One Less, But One at a Time
by Katelin Mirkin, Northwestern University
Anyone who’s turned on a television in the past year has the Gardasil slogan down pat. “I want to be one less” chants a human kaleidoscope of female ethnicities as the commercial goes on to discuss statistics supporting Gardasil as an effective vaccine against cancer caused by human papillomavirus or HPV. Contrary to the many implications supplied by the commercial, though the vaccine is widely available, being “one less” isn’t always attainable.
Though the fight against cancer has received considerable aid since Gardasil’s debut on the market in 2006, after approval by the FDA, the world still faces a variety of obstacles in the quest to eradicate several strains of HPV. Among these obstacles lie financial and political dilemmas, the inability to vaccinate the male population, and parental backlash.
Financial and Political Dilemmas
The three shots included in Gardasil range from 300 to 500 dollars. So while Gardasil’s advertisements depict girls of many backgrounds desiring the vaccine, the reality is that the cost of the vaccine could prevent several socioeconomic sects of the population from receiving the vaccine.
In an attempt to allow widespread access to the vaccine, several states have developed programs, or are in the process of passing legislation, to pay for the immunizations. Based on the CDC’s recommendation for females between the ages of 9 and 26 to get the vaccine, several states have proposed legislation making the vaccine mandatory for school entrance. All of the passed legislation thus far, has included a policy that would allow parents to opt out of vaccinating their daughters.1
Such legislation originated in Texas, in February of 2007, when Texas Governor Rick Perry issued an executive order (merely a recommendation, not a law) requiring all girls entering the sixth grade to receive the vaccine beginning in September 2008. 2 The order was immediately met with a backlash from a group of Texas families, despite the opt-out policy, and by late February, the families filed a lawsuit to stop the executive order. Perry’s order was overruled in April of 2007, and Texas forbid enacting mandatory vaccination at least until 2011.3
New Hampshire’s current policy, which consists of a program that supplies free HPV vaccinations for all girls between the ages of 11 and 18 who want the vaccine, has been met with wide acceptance.
Other institutions are also working to make Gardasil more attainable. The Center for Disease and Control has a Vaccines For Children (VFC) program that provides free vaccines to doctors to administer to children under 18 who qualify for the program.4 The CDC is currently working to include Gardasil on its list of immunizations. Merck, the drug company responsible for Gardasil, provides its vaccine free of cost to both children and adults who do not have prescription drug or health insurance coverage and who, without Merck’s assistance could not otherwise afford the vaccine.5
Contrary to the efforts of such programs, some insurance companies refuse to cover Merck’s Gardasil. This has forced several physicians to require patients to either pay up front or sign a waiver stating that the patient will pay for the vaccine if their insurance company fails to.5 Some physicians have refused to even stock Gardasil due to inadequate reimbursement from insurance companies.7 With vaccine inventory and maintenance charges totaling over $50,000 a year, many practices simply cant afford to absorb the damages, when insurance companies are reimbursing physicians $2 to $15 for a $120 dose.7 Ironically, while insurance companies are not willing to cover the relatively small cost of the vaccine, they are willing to pay several thousands of dollars to cover a patient, should she develop cervical cancer.
Gardasil Not Yet Approved for Males
When attempting to eradicate a disease through immunizations, it’s best to vaccinate all potential carriers of the disease. This thorough practice of vaccination allowed for the relatively swift and effective eradication of smallpox, the original poster child of contagious disease. Unfortunately, this methodical process of immunization cannot yet be applied to HPV because Gardasil has not yet been approved for males. To date, there is no approved method to test for HPV in men, nor are there tests approved for the early detection of HPV linked cancers in men.
According to the 2006 projections of the American Social Health Association, approximately 75% of the reproductive population will be infected with one or more of the sexually transmitted types of HPV at some point of their adulthood.9 The CDC estimates that over 50% of American men will get HPV at some point in their lives. 10 The incidence of HPV is even more prevalent in the gay community. Despite these dire statistics, half the population does not even have access to the vaccine. The inability to vaccinate males not only inhibits the world from limiting the spread of the disease and effectively eradicating it, but also places men at risk for several types of cancer caused by the virus.
HPV causes cancers that affect both men and women. Interestingly, the tissues infected by HPV are all very similar to those present in the cervix. In addition to cervical cancer, HPV can cause penile and anal cancer, and cancers of the tongue and throat. While these cancers are much rarer than cervical cancer, it is important that HPV be recognized as a threat to both genders and all sexualities.
The CDC reports that there is a correlation between HPV and penile and anal cancer.11 Both cancers are uncommon (both affect about 1 in every 100,000 men), however, certain risk factors greatly increase the odds of developing HPV-related diseases. For instance, the risk for anal cancer is 17 to 31 times higher among gay and bisexual men than among heterosexual men.11 While abstinence is the only sure way to prevent HPV infection, limiting the number of sexual partners and using condoms, slightly decreases one’s chance of infection.11
Recent studies have reported that individuals who have had more than five oral-sex partners in their lifetime are 250% more likely to have throat cancer than those who abstain from oral sex.12 Researchers believe that this is due to the transmission of HPV through any sexual act, not merely intercourse. This conclusion was made after controls were set for other risk factors for throat cancer, such as drinking and smoking. The analysis showed that those who had a prior HPV infection were 32 times more likely to have throat cancer than those who had not ever been infected.12 While tonsil and throat cancers only affect approximately two in every 100,000 Americans, it is expected that the discovery of the correlation between these cancers and HPV will be followed by a push for vaccination in men.
Parental Backlash
Vaccines have always been met with controversy, dating back to the 1770’s when Benjamin Jesty inoculated his own family with one of the most deadly diseases of the time. However, few in modern day have been received in the same manner as Gardasil. Because Gardasil vaccinates against a sexually transmitted disease, several groups have interpreted the drug as encouraging promiscuity instead of ridding the world of a dangerous virus.
Some parents fail to see the necessity of getting their daughters vaccinated at such a young age, claiming that their children are not sexually active. And while most teens may not be sexually active, a large percentage of them are. The CDC Youth Risk Behavior Survey of 2005 reported that 47% of high school students reported having had sexual intercourse, 34% had had sexual intercourse with more than one person, and 34% of those sexually active didn’t use a condom the last time they had sex.13 Even individuals who aren’t sexually active and remain abstinent until marriage are at risk for contracting HPV. According to the CDC, 14% of women between the ages of 18 and 25 who had only one lifetime sex partner were infected with HPV.14 By denying daughters the vaccine in an attempt to preserve a wholesome image, parents need to realize that they are denying their daughter protection from a dangerous cancer.
Parents may find it comforting that there is no evidence that vaccinations or sex education increases sexual activity among teenagers. 15 In reality, sex education actually delays the onset of sexual activity. 15 In that respect, discussion of Gardasil with teens could actually hinder promiscuity.
Some worry that Gardasil could be misinterpreted as an STD vaccine, and thus encourage promiscuity. For this reason, it is important that the public understand that Gardasil is not an STD vaccine, as it only provides protection against certain types of HPV, and does not provide any protection against HIV, herpes, or other STDS. Parents, physicians, and representatives of the vaccine need to make Gardasil’s limitations very clear so that patients do not receive a false sense of protection.
Others still, are concerned about the safety and duration of protection of the new vaccine. While Gardasil has been approved by the Food and Drug Administration (FDA) and recommended by the American Academy of Pediatrics (AAP), time has not yet allowed for the long term effects of the drug, if any, to surface. Currently, studies show that the vaccine does protect for at least five years after the vaccination. 14 Should the vaccine not provide lifetime protection, booster doses may be considered.
Conclusions
The picture painted by Gardasil advertisements is unfortunately one of fantastical proportions. Its message that all girls can find refuge from a calculative killer is a valiant one, yet it currently lacks reality. Though the artillery exists, many are being kept from its protection. So while many girls are becoming one less, until society and medicine can overcome a number of stubborn but defeatable obstacles, the battle against HPV is going to have to proceed one girl at a time.
References
1.) “HPV Vaccine.” National Conference of State Legislatures : The Forum for America’s Ideas. 14 Aug. 2007 http://www.ncsl.org/programs/health/HPVvaccine.htm>
2.) Peterson, Liz Ausin. “Texas Gov. Orders Anti-Cancer Vaccine.” Washington Post. 2 Feb. 2007. Washington Post. 14 Aug. 2007 http://www.washingtonpost.com/wp-dyn/content/article/2007/02/02/AR2007020201528.html>
3.)Blumenthal, Ralph. “Texas Legislators Block Shots for Girls Against Cancer Virus.” New York Times. 26 Apr. 2007. The New York Times. 15 Aug. 2007 http://www.nytimes.com/2007/04/26/us/26texas.html?ref=health>
4.) “Vaccines for Children Program.” Center for Disease Control and Prevention. 13 Aug. 2007 http://www.cdc.gov/vaccines/programs/vfc/default.htm>
5.) “Merck Programs to Help Those in Need.” Merck. 14 Aug. 2007 http://www.merck.com/merckhelps/>
6.)”Detroit News Examines Cost of HPV Vaccine Gardasil.” Kaiser Network Organization. 29 Mar. 2007. The Henry J. Kaiser Family Foundation. 12 Aug. 2007. http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=43913>
7.) Johnson, Linda A., Cancer Vaccine’s Price, Insurance Problems Limiting Patient Access. USAToday. 2 Feb. 2007. USAToday. 14 Aug. 2007. http://www.usatoday.com/news/health/2007-02-02-gardasil-limits_x.htm>
8.) Payne, January W., “A Shot, or Not.” Washington Post. 18 July 2006. Washington Post. 14 Aug. 2007 http://www.washingtonpost.com/wp-dyn/content/article/2006/07/17/AR2006071700955.html>
9.) Baseman JG, Koutsky LA (2005). “The epidemiology of human papillomavirus infections”. J. Clin. Virol. 32 Suppl 1: S16-24.
10.) “What Men Need to Know About HPV.” Digene HPV Test. 20 Sept. 2007 http://www.thehpvtest.com/HPV-for-men-FAQ.html>
11.) “HPV and Men - CDC Fact Sheet.” Center for Disease Control and Prevention. 20 Sept. 2007 http://www.cdc.gov/std/hpv/STDFact-HPV-and-men.htm>
12.)Khamsi, Roxanne. “Oral Sex Can Cause Throat Cancer.” NewScientist. 09 May 2007. New Scientist. 14 Aug. 2007. http://www.newscientist.com/article.ns?id=dn11819>
13.) “Morbidity and Mortality Weekly Report: Youth Risk Behavior Surveillance – United States, 2005.” Center for Disease Control and Prevention. 9 June 2005. The Center for Disease Control and Prevention. 19 Sept. 2007 http://www.cdc.gov/mmwr/PDF/SS/SS5505.pdf>
14.) Iannelli, Vincent. “HPV Controversy.” About.com: Pediatrics. 10 May 2007. About.com. 19 Aug. 2007 http://pediatrics.about.com/od/immunizations/a/0307_hpv_cntvsy.htm> 15.) Tanne, Janice Hopkins. “Cervical Cancer Vaccines Provoke Controversy in the US.” BMJ. 19 Sept. 2007 http://www.bmj.com/cgi/content/full/332/7545/814/DC1>
16.) http://www.gardasil.com>
17.) “What does Gardasil Mean for Women?” WebMD. 8 June 2006. CBS News. 20 Sept. 2007 http://www.cbsnews.com/stories/2006/06/08/health/webmd/main1695636.shtml>
Networks, Information and Society
by Rohan Dixit, Northwestern University
By this time in the Digital Age, many electronics consumers are familiar with Moore’s Law, even if not by name. The “law” comes from the observation that computer processing power tends to double every two years, an exponential trend. The implications of this exponential growth pattern are manifold, but we see its effects in our own lives when a new laptop bought for Christmas becomes obsolete by the spring thaw. But, fascinatingly, it appears that Moore’s Law may represent a window into a larger phenomenon that is left largely undiscussed in modern society- the accelerating rate of human innovation itself [1].
One of the most shocking illustrations of this trend lies in the exponential rise in so-called ‘paradigm shifts’ in history of the universe and life on Earth. This chart marks events considered major watersheds in human cultural evolution, like the invention of the printing press or the first bioengineered organism. The trend is unmistakably exponential over recorded history (*note: it’s plotted on a logarithmic scale, so this linear graph implies an exponential relationship).
There are multiple views as to why this is occurring, but one interesting perspective lies in an emerging field called complexity science. Imagine one of the neurons in your brain for a moment. Alone, it’s a complex but useless mechanical unit, incapable of learning on its own when separated from its 100 billion fellow neurons. But add enough of these simple components together and, past a certain threshold, complex behavior emerges from simple underlying relationships.
Individual humans and human society could be analogous to the neuron/brain relationship. Past a certain threshold, complex results can emerge from large numbers of networked people. Take Wikipedia, the open-access, open-review online encyclopedia. Seven years after its launch in 2000, Wikipedia had over 5.3 million articles and, according to an article published in Nature, was on par with the venerable Encyclopedia Britannica concerning science content [2]. So, growth in the size of human networks leads to more efficient organization. As more and more users around the globe begin to network together, through mobile phones or the web or both, astonishing results will continue to occur in tandem.
Pundits have proclaimed the advent of the “Internet age” for almost a decade now, but applications of the internet towards non-business ventures has received only superficial coverage. Nevertheless, the truly revolutionary function of the internet is actually the efficient transmission of information. The days of poring through textbooks and cross-referencing in dusty libraries are rapidly coming to a close—students and professionals alike [3] now Google just about anything and instantly have hundreds of credible sources assembled from all over the world (and, increasingly, backwards in history as web editions of thousands of classic texts are published online.) Meanwhile, internet movements like Open Access and the Public Library of Science (PLoS) are working towards the tantalizingly close fruit of universal, free access to peer-reviewed literature from all scientific publications around the world. This is effectively the democratization of science and, more broadly, information itself.
When examined in the context of the massive popularity of social networking sites like Myspace and Facebook, which so far claim about 140 million users, the trend towards instantaneous, universal access to information of all types begins to crystallize. In fact, these networks are such efficient transmitters of relevant data between users that the CIA recently instituted its own private Myspace and del.icio.us knockoffs strictly for its intelligence community [4]. (“del.icio.us” is the quirky web address of one of the emerging “bookmark organizing” sites which allows users to save news articles, online radio stations or interesting websites of any type in a format that is easily searchable to both you and, if you choose, everyone else.)
These seemingly divergent web services are becoming so hugely popular because they simply facilitate information transfer between many individuals in the most efficient way possible. And this, ultimately, captures the fundamental essence of any type of communication between humans— and makes it many orders of magnitude faster.
There are political and social possibilities inherent in these networks that are only beginning to be tapped. Youtubed videos of police brutality in Los Angeles have been caught on cell phone cameras, uploaded the same night and then virally spread online until being picked up by mainstream television news corporations [5]. Facebook has added optional applications that allow people to fundraise for political candidates online. And Google (which bought Youtube recently) hosted one of this year’s Democratic Party debates in conjunction with CNN by relaying video questions from internet users to the candidates, who themselves had already posted campaign videos on the website.
Undoubtedly, information is king—and since knowledge is power, as the old adage goes, the full potential of the internet may actually lie in shifting societal control over information dissemination from rigid constructs like radio-television-print media conglomerates, professional scientific journals and governments alike back to the jacked-in, exponentially growing global population. Despite major setbacks to increasing networked efficiency (take massive internet censorship in China [6] or rewritten oil spill Wikipedia entries by Exxon-Mobil employees [7]) the world-wide trend towards free and open network information is now probably unstoppable. Expect some complex results.
References
[1] Graph of world human population (in millions) from 10,000 B.C. until present. Creative Commons license. http://en.wikipedia.org/wiki/Image:Population_curve.svg
[2] Internet encyclopaedias go head to head (2005) Nature. http://www.nature.com/nature/journal/v438/n7070/full/438900a.html
[3]Googling for a diagnosis: use of Google as a diagnostic aid (2006) British Medical Journal (BMJ).
http://www.bmj.com/cgi/content/abstract/bmj.39003.640567.AEv1
[4]http://www.ft.com/cms/s/0/6e2648ea-5014-11dc-a6b0-0000779fd2ac.html
[5] http://www.msnbc.msn.com/id/15649790/
[6] http://www.itbusiness.ca/it/client/en/home/News.asp?id=48400
New Urbanism : The Advent of Sustainable Urban Design
By Andre Tartar, Carnegie Mellon University
Industrialized and industrializing countries alike wake up every day to smoggier skies, rivers polluted by chemical runoff, countrysides marred by mountainous land dumps, and cities growing unchecked. Nowhere is this trend more evident than in the United States, where the “inherited city” – represented by the New England town – has given way to the concrete expanses of distressed inner cities and suburban sprawl. (1) With the onset of modern communications and transportation, this urban decline and suburban exodus came to be considered as inherent to the country’s growth. But many architects and urban planners in the early 1990s recognized serious social concerns resulting from the automobile-obsessed transient culture that was emerging. The emerging counter-movement, dubbed New Urbanism, is ideologically rooted in the civil rights movements’ rhetoric of socioeconomic equality, and emphasizes using the very structure of society to enable social change. It is a response to an urban landscape that has spawned several troubling dichotomies: suburban “homes” linked by hour-long commutes to downtown “jobs” and crumbling inner cities deteriorating as affluent yet impersonal suburbs spread. The solution that New Urbanism proposes to these schisms is simple: to revert to elements of the traditional American town and the stable identity they foster. (1) In reality, New Urbanism is actually a revival of the original (read: old) American urbanism. (1)
According to David Lewis, a professor at Carnegie Mellon University’s School of Architecture, the traditional American town or neighborhood is characterized by a gridded street network (contoured to a region’s topography), standard lots with personalized house designs, and all the necessary retail and public venues within a ten-minute walking distance. (1) Moreover, residents tend to be employed within the nominal town limits, either at a major factory (the mainstay of the bygone industrial American town) or the supermarket a few streets down. According to New Urbanism’s rationale, this balanced combination of planned structure and mutability is what cultivates cohesive communities and why most towns and neighborhoods can claim a unique character. (1) Imagine being able to walk to work in the morning, stroll to the nearby stores in the afternoon, and then saunter a few blocks home for dinner at night. Imagine direct interactions with other residents throughout the day instead of the constant “automotive contact” that nowadays defines how most daily activities are approached. This sense of community is what proponents of New Urbanism claim is essential for any urban setting, because it satisfies a basic human need. (1) The Congress for the New Urbanism, the movement’s official organ, frames this vision as the “reconfiguration [of] sprawling suburbs into communities of real neighborhoods,” communities designed around pedestrian and public transit (low carbon-emitting, naturally), with unifying and esthetic public “green” spaces, and a symbiotic relationship with their surroundings. (2) Yet this is the element thoroughly lacking in the modern city. To retrieve or redefine this lost identity (at least at the neighborhood level) the movement is reaching out to urban-planning theory and the technologies of sustainable urban design.
Clearly bridging today’s laissez faire attitudes toward population and infrastructural growth with New Urbanism entails a change in how modern society conceives the “city.” However, mediating an introspective society-wide public discourse is somewhat beyond the capability of New Urbanism’s proponents. What it does offer is a range of reforms to deal with this impasse that includes community participation in the urban planning process, reviving former inner-city hubs through economic development rather than government subsidies and social services, fostering a sense of public space with street side zoning, and retrenching the visibility and centrality of civic buildings. (3, 4) Inviting members of a community to shape the structure of their surroundings will ensure that the urban dynamic reflects its identity. The social crises of inner-cities have been shown to respond better to private-sector economic development (presumably catalyzed by government incentives), which increases employment and encourages a stable environment for business. (3) An example of this is Pittsburgh’s inner-city neighborhoods (primarily the Hill District bordering Downtown) which are currently undergoing an intensive revival coordinated by the city government but fuelled by new businesses and their capital and social investment; abandoned buildings now house upper-story lofts and street-level businesses and empty lots are being rezoned as parks or community centers. (1) Part of this community-building process is to cultivate a “street life” by clearly delineating public spaces and keeping them safe for all. (4) Presently, street zoning in suburbs and cities considers the automobile the main user, and not the people. Some theories argue that conditions such as on-street parking, narrower streets, and building facades lined up create a sidewalk-street continuum that is a clear public space and safer for pedestrians. (4) This mixed-use character of the street can even be extended to the actual housing mix that defines most neighborhoods. As part of its underlying social agenda, the Congress’ charter strongly pushes “affordable housing” to “bring people of diverse ages, races, and incomes” to “strengthen the personal and civic bonds essential for community.” (2) Although this tends to elicit strong reactions from value-obsessed homeowners, a tempered strategy of interspersed low-income housing is a possible middle ground. (4) Consequently, this rhetoric of cross-class community is one of the driving ambitions behind New Urbanism. In short, the model cityscape is “the physical definition of streets and public spaces as places of shared use,” social integration, and natural elements. (2)
Besides “community,” another pillar of the New Urbanism philosophy is sustainability. This is emblematic of the continuity that today’s architects seek to establish between the land and what is built on it, necessitating the infusion of new building technologies as well as large-scale “recycle and reuse” practices. The Intelligent Workplace, an impressive architectural/design project at Carnegie Mellon University, represents a major breakthrough in the material use and targeted design that can make our homes and office buildings more sustainable. The Intelligent Workplace is a prototype of a living/work space with substantially increased energy efficiency and environmental sustainability that is still, ostensibly, economically-feasible. (5, 6) Notably, the Intelligent Workplace has managed a three-to-four-fold decrease in energy consumption, constituting a major reduction in the space’s environmental footprint. As much as 40% of the world’s greenhouse gas emissions are attributable to the heating/cooling/lighting energy needs of [primarily commercial] buildings. (3) The Intelligent Workplace achieved all this through a series of technological adaptations and structural design tools that are central to some of the more ambitious New Urbanism projects. The use of prefabricated modular structural units facilitates speed of construction and greatly reduces waste, even allowing for later re-use or recycling; a heavy reliance on recycled materials; structural designs that emphasize low waste manufacturing and low material needs. (7) Using modular internal components (chosen for “minimal obsolescence”) allows for even less waste production; control of the source-to-sink [local] resource use permits material sustainability, essential to any environmentally sustainable design. (8) “Natural conditioning” is paramount in attaining any real reduction in environmental impact. Natural daylight (or “dynamic shading/light redirection”) for lighting, natural ventilation rather than artificial airflow, and highly insulated exterior facades to partially supplement notoriously energy-intensive heating/cooling systems are all steps to this end. Even rooftop photovoltaic solar panels further defray energy consumption. (9, 10) According to New Urbanism, however, it is important that such a space not only be eco-friendly but user-friendly as well. Advocates allege that a greater integration with one’s natural surroundings should enhance quality of life at the practical level. This embodies another major rhetorical move by the movement. Who doesn’t rebuke the sterile air and garish incandescent light of the modern work environment, or resent the total insulation from the natural sounds and smells on the other side of the window?
A city cannot truly thrive unless its structure and design are grounded in the particulars of the land and collective heritage. (1) Founded on this principle, New Urbanism and the sustainable [urban] design paradigms it has spawned embody a new social model – closer-knit urban communities integrated into the local natural context – facilitated by a coterie of novel technologies and tools available to the architect, sustainable designer, and urban planner. This model is also a grand vision for a revitalized society, one that captures the fervor of New Urbanism. It remains to be seen how strongly the ideals of New Urbanism will inform the next cadre of visionary architects and urban planners, a generation ready to respond to the last urban upheaval – the century of the skyscraper. Maybe, we can stand back and watch as cities embrace the past to find a better future of pedestrianism, mixed use, and greater social integration.
References:
1. Lewis, David. Teaching Professor. Carnegie Mellon University School of Architecture.
2. “Charter of the New Urbanism”. The Congress for the New Urbanism. (http://www.cnu.org/cnu_reports/Charter.pdf).
3. Porter, Michael. “The Competitive Advantage of the Inner City”. Harvard BusinessReview. May-June 1995. 55-71.
4. Duany, Andres. “Traditional Towns”. Architectural Design. 1989. 59-64.
5. “Urban Design”. Carnegie Mellon School of Architecture. (http://www.arc.cmu.edu/cmu/about_sa/defining_interests.jsp?id=10).
6. “About the IW”. Carnegie Mellon School of Architecture: Center for Building Control and Diagnostics: Intelligent Workplace. (http://www.arc.cmu.edu/cbpd/iw/iw_about.html).
7. The Intelligent Workplace: Structure. (http://www.arc.cmu.edu/cbpd/pdf/iw/iw_structure.pdf).
8. The Intelligent Workplace: Interior. (http://www.arc.cmu.edu/cbpd/pdf/iw/iw_interior.pdf).
9. The Intelligent Workplace: Enclosure. (http://www.arc.cmu.edu/cbpd/pdf/iw/iw_enclosure.pdf).
10. The Intelligent Workplace: Lighting. (http://www.arc.cmu.edu/cbpd/pdf/iw/iw_lighting.pdf).
Knowledge Factories: Universities and the shift towards marketplace paradigms
by Daniel Choi, University of Chicago
Adorned on Leland Stanford Junior University’s school crest is a single pine tree surrounded by the words “Die Luft der Freiheit weht,” German for “The Wind of Freedom blows”. Under Stanford’s banner and those of many other academic institutions, however, there lies a possible threat to the very academic freedom declared. In 1973, Stanford University’s Stanley Cohen and Herbert Boyer developed the technique of gene splicing, an event that gave rise to the biotechnology industry. Unlike their predecessors, Cohen and Boyer crossed the traditional line between university and corporation by patenting their discovery, claiming ownership to a fundamental and basic technique that would lay the foundations of a new science. Of course, no one can blame Cohen or Boyer for wanting to expand the university’s control over the uses of its work, but to what extent can universities assume corporate paradigms without losing their traditional identities?
Commercialization in academia is not limited to patenting; more universities are making lucrative deals with corporations and private industries, which will undoubtedly benefit universities with funding and resources. However, this new income has strings attached, as many corporations are funding what is monetarily beneficial to their own goals and not necessarily what is beneficial to the public, that which the universities purportedly serve. So the questions remain: are the goals of corporations compatible with the goals of academia? What are the effects of integrating the university and the market? Are “market- model universities” beneficial in the long run? To answer these questions it is necessary to understand the history of the relationship between universities and corporations. During WWII and the Cold War, the United States’ federal government required the cooperation of academia, especially in military research and development, and naturally became the dominant source of income for universities. [1]
However, the “golden age” of federal support for higher education was over by the mid-1970s and academia faced a monetary crisis. There were many events during this period that led to a lack of federal funding. Financial cutbacks in the federal budget, especially during the energy crisis of 1973, limited the amount of money the federal government could expend. During the 1980s, American priorities shifted from the Cold War to economic competition with industrial superpowers like Germany and Japan. [2] This decrease in funding for higher education coincided with an increasing demand for adult education and doctor education to accommodate a more complex post-WWII society. [2] To meet these demands for education with limited resources, universities had no other option than to seek private sources for funding. The 1980s were especially advantageous to universities searching for corporate funding because of the rush of private enterprise that accompanied the Reagan Administration. Congress passed the Bayh-Dole Act in 1980, which allowed universities, small businesses, and non-profit organizations to license patents that resulted from research funded by the federal government. [2] With more direct control of the economic impact of their research, universities expanded their financial assets through this new “research rush.”
By the year 2000, academic institutions, on average, were receiving more than $1 billion per year in royalties and licensing fees. [2] Of course, well-deserved recognition for life-long projects and revolutionary discoveries are sometimes financial, but what would happen if monetary rewards were the only incentive of academic research? Is it possible that a university would leave its traditional role of education and enter instead the world of business as yet another producer of commodities?
The trend is certainly headed in this direction; currently, universities tend to function more like businesses than schools. Lucrative deals between major research universities and industrial corporations, such as the Harvard-Monsanto deal (1974), the Columbia- Bristol-Meyers deal (1983), the Berkeley-Novartis deal (1999) [1], and the Clemson-BMW Deal (2002) [3], are becoming commonplace. These “academic-industrial complexes,” [1] which blur the line between academia and corporations, are forming at an alarming rate. It seems inevitable that, in a post-industrial economy, every institution should commercialize and conform to market models—however, there are three serious problems that arise when universities adopt corporate ideologies: “commodification” of knowledge, secrecy, and conflict of interest.
In his book Universities in the Marketplace, Derek Bok, current President of Harvard University, explains the fear of the “commodification” of knowledge. Academics are afraid that the current knowledge- based economy will turn knowledge into a product and universities into “knowledge factories.” [2] The rhetoric used by these academics, Bok explains, is actually leftist in nature and the fear could be a political one, based on a general distrust of capitalism itself. However, there are legitimate concerns with this issue. For example, some critics fear that “commercially- oriented activities will come to overshadow other intellectual values and that the university programs will be judged primarily by the money they bring and not by their intrinsic intellectual quality.” [2] John McMurtry, Professor of Philosophy at the University of Guelph (Ontario, Canada), explains that there is conflict between market and education — “The overriding goal of corporate agents in the marketplace is to maximize private money profits.The overriding goal of educational agents in schools, colleges and universities is to advance and disseminate shared knowledge [original italics.]” [4] The “commodification of knowledge” (i.e. adoption of marketplace ideology) is contrary to the goals of the “agents of knowledge” (i.e. academia), which means that this new trend towards commercialization in education erodes the purpose of education itself. As knowledge is transformed into a commodity to be owned, universities will turn from their roles as educators and instead focus on maximizing profit from their ownership of that knowledge.
The rush for patents and licensing is a driving force behind research in today’s universities, especially when this hysteria for profit is coupled with the “publish-or- perish” attitude that plagues the current world of academics. The intense competition, both for recognition and for knowledge ownership, leads to academic secrecy, in which researchers would delay publications, withhold data, and participate in other activities that will prevent any leak of information to competitors. This may seem counterintuitive at first—why would a rush for patents delay publication?
Although sloppy work and haphazard conclusions might be a more likely outcome of pressure to publish, any mistake on the part of the researcher or the group that stems from carelessness would actually damage the reputation of those involved in the project. Error is inevitable in science, but when that error turns out to reveal a new detail or a new perspective of things, it becomes a diamond mine of discovery and profits. Because of the value of new information/discoveries, scientists will be very reluctant to share valuable information with competition. Such activities in academia, however, create crippling harm, as they dramatically decrease opportunities for synergy between different scientists and institutions, and work against the open community and common knowledge base that academia is entrusted to develop.
Bok, however, does not believe that secrecy is a very large threat in the long run, as only 12% of university ititutions have policies specifying clear time limits on keeping discoveries a secret. [2] Bok assumes that most institutions will not impose a minimum wait time before the presentation of information and results with the community at large. However, even though many institutions lack a clear minimum wait time, information, especially unfavorable information, is still withheld. In 1995, Nancy Olivieri at the University of Toronto was working on a thalassemia (genetic blood disease) treatment that initially showed favorable prospects, but seemed to be ineffective and even toxic as the trials progressed. She felt it was imperative to publish these results in the New England Journal of Medicine, but her research contractor, Apotrex (a generic drug company based in Canada) threatened her with legal action. The situation was at a standstill until the story leaked to the media, and by 1999 Olivieri was bound by a gag order that prohibited her from discussing the case. [1] The suppression of urgent information in this case was not only harmful to scientific progress, but also to human beings. This incident not only highlights the dangers of academic secrecy, but also illustrates the conflicts of interest that arise in the academic-industry complex.
The Olivieri Case is not an isolated one. Conflicts of interest arise in scientific research where there are high stakes involved, especially in medical/clinical developments. In 1999, the death of eighteen year-old Jesse Gelsinger during a gene therapy study the
Error is inevitable in science, but
when that error turns out to reveal a
new detail or a new perspective of
things, it becomes a diamond mine
of discovery and profits. Because of
the value of new information/
discoveries, scientists will be very
reluctant to share valuable
information with competition.
University of Pennsylvania led to an investigation by the FDA, which revealed that there were unreported cases of serious adverse effects. Even more horrifying, though, was the discovery that the lead researcher of the therapy owned the company that was funding hisresearch and he also had several patents on techniques used in the study, standing to benefit immensely from the success of this therapy. The NIH then called for a review of all gene therapy investigations, reminding institutions that any adverse reaction must be reported immediately. Six-hundred and fifty-two cases of serious adverse effects were previously not reported and 7 previous deaths before Gelsinger were not reported. [1] Although it can be argued that all scientific research has biased results, conflicts of interest, especially in medical research, can jeopardize public health. As extreme as it may sound, the adoption of marketplace ideologies in academic research can lead to the erosion of academic goals at best, and the loss of human lives at worst.
Of course, viable arguments for the adoption of marketplace ideologies exist. First, government funding for academic research is lacking, especially with the growing federal deficit and an increase in competition for the available federal funds [5], and it becomes a burden on taxpayers to support higher education. This absence of public resources forces universities to turn to the private sector for funding. Corporate involvement in academia is necessary to maintain the financial stability of universities, as they are the primary source of funding for many university endeavors. Corporate involvement also does not need to be negative—the funds that are transferred to the university can be used towards maximizing opportunities of academia through scholarships, grants, and other programs. Most importantly, however, efficiency is required for the survival of academia. Since college deans and presidents are under constant pressure to meet demands for new academic programs and added faculty/facilities, they are anxious to not wasteresources. [2]
Despite the many hazards, the shift towards marketplace economy makes it impossible to avoid marketplace ideology. So what are the solutions to maintaining two seemingly contradictory institutions? Bok suggests three steps. [2] First, resist the urge for secrecy. This course of action will be very difficult due to the nature of competition, but if academics hold at bay pure marketplace ideology, they will see that their work is more comprehensive and profound in human development than the short-term economic profits. This will also maintain the necessary academic and ethical rigor that was absent in the Gelsinger Case. Second, establish clear rules governing conflicts of interest. This step is even more challenging, as pre-existing financial ties, if broken, could compromise relations between academic institutions and other entities (e.g., government organizations). However, if conflict of interest were better addressed by educational institutions, tragic cases like those of Olivieri and Gelsinger could be greatly reduced. Finally, the best way to maintain academic autonomy is to limit reliance on industry support. This step is also greatly challenging, since the private sector is a vital source of academic funding. But conflict of interest will be greatly reduced if corporate ties are limited, as fewer strings will be attached to funds. Unfortunately, these steps are extremely unrealistic as academia is already deeply immersed in marketplace ideology. Additionally, if all conflicted corporate funds were cut, universities would be bankrupt. Where then will academic institutions turn to for support? Even though academia and corporations have opposing goals, it is nevertheless true that academia relies on corporations, as corporations also have much at stake investing in academia.
The “market-model university” is an inevitable result of the exponential commercialization of all social spheres, but the examples above illustrate how the ruthless drive for profit will damage not only academia, but the general public itself. It is absolutely imperative to evaluate whether the given examples are merely tragic accidents or a foretelling of what to expect from the “academic-industrial complex.” Whatever the situation is, steps must be taken to keep the Winds of Academic Freedom blowing.
References:
[1] Washburn, Jennifer. University, Inc.: The Corporate Corruption of Higher Education. Paperback ed.. New York: Basic Books, 2006. pp 11, 12, 16, 24, 64-66, 139-156.
[2] Bok, Derek. Universities in the Marketplace: The Commercialization of Higher Education. 1st ed. Princeton: Princeton University Press, 2003. pp 4-5, 46, 123-124, 125-127.
[3] Browning, Lynnley. BMW’s Custom-Made University.” New York Times 29 August 2006, late ed.: C2. [4] McMurtry, “John. Education and the Market Model.” Journal of Philosophy of Education. 25(1991): 209-217. [5] Zerhouni, Elias A. “NIH at the Crossroads: Myths, Realities and Strategies for the Future.” NIAID Council Meeting. 22 May. 2006.
Microfinance and the Global Poverty Problem
By Michelle Tsao, Northwestern University
Microcredit is a banking strategy for offering small, “micro” loans to poor clients for self-employment projects. This type of initiative has spread to diverse countries around the world and offers a new, proactive approach to fighting global poverty. Microfinance institutions are designed to meet the credit needs of impoverished people, and successfully capture a demographic traditionally excluded by commercial banks. As it is often said, it takes money to make money, and in this spirit microcredit has emerged as a promising catalyst for myriad investment ideas to take root. As implied by the name, most microcredit transactions involve relatively small amounts of money, frequently less than $100.
Beginning in the 1970s, the microcredit movement spread rapidly throughout the developing world but only recently achieved global stature. Vikram Akula, founder of an India-based microfinance organization, explained that “the movement has hit its stride, especially in the last couple of years. There are a whole host of new players that are moving incredibly fast – it’s not just an isolated thing in one or two places, especially relative to the lack of progress in other poverty eradication effects,” [1]. Akula himself is part of this exciting movement as founder and CEO of SKS Microfinance, which serves about 350,000 total borrowers.
The global momentum behind microfinance is becoming apparent. Just last year, 66-year-old Economics professor Muhammad Yunus won the 2006 Nobel Peace Prize for his work towards eradicating poverty through the microcredit movement. Dr. Yunus shares the prize with the Grameen Bank, the microfinance institution he founded in Bangladesh. The Nobel Committee’s statement said it awarded the prize to Dr. Yunus and the bank “for their efforts to create economic and social benefit from below.” The Nobel committee dramatically concluded that “lasting peace cannot be achieved unless population groups find ways in which to break out of poverty,” [2].
Dr. Yunus has been working to develop microfinance into an ever-greater tool in the struggle against poverty for over 30 years. Admittedly, the achievement of peace and stability through small loans is not an immediately obvious link, but even though Dr. Yunus is not negotiating treaties between political rivals, he is furthering peace by attacking one of the root causes of conflict: poverty.
Grameen Bank was initially a non-profit organization but is now a for-profit business. Unlike most microfinance operations, it is actually able to turn a profit. Since its inception in 1983, Grameen Bank has lent more than $6 billion to over 6.9 million people to help them become financially independent [3]. One well-known innovation by microfinance organizations is the group-lending model. In this model, members are jointly liable for individual loans [4]. Many other microfinance institutions have emulated the Grameen Bank’s peer-group loan methodology. Individuals seeking loans are placed in groups and initially only a fraction of the group receive loans for businesses, such as pottery manufacturing or auto repair. The others receive loans only when the first set has demonstrated a strong capacity to make repayments. This method has resulted in a highly unusual low default rate of approximately 1% [1].
“I’ve always felt that the greatest threat to world peace was the global poverty crisis — seeing the competition for resources and how it leads to tension and violence,” says Alex Counts, president of the U.S. based Grameen Foundation. He added that he felt the Nobel committee was right in viewing peace in a broad sense, as a dynamic interplay between multiple societal causes. [1].
Dr. Yunus has been tackling poverty on many other fronts as well. Grameen Bank now has many offshoots, from Grameen Shakti (Energy), a power company devoted to providing renewable energy sources in rural villages to Grameen Shikkha (Education), an office devoted to the alleviation of illiteracy and the development and promotion of mass education in rural areas. Dr. Yunus calls these “non-loss” companies since they are not being used to maximize profit but to provide sustainable solutions to tough problems in the developing world [1].
In the rapidly growing field of microfinance, there is increasing interest from private-sector and multinational banks, including Citigroup, ABN Amro, Standard Chartered and ICICI, alongside government banks such as State Bank of India and the National Bank for Agriculture and Rural Development [5]. Citigroup is increasing its microcredit support and services supporting technological improvements. AIG recently invested $5.25 million in a partnership with Accion International, a global microfinance organization, to develop and deliver a broader menu of more sophisticated financial services like financial literacy, insurance, and other needed products. “We’re calling the investment ‘beyond credit’ because we feel that the industry is ready for the introduction of additional products and services that go beyond straight lending, and we want to play a role in developing that capacity,” says Ned Cloonan, AIG’s vice-president for international and corporate affairs [1].
Private donors have also made a great impact on the field. In September 2006, former retail furniture entrepreneurs John and Jacque of Phoenix pledged $50 million to Opportunity International, an Illinois based nonprofit microfinance organization. It is the largest single private donation to a microfinance institution ever, says Counts. Large donations help bring attention to the field and can also fuel innovation because donors are free to put their money toward things that may be considered ‘too high-risk’ by corporations. However, if an individual would like to contribute to a microfinance institution, they need not feel as if they have to donate millions to the cause. They can rather have an investment as small as $2,000 invested in microfinance, with a small social rate of return of about 2.5%. Deutsche Bank is doing just that, having developed an $80 million fund that invests pension and institutional investors’ funds. For qualified investors (very wealthy people who are able to take significant financial risk) Accion Investments projected an annual return of 5.9% but in its first three years, generating close to 10% internally [6].
How much of their portfolio should investors commit to microfinance? Roy Jacobowitz, senior vice president of Accion International, explained that “I don’t think it’s a financial decision. I think it’s a social-benefit decision people are making, and then they figure a number that’s appropriate…The other way that ethical and socially responsible investors can think of it is: Those who have created a family trust or a family foundation are required to use 5 percent of a moving average of their underlying assets in the foundation, and they can do what’s called a program-related investment, where they can actually make an investment in a social activity. That’s another way that investors can think about a way of coming into microfinance, doing some good, and also being responsible for themselves.” [6].
However, there is a good deal of criticism of microfinance institutions. There are many issues including low repayment rate, high interest rates, coercive debt collection methods, and questionable accounting practices [7].In addition, even as investment itself in the developing world is fast expanding, some worry that the microfinance sector is not progressing quickly or broadly enough. Microfinance services reach only 20% of at least 75 million households living in extreme poverty, says Vipin Sharma, program director of microfinance at Care India, an arm of the international humanitarian agency [5].
Dr. Yunus’s vision of eliminating poverty cannot be achieved by microcredit alone. While microcredit can be cost-effective strategy that complements other interventions, it is not a magic bullet. Thus, there is also a concern that overemphasis of microfinance may lead to too much reliance on this single technique and an unfortunate reduction of other types of necessary assistance, such as government welfare. Hopefully, the awarding of the Nobel Prize for Dr. Yanus’s work will bring the issue of poverty to the forefront of the global conscience, galvanizing the global community with the realization that economic development and self-sufficiency is crucial to achieving world peace.
References
1. Gangemi, J. “What the Nobel Means for Microcredit; Grameen Bank founder Muhammad Yunus promotes peace no by brokering treaties but by uprooting poverty through entrepreneurialism.” October 16, 2006. Business Week.
2. “The Nobel Peace Prize for 2006” Norwegian Nobel Committee. October 13, 2006. Accessed February 20, 2007. http://nobelprize.org/nobel_prizes/peace/laureates/2006/press.html
3. “Grameen Bank Statistics” Grameen – Banking for the Poor. February 13, 2007. Accessed February 20, 2007. http://www.grameen-info.org/bank/Statement1US$.htm
4. Gutiérrez-Nieto, Serrano-Cinca, Mar Molinero. “Microfinance institutions and efficiency” (2005) Omega 35: 131-42.
5. Yee, Amy. “Farmers’ small loans cultivate knowledge INDIA: The spread of microfinance is also spreading financial literacy” November 9, 2006. Financial Times.
6. Belsie, L. “Can you invest in a Nobel Prize-winning idea?” November 06, 2006. The Christian Science Monitor.
7. Pearl, D. and Phillips, M. “Small Change: Bank that pioneered loans for the poor hits repayment snag. ‘Microcredit’ icon Grameen faces question as rate of delinquencies rises.” November 27, 2001. Wall Street Journal.
[8] Article Image: Creative Commons license from http://en.wikipedia.org/wiki/Image:Muhammad_Yunus_2.jpg
