In richer countries where high life expectancy has come to be associated (only partly correctly) with high-tech medical diagnoses and treatments, it is easy to forget that we have arrived at this stage of health only by controlling communicable diseases. I thought of this when reading the story about the American Society for Microbiology's latest survey of hand washing in public lavatories. Most, but not all Americans, appear to wash with soap and water after going to the bathroom, but those who don't are the ones putting the rest of us at risk of spreading whatever infection they may have. This is all based on our knowledge of the germ theory which, like vaccinations, is a product of 19th century European science. A recent report from China revealed public resistance to childhood measles vaccination campaigns because parents were worried that the preventive treatment would be more deadly than the disease. Yet, it was simple things like vaccinations that allowed the "barefoot doctor" program to raise life expectancy in China even at a time when levels of living in that country were very low. Into that discussion has to come trust in the government regulation of drugs and treatments. The person in the United States who has been credited with establishing the credibility of the US Food and Drug Administration is Dr. Frances Oldham Kelsey, now 96, who is being honored for her pioneering regulatory work by her former agency.
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