Wednesday, September 09, 2009

Ethical Responsibility and the Flu

I heard a debate on CBC's The Current this morning about the amount of money western countries are spending on preparation for the H1N1 virus. Some fellow has called it an "epidemic of indecency" to spend billions on a relatively mild virus while millions around the world are dying of malaria, TB and other diseases.

This is one of those cases where rational reasoning talks its way around to absurdity. We have to be able to hold to our own interest: first myself, then my family, then my circle of friends, then my community, my country, my country's allies. A flood in my town that kills two people is more important to me than a flood in China that kills a thousand people. It has to be that way: we each have to take care of our own, look out for our own, before we can reach out further.

To suggest that I should be more worried about children in Africa than about my own child is simply not on. Yes, I know that children in Africa are much more in need than children in Canada, but it is my right and my responsibility to put my own first. We applaud Bill Gates for providing aid to people in need around the world, but we would also rightly condemn him if he neglected his own children.

In this case, there is a lot more riding on the preparations for H1N1 than just the fatality rate. The world has not yet come out of a global financial crisis and recession, and H1N1 could destroy our recovery - whether or not a single person dies. Even in its current "mild" form, H1N1 makes people very ill for a week or two. Look at the transmission rates in Australia and New Zealand during their flu season last year. Look at the transmission rates on US college campuses this fall. Now imagine your company: what would happen if 50% or more of employees, suppliers, and service workers were too ill to work for two weeks? Even if they weren't sick, parents would have to stay home if their kids were. What if schools closed, transit was curtailed (due to sick drivers), grocery stores went unstocked, banks shut down, we had electricity brown-outs? That's not even mentioning chaos at doctor's offices and hospitals, where staff unavailability could threaten people who require care for other sorts of ailments. And it's not taking into account the very real threat that the virus will mutate and become more dangerous.

It's not "indecent" for our government to spend a lot of money preparing for this year's flu season: it would be indecent if they didn't.

I am reminded of a small section of Harper Lee's To Kill a Mockingbird: a church group in the small southern town is collecting money for people in Africa while showing no concern for persecuted African-Americans in their own community. The reader's instincive response should be that it's appalling and hypocritical that they care for people far away more than for their neighbors.

Other than the ethical issues, there is a practical problem with caring more for the far-flung than the local: help is much more effective when applied locally. Parents have to be the ones to take responsibility for their children, and governments have to take care of their citizens. It seems absurd even to have to argue this point, but I increasingly run into arguments that deny the primal importance of the personal and local, and attempt to assign a universal guilt because of the mountain of suffering elsewhere in the world. Part of this line of reasoning is the fallacy that our own problems are somehow invalid because other people have bigger problems.



Bert said...

I find myself wondering why we are spending so much on H1N1 preparation, of which releatively few people have died from, when during a regular flu season, so many more die.

The same thing concerning AIDS funding bothers me. I'm a diabetic. Check the stat's to see how many people worldwide die from diabetes, and how much funding diabetes research gets, and how many people have AIDS (and die from it) and how much funding it gets.

Mark McLaughlin said...

Just had this conversation with a coworker. The money follows the hype. AIDS gets way too much funding for it's societal impact, but Hollywood and the political left champion it because of its focused effect on a marginalized demographic. (Don't kid yourself thinking it's about Africa.)

H1N1 is the same. There is little societal impact at all, and certainly no more than typical flu, which we live with already. The truth is the greater sick days in the winter doesn't hold a candle to efficiency hit of all the vacation time taken over the summer does.

The money is wasted, only because if there happens to be a bit of an outbreak, the media will blow the thing out of proportion and a governmeent risks seats. Nothing more complicated than that.

Anonymous said...

The issue Yappa is discussing seems to be whether we should prioritize issues close to hand, rather than think problems remote from us have an equal claim on us. It's hard to dispute what she is saying. But on the other issues Bert and Mark raise: preparation for H1N1 hasn't seemed to limit preparation for regular flu; my GP is going to have shots for both ready soon. And isn't connecting this with diabetes research a tad tenuous?

Yappa said...

Hi guys,

I think the particular problem this year is that H1N1 could send western economies back into recession. It's not in place of regular flu and holidays, it's in addition to them (and Mark, I agree about holidays: it amazes me that we can function profitably at all, given that July, August and December are all virtual write-offs in many offices).

Comparing money spent on diseases is difficult. I think diabetes research is more a factor of basic science research than some illnesses, and a major branch of it is research into stem cells (which covers Parkinsons, cancer and some other conditions as well).

As to AIDS... I have seen too much of the horror of AIDS to agree that too much money is being spent on it. It is targeting the most educated in Africa (the more affluent) and thus doing all kinds of additional damage. The average life span has dropped decades in some African countries because of AIDS. I have had a good friend in Canada die a horrible death from it, and my boss from when I worked in Africa died of it. In fact, AIDS activism has helped all diseases by showing how public pressure can get resources moved to research, by raising money that wouldn't have been raised otherwise, and by providing a model for activism (which was borrowed soon after by women raising money for breast cancer). AIDS activism has helped reduce the spread of the disease and helped public understanding of something that initially resulted in some really tragic prejudice.