Skip to content

Uncategorized

A fatal irony: Why the “circumcision solution” to the AIDS epidemic in Africa may increase transmission of HIV

By Brian D. Earp 

* Note: this article has been re-posted at various other sites, sometimes with minor edits. This is the original and should be referred to in case of any discrepancies.

 

A fatal irony: Why the “circumcision solution” to the AIDS epidemic in Africa may increase transmission of HIV

1. Experimental doubts 

A handful of circumcision advocates have recently begun haranguing the global health community to adopt widespread foreskin-removal as a way to fight AIDS. Their recommendations follow the publication of three [1] randomized controlled trials (RCTs) conducted in Africa between 2005 and 2007.

These studies have generated a lot of media attention. In part this is because they claim to show that circumcision reduces HIV transmission by about 60%, a figure that (interpreted out of context) is ripe for misunderstanding, as we’ll see. Nevertheless, as one editorial [2] concluded: “The proven efficacy of MC [male circumcision] and its high cost-effectiveness in the face of a persistent heterosexual HIV epidemic argues overwhelmingly for its immediate and rapid adoption.”

Well, hold your horses. The “randomized controlled trials” upon which these recommendations are based are not without their flaws. Their data have been harnessed to support public health recommendations on a massive scale whose implementation, it has been argued, may have the opposite of the claimed effect, with fatal consequences. As Gregory Boyle and George Hill explain in their extensive analysis of the RCTs:

Read More »A fatal irony: Why the “circumcision solution” to the AIDS epidemic in Africa may increase transmission of HIV

European versus US attitudes to geoengineering

Casual observation suggests that among scientists researching geoengineering technologies there is a marked difference in attitude between Americans and continental Europeans. The United Sates is the home of the idea of the technofix, so American researchers tend to have more faith in the possibilities for technological intervention to control the global climate. There is a… Read More »European versus US attitudes to geoengineering

Crisis in the Catholic Church

Professor Tony Coady is Professorial Fellow in Applied Philosophy and Vice Chancellor’s Fellow at Melbourne University. He is currently visiting the University of Oxford as Leverhulme Visiting Professor at the Oxford Uehiro Centre for Applied Ethics. He is a Catholic.

In the early years of Queen Victoria’s reign, the famous Protestant historian Thomas Macaulay wrote admiringly of the Church of Rome and the Papacy commending their ancient lineage and current vitality. He saw no signs of decline and speculated that the Church “may still exist in undiminished vigour when some traveller from New Zealand shall, in the midst of a vast solitude, take his stand on a broken arch of London Bridge to sketch the ruins of St. Paul’s.” 

Today, Macauley’s assessment seems unduly optimistic. Scandals about clerical sexual abuse of children and the associated official evasion of responsibility as well as inflexible attitudes to so many of the values and dilemmas of the contemporary world have combined to undermine to a large extent the confident self-image and apparent cohesion that helped sustain the durability and vigour that enchanted Macaulay. Following a series of alarming revelations about the extent of clerical sex abuse in Ireland and the gross inadequacy of the hierarchy’s responses to it, coupled with the Irish Prime Ministers strong denunciation of the official Church’s record on the matter, the recent BBC program “The Shame of the Catholic Church” (broadcast 2/5/12) added further fuel to the blaze. Although the broadcast was primarily concerned with the abuse and evasion of church authority it also indicated the depth of the wider crisis in the Church.

 Read More »Crisis in the Catholic Church

How to be a High Impact Philosopher

Philosophy is often impractical. That’s an understatement. It might therefore be surprising to think of a career as a philosopher as a potentially high impact ethical career – the sort of career that enables one to do a huge amount of good in the world. But I don’t think that philosophy’s impracticality is in the nature of the subject-matter. In fact, I think that research within certain areas of philosophy is among some of the most important and practical research that one can do. This shouldn’t be surprising when one considers that philosophy is the only subject that addresses directly the fundamental practical question: what ought I to do?

In this post I’ll focus in on normative ethics, practical ethics, and decision theory. Within these areas, I’m going to give a recipe for choosing research topics, if one wants to maximise the practical importance of one’s work as a philosopher. Here it goes:

Read More »How to be a High Impact Philosopher

The price of uncertainty: geoengineering climate change through stratospheric sulfate

With thanks to Clive Hamilton for his talk. Stratospheric sulfate seems to be one of the most promising geoengineering methods to combat climate change. It involves the injection of  hydrogen sulfide (H2S), sulfur dioxide (SO2) or other sulfates, into the stratosphere. Similar to what happens after major volcanic eruptions, this would reflect off part of the sun’s energy and cool… Read More »The price of uncertainty: geoengineering climate change through stratospheric sulfate

How will the future change your politics?

Your politics are determined by your values, your opinions about the facts of the world, and, let’s be honest, just a little bit of tribalism. But the future is approaching, as it often does, and great transformations may be in the cards. Transformations that could dramatically affect the facts of the world. So whatever your values are, there is a chance that you may soon be arguing for the opposite of your usual policies. For instance, what if the future were necessarily…

Communist: one of the easiest ones to conceive of. Here it turns out that as barriers to trade are removed and transaction costs go to zero, the natural state of the economy is one of perpetual crashes. Celebrity and fame feed upon themselves: everyone demands the best, and the definition of the best is shared widely: niche markets don’t exist. Incomes follow such a sharp power law that only a few percent of the population have any wealth at all. Automation means that most people can’t earn enough to sustain themselves: their income drops below the costs of keeping them alive. Hence a large, bloated, over-regulating government becomes a matter of survival.

Ultra-capitalist: as barriers to trade are removed and transaction costs go to zero, the whole market segments into small niches. Everyone can find some buyer for their work, as new demands and new suppliers spring up immediately, connected by new technologies. Technology solves known externalities (like global warming), so there is little need for a centralised controlling authority. Change happens so rapidly that any governmental intervention is counterproductive: by the time the change is implemented, the benefits and costs the government was trying to influence are things of the past. The efficient market, the only thing fast enough to keep up with itself, flows like a river around any blundering governmental efforts, rendering them moot.

Read More »How will the future change your politics?

Why I study geoengineering

I guess I should say, firstly, that I don’t.  Or at least, not directly.  I am a research fellow looking at the ethics and governance issues: the moral and political implications of geoengineering research and eventual deployment, should there be any.  I have a long-standing interest in global justice and climate change.  Climate change raises enough moral and political questions and I never thought any subject could be more complex until I heard about geoengineering.  Information about geoengineering can be found on the Oxford Geoengineering Programme’s new website:  http://www.geoengineering.ox.ac.uk/   Read More »Why I study geoengineering

A Teeny-Weeny Baby Puzzle

I have been thinking about babies recently, for various reasons (let’s call them Saul).  It had always struck me that procreation was a classic example of a prisoner’s dilemma.  It was good for each couple to have children, but if everyone churned out these resource-chomping monsters it was disastrous for us all.

That was until friends (philosophers) kindly pointed out that study after study shows that having children actually makes people unhappy.Read More »A Teeny-Weeny Baby Puzzle