BAREFOOT & PREGNANT
Regarding Ayelish McGarvey's July 18/25 "Plan B for Plan B": There is precedent for the FDA switching a prescription drug to an over-the-counter one but with age, and even location, restrictions. In the mid-1990s, it approved Nicorette and NicoDerm smoking-cessation products for use without a prescription only for smokers over 18. (Presumably, if you were 18 or under you still needed a doctor's prescription.) In addition, the FDA said the products could be sold only in retail locations where there was a pharmacist--therefore not in convenience stores, the number-one outlet for cigarettes. Certainly reinforces the political aspect of a "scientific" decision.
Skidaway Island, Ga.
Congratulations on facilitating the resignation of David Hager from the advisory panel of the FDA. This evangelical physician has done harm to the cause of women's health, as pointed out in your May 30 and July 18/25 issues. The American College of Ob/Gyns and other groups tried, but you got it done!
STEVE GORDON, MD
THE PANDEMIC LOOMS
Stony Brook, NY
Mike Davis's July 18/25 "Avian Flu: A State of Unreadiness" rightly focuses attention on the emerging danger of an avian flu pandemic. One challenge that he could have emphasized more, however, is the difficulty that scientists have in monitoring flu dynamics within Southeast Asia because of the manner in which samples are analyzed. The international research community has emphasized the processing and analysis of samples at labs in Europe, Japan and the United States, rather than within the countries most affected by avian flu. Little effort has been made to develop scientific capacity within these countries, with the result that analyses are delayed and questions can arise because of contamination and confusion during international shipping.
As Jeremy Farrar, director of the Wellcome Trust Clinical Research Unit at the Hospital for Tropical Diseases in Ho Chi Minh City, says in a recent issue of the journal Nature, "The international community continues to suggest that countries ship samples out somewhere else, while doing absolutely nothing to invest in enhancing the scientific capacity of the Vietnamese to respond to the epidemics themselves." Such investment is essential both for more accurate analyses and more rapid responses. The US and international health communities should press for more support to develop capacity in these countries. A key in addressing infectious disease threats is rapid response to the correct problem in the right location. Improved scientific and medical capacity within the countries most affected will help give us that key.
Professor, ecology and evolution, SUNY
Mike Davis characterizes the work of Trust for America's Health (TFAH) as "glibly" perpetuating a "bioterrorism myth." While we laud Davis for his attempt to capture the seriousness of the threat of a pandemic flu outbreak, we take issue with his glibness in pitting aspects of infectious disease prevention against one another.
We believe he missed two major points in our recent report on public-health emergency preparedness. First, we provided data that demonstrated that post-9/11 federal bioterrorism preparedness funds have resulted in some significant improvements in the public-health system's abilities to respond to both bio-threats and more traditional health concerns. The country still has a long way to go toward being fully prepared, but we have made some important first steps.
Second, TFAH has consistently recommended viewing bioterrorism preparedness in the context of an "all hazards" approach to improving readiness for any potential public-health emergency. In fact, we have highlighted the threat posed by a potential pandemic flu outbreak as an example of the need to "focus on the fundamentals."
We don't know whether the next major US health emergency will be instigated by Mother Nature or by a bioterrorist. We do know that we will all be better off if we make improving overall public-health preparedness a national priority.
MICHAEL EARLS and LAURA SEGAL
Trust for America's Health
Dr. Lerdau's point is all-important: Vietnam is currently the front line in the battle against avian influenza, but containment efforts are faltering because of the refusal of rich countries to provide relatively trivial amounts of financial assistance to Hanoi. Earls and Segal, for their part, correctly stress TFAH's admirable efforts to alert Congress and the public to the dire condition of our public-health system. Indeed, Nation readers will want to consult the Trust's recent sobering report on the continuing lack of preparedness to deal with an avian flu pandemic (see "A Killer Flu" at www.healthyamericans.org). But I stand by my charge that TFAH has been both glib and opportunistic in endorsing the Bush Administration's self-serving contention that we live in "The Age of Bioterrorism"--the subtitle of one of TFAH's reports. Public-health priorities are not served by hitchhiking a ride with Washington's spurious "war on terror."
JEFFERSON'S LEGACY ON RACE
New York City
Daniel Lazare's review of Christopher Hitchens's Thomas Jefferson: Author of America ["The Heritage Foundation," June 13] refers to the third President as having passed on his "conservatism, his agrarianism and his racism" to the nation as a whole, as if Jefferson were primarily responsible for America's adherence to white supremacy. Whatever one can say about the first two traits, it is just wrong to describe Jefferson as having passed on something that was endemic in American society before he was even a gleam in his father's eye. There was no passing to be done. It was always there. In fact, Jefferson lived what his society bequeathed to him; and he, like the overwhelming majority of his cohort in the North and South, was unable (unwilling) to totally rise above that bequest.
It is highly probable that over the years the vast majority of Americans have known Jefferson through the language of the Declaration of Independence, not his far less widely circulated views on race, which have occupied scholars since the last half of the twentieth century. Indeed it was, in part, the language about the equal humanity of mankind that made Jefferson, rightly or wrongly, a suspect character during his life, and an ambiguous figure in areas of the South outside his native Virginia many years after his death.
Ironically, whatever Jefferson felt privately, his more well-known words--and the promise contained in the Declaration--have been used by blacks as effectively as any other piece of writing in American history. Though probably not intended, the recent trend toward presenting Jefferson's racism as if it were some anomaly in American public life totally misapprehends the pervasiveness of white supremacy in this country and lets far too many people off the hook. No one person brought that into being, and no one person could have ended it.
New York City
Annette Gordon-Reed makes the elementary error of confusing a geographic region with a political entity. "America" is one thing, the "United States," which is to say the republic that came into being in 1775-89, quite another. While the first suffered from no shortage of racism, it did not necessarily follow that the second would grow more racist over time or that it would eventually emerge as the most powerful slave republic since ancient Rome.
This, to a considerable extent, was Jefferson's doing. More than anyone else, he helped structure the new Republic as a herrenvolk democracy in which freedom would accrue only to those with white skin. The effect was to encourage citizens to assert themselves democratically by asserting their whiteness, which is why periods of radical ferment like the Jacksonian era were also periods of rising racism. Jefferson was the chief architect of this topsy-turvy system.
So, yes, I think we can fairly say that he "passed on" his racism to the nation as a whole, provided that "nation" is understood in the political sense rather than the merely cultural or geographic.
OPRAH, SPARE OUR LILY-WHITE SKIN!
Re J.M. Tyree's essay about Oprah Winfrey's Book Club embarking on "A Summer of Faulkner" ["As I Lay Reading," Aug. 1/8]: Faulkner is dangerous beach reading. One summer, while attentively rapt in the vortex that is Absalom, Absalom!, I neglected to move my body in the hot Cape Cod sun. Upon returning to the cottage, I discovered that I was sunburned down half of my face, chest and lower body. Read Faulkner by all means, but use sunscreen--and turn from time to time.
RICHARD G. SOSSEL
OOGUM BOOGUM BOOBOO
I'd like to offer a correction to Susan Straight's excellent essay "Even" [Aug. 15/22]. Toward the end of the piece Straight mentions three soul songs from the late 1960s-early '70s. "The Oogum Boogum Song" was recorded by Brenton Wood, not Brook Benton. Benton, while soulful, would not have attempted anything so funky. Also, readers may be interested to know that "Thin Line Between Love & Hate" was by The Persuaders and "Only the Strong Survive" by Jerry Butler.
AND ANOTHER BOOBOO...
In Eric Alterman's August 15/22 "The Liberal Media" column, it should have said that Slate editor Jacob Weisberg complained that James Wolcott's book (not Graydon Carter's) offered a "free pass" to liberal commentators.