staying alive

In the madness of the UK's Covid response, public health expert Devi Sridhar was a lone voice of reason. Remembering this, I was keen to read her book about the wider application of her thinking to population scale life and death from all causes and found it quite enlightening. Most importantly, she demonstrates how dramatically the political decisions affecting public health differ between countries and how that leads to very different results in avoidable deaths from causes ranging from guns to cars.

How Not to Die (too soon): The Lies We’ve Been Sold and the Policies That Can Save Us
Devi Sridhar
Penguin Viking 2025

My review of the book is now out in the April issue of Chemistry & Industry:

Health accountability

Chemistry & Industry Volume 90, Issue 4, April 2026, Page 34

access via:

Wiley Online Library (paywalled PDF of the whole review section)

SCI (premium content, ie members only)

In the same issue I also have a feature about plant microbiomes. I've covered the field a couple of times in Current Biology (most recently in 2022), but this one is slightly different in emphasis as C&I wanted more about the application side of it than I have previously covered.

Plant probiotics

Chemistry & Industry Volume 90, Issue 4, April 2026, Pages 22-25

access via:

Wiley Online Library (preview of the first page and link to paywalled PDF)

SCI (premium content, ie members only)

moving backwards and breaking things

I've been trying to distil the events unfolding in the US since January 20 into a reasonable narrative that remains valid during the 2.5 week production period and beyond, so I focused on the public health implications of dismantling both international cooperation and federal agencies meant to protect people. Whereas there is no telling which changes will remain and which ones won't, one thing is for sure that many people will suffer and die as a result of certain oligarchs moving backwards and breaking things, and the climate catastrophe will accelerate further, which, again, will cause more suffering and death among humans and wildlife alike.

In retrospect, why didn't the assaults on global public health and on the survival of a habitable biosphere in the early weeks of the Deatheaters takeover get a similarly energetic response from Europe to what we're now witnessing in the context of Ukraine policy? I happen to think that on a dead planet, there won't be a free Ukraine either, so protecting the planet should have been be a bit more important.

Anyhow, my trumpocalypse 2 feature is out now:

Rolling back public health

Current Biology Volume 35, Issue 5, 10 March 2025, Pages R159-R161

FREE access to full text and PDF download

See also my Mastodon thread where I highlighted all CB features of 2025.

The thread for 2024 is here .

Healthcare for women is particularly threatened after the US administration announced the departure from the WHO. The photo shows a Shakila midwife listening to the heartbeat of a pregnant woman at the mobile clinic organised by the WHO at the Garm Abak of Waras district in Bamiyan, Afghanistan. (Photo: © World Health Organization/Rada Akbar, 2015.)

the right diet for me

review of:

The wine diet
Roger Corder
Sphere, 2007

I may be a bit biased, as I am very partial for a glass of Côtes du Rhone and a bit of dark (>70%) chocolate, so any book that tells me these two are good for me already has one bonus point. On the other hand, I’m not much of a foodie and wouldn’t normally dream of buying a book that has “diet” in the title, so I guess that cancels out.

My lifestyle choices and agreement with the author’s opinion apart, this is an interesting blend of popular science writing and nutrition advice including recipes, all informed by the author’s own research into the effects that one group of chemicals found in red wine and fruit has on the lining of our blood vessels and hence on the health of our heart and circulation.

The short message is that oligomeric procyanidins (and not the more widely known resveratrol) are the likely cause of the “French” paradox, namely the unusually long life expectancy of people in Southern France and other places where a Mediterranean lifestyle is cultivated (Sardinia is the place to be, apparently, if you want to live to 100!). These polyphenols are present in certain red wines (especially in those produced following more traditional procedures), as well as in fruit and berries including cranberries, pomegranate, and raspberries. As these molecules have an adstringent effect as well, modern food processing methods tend to do what they can to remove or destroy them.

The author is very eloquent at explaining what - according to recent research from his lab and others - is good for us, and manages to debunk some “voodoo science” along the way, including the excessive cult of antioxidants. Very interesting read – obviously even more satisfactory if you happen to like the kind of food he recommends.

Weber Test

I found out about this brilliant diagnostic test, which one can actually do at home, while waiting for an appointment to get my ear sorted out, which is a bit blocked up right now. If you have hearing loss on one ear, strike a tuning fork and hold it against your skull along the symmetry line (actually, I put it between my front teeth, as I do when I use it for tuning), to make sure it is at equal distance from both ears.

If your hearing problem is due to sound conductance within the ear channel (as mine is), you will hear the vibration of the tuning fork louder in the affected ear than in the healthy one, so the sound seems to be coming from the affected side. Which is a bit surprising when you have spent days not hearing anything on that side.

If, by contrast there is a problem with the actual sensory mechanism (or further downstream), the affected ear will be dimmed as in all other hearing, so the sound seems to be coming from the healthy side.

Works really well, and it is kind of reassuring when you get the right result.



More about the Weber Test in Wikipedia

"opportunities to learn from Cuba"

[deutsche Version]

The US trade embargo against Cuba is turning 50 this year, and one should hope that after half a century of watching this policy fail to achieve its goals, even the most blockheaded lobbyists should start to scratch their heads and have a good re-think. But then again, one should have hoped that, too, after a whole century of catastrophic failure in the “war on drugs.”

Anyhow, very subtle signals seem to indicate that the US are slowly but surely beginning to move on this issue. Among the signals is the recent publication of a “Policy Forum” piece by Paul Drain and Michele Barry in Science magazine (vol 328, p 572, 30.4.2010), analysing the effect of the embargo on public health in Cuba and the reasons why Cuba’s health system has been spectacularly successful in spite of it.

One particularly insidious part of the story, I learned from the Science piece, is the “Torricelli Bill” of 1992, which suppressed the export of medical supplies to Cuba and did have a measurable impact on public health in the country. (I really can’t get my head round this – the lobbyists in Miami must have been twisting lots of people’s arms to ensure that their relatives back home don’t get medical supplies when they need them. Does anybody understand this?) Apart from the blip following that law, however, life expectancy in Cuba has risen steeply in the 50 years since the embargo began, and has drawn equal with the US, even though health spending in Cuba is by orders of magnitude less than in the US. It is tempting to cast a cynical eye at the data and conclude that the Torricelli Bill was a desperate attempt to stop Cuba from overtaking the US on health indicators such as life expectancy, and as such it has, just about, worked.

But how could Cuba achieve what has been described as “developed world outcomes at developing world prices”? The article highlights the Cuban emphasis on disease prevention and primary health care. Educating people about health risks is relatively cheap. Letting them run the risk and then trying to cure the diseases with pharmaceuticals, as done in the US, is much more expensive. In terms of access to primary medical care, Cuba has a very large number of physicians per capita, and even in remote rural areas, access to medical care isn’t much of a problem. And, unlike the UK’s NHS, they do believe in checkups. Every Cuban citizen, I learned, is expected to see a physician at least once a year.

Disease prevention also depends on vaccination programs, which in turn depend on the manufacturing and indeed invention of affordable vaccines. When I visited Cuba in 2004, I was fortunate to catch the story of the new, affordable HiB vaccine developed at Havana just before this advance was published in Science. This was an outstanding success, but more generally, the biomedical research institutes in Havana are widely recognised for their world-class research, which directly leads to effective and affordable vaccinations for the Cuban people.

Sensationally for a publication that is kind of a flag carrier for US science, the article concludes that in the wake of the US healthcare reform “there may be opportunities to learn from Cuba valuable lessons about developing a truly universal health care system that emphasizes primary care. Adopting some of Cuba’s successful health-care policies may be the best first step toward normalizing relations.”

Call me crazy, but I am feeling cautiously optimistic that the embargo madness won’t last for another 50 years.

Reference:
Paul K. Drain and Michele Barry
Global Health:
Fifty Years of U.S. Embargo: Cuba's Health Outcomes and Lessons
Science 30 April 2010:
Vol. 328. no. 5978, pp. 572 - 573
DOI: 10.1126/science.1189680
summary and access to PDF file (PDF access may be restricted, not sure)

blind as a bat ?

Thanks to a tweet from Peter (@PD_Smith) I was reminded of the issue of echolocation in blind humans, which appears to be so unknown in the UK that the BBC ran a news story on a child using the technique.

Goes to show that we live on an island – elsewhere it is quite common for blind people to tap their sticks very loudly and use the echo for orientation. I lived in Marburg for two years, where Germany’s national school for blind people is located, and the first thing to learn when you move to that city is to jump into the next ditch when you hear loud tapping sounds approaching. Well I’m only exaggerating slightly. Truth is, many blind people there walk around so fast and confidently that they are almost a danger to others.

I had considered this the normal state of affairs until a few years ago I came across the issue again when editing entries for a UK based encyclopaedia, where the entries for echolocation and blindness seemed to lack this piece of information. Doing a bit of research I found a text by Jim Blackshear, apparently written as teaching material. Apart from various interesting bits of history (apparently human echolocation was first observed by Diderot in 1749, so well done to the BBC for trying to sell it as news!), the text also contained the crucial information as to why the technique is unknown in some countries and common in others. Apparently, many people, especially when they are blind from an early age, develop the technique naturally, but in some places it is actively discouraged by education professionals.

Blackshear cites Robert Feinstein who writes in Bent Voices:

Sadly, echolocation is not talked about, nor is it taught. It's only learned intuitively or by example. I read about it only once, in a book called Follow My Leader, which claimed that an eleven-year-old boy, blinded by a firecracker explosion, had developed the skill. From all that I can tell, however, those blinded later in life almost never learn how to do it. I know a girl, blind at fourteen, who will walk smack into a wall, even though she has been blind for twenty-eight years. Once she walked straight into the closed door of my lobby. "Didn't you hear that door?" I asked incredulously. "Don't be a retard!" she countered, "you don't hear doors!" "I do!" I said, in my most condescending voice. "Yeah, right!" she said, and I supposed you hear traffic lights!" "I hate you damn sighted blind people!" I remonstrated, and changed the subject before we got into a fight.

As we grow older and learn to use canes or dogs we grow to rely less on the information gained from echolocation. The skill is there, but it can go dormant. Mobility instructors discourage echolocation, especially clicking. While training with my first dog, I forgot myself and clicked to determine if I was near a pole. The instructor told me that my dog would be taken from me if I continued to make "those sounds," that they served no purpose, that they made blind people objects of ridicule. And furthermore, I'd confuse the dog. I stopped clicking—until I returned home!

Now that really drove me up the wall when I read that he was discouraged from clicking. If you have the choice between not perceiving your environment at all, and perceiving it through echolocation while looking a bit silly, I think it is perfectly obvious what everybody would and should do. Discouraging people from using echolocation is to me like robbing them of their eyesight all over again.

health checks

A few months ago, when I came to realise (belatedly) that I had arrived at the wrong side of 40, I asked our family doctor (whom I've troubled only once before in 15 years) whether there were any health checks on offer for people of 40+. Maybe she could check whether my heart was still beating and the blood vessels weren't clogging up and things like that, I suggested.

She looked at me as though I had just landed from a different planet, so by way of explanation I offered that these checks are quite common in countries like Germany and France (where, as I have learned, a lot more people live to 100 than here). She then explained to me that British doctors don't believe in this kind of thing, and if I wanted to spend money on it, I could do a full check-up at the private clinic next door for 500 pounds.

So I was more than a bit chuffed to read in yesterday's paper that the government is introducing free health checks for all people over 40, once every 5 years. This must be the first time in years (since the downgrading of cannabis?) that HM government said something that I actually approved of.

What I still don't understand is that the medical association protested against the move. As a biochemist I believe in testing and measuring things, and even more so if it can help to avert disease and death. Why the medics prefer to let people get a heart attack first before they are willing to deal with them is absolutely beyond me.

Why Cubans live longer

There is a detailed investigation of why the results obtained by the Cuban health system (e.g. in terms of life expectancy, or cancer survival rates) are better than in the US and at least as good as in the UK.

First world results on a third world budget


Prevention seems to be a key issue. I haven't been really ill in the last 10 years or so, but recently visited our family doctor to suggest she might want to check whether my old heart's still beating. Over in Germany, at my ripe old age, I would be bullied into taking part in regular cancer screening. But here, nothing. The doctor looked at me as though I'd landed from another planet. Next door was a private clinic, offering a general health check for 500 pounds, she suggested, while measuring my blood pressure.

The way things are going here, I reckon Cuba will overtake us, too. Recently, the UK came out in the bottom third of a European league table of cancer survival rates, surrounded by countries from the former Soviet union or Yugoslavia.