dcnieued so /ir r. Srrona ledde*fir? is delirirelt/ essenlr aI fot a suc.essfuI econonl!
but cainat be considercd nbsr cssentol ds ioe ncc.l r. dlso consrder olier essenndl
/d.rors llte ostro,rg dndrtustuorthU citize t!).

Ifyou study tlie pa.agriph carctully, you wiLl realise that wc act ally int rod uced thrcc
areasofcontcDt. Most obviously. stlcccsstul Sovermnce-necds to beQ.ied to i toduce
De$.areas ofdiscussioD fo. eich point: e.g. successful environmental SoverDance or
successlu l govemancc ofpopulation groi{th.

l
,vu,s n,ke.V, Ptoro cr.[Drr/..a'lsie1d. IlirkrcrrtiveconnnD.r
'n
rB Bf0ADlR PiKPffllvf5 the h.dithcitt! issuc
W"il.o\., . I runo i... .hit.rn ,r.... dat , "gilJ\n.o ,. nt-qr.ur ir..1rntrlr' ..
FLrrther pa.agrrphs wo l.l halc rcquned us lo re(leftre "st.ong le{.lcrshilt as Dcrtrrps
haviDg cler. visior lbr thc counq or !!islonr necessary to makc good decisions. l his
laiation of 'stroDg lcad€rshif wouLd ol(ou.se Deed to bc comparcd !ith ot|er tac(orc
th{t rre csscntial to success lu I goverDaDce. These othcr factors could include i country's
avajlablc rsources. the p.esence ofregional assistancc /.lissension or eyen the advent of
lifc alt.dng lech oLog).

Flach piragraph i{ouldrcquir. trs to keep vat,i g these a.eas. finding


toi.ts of.onrpa son
aDd assessirg lcaderslif isindeed
thmugh a con\in.ing aGunrent $,hether or Dot "strong
mostessenti.Thcrjsnoneedrorufevmplesforeachlariablcaswehavedone,butof
cou.se lour argument \!il1 be all the more conrnrcing if you hale lIe rel€vant oDes.

Thc sinrple.2 variable comparisoD is chamctoised b] lhe jolLowins sisDposts:

BET'T!]R II{AN, MORE TII{N, R-A.THER I HAN.

]'here is in this casc no need lo i.troduce othe. fackrs to dralr aD], cnmpadsor. You simpll
jNtn.cd to comferc th€ t$,r, fictors p(^idcd.

Hosti a ttriar spottig etenrs crcates nnrc prcble,xs thon b.nqriis.

This questjor ori) nccds ustoconpare ip.oblens" ald"beDcfits"in each p agraph. lhere
is absolltclr Do nccd to b ng in other fi(tors $ the ar suncni is alreadv linr iled Lo iddr€ssjnJr
th.'\norc th.n cl.use.

z. 7'he a/so/ttl. .r71-taenl


thistype ofarsumcntjs characterised by the lbllowiDg signfosts:

ALWAYS, Ntr\TER, E\'ER

T]ris is perhals the nost connnon argurncnt in Paper One. cenerally st dents ar. taugbt
to disngree with the absolutc statcmcDl as it is an ert.eme strnd rnd thercforc rarclvtrne.
Ho$.ever let ne liake oDc imNrt.nl caleal. Absolutes do exist as val csortnne |onored
traditidN. Takc for ilstan.e ihe value that ne shoul.l ncvcrlic, or ne should never gne up
hopc. Or consid.r the nditions thrt we should ahrals cclcbrate 5oth weddin8 :nDi\ersa.ies.
1r

In cac| ofthese cases, these values/tMditioDs cxisi h our psyche as absolutes that $€ ideaily
do not lvanl Lo undennitie or challcngc. Expl.ining lhes€ ideils preseDts opportuDiti.s at
lIe begnr hg ofrn essav for grcatd .vahratio. or jn the conclusioD {s a rcfrcsbiDg point

Besidcs this ircatnent o l the algu nent challenging th. absolutc also ca n be don€ by rie$ing
itthrongh dre contert oltiine or space.

l9 BR0ADfR PtR5PtOlVtS ttu h ltht.rr i\:1.


ISSAY MAl(E(]VER

Considcrthe follorving argume'rt:


Does modetn tednlolos! oluaas ntryroDe the qualita oJ people's lires2

t}le possible argumeDts we car raise would be that this nay have beeD true olthe llast bui is hos e!e.
not true lbr the prcscni or tuture (tnne based analiEis). or wc can anallse tlie questlon \ia a contc\tral
analysisj i.e. bellveen dch or poor, east or west or even seeing thh question in the light ofrcligious
n-s,rul rrr.'r's,.p .pbr\4d.nari.J.l.

z. ,4r3ztmunls z.;il h unJer/yin3 a55zzm7/i<>n5


Some arsumcDis lcedto be fully addressed simply by fint discussing the underlyiDs assunPtion
in the key lrords used to cftend the argun1enl.lt is desimblc if we rot only addrcss these assumptiius
but : so vary these assumpiions in er€ry pangraph. Herc arc three of the most conmon oncs and
the priDcipal argumenl behind each one.

1. TOO
ln orderto coDviDce us that there is too much ofsomethins, we need to Drovc that t{e have Lone
in excess of$hat is connonly acceptnble.

HoDe ue beconp lao reliant on teclDblaqv tualaa?

In this case, $'e need to e\plain what aD acceptable reliance on technolog) is and show how the
wo d has sone overboard in ils dependalce. The conmonly acceprablc lcvcl is unfortunately ver:,
subjectivc and is nore easily defined byestablishins alevel thai is p.obably univeNally accepted.
i.e. the loss offrccdon,loss ofidenlity,loss ofvalucs. If cardidates can prove how Man s reliance
on technolo&v has causcd us to forsake ourlieedom. ideniiti, privacl orvalues, lhen thcy sorld
have cedainLl proved too".

2. SIMPLY, JUS I- MERE


Thcsc words suggest that the subiectrnattcr is fisigDificant.In ordertotully addrcssthe question
we needto fiNt e\phin wliy p€c,ple assurnethc subjectmtter to be useless or Deslisible. We then
need to argue that this is a nisiaken assunrplion andilrat in fact the subiect naner is vcry siSDificant.
VaryiDg this thereforc largcly depends lpon nhether we can gcDerate different reasons why pcople
xor d "simply" do somcthins. Possible sceDarios include hafins no other choice, beins e\pcdieDt
iDtheir approach to an issue orbcingcareless intheir lreatmeDi of tlie issue.

3. NO LONG[R, STILI-, AN'!']\{ORE


This arsum.Dt also connonLy appears in qucstioDs. The assumption behind each one is that an
issue $,as in fact tluc the past, but is now no longcr hre. The question therefore rcquires a student
io vary reasons nhy things were true in the pnn.

Take for nNtanc€ th€ tbllo$'ing qucstioD:


Is there still e place for chatit! in the uorkl todau?

the assumption we are naking is that therc $'as indeed a place lbr cha ty in the past, and the
candidate is expecicd to lary these reasons in every paragraph. Theywould subscquently need to
addressthe argunent whether these reasons in the past arc still lalid today in each paragraph/point
thcy raise. (t

?0 SR0ADtR PtRSPtOIVIS r/tc /raltlr.ore issre


A MAITER OF OPIN|Oi\|

Is eating healthily the sole


responsibility of the individual? ,\l!()ul tllls

to\TL\T/-r1' r.\ s,.i 'd It '.^l\.d l\!\lPl ls/ NO


hcmcndouslv as morc societies shilt li om an agarian a) Conmcrcialisarion and indusrrialisation
based culture Lo an industrialised one. Cedainly, what of food in(lu\lr!: llo l"o r" ,r.J ir AI,LO\ftrD /
an'r'uponu,.r !J,F :n'jinu,.r bul: .i .'.1 .i 'r supernarkets rre p.odrced to na\iniise p.ofit,
that has alwals beeD iD our haDds. But as nore ofus extend shelflife and ilhet cons ner appetitites.
cjty-di{ellers depen.l solely oD restauraDts and Tlis affccts thc lcvcl ofadditircs. nutritidr.Ll value
supermarkets as our sole source offood. i{hat gocs to calodc laluc ratio as i{cll as portioD sizing.
onto our dinDcr tlatcs is also an outcomc of dccisions
nade by food corpomtions and farners. b) New fangled diets: Ne{ diel lads co'ne add go
e!e.y year, pronisirg ni.aculous $.eight loss
What us€d to be a sinple niatte. of 'eatirg more oncebizrne eatinghabjts are adopted. e.g. rlood
fruits and legetables ' has evolved into r cacophorlt ?ype rpi,,1tftirs,Dpi, South Eeach Diet etc.
ofcoDfusion. s obesitv rates sorr aDdthe Dunber
ofnc$'discascs muliiply ocn in thc Drost DrodcrD of c) Thc orsanic food movcmcnt: Dcdicai.d chcfs
cities. nLrhitional scieDtists, investigatjleioLrnalists, lile Alice \\iaters ol C|ez Panisse |ave long
.on,"n n, g . r ,^ dn l d:' I B' r.. Jr4 l. .\.t !i ,g championed the caus€ olfoodsproduced $ilhout
in their two cents norlh about ho$' modern day diets coDventional pesticides, &tificirl fetiliseN, sermge
ue impacting our bodies. ", JJ' .' ,l i-.. "\ '-- -'lr'lr]u, I r' ib u. '..
groxth horDroncs or gcnctic modjfication.
Doi{cj si nccd to rctum io that old fashioncddiorn
to fics| foods and cx.rcisc nrore" or should wr
cat d) The bcalrh supplcmcnt industry: Oftcn
let thoughts ol $'hether we are ingesLing enough targetted br journalisLs liiie xlichael Pollan and
ornega 3 fattr acids. oat bran, fish oil capsules, Maion Nestle, this indust$ has beeD accused of
llcopenes aDd antjorid{Dts consume our ninds? pronot g a pill-filled diet.

ranclj hent. lunch PIoro cRtrDIT/ sd/ao d(o&tsd, l.Tictr a',!dn!. a-bDDr.ns

?l ER0ADtR PTRSPt(TlVtS li. ledlllr(,1, Ns!f


,,rl rl I ,ri |J liNlil i ,,:

A Healthclub CEO Answers


Healthclubs nllrlti-llrillion clollar inclustry that iidvocatc taking pelsorral rcsponsibiliq| fbr
ar'r: a

onr:'s health b-"- exercising. IIo1\ lvoulcl they apploach the nholc del)ate on our- mod.m .ijets?
A\ co'rcei\ cd b\ Lirn Pei Pei

$r'
\
o
tuht's
Is eating healthily the sole lesponsibility ofthc individual?

\lcDonrld s list liiod di{tto pr^e tLal instfoodltrs


believe that one must drrknrg lmericrDs sicl nDd ob.se. I conld hr!. tul.l
take responsibiliS' for one's Ii.r t|rt. rDd s!\ed l,inr i|onr corstrnirg the.rtr'.
health and fitness. and an 5.ooo.rlo cs daih and 8aiirj.g rn cxtra 1l ltg. rs \!ell
rs sullerirg mood ${ings rrid li!.r drmage. I could
,r. borh Drrkiril integral part of that belief is that hrie rlso !u\ed hnn th. Nlseqnenl IoLutccn dilicllt
\vhll \ulr puL rnlo )our DooJ IS lurths he Deeded to losc that \!ei!,lt1l Anlonc.an
important. r'1"r. I sot itrlo lhe h.rlth aD.t
..',..r1
1 e Yosr {irh snrllo r'irr''lt '"h)
,r'J -r''' osl.Dsibh innrctrous urd ..ononiicrl ProPosal ol i
'r.- riren0 rnd qnick tpsize achrall] costs niore llra .
philo$pli!of livc lre ll.r' th(Ngliont tlLe wo,1d. and
grnrnrg spacr i! tlrc pretlr t.nn]. Eut mch rre t|. lri.ls of$me lool
\v. advocrt. tliat nr€sse!,c it all our interi,allodal
. u l l r''" ,.'i
1he herlrhohl CIO is frofit nlrEi!s e1lhcir custonrcrs e!1)rnsc lPun
liliell tr) be!.rr ir r Tlic scrnt regard lbr llt. hcrlth of(oDsuhcrs intcndcd). UJho c;rn rcsist tli. rLlu.e.il r 5.) c.nt
bilin.ed appror(h lo shoB by the profit-moliratcd lood iDdusl+ -t. r.r...t r...,.,,,j, u,Lro
h..lrht Lnnrs cati ! t!r a good dcal ni tliese bell lig|tcDing tines.
$'rs rl$ highlighL€d in Fi ich Scholossers /'irsr !b.d
brhnoed muls rlril.
gertirg pl.rtr .l Ndri.r. ID the slio$, lhe urhlgicnic rnl sloPl))
The need Lo boost profits aDd p.rd botlolr liDts has
.\ercisenrldncJ:iLr.l trc..ss.s nr thc slaughte,lo s. causcd tlie nreal lo
{r\s As r sr...!!lIl be corlaDin.tcd b) faecal lllnller. Yon litcrallr Eel
.lri1en solie lood coDiprnies to r!1 .oDr.rs. \\ihjle
...f .rarc crlruli\ r. h. crrp Nher \o! ertiuDk f{nnl. 1u s!.e n.nl of}ou s.nr cnt the n! Lrit jonrl .ontcnt oi their tood pbdncts.
rrillbenDlilicl] toll. t ''. \, |-l\i n sl 'l 'j1 . "1, I
othcrs .ftificially inll.rt. drcm Nitlr addjlir.s.
b snresses ard nro( sonrelines rcsultiDg iD disaslrolrs coDstquences. Jusl
whi.h Sprrloch subje.L.d hiDself to a 30 dr)
liiest\ les t. iDdridrrl
l..t rl lh. d.aths caused b\ lb..trn.nt tainted rrillt
rcsPonslilil)

2? SROADte PtR5PltTVtS iif ifoll]r.d,? isrdr


R[IATID SSUTI
t00D
scaDdal in ChiDa where nrelamine was added to Arihur Agalston
Beach diet created bv car diologist. Dr. BUS ttSS & rrHtC5

.rtificially raise the prolein collLerll in the rnilli.lts that focuscd oD catnrg thc right cariohydrates and ,4GRIIUITURI

grim ircny indeed, $hensuch asoureofs stenance fats. Ho$'about t|c Blood TIpe diel deleloped by MODIRIi L II
is rade Loxic due to uDscNpulous corNption and Daitrrof.tbic physician. Peler D Adamo which
9]RIT11I\
declared lhal people are fitte. when thei. diets are
cuslonised to theirspecific blood bpes? trveDbodv
I reccnilv rcad }lichacl Pollni's tt1D.li,w ol t ootl knoils rou stiouldjust ext less, nake sure tou hay.
ri.h attacked all Lhe scienlilic advic€ we halebeer b{hDce.l mcals, aDd kccp moliDgl I-ook at the
g€ltirg abouL lbod throughout the prst 5() )ears. t|c h€alr|iest in the $'orld the.t
,Iapancsc $'ho arc
Pollan belie!€s that redrLciDg food jDto DutrieDt dontlvorwabout sood carbs a.d badcarbs'a d
conpon€nts is a ftliculous puadism that has hchcd ccrtainlydon t lhinLabout $4rit susli rnatches whicli
the health supplements iDdustry rnakc milllors
oui ofthe latcst Dutlicnt ircnd St Jo|n s Worl. C00D Mosuhe (he{ks our

sinsko bilabo, fis| oil pills, mangosteen jujce. so There is Do lack ofsucc.ssors for cach passing fad vho'rhe U$ ir ml ns from
Dany products that lout tlienselves xs health foods becarsc crcatiDg nutdtion fads are necessary to slay
and supplements end up haming the h\€s ofthosc profitablc. To leep nry titnels centre successful, I
who consume them, rnd notjust physically. I kDoN loro$'I musl constanllr looli out for novel aDd
some athletes wlio realjscd toolatc that thc frotein ir I o\' l..r Fr-r' i.e r mr l" Jpl rr-.1.-.'1.- r ir_
t
pplements thcy i{crc taking to build op nruscles ul o,rn r ,brr..'nJ r--p tl- r" r'ir'3h:-l.\^.r
lrad bccn adulterated !vi(h steroids. as tlie canrot just have aerobics aDd spinnins classcs
manulactu.ers warted to artificiallv eDhance the anlrnorc. lbu nc.d dance|cise. kic.kboxing aod l'oga.
etlects ol th€ lroducts. And there aresoneprodncts -{Dd not snnp\'vo8a bul Hatha loga, ltelga.toga,
$'hich are nerely placebi)s of iimitcd trsc. I ihink Bikram )oga ma)be lr tslood ]-vpe roga is Dot too
PolhD nuy be scareDronscrnrg i{hcn hc condemns lar ofll uode.n people cherish thei. comfort, set
health supplcm.Dts I takc rnulti\itamin! nrysellLc) bored easily ard like to hrre De$'thiDgs to tr,a so thcv
stavc off colds. I believe as long as trustwortliy lu- l -\r). , I' d nrc. ...-dI g I' q\Jr '.
associations such as t]lelleaLth Supplemerts In.lustry rationally hcalthier fort|em.IIan) do noL like the
Associatjon of SiDsalore (HSIAS) aDd thc Hcalth boredon or dificully oi co sistent ex€rcise and
Sciences Authoritl (HSA) do thcir job better healrhyealinil.
safeguards and fiforDration on th.se supflemenls
.. rl\" t n. d, d. \\'|t r1;i ior i- I Li16 F 1.pr'i inF Blanirg (or?outjoDs for conspirins to NiD nha rc
(TCII) becomins more popular these days. it is also -., Ltr l.r 'n.'. 1,. . .rla r' r',s i!.,r'rp
hearreninB lo linow that HSA also oversees the that ar. dcdicat.dtolourheakh and Dranvcustomers
.egulation ofTCXI prlducts. Ultimrteb, it's still cvcrl who keep Lrs nr business. if lood corpo.aiioDs are
indiiidual's responsibilivto chcck $lut hc consDrnes, nraling bad lbod, it's niajnlr because $'e stjll happily
as last cases have sholn that dcspitc th..}ec.ks and pa) lbr bad lood. xlorc people are choosinst{r pay a
regulations, nnsafc suplnenrents and dftrgs stiLl premnun for chenical-free oryanic rood andfi..
managc to tind t|eir lval to the shops to be bought range cattle and po ltrl', and suffofiing rcstaurants
bv nsuspectnrgconsun1ers. likc Chez PaDissc and bxsinesses like Whole Foods.
Bis food coryorations liLe Henrz and Krali ultnnateb
I'm also coDcerncd that advcrtiscments ererlnrhere cnrc about where the Diarket jsgonu aD.t if coDsruneN
sccmto.quatc hcalib! lning with raDid \€iAhl loss. a.e goilg healthy, they will be forced to go thc sarnc A8I]l]TI|]IWRTIR

Uhatc\cr hafp.ncd to exercisinit and eating sensjbl)? rorte.It is your haDd that chooses i{hich rcsiau.ani
So nrany De\r faDgled diets have turned such doo.sto opeD,r'hatto tut in vour sholping calt and
conlentional wisdo r on its herd. There was that 'lorr when to fut do$n that forl and liftt|ose dumbbells.
crrbs craze in the earl,v nilleDiuDr. thaDks to thc Wc are nhat we eat and we are also what we pa)
Allir'" ,li l ll "l ,a ,\ ,ft d t ^tr ' ro ,',r', p ll p - for, where we shop aDda']ro xc sufport.It
iDtakc of carbohldrates. Then there nas the South

PIIOTO CREDIT/ PtrrkJr., FLi.L{ Crdrtnd coMnons

23 ER0ADIR P[RSP[OIV[! the het thItu i:\rt


A MAIIER OI OPINION

A Macrobiotic F'armer
Macrobiotic farme$: are thevirrst paranoid hea]th nuts or do they have soDrething reasonable
etr**,
to say about t]le way we eat today? ds conceived by Lorraine Lce

Is eating healthily the sole responsibility of the individual?


Japanes€ Dhilosopher
ceorge OhsaNa drew problcmatic portion sizes aside, it's simpb lrightcning
fron Eastern lollr Y t's clearer to me over
t s gotten clearer ov
to knoiv l'hat soes into your food. Colournrs to nake
nedicile to creatc lis I the vears that everyone,
evervon it look aitractive, addiiives to make it taste better,
tersion ofa rraditioml
approach to health. Ee I i p o r t - d p e ,t i ent t
- " "
preseNaiives and siabilisers to make it last longcr on
ihe shelf. Food production caried out by the big food
S ingaporeans included, need a
dubcd it macrobioti.s,
dcsc.ibing a lifcstyle companies is often a science in itselfand we re the
that iN'olved a sinple, return to better foods that are lab rats who pay to eat it all- Fron the inorganic to
balanced diet thai the syntheiic and the nature- enljcal additives, we
pronroted health and completely natural. or cou."" tt'ere a"e have aU manner of things donc to our food like
longelilv. Snrce Ohs.M conorations that sell orgatjc food btrt really, the
b"r\irrs.thi.l,,inB."qPele,,8.El,inga,d 5rming
bouglit nadobiotics to nuke su.e tou knoi{ what !,oes into vour
safest \eav to
tlc West in the 195os, The baby" car.ots we buy are actually cut lionr
food is to grorv it yoursclf and that s exactly what I'm
lol I orvers ol tle ord ir1 .zrr ci-n drrldiptFd nirnlorinF.ouno,
doins.
dracrobiotic approact to retain tbeir bight orange colour' No reports ol
h.!r believed that f.od health problenN have eDerged lrom coDsming babf'
and food qualiil l^Ila h^rri-s m" i.lh' ,nr"d wa\. .1 .'"rporil .1.
can ts tliough onc nNst note that these carrot pjeces
postrtully atred heali!, can fool us and how hnited tbe efforts of 8ov€rDnents
1a\, ,.ffdd) hF' r''rripp"d ol rnJnror t"\ir,min'
$c1l - beins, and aDd henlth authoitie! are in monitoring $hat haPpens
happin€ss, aml that . that lje bcneath ihe skiD. In the lishi ofihe curfent
in productioD and markeinlg. Have )ttr really paid
l.ss proc.ss€d melanine food scare, it is clear that foreign substances
aiiention to portion sizes? If )ou paid attention to tlie
oac.obioiic diet has added toorrfood incrcasethe strain on our internal
food you purchased aithe supermalkct, youre also
more beneficidl efaecls organs and there may be a build-up effecl jf$'.1e
t!aD others. probably buyins more than you Deed becaLtse they
consuming rnore tlian our body can handle lro c. ly,
Ma.robiotic foods t'+irin o, .:n.a'"1lhrnq Pnrtor'rlu.busi Pi
corporations are meetins consumers' deniand for
compdse of ldmented that makc you feeL Like it s morc value for,\ou. monev.
foods ihat are hjgh in Dutritional lalue which look
soy prodtrcts, sealveed Profi t-nrorivated food corpomtions encourage
.nd $trole srairs, liesh and wholcsone with prod cts that arc doctored
you to consurnc more ivithout realising it because thnt
prlses, tegetables, and rvith synthetic and sometines toxic substances
fruit that are lo.alll
.eally ncans more noDey for lhern! Packaging and ]

24 BR0A0tR PtRSPIOlV$ rfie /rc.rlrlt.dre dsre


RILAIIDI55U15

Even in lhe case of health supplemcnts aDd formulatcd to nntrcle diges(ile ard i rnunit! tn f00D

traditional Chnrcsc medi.ines, regLrlalion continu€s BUS NtSS& til]t(S


viuses. Diet foods give y(N a falsc scnsc of coDhol
ACRITLlITURI
to be a problem. lD the US, supplcmcnts ar. oler your lile even as you participrte ir each new
considered tbod, no! drLrgs, ard the p.oducers are rvave ofdiets that thc food iDdustn .reates.
M0DtRti Ift
mostly exempted fton tcstiDg aDd rcgulation unless
\URI IIl 5
consumers become se.iotrslJ ill
or the product Icoflc doD'tthink about what iloes into their mouths
ir
advcrtiscmcDts coDtain medical clains. L'he Slimro these days parl because therc's Do tirnc to thnrk
EEE EE
tragedy iD Sirgapore that killcd oDc aoDian and
caused lele!ision peftonaljtl ADdrea decruz to
or queslion, and lrlso becar6e th€y re come to accept
it as fart and parcel of city living. Ila)be it-s because trffiffi
trndcrgo a liycr transplani, resDlted in lhe tighte. we re so focused on tiie flrture and oD doiDg things -'"- = ltFffi
rcgulation ofsrch p.oducts that are arailablc $ithout $ith ever srcater speed and elliciency that the i{hole 8I]YIN(;NRI;AN
a ucsc ptio!. The Siinr r o pills came labelled as only coDcept of "sliN" has bccD tluowD outthcsindo$'. l]000 t{o0orior rh'{k5 our
containing nrtural ertracts but in actual fact The nuniber r,f last food rcstruraDts or coN€niexee uho ovBihe f omily {o,np!nie!
contained toxicchemicals that ilere not discovered siorcs offcing instant w]ripped potato, hotdogs, lhol mok' your hco rfy
r1--
in prcvious tests. Even noi{ the HealLh Scjence ni,hu"\vi$ ' :'r'df,rst,,rrn' 1rn'.rd ir in) snoorhieJ ! rd .r!.[ed vkor
Autlioirt' contirues to !Dcoler Chnr.sc iladitional island is just nrind bogslirg. wikipeclia prts the
healt| products like teas, medicinalpills aDdtoDrcs numbcr of 7 ll outlcts in SiDgapo.e at.+r9l When !d oi/tuorus/lll ll! (!oni(
ihat contain toxjc lcvcls ofarsenic or mercurr'' that food comes so easily, cluickly aDd nr such abundaDLc,
have Lo be .ecalled or banned in sinsaporc. Thc cosi you dont think aboul i{hat r''ou are eating and end
and impossibility of testinit everythjng thl:,roughly !p with liealth problcms and obcsi\ . I'n all for the
will meaDthatae connnnc$ havc to take personal idea ol slow lood '. lt s been a.ound sirce 1989, but
rcsponsibilitr in exercisi!g more caution especially rcally hasn't hii Sinitapore the way it s gained
for producis wc regularly consuIne. CompLacent .ecognition in Europe aDd Amcrica.
Singaporeans shor d do niore rcscarch, not sinrpl!
follow trcnds, go bt.' hea.say or expect the goveniment L. \s,Fr,.rr.r'd..".^n rn.r.iarisr r'r,l I Jrrre irs
to cover all grouDds. Labcls can lie. Tenns like "ifor..ldborrroF.,n'li* 1b\. 1-n,.'- p L.l,.1iur
''ruLritional supplenlent'- healtli supplemeDt", offoodlWe mustrctum to the land and takecontrol
"jmmunc sysicn booster" or "naLLrral hare to be of producing the food rrc eat. Without thc lsc of
vierved r{ith a hcalth! dosc of suspicion. dangerous lertilisers aDd chenicals, o.sanic lood
is morc flavouful, environnrentaily Iriendlt and
Rcrliy, pcoplc nccd to wake xr
and realise what herlthy. E en snull, urbaD Sirgaporchas ahistory
corporations a.e doins to us. Food is bis blrsin.ss of famrnrs wirh local prcduce like poultry, esgs, pork.
$'ithbillions ofdollarc nrvolved ind corNuners de vegetables and fruits. In 1988 thcrc \rcr. 2,o75
uflrl I lr1. 1-11 f l\.l,rgl'.y.\t^J""rl i,rrIrg licensed tarms occupynig 2,o37 hectares of laDd,
ol$ays to get rjch, rather than $'oq'ing tdr nuch {ith a total output ofsonre 55362 |rillio worth c,f
abotrt what s good for the pe.son consumiDgthe food fami produce. Just 2.J ycars on, Singaforeans have
atthe end of the productioD chanr. Too oftcn \c arc gotten snobbish, prcler.ing lood products fron other
bonrbarded with claims and even wlien rve tryto eat couDtrics and simflygiling in to nrstant and ready
right or eat beticr, \'c arc just btrynrg irto ne$' lbods that are tuss free and do noi rcquire assemblyl
mark€ting strategjes corporations have u€atcd. Takc Wc havc lost our identif* and sense olcontrc,l, fully
thc dict fads thathave become so hshionable and at tlie tnerc! of whatever thc othcr cornh ics $€nt to
such big business. From thc Blood TWe Diet to the -llL dnd h.'dr.'r.,o n,. r- Ji.-,4..,piJ-r ,r.
AtlijnJ Diet and the South Beach Diet, eatirg right and weat|€r pattems overseas.I lo. o e am proud
J.r. ,."r. '1. 1^l r,l',. ! n le.,,o,,er.".li.rB to be going back to the land aDd caNjng out ny oM
books, shnning progmmmcs and food products identit] and se|se of productivity through the literal
ilpqrp.Fd I ,I all. o' .h:r.a)ur.r$-iLlrt;i/. u
ASllt]TiHfV/R TIR
''live a balaDced lif.stylc '. You can buycon\€nience
,cst thd lrti.lc sio ld
foods like smckbars, frozeD entrees, salads, ccrcals, To nre, t|e c|oice is crvstal cLear. Sav no to
oJfcnd, Latrulnc is stilt
d nts and desserts tron ltalt iroods tine called the coryorationsl Say Ics to bctt.r food and fewer
.ltcpllt !ttat./1t to the
"South Beach LiriDg ' or buy Right For Your 1\?e- , feaNl(l coryaratitns Jnt o great
''Mone! Saring Pl]cks' of health suppleneDts
nunlbct of belaLed

25 ER0lDtR PIR5PICTIV|s ttu hcaLthLareiss1L


[0tAL vs. GL0BAL

Who Pays for Health?


A comparison ofthree h€althcare systems arcundthc lvorld b]'Elizabcth Kon

Nationalised Healthcare
TIIT RR]TISH NATIONAL H!;AI-TII SYSTEtrT (NHS)

he NHS offers univcNal, coniprehensn e


,nd fia'e herlth.are to all. Started in
1948, its rin was to otTcr ihe British
the freedom fron fear, sp€cificallythe
fieedom lrom thccosts ofillhealth. The
thinking afterthe rvlrr was that if BritaiD was going Protecl ou
. , .i "r,d -8,"
. n.n.L' tr.lltini
Irainins
ernpLor-ment, thaD it sliould also apply the same
principles (o guaranteeing their citizeDs the ights to ProtGct
health care, and thus usher ir a nrorc just society
bascd oD equity and thc rcdistribuljon ofwcalth.
lhis mcasure so removes thc siigm ofcha tlby hmilydo.tors and GPs l]rc not auilable on weekends
treating all its patieDts on thcbasis ofDeed. nol i|c even thoush thcir pry lias r,on. uf by !o% (43% of
:Lbiljty lo pay. cn.a money gncD to the NHS sincc 2oo2 has gone
nrto lisher pay) and the runber of doctorc and ruNes
The grumblings about this systen is that i{lile the Ialc arisen. Dentishf, orthodontic seniccs andlong
nodel $'as baclied by Doble rheto.ic, il is siatliDg to Lerm care xre Dol considcrcd part olthe publictrust
loot aDiiquated and inadcquate to the needs of groups and tcnd to b€ lerf costlv.
modem society. Tlie loudest complaiDts have to do
with ils bDrcaucratic inflexibiliq, and is i\,. Brilons Tliis n:itionaliscd slstem that employs oler I illjon
alrcady do pav \crr little fb. health carc than iD nosl siaff, stilL has Do integrated l l' s,v''stcm of paljenl
de'eloped natioDs. Free healthcarc cones funded rccor.ls. A proiect, costirs billio.s, to consolidate
fron certraL ta{ation aDd individuals only pay at Drost elcctroDic patje t recods will not corne onhne till
5% for the cost ol d rLrgs, onc of the lowesl Frccntages 20r4. Thc citicisn1 is thrtthrcsins pots ofrnoDclat
in lhe i{orld. But the securiq ofa govemnrent fundcd the svstern has soDe to lir,h er cnsts rather than bettcr
nroropoly is out$'eiglied byits unrcspotlsiveness to
patienLs nccds and its slowness in inDovatirg. Too
rr.ry1e, lie.t ll\ rl I'r.u," "a^d. lurup r''liors A lieavy handed go\trnnenLal sl stcm also means a
- 7oo-ooo at anyoDctime iD the quetrc. Health care lot ofbureaucracy and nicrcmanaging. Doctors aDd
is ratiinied on the urgcncy of clinicai needs, so ltrits nurscs sometines saoific. patient time becausc they
can vart wideiy ivithin rcsions. a.e busy satisi ing ew n:forDN and ta.gets irNtcad
of focusing oD qualitr care. Thc NHS cost cortrol
167 bjllion was speDt in 2()06 and !98 iD 2olr8 onc nechanism is considered mostl,''' scDsible even thoush
fiftli oltsdlain\ yearly erpenditurc, and an rnount there are still many medicines wit| proven efficacy
ABOU] IHI !'JR]TI R
bigger than most world econo ies dcspite record not alailable ihrough the NIIs. \Mrat docs Dot make
flrndiDg during thc fast decade, il still cannot neet sens. to chronically ill patients is not bciDS able io
dernand and tnr payers at. Dot getling thei. moDey's pay for these drugs and hcatmerts thenselvcs. U4leD
woth. CaDcer treatnrent is still poor, and hosDital the' do. thcv xre c.rnsidered a p.ivate patient and
intections have becorne lrightcniDgl,v freqren l, with hence unablc to retain their frec medical care stahts
hospiial wards amazingl! lessthan clern and steilc. in dle NHS.

26 BR0ADtR PtRSPtiTlvtS tic ft(ollr.or.r asr.


'1 he consensus js that B.itai s low Levei of private The doom and gloom aboutthc NHS inthc mcdia
spendirg on liealth nay have to chaDge, as thesc maybc.trrious; it is laudcd xbroad aftcr all.
altem{tives Noukl provide more resolrrces for thosc I'Icdia rcprcscntation of a bunsled D.ndemic of
with the greatest DeedaDdnrcrcase cfficicDcv. After epic prcl)oltio.s nraysirnplybe nedia lbdder.
all, nr mosi frcc markcisj consumers drive up E.\cepriors rill alwats make the ews but
s. idJ d ,d dri!. , n' p Ll '^r'ra,\i \ '\' il the lhirg to relnemberjs that ther" are
walleis. BuI slch choice is missing nr the Nl lS thoush prevaleDtjn all healtlicare svstens. The 't
thegovernmenl is lryirg toproDote niore choicebl Ditish nuv be tessinistic about tlicir
gjvirlg people the.iglit to choose hospitals iD flrture. politicians' abilitv io fus| t|rough rcal
]\nd finally hospitals will be mandated to publish rcfomr in thc NHS. Hoi{ever, thel should be
safeb .epor1s, success mtes ofofcmtioDs and otircr rcassured th.t the socialist begin.ings ol (hei.
qralit! indicaiors. Paii.nt suNcys \ill dctcmrin. ul) heallhcare sysLenr are conside.ed so sac.osanct
to 4% ofallocated budgets in tirtu e. that all Eritish political parties, p.esent an.l
tutlrrc, \rili al$als fightto rpholdthcrn. at

The Failure of Private Enterprise


THB UNII'ED SI'A'I'ES HLqITHCARE MODEL
WAIIH TH I
he Aneican healthcare system, ir qualill'ar dcficicDt and a causc ofconstant teeth
coDt.ast $'ith tlie Bitish natioDaliscd gnashiDg. Thc par.dox of the Ame can heallh sysienr
nrdcl, is goiDgthrough a i{orsc oisis. is the failLr.e oipri!ate corporations in providing
Its imfloding failure is so nell crmpetilion to brirB down pdces. Worse, thissystem
tublicis.d, it makes B tain s concems competes on zero sun levels to shift costs to tlie
seem almost miDiscule and €asilr resolved by coDstrner and to restict choice ud serrices.
.on.t rr: .on Nor o rl' i'
\.r-ri''' "r . ,i tl.. t-n
ivealthl nrtioDs iD the ilor'ld that docs noi offcr Bcst practices arc slori to sfrcad and innovrrior
universal health care, it has nicrcasnrs raDks ofihc highly rcsisted. None of t|is. ol corrse, adds any
uniDsurcd. 46 million AmcicaDs are.urrentiv value lo a sich patient iI] the slslem.
MIiHAILMOORfS
uninsurcd or cannot alTord health nrsurance. even
srrc (2004
durins a decade of overall economic growth ard 'lhe s]sieD s iDelTicienct is a large coDtribution to
..\, n A,np, i. i d.re ,J. r,-n, in; Jn ,, rnl r"
'
rs% of GDP on healthcare - already averasnrs $2
nuraw{I costs. Bloated bureaucracies and hugc
admiDjstlatiyc cxpcnscs to do $'it| paper fornrs, ffi
.fll r"r',\ 'r.r,l-\ 'p.-l ^d'rllnrl h..n,rig
decade. He thcarc costs arc siDg so much fastcr
than \.agcs and inflation ihat mcdical c.uses are
J l\ . r d lyl,i
".r -rtt.\ rlFrq r'r .o, rtr'., i"
'
claims, conrflicated bill par-ing stsLetns and high
Drarketing costs all clog up ihe svstemjs ability Lo
rLrn sea lesslr. A dive.s€ and !a.)irg nunber of
health care providers also laclt coo.dirrtiol rnd
H
P85'YI(AROllIIDTl][
i]Y0RrD(200/)
' ', tr'nr'l'.1lh . ,lr ,81.1.,, h-j l..Fn r: .F,,in; iDcrease the ftrgmertrtion of proce.lures. This.esults
eye ore iDdividu.rls vulnerabLe ard a{ra tocli&le loru wait tines for tests or rcpcatcd tcsting bccaNc
luticnt's gehefened to doctors unfarniliarrvill them.
It is a little i{onder t|an thal Ame.ican palients lead
ll i.r ".. , \.ft'll.J dt'l\J.'rrri,g theso.ld in lo r ing to nedic.rl sel|help bool$ and
with govemment support onl) ior Lhe elderlJ" and web posti gs to deal with their frustratioD rnd
the very poor. Actual delivery and execution oI dislrust ivith the svsteDr.
heallhcare is unde.taken by private insuers or
designe.t around private vohuitary iDsurancc. A hcalth sr-stcm that rclics so hcavily on i|. protit
Ironically, despite the usc ofp vatc cntcry sc to d veD .onrfrnies to provide whal is essenlially a
handle nost of jts proccsscs, acc.ss, cfficicncv and Dubli. good also increases the ineq!ality olaccess.

Z K0ADIR PtisPtolvts th. h. lth rr;\\rp


L0[{i- ri t]tuilii

R15IARI:Hil]I5:

4ltalllTYPt5 0t obaDra are debaiiDg reducing costs \trsus iDcrcasins


Suc| compaDicschasc{fterpeopLervhoilreadyha!e
-l-r
HTAI1BTARI SYSTIM5
LUU \p ar'r '.n ff^rdrbLr'rr?.'.,J-\'nlh,. .o\cmgc io no real conclusior.ls Lhe Anreien systcm
(A(mdins ro PEs.ors)
that node.n nredicin€ can pr.r'idc. Thclosers a.ethe Lhen iust doome.l to another erpersive and
pLL.. .., nL ci lr I 1 ,d r',n." hr I d s brli.i' s dishea.Lening stal.matc? Some poiDt to the llig|t of
rl]r BtvtfttDcI I{00tt
$'lio are repeatedl) denied a.c.ss and excluded Am€rican nredical rctugees" {s a Decessary cat.tlyst
bcca sc they onlt rdd to insurerj risk. This foint is tliat e,ill shock hospital ad.rinistmtoN and insurem
crnphasised in x1i.Iael Moo.€'s Sicko rere applicaDts into trying harder to fix a tr'oublcd systen. x{aybe
are ruthlcssly screcned and rejected on a long list of this will brnu the $.rwing polilicnl prcssurc for refoml
erclusions. Unfortunatcl!, tliis does not serv€ Lhe to a hcad as the prospect of losjnil .evenue to lDdia,
people who nrosl need insurancc. 'lhailand or singapore is .listasteful €nough toshakc
sclerotic Anrerican health-DaiDteDanc€ olganisaiions
46 millioD ,{mericars wiLhoutinsunncc also include o,.t ot rlFir'''"n"ild n-u.lr.? r,l 'u|.te lio,
tubo, hofq Korq, 6nor alarse poftionofthe middle class,Nho havc cnoush rnd transpnrercy. Or not. Wc can onlr woDder hoi!
8 oln, Nav bolond, Spoin io disqLlalit theDsetves fronr gove rment fund.d tlie richest cou Lry in the world clcr let itself get into
programm.s and yct not enough pe.s.rnal resources
TUt I5l\lr\Rt( M0DIt to ifiord comprehcnsiyc private insurarce. Such
lIeo rh{ ! re i5 ioiflly people are rore likel], than oth.r citizens fron the
developed e,orkl to dela) secting mcdical care
onl,v resrlts ir
nore erpensive nredical cises later
wlich Individual
oD. Because tliey clo not have access to r.gular
healthcarc aDd preventive se.vjces, this sitxaii^n
Responsibility
quiclJt becomcs oDc of life rnd death. SuNets cile
the lacl thatthos.sitho t insurrDce we.e 7c) % ntore
& Supply-Side
llelher ond5, Sv lzorlond
liltel)
three
tha
yea.s
lliose with irNurancc to die over the Dext
aller being diagnoscd with colorectal
Government
THI NATIi]NAI HTAITH
Intervention
INSUR,\ tIMODII This also cxacerbates rr al.eady conrpromiscd
slst.n $'hcre senices and treatrnenls are TIIE SINCA] 'ORE IIE;\I,TIICr\RE MODEL
henlrhcrm
Bism o rtk nodel. selected and fro\id.d on frofit.ibilit-v beDch markers. zAI np.'r.or .n.. I n.,'n..slenr:i.oniirLenLh
not n€ed. Services .r hcDcc capped or rest.i(ted and \\! -1', .dl,\,i ',:,,i ,,r1,\!,, d.o,Fo
fall $.eLl shorL .]1 recomnrcndcd carc.Itdoes not hel! n \ I ,F I,F.r ", h, \.n 'l srrj"pul hJ , o
through o nole ruf
that it is privrte manager's, not doctors or patierts l\/ ,,:,.,,,r r,edl h ,, ,rrlrc d!. \cr I
who liavc the final sa," ir makins rcfcrcnce, consiilered a g.eat success and a modcl for other
prescription and treatment decisions. Doctorc arc counhics to follo{. Though Singapore pats only oD.-
incenli\isedb how Duch costs tliel cut, nol on how 1l1l| to onc sclcDth of \tiat Americans pay elcn
$el1 or sLrcc.ssfully they t.eat their patients. nakinst|eEurcf.aDslookspendthdli and hasless
careBilers percapital. SiDgaporerns on mosl heallh
cilen how problematic this systcm is, $'hy have the indicators (liie evectaDcl', infant nortalitlrate, etc)
lutO1lT0tP0((rrtl0Dft AneicaDs Dot s$.jtched to a singlc talcr systeni are herlthier than mant dcveloped nrtioDs.
0ny40ofrheword'i200 \rhc.c a plblic agencJ or the Sovernnrent t.k.s charg.?
"1, gn\" i, ",
ll does not h.h that Arnericrns are s., suspicious of
",. rr,d iu.1o""^':r".r^-"
bjg governmcnt intrudiDg irlto their lives lhal suc| total hcalth costs - app.oximalel) 4% of GDP.
sohrtions bandicd onnd do not so verl fariMichael lndividuals and cmployers pal the rest. Unlike dre
Moore stu ts in socialist countrics oDlygoiDgso fa.. heary hnnd that sovcrDDrerts ilield in natioralised
healthcare systenrs. ihc SinsaDore Aovernnent has
It is a sign of how nnpr,rLarL t|is crisis is that aDy trken the patli of choice and comfetition over
nr.jor pohtician wantnig to bu rish his national cornmand and coDtrol. lntercslingly, as of 198.{ the
c.edentials nrFt ofler r herlth care plan to $'in the Singaporc healthca.e slsten followed thc British
elecLorat. ov$. Currently, Johr Mccain and Ba.a.k nodel closcly, i{ith nedical costs linanced through

?8 BrT)AlrlR PflSPt(iWtS tl 'h. lttunr. issrt


trxes and se N ices provided .lt anomiDalcharge. But thatiiis mostlv poorer ciL izens who Rap the beDefits
wjlh henlihcar€ costs escalatiDg, the govcmmcnt of sxch goverrr €nt subsjdies. These clieapcr
decidedto reforn the system into onc that srs more healthcare options also force pri\'{t. hcalthcar.
flexjble rDd sustajnablc for ihc long tcrnr. The provjders to be rnore conpetiti\c in their pricnrg. Thc
National Health Plan was coDcciled and the result is goyerDnient encourages snch coDUctiiivcncss bt
the 3M modcl of hcalthcare drat we see today. t hese cornpellilgihc pnblication ofdciail.d tdce lists so
relorms introduc.d in t|e r99osj have gone a Long d b gic consumcrs morc intbmration to nralte beLte.
r{al tr conlrolljng health c:r.e costs. dccisioDs s'hen ihe! go co rpirison shopphg. The
p. ornrances ol hospitals are also contiDuall)
Singa!o.e uses medicalsalinss accouDts Mcdisav.. bedch.,irked agrinst other internxtioDalhosfitals
N- : hi'l \l-Jitur'Ll-.^,'_1. I"rnr. ."r'.
.',,11 lo maintair hjgh standr s ofhealthcarc. Lifonution
the elemeDts of nldiridual rcsponsibility and Lechnologv is also to bc haDcsscd to b ng about
governnent s pport. Th.sc accounts are ta\ hee, , '.? f. r' , .:.' \ , 'ai
thcv .arn jDtcrcst and aretopped op withmardatorl Slstem$'ill coDsolid.tc.lectrcnic,nedical rec.,rds
dcductions fron lhe i djlnluals patcheqtre and across thc nhole svsled.
enrployer co tributions. Individuals caD takc out
mon€y to pay for approred categorics of mcdical '|\Fil. a inb 1., Lu , Lt l .. l'1 ,:'-. . ., r ,9
treatnents aDd procedures aDd cvcn for nrore iL,o|.inn.-l "luu
.'.1.'L,'l!. lr', l. s. a .19
expensire treatmeDts snch as chcrnotherapy or HIV the ivo.ld. SiDgaporeMcdicinc, a rnulti agency
dmgs. The accouDtsalso pr!\ide an nrsulancesafetl i tiative, xrs lauDchcd in 2oo3 totake adlanlage ol
Dct to strppoft lori income eamers aDd the poor. this oppotuity and to posiiio n Singapore as a leadhg
P.ople ar€ req!i.ed to sare to rneetthei. om medjcal ., 'rilI L',,C Lednt:onrlocrltl--!rdL\ -!- run.
e\Fnses in the tuture and Dot relv too hea\ily oD thc T|e besl Singapore liospitals already iral many
3o.4.r,rnan l'b':l l,-1 Lr InIiJ|,.,.-8 i.i . |ospilals in the developed $'orl.1 aDd athalfth. cost.
't h€) are also expe.ted to pay morc whcD tbci d.rnand A! such- the consistent quali\ and vakrc ofSnrgal)or.
-r\
r h rl - i [ .a r... \LJ\|. .'r,r p. F healthcare is crsily a dra$'for Dr.dic.l toDrists.
coDsumttion arc th.refore ke!L in check b) Silgaporc ainN to atimct 1 nillion nredical lourhls
dcmandins personal accountability. by2(l12,. group thal colld bewodh $TbiLljoD aloDe.

Such sivings i! costs fiees up the golcrDrncDt to c ,' a,r' ii.," !' r' i., b'.' li. -.lru, .. "r ,

spend tli€ noDey else$'here that focuscs on prc\cntile adranlages uni.tue to r snall nation statc. SiDgaforc
care prosunines (promotioD of hcalthr eaft rs habils, lns a srull aDd relatively vouns populatio!, politi..l
sports aDd heaith club subsidies to encou.age an stabilitl that cnablcd sncc.ssivc gov.rnnrflrls lo
activc lifc) or nnfroving erNironnert lactors like the intrcducc timcl! and suptofiinil
raFr ro, o'.o-JC:o,."i \-.','l l,-rrl', rnl hcalthcare regulalion, an(l heaithca.e irfrastNctLre

^lp^-l r(^,. c..pntidt, LU.ir.,rn L ,.er1 ri ^, ihat hrs close prorinrit) to one aDotlier. Part of
comes in Lhe lomi of supply-sicle policies that rcgulat. Singapore s srccess is also that grorvtli of thc
the nurnber ofhospjtal beds, doctors aDd the use of Singaporc's econon] has actralll outpaccd irlcrcascs
higli-cost technolo$ . Thcsc Drcasurcs guards aita insl in healtli care inflatioD. B t this slst.m is an iling .t
or€rlv-long hosfital sta)s,.are tlat Ias to be based a crossrcads as SingaDorc faccs t|e c|allenges ol
oD high volunre to be Drofltable, and ar over reliaDce contiDucd cost contanr merrl s'hjle haying Lo deal with
on e\l)ensive lec| olo$. rr', sr,Jr,rlpir\,rF,, ,., ot r. ; i,.pupll rur'
and increasinillr e\pensive Diedical tecliDology.
't he gole.nneDt .lso lieeps basic healthor. atrordable Sinilaporc needs to be e\eD nore frrseeins and Dnnblc
b) su bsmisins public hospitals (rdcccaps ar. fla.ed in order to balan(e the elenmts of govcrnmcDi
or all services and rroccdurcs).nd sover.nient suppoft, persoDal responsilility and frnat.
o tpatient clinics. Even this is not a lree lunch that
'e^,sr'\.ri'_i,.Jf',"F, ..r.',F-l ir;L
to bein oduced ir 2ooo 1o rnrke eveD norc suc

?9 BR0A0tR PtRlPtt]lvts theiedlti.drc i$uc


IUTTUREWAICH

cHRONrc FATTGUE SYNDR0ME (CFS) ATIENTToN DEHOT DIS0RDER (ADD)


Havc you cver felt loDs'd.awn physical or mental lve used tojust punish hi?eractivc childreD relio could
exhaustioD coupled with w espread pain and aches not sit still in class but now, persistcnt patterDs of
that restcould not cvcn relieve? First named in 1956, irnpulsivcDess atrd inattention can be diagnoscd as
nyalgic ercephalomlclitishas been unslnpatheticilly ADD or ADHD (Attention Deficit Hyperactility
dubbed r uppie ll u . Slffercrs have been accused of Disorder). Thoush there is a st.ong genetic and gender
simply n'aDting attention, being hypochondIiac or component to ADHD (it occurs twice as conmonly in
nalinserirs, rvhich is ro wonder, for it can bc fairly bu's Li n in g:r1.,. adu \ c-r' dr\r Lp .up n!
easy to fakc CFS syndromes to gel llnancial or neclurisms with nedication and couDselins. Sone
emotional bcDcfits. CFS sutrerers argue that sir| so cducators aDd parents though a.e hcsitant to label
nan, people belieliDs that they a.e f,l<ing their illness. inattcntile clildren so readiLy as ADD sulTerers for
they often leel bullied bymcdicat professionals as well fear ofharmnrg thejr self-esteem or giling thern an
.b u\rL ules sho Lr-\ill'se Jld 1 o.t 'l,e,r.unJiriur'. excuse for brcttish misbehaviour. Sone neurologjsts,
Not getting the sane amount ofsupport other sick ho ever, have blasted ADHD as a fraud perpet.ated
people gct unfortunately puts Cl.S sufterers ai|i8hcr b)' psychiatrists and pharmaceutical corporations to
risk for defrcssioD -]€t anotlier controversial illness milk anxjous parents of their noney. Thc church of
ABOUTTHI\vRITIR
whose sulTercrs arc mislabeled as not wanting to tnap Scicntolog) atrd its most prominent spokesnanTon
out ofit". It Cruise in farticular luve lashed out ailainst ADHD
medication Riialin and r\dderall as being no better
CILIiRRITY SUFFERERS/Lauren HillenbraDd, than street dnrgs. It
author of Scabiscuit"; olaf Bodden, soccer player
CELtrIIRI'IY SUFFERERS/Robin Williams, walt
Disney, John Lennon, Clier

SelfPorh dil COr']RICHT/ Sinion Pak nronas flirkr ctuative CorrDN

30 BR0A0tR PtRSPlOWS t'hp hrolt'hrtrt issut


OBSESSIVE (OMPULSIVE DISORDER Heroes&Villains
DocnDrentins onr fi(kle w)rld's cLeFclungnra prrrcptnnrs

.
" aDd pedectionistic, people rith thosc'
qurlitites mat not neccessarill snffcr fron OCD but
ocPD lobsessile-comfulsivc pcrsonality disord.r).
$rlut s.famtcs soDrconc idro is mcrcly iastidious il orn
{r ,r \q.l o, Dr,\Jtl .^\.,s.i^r .^r.^nprl..o-. GlaxoSmithl{ine
uv' l. ' r, . '\.'..\"r-ur'\e.n,at1,F u, IIl,lRO / Don't dismiss Big Phamayct forhaving no
' 'i,'- heart. ID JuDc this vcar, GlaxoSDrithKlinc ((;SK)
emotionally distlessinit and caose impaiDneDt in lis
r€lationships. OCD sufterers rnay obsess over certair 'n,.ur.,dtl., I,. \,,, IrrB \.i'l.r gFlo.'.
inapprcp.iate thoughts or compulsively repcat c.ftain frofilnrg dala llom slud)jr)g ca cercells lorfree to the
rcts like srvitchtug offlights at a c.rtain fixcd iimc. '''. ndl:on I rF. r' l, ' n'rn ,r.il. ll,i, 1..'"si\-
iiDiDg up all thcir cloihcs in tmfect position donation is of g.eat benefit to the b.illiaDt bui
and taking only a ccrtail .umber ofsteps to reach n underinnded encer .esea.cliers Nho do not havc acccss
destinition. Theseacts are us!ally aimed at p.eventing to the truckloads of eafcDsivc irfomratioD GSK has
some unrelaled d.eaded erellt tliat th€r believe \rill amasscd. qnics may scofi thai all Bis Phann. is doins
liappen iftheir self-imroscd Nlcs aE not folloi{ed.It is relyins on smaller companies and acndemics to dc)
pioneering $o.li betr,.e s$.oopi!g back oDto the sceDe
Clll-llllRI]I SUFItrRERS/ Cameron rliaz (cleannLg lo spjn offnew and profitable products thrt leverage
doorknobsl. Da\id Becha.r rs!nmetNl. LeoDa.do di upon their ilork. Still, jfthe outcome is tl t lons-ai{aited
Cap o (no steppirs on cracks h the pavemerts) cu.e for caDcer. should cSK Dot desenc soDc financial
retums for hclpiDs to bdns it about? ft

EAIING DISORDERS Pro-Ana Sites


So D ny fenule celebritieshalc com. out \iILL\IN / lhe lnte ret is a treantre
ofthe closet to admii thcj snffcrd from cit|cr t.ove of social leLworks rateriDg to
bllimia, aDorcxia or bngc .ating t|at cating erery i erest, Do rnatter liow nnDxlaDe
disorders |a!ebecome a stranse Dosimodero or srotesqle - aDd pro-ana (],ro
badite ofpride. lhough srereoLyped as a aDorcia) and pm mia 0ro buhnia)
youDgwhitegi.l s disease, ffere$ ma) lvebsites c€rtainlv Dake lle .ur.
conefron all ethnicr+oups, all ases - and Faccbook, llr'-'Spacc rnd Blogiter have bee
rnore ofthem are nale thar $'e thinkbccaus. uncerernoniously linled to groups exlolins eatiDs
bo)s fir1d it especially shamcflrl to confcss it. disordeN as n glamourous ljtesttle clioice.athe. thaD
It is nowoDdcrthc prcsshailcd UK'stbrnrer a lelhal disease. X{}s!ace grlup Pr! Nation's r,ooo
d.f!t] prnne minisler69 year old Joh ^m aDorcxics arc
odd Diembers .leclarc's that Do r.corcriDs
PrescoLl as b.nye when he coDfessecl to the allo$'ed to jonr bccausc it Nins our notivation .
BBCthat he had been bulinicforteD vears, Faccbook groups 'Yes, I lrale an eati.it disoder. No,
and nost chroricaliy du nshisrearsnrotricc. it\ notyour problern. and "Cet lhinordie triing'sLun
Snfferers lite Prtss.ott.l.,rl! s|.w tlrnr up besl the deliant. selfrighteous attitl es oftliis
sometim.s pcoplc rcsor-i io catins disorders cu.ious grou! of ertrerne dieters. X{enbe.s share
as a taistcd i{ay ofgainilg conlrol over thejr lives infornation oD ho$'to hjde tlieir habits fiom familr,
during tines ofgreatdistress ancl powerlessDess. tt conpete iI weight loss coDtcsts, swap i{ar storics of
closc shav.s nith dcat| .nd s.el solace in i.raites ol
Cl.lLl.lttRll Y SUl.lliRliRS/ Karcn Ca{enter, Paula slinn] gi s Io. thinspiratjo . Relentless self
]\bdul,linccss DiaDa, Calista Flockhcaf, Elton John destmction is noi{ no more thnr a lifestyle c|oice. (t

3l ER0ADtR PtRSPfUlVi5 il.lt.dldtcdrc dsur


RTBOOI YOUR MIND

The Future of Health


Going by t]le medical breakthroughs we have seen over the past 5 yea$, The future is not too

bleat for healthcare. witl tlle Internet and brealithroughs in material technolosr, tl1e future
of mankind (at least for those who can afford it) looks reasonably healtly. By Nadja Mah

NAN(}TE(HNOLOGY'S WONDERS
SMALL SIZE, RIG IMPACT / Surgery is
essentially about using tools to rip open the hunan
body and patch up prcblems - aD invasive, aen mrde
sohition that results in complications and a longer
healing process. However nanotechnologypronises
io reduce the size of surgical tools so radically that
suryerycatrbe done interDaliy, bypassing the need
io cut the body up unnecessarily. Scientists fron the
Universiiy of Texas and Rice University have
-,orrld1,
di..overedhowtolr-,1li'Fr .rr'r{ sI
ncigirbournrg tissue. In initial er?eriments, scientists
implanted carbon nanolnbes so minuscle ihat
7s,ooo of them lined side by side would be tbe width
"l J lurnar hr.r -,lir".rl) inro liv"r tumouh rr
l"bbiLs. The rabbits were then er?osed to radio waves
and the nanotubes pmduced heat, destroying the
ttrmotrr directly. A new Datlo sjzed endoscope will ARTIFICIAL ORGANS AND IMPLANTS
also allow doctors to discover even the smallest aDd WHERT] DOES MY HEART BEAT NOW?/ Its
most elusive tumours. By using light from a sinsle nam€ is a nouthftrl - the Chmniclc Implanrable
optical fibre through a probe about the width ofa FlaemodyDamic Mo. il or. But wliat it does is simple
human hair, the endoscope can navigate the most and life saving: it is a 2417 heart monitor inplanted
delicate areas of ihe human body like the middle ear in lo pdlienl whi.h .eids a mns.JSc M-ciFss y vi:
or ventricles in the brain, resultiDs in less tissue the IDternet to their dociors the moment ihcir heafts
dn,l damag" lron p\ce,.ivp ana.sll,.sia. get into irouble- With the Chronicie IHM, doctoN
"!matF @n monitor their patient's condition fron anlNhere
\anorF'l,nulo$ hJ"dl.opro'idFdaldndvso u io l via th€ world Wide web - heart rate, body
to health problens caused by contaminated water. tenperaiure, fluid lelels most significantly the
aDd

About r.7 million deaths take place in the world due diastolic and systolic pressures of the heart.
to poor waier hygiene- ScieDtists {ion the Unive ity
of South Australia have succcssfull)' used Anothe. major breathrough for lung transplaDt
DaDopaticles to exert an electrostalic atLract ion onto patients has been tlie iDvention of the BioLuDgby a
toxiDs. Once dirty water is flushed through a filter Michisan professor of surgery. The artificiai lung
with the nanopanicles, the toxins attach themselves works with a paiie 's heart to manage oxygen and
AEOUTTl]IWRTIR
ro h. pani.le zIdJtsl lrippFo:n IhFijhFr.leavng blood fow h"ouglo'r rlpbod).Sin'1 rhFLleri.F
behind clcan, potable wate. - and a significantly depends on tbe heaft rather than some neclianical
cheaper, less enersy consumins method of $'ater device to pump blood, patients do not have to be
puificatioD. rt hooked p to a machine in hospital and are frce to

32 BR0ADIR PIRSPIOIVIS t/ze ledlticdre rssue


lTHIRMID(AtAND
HIALTt]TARI ERIA(THR()LIGH\

PATIENT IO PATIENI SUPPORI GROUPS


Dl{. Pr{tItrNT! lr.D. / When cycn docloN chcck
,ft
wEtL "''-"-" -
Iiikipedia on thc sl) lo lin.l our Drore up to clatc
inlirnation aborn nredicinei von c.r. bet that t|.
lhe aveftg. taticDl \!ith an lDtcnot connectidr h.s
a,
SURl] tAIIOtUT1]N5
also becoDr. r l.rL liorc \.cll infonned abonr liis L; lR0r\1lllt 5tA
il, ",li.,,ur '{rr|g t,, , .ti., 1rr,,r,,. I'om humh e oobriels,
passji c d iagnosis or tack o l detaild .xfl. . ar ioDs. A!nr or rcreo(he6 hove
ThaDks 1o printouts tioDr n€$,sgrouts. nrrili,,il lists le!eloped SursiL!x, o rhtn
aDd a !lethom of nrtcr.ationai Drcdi.al $,ebsitcs poynsflhrhd mn be senry
oDline, prtjents arc b. . d ilg togctlrd l o l.rke char3c heoted ond smootlrel ike
of lheir own hcrllh and establishing their oi{n re iophone to perlrtyeolo
surporl g(tr'psj researdr projccls, lobbvnrs dd\rs. wolnd Thi5wil be mot uselu
latabascs, llood tnd tjs cbr.ks ancl regishies As n bro n ord n*w rrq*y
peoplc groi{ ore awrrc ol lrealtlicarc rcso!.cc! viere mive nilde5 olkn

onlir., t|ev are morc aggressivel! rcs.fuchirs 06e pojr surqery infod ms

altcnr.lne cures and di.gnoses to $'hat thei. doctds Mennwhie, New Zeuhfder

,"" P,u ,u,.d,.t, ..r 1.1.J "tJi !r ,r.. ftfrilll hove derivsd lfre hoy
lo. Dedical $rccess stoies wit| n contact list of
qrololnedko
.'ili, tr',.,',,t..ri.'.:.' ^,1- l., r. doctors rnd cu red prtients to nr i. e practical Nisdom
fidn suids.
se r

Theqe isonfbhedinsmdonri
u'he.e evcrt hc,daclre and ras|.o!ld be Lbol..nd tlut nrighl jLrsl get thcm rl ough rhejr da*csl d.t) s. sro.tug, moking I ideo forsiid
ereryeroticcur. li.rnr cnstd |crling to mrcmbiotj(
rgeiy,ornreri( rgnyord
diets - lcgitimxle. Ilost trtbrts Lhough, itcl lhnl CHECI( OTTI'
rnore good thr. i{ill b. b.urre lJ]' this t.lienr
bad ]\sl Dr' \{'eil. uuir.dru]t1.(rn
toTrticDl .royement Dr Weil of thc nn.)efsel) McdlineplLrs. uuLu.n/D r r ih.s aD/Dlc.llrti?ttrs ONIBTOl]DTYPI
popuiar sil€ lrleil.conr drcarrs ofsomcdrr seeils (rons! i ner La b, LU!ri o.consuilerlah..o 10 RUrrlHtMAtt
an o.llne heahngrcgjslJ\' $hercl)aii.nlsca!sc c| lverybody ovu rype 0bood
lr is ihe me b oorlrype rhor wo*s
of oll pmpie. Io rove rhe
OUTBREAl( WARNING SYSIEMS ptrsrio shortogc thor blood
bonks ko md min mi$ e$ol
EXTIaA l.rxlld\ REAI) ALLr$()Ul lt /Should
mlx ups, medl(ol omprry
th. n,r\l arian flu or nitah viNs ourbrealt hit. votr Zyme0!6i is wo'kif! oi
crn bet tlrrt thc IDro.eL ivill bc thc firsL ro br€lkth. le{hnolosy rhor wi I ionven ol
r1, ,,,..ir, .", ,.: t,...."f. b oodrypg ro 0 by remov ns rhe
li.ding trustworlhy irtbrnution n,nid thc vilru.l $gormole(ules o1didore
llotsam rDdj.ts.rn, Nr! bc a Irl'(l task. Noi{ rhrnl,s
to llealthll.f. !o! \!ill not ]r.ve to sjcvc rhrouglr
l \ '{r.l r, 5. i-,, i e i.,.-.,I stARtIS'SLJRGIRY
'111.r,
hox.sick lhe BndgcliD. s childreD u. to ger ro tlie W]TH IVIl]NITs
most cJ\,cirl facts. H.aLtl$lap sip|ons tert fionr ln ?008, oarsmf rcmoyed o

Google News, thc World llealth OrgnnjsrtioD aDd poliert kidney throush llie

other onliDe discnssioi, grotrps, thcn lllte.s it do$D lely bu|or, eviry o neory
suppoltcd herlthcare slstcms have lundic.pped
nsbh sro.Ihis remokob e
nrlo Nalpcd data lhaL uublichcrlrh \aorlters, mcdicat discasc .ontrol efforts. (loojlle.org Irs granred
firnrlirrk rd p'o@d!re w6
researchers aDd tIe public can nsr to Lrrckthc lat.sr Ilcrlthllip S,l5o.ooo to heb its cfforrs since its
outbrcrks. r.gjo!
on/y po$lble rhrouqh AGS !
b! r.gion. Brsed oD fn|liclv rynem of moqners p ored
xlailallc ne$s sourccs aDd lo$.op.ratnrg (osts,
o!rrlde obdomen rlror
I lcrlthll.rp .enuils a 1i c. se n ice that will be .rl nxrst cHricK oul' \lorked
'lre
loseih {irh orhcr
nntofrnre to thc d.y.lot)ing i{orld $,bere poortl He{lthmrt. uLr!.l,edliiD&p.or.i mogmt droded rorinysrgi(l

t_ roo twirhii rhe obdomfl ihelf

33 8R0ADR PtR5PttTlVtS t/r. /r1////r(dr. r$r.


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:
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t=.:\ a

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gle::;
z

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1= +!

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2a;7 ,,!

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