填空题The Power of
Nothing
Want to devise a new form of alternative
medicine No problem. Here is the recipe.
A Be warm,
sympathetic, reassuring and enthusiastic. Your treatment should involve physical
contact, and each session with your patients should last at least half an hour.
Encourage your patients to take an active part in their treatment and understand
how their disorders relate to the rest of their lives. Tell them that their own
bodies possess the true power to heal. Make them pay you out of their own
pockets. Describe your treatment in familiar words, but embroidered with a hint
of mysticism: energy fields, energy flows, energy blocks, meridians, forces,
auras, rhythms and the like. Refer to the knowledge of an earlier age: wisdom
carelessly swept aside by the rise and rise of blind, mechanistic
science.
B Oh, come off it, you are saying. Something
invented off the top of your head could not possibly work, could it Well yes,
it could—and often well enough to earn you a living. A good living if you are
sufficiently convincing, or, better still, really believe in your therapy. Many
illnesses get better on their own, so if you are lucky and administer your
treatment at just the right time you will get the credit. But that’s only part
of it. Some of the improvement really would be down to you. Your healing power
would be the outcome of a paradoxical force that conventional medicine
recognises but remains oddly ambivalent about: the placebo effect.
C Placebos are treatments that have no direct effect on the body,
yet still work because the patient has faith in their power to heal. Most often
the term refers to a dummy pill, but it applies just as much to any device or
procedure, from a sticking plaster to a crystal to an operation. The existence
of the placebo effect implies that even quackery may confer real benefits, which
is why any mention of placebo is a touchy subject for many practitioners of
complementary and alternative medicine (CAM), who are likely to regard it as
tantamount to a charge of charlatanism. In fact, the placebo effect is a
powerful part of all medical care, orthodox or otherwise, though its role is
often neglected or misunderstood.
D One of the great
strengths of CAM may be its practitioners’ skill in deploying the placebo effect
to accomplish real healing. ’Complementary practitioners are miles better at
producing non-specific effects and good therapeutic relationships,’ says Edzard
Ernst, professor of CAM at Exeter University. The question is whether CAM could
be integrated into conventional medicine, as some would like, without losing
much of this power.
E At one level, it should come as no
surprise that our state of mind can influence our physiology: anger opens the
superficial blood vessels of the face; sadness pumps the tear glands. But
exactly how placebos work their medical magic is still largely unknown. Most of
the scant research done so far has focused on the control of pain, because it’s
one of the commonest complaints and lends itself to experimental study. Here,
attention has turned to the endorphins, morphine-like neurochemicals known to
help control pain. ’Any of the neurochemicals involved in transmitting pain
impulses or modulating them might also be involved in generating the placebo
response,’ says Don Price, an oral surgeon at the University of Florida who
studies the placebo effect in dental pain.
F ’But
endorphins are still out in front.’ That case has been strengthened by the
recent work of Fabroizio Benedettil of the University of Turin, who showed that
the placebo effect can be abolished by a drug, naloxone, which blocks the
effects of endorphins. Benedetti induced pain in human volunteers by inflating a
blood-pressure cuff on the forearm. He did this several times a day for several
days, without saying anything, he replaced the morphine with a saline solution.
This still relieved the subjects’ pain: a placebo effect. But when he added
naloxone to the saline the pain relief disappeared. Here was direct proof that
placebo analgesia is mediated, at least in part, by these natural opiates.
Still, no one knows how belief triggers endorphin release, or why most people
cannot achieve placebo pain relief simply by willing it.
G Though scientists do not know how exactly how placebos work, they have
accumulated a fair bit of knowledge about how to trigger the effect. A London
rheumatologist found, for example, that red dummy capsules made more effective
painkillers than blue, green or yellow ones. Research on American students
revealed that blue pills make better sedatives than pink, a colour more suitable
for stimulants. Even branding can make a difference: if Aspro or Tylenol are
what you like to take for a headache, their chemically identical generic
equivalents may be less effective.
H It matters, too, how
the treatment is delivered. ’Physicians who adopt a warm, friendly and
reassuring bedside manner’, reports Edzard Ernst, professor of Complementary and
Alternative Medicine at Exeler University, ’are more effective than those whose
consultations are formal and do not offer reassurance.’ Warm, friendly and
reassuring are also alternative medicine’s strong suits, of course. Many of the
ingredients of that opening recipe—the physical contact, the generous swathes of
time, the strong hints of supernormal healing power are just the kind of thing
likely to impress patients. It is hardly surprising, then, that aroma
therapists, acupuncturists, herbalists, etc. seem to be good at mobilising the
placebo effect.
—New Scientist
你可能感兴趣的试题
1.填空题The Power of
Nothing
Want to devise a new form of alternative
medicine No problem. Here is the recipe.
A Be warm,
sympathetic, reassuring and enthusiastic. Your treatment should involve physical
contact, and each session with your patients should last at least half an hour.
Encourage your patients to take an active part in their treatment and understand
how their disorders relate to the rest of their lives. Tell them that their own
bodies possess the true power to heal. Make them pay you out of their own
pockets. Describe your treatment in familiar words, but embroidered with a hint
of mysticism: energy fields, energy flows, energy blocks, meridians, forces,
auras, rhythms and the like. Refer to the knowledge of an earlier age: wisdom
carelessly swept aside by the rise and rise of blind, mechanistic
science.
B Oh, come off it, you are saying. Something
invented off the top of your head could not possibly work, could it Well yes,
it could—and often well enough to earn you a living. A good living if you are
sufficiently convincing, or, better still, really believe in your therapy. Many
illnesses get better on their own, so if you are lucky and administer your
treatment at just the right time you will get the credit. But that’s only part
of it. Some of the improvement really would be down to you. Your healing power
would be the outcome of a paradoxical force that conventional medicine
recognises but remains oddly ambivalent about: the placebo effect.
C Placebos are treatments that have no direct effect on the body,
yet still work because the patient has faith in their power to heal. Most often
the term refers to a dummy pill, but it applies just as much to any device or
procedure, from a sticking plaster to a crystal to an operation. The existence
of the placebo effect implies that even quackery may confer real benefits, which
is why any mention of placebo is a touchy subject for many practitioners of
complementary and alternative medicine (CAM), who are likely to regard it as
tantamount to a charge of charlatanism. In fact, the placebo effect is a
powerful part of all medical care, orthodox or otherwise, though its role is
often neglected or misunderstood.
D One of the great
strengths of CAM may be its practitioners’ skill in deploying the placebo effect
to accomplish real healing. ’Complementary practitioners are miles better at
producing non-specific effects and good therapeutic relationships,’ says Edzard
Ernst, professor of CAM at Exeter University. The question is whether CAM could
be integrated into conventional medicine, as some would like, without losing
much of this power.
E At one level, it should come as no
surprise that our state of mind can influence our physiology: anger opens the
superficial blood vessels of the face; sadness pumps the tear glands. But
exactly how placebos work their medical magic is still largely unknown. Most of
the scant research done so far has focused on the control of pain, because it’s
one of the commonest complaints and lends itself to experimental study. Here,
attention has turned to the endorphins, morphine-like neurochemicals known to
help control pain. ’Any of the neurochemicals involved in transmitting pain
impulses or modulating them might also be involved in generating the placebo
response,’ says Don Price, an oral surgeon at the University of Florida who
studies the placebo effect in dental pain.
F ’But
endorphins are still out in front.’ That case has been strengthened by the
recent work of Fabroizio Benedettil of the University of Turin, who showed that
the placebo effect can be abolished by a drug, naloxone, which blocks the
effects of endorphins. Benedetti induced pain in human volunteers by inflating a
blood-pressure cuff on the forearm. He did this several times a day for several
days, without saying anything, he replaced the morphine with a saline solution.
This still relieved the subjects’ pain: a placebo effect. But when he added
naloxone to the saline the pain relief disappeared. Here was direct proof that
placebo analgesia is mediated, at least in part, by these natural opiates.
Still, no one knows how belief triggers endorphin release, or why most people
cannot achieve placebo pain relief simply by willing it.
G Though scientists do not know how exactly how placebos work, they have
accumulated a fair bit of knowledge about how to trigger the effect. A London
rheumatologist found, for example, that red dummy capsules made more effective
painkillers than blue, green or yellow ones. Research on American students
revealed that blue pills make better sedatives than pink, a colour more suitable
for stimulants. Even branding can make a difference: if Aspro or Tylenol are
what you like to take for a headache, their chemically identical generic
equivalents may be less effective.
H It matters, too, how
the treatment is delivered. ’Physicians who adopt a warm, friendly and
reassuring bedside manner’, reports Edzard Ernst, professor of Complementary and
Alternative Medicine at Exeler University, ’are more effective than those whose
consultations are formal and do not offer reassurance.’ Warm, friendly and
reassuring are also alternative medicine’s strong suits, of course. Many of the
ingredients of that opening recipe—the physical contact, the generous swathes of
time, the strong hints of supernormal healing power are just the kind of thing
likely to impress patients. It is hardly surprising, then, that aroma
therapists, acupuncturists, herbalists, etc. seem to be good at mobilising the
placebo effect.
—New Scientist 参考答案：charge of charlatanism 2.填空题You should spend about 20 minutes on Questions 1-13, which are based on
Reading Passage 1 below.
Malaria Kills Twice as Many People as Previously
Thought
Malaria kills twice as many people every
year as formerly believed, taking 1.2 million lives and causing the deaths not
only of babies but also older children and adults, according to the research
that overturns decades of assumptions about one of the world’s most lethal
diseases. The research comes from the highly respected Institute for Health
Metrics and Evaluation (IHME), and is published in the Lancet medical journal.
It has reanalysed 30 years of data on the disease using new techniques and will
force a rethink of the huge global effort that has been under way to eliminate
malaria. That ambition now looks highly unlikely by the UN target date of
2015.
It also raises urgent questions about the future of the
troubled global fund to fight Aids, TB and Malaria, which has provided the money
for most of the tools to combat the disease in Africa, such as
insecticide-impregnated bed nets and new drugs. The fund is in financial crisis
and has had to cancel its next grant-making round.
Dr.
Christopher Murray and colleagues have systematically collected data on deaths
from all over the world over a 30-year period, from 1980 to 2010, using new
methodologies and inventive ways of measuring mortality in countries where
deaths are not conventionally recorded. The work on malaria is part of a much
bigger project which has already led to new estimates of the death rates of
women in childbirth and pregnancy and from breast and cervical cancer. Their
figure of 1.2 million deaths for 2010 is nearly double the 655,000 estimated in
last year’s World Malaria Report.
The good news is that they
have confirmed the downward trend that the World Health Organisation’s report
showed, as a result of efforts by donors, aid organisations and governments to
tackle the disease. The bad news is that the decline comes from a much higher
peak—deaths hit 1.8 million in 2004, they say. That means the interventions such
as better treatment and bed nets are working, but there is much further to go
than everybody had assumed.
’You learn in medical school that
people exposed to malaria as children develop immunity and rarely die from
malaria as adults,’ said Murray, IHME director and the study’s lead author.
’What we have found in hospital records, death records, surveys and other
sources shows that just is not the case.’ Most deaths are still in children, but
a fifth are among those aged 15 to 49, 9% are among 50- to 69-year-olds and 6%
are in people over 70, so a third of all deaths are in adults. In countries
outside sub-Saharan Africa, more than 40% of deaths were in adults.
In Africa, though, the contribution of malaria to children’s deaths is
higher than had been thought, causing 24% of their deaths in 2008 and not 16% as
found by a report by Black and colleagues, whose methodology was used in the
World Malaria Report.
That means that malaria needs a higher
priority if the millennium development goal of cutting child mortality by
two-thirds between 1990 and 2015 is to be achieved, say the authors. They add:
’That malaria is a previously unrecognised driver of adult mortality also means
that the benefits and cost-effectiveness of malaria control, elimination and
eradication are likely to have been underestimated.’
There is a
need, they say, to pay attention to the risks malaria poses to adults and they
support the recent strategy to hand out insecticide-impregnated bed nets to
protect all members of the household against mosquitoes carrying malaria
parasites, instead of insisting they are only for babies and pregnant women, as
was originally the case.
Malaria deaths have come down by 32%
from 1.8 million in 2004 to 1.2 million in 2010 because of the sustained effort
to get bed nets into homes, indoor spraying and new artemisinin combination
drugs—older anti-malarials do not work in many areas because the parasite has
developed resistance to them. More than two-thirds of this has been paid for by
the Geneva-based global fund, which has suffered from donors’ unwillingness to
invest more money.
Professor Rifat Atun, director of strategy,
performance and evaluation at the fund, said more than $2.5bn (￡1.6bn) had been
disbursed for malaria control between 2009 and 2011. By the end of 2011, 235m
bed nets had been distributed. Money that had been pledged was still coming in,
he said, which meant it would be able to invest substantially this year and
next. ’What we are not able to achieve is the rate of increase in investment of
the last few years. The trajectory we have been able to establish will not be
realised,’ he said. ’Given the new burden that Christopher Murray has been able
to show, we really need to ramp up investments in malaria and that really needs
more funding. The mortality figures are much, much larger. We need to double our
efforts to address the burden that we have.’ The Department for International
Development said: ’We are committed to helping halve malaria deaths in at least
10 of the worst affected countries. We will do this by increasing the number of
bed nets used by women and children; improving the diagnosis and treatment of
malarial; and strengthening health information systems to better monitor
progress and target interventions.’
—GuardianThe effective practice is not to hand out bed nets only to babies and women but to all households. 3.填空题The Power of
Nothing
Want to devise a new form of alternative
medicine No problem. Here is the recipe.
A Be warm,
sympathetic, reassuring and enthusiastic. Your treatment should involve physical
contact, and each session with your patients should last at least half an hour.
Encourage your patients to take an active part in their treatment and understand
how their disorders relate to the rest of their lives. Tell them that their own
bodies possess the true power to heal. Make them pay you out of their own
pockets. Describe your treatment in familiar words, but embroidered with a hint
of mysticism: energy fields, energy flows, energy blocks, meridians, forces,
auras, rhythms and the like. Refer to the knowledge of an earlier age: wisdom
carelessly swept aside by the rise and rise of blind, mechanistic
science.
B Oh, come off it, you are saying. Something
invented off the top of your head could not possibly work, could it Well yes,
it could—and often well enough to earn you a living. A good living if you are
sufficiently convincing, or, better still, really believe in your therapy. Many
illnesses get better on their own, so if you are lucky and administer your
treatment at just the right time you will get the credit. But that’s only part
of it. Some of the improvement really would be down to you. Your healing power
would be the outcome of a paradoxical force that conventional medicine
recognises but remains oddly ambivalent about: the placebo effect.
C Placebos are treatments that have no direct effect on the body,
yet still work because the patient has faith in their power to heal. Most often
the term refers to a dummy pill, but it applies just as much to any device or
procedure, from a sticking plaster to a crystal to an operation. The existence
of the placebo effect implies that even quackery may confer real benefits, which
is why any mention of placebo is a touchy subject for many practitioners of
complementary and alternative medicine (CAM), who are likely to regard it as
tantamount to a charge of charlatanism. In fact, the placebo effect is a
powerful part of all medical care, orthodox or otherwise, though its role is
often neglected or misunderstood.
D One of the great
strengths of CAM may be its practitioners’ skill in deploying the placebo effect
to accomplish real healing. ’Complementary practitioners are miles better at
producing non-specific effects and good therapeutic relationships,’ says Edzard
Ernst, professor of CAM at Exeter University. The question is whether CAM could
be integrated into conventional medicine, as some would like, without losing
much of this power.
E At one level, it should come as no
surprise that our state of mind can influence our physiology: anger opens the
superficial blood vessels of the face; sadness pumps the tear glands. But
exactly how placebos work their medical magic is still largely unknown. Most of
the scant research done so far has focused on the control of pain, because it’s
one of the commonest complaints and lends itself to experimental study. Here,
attention has turned to the endorphins, morphine-like neurochemicals known to
help control pain. ’Any of the neurochemicals involved in transmitting pain
impulses or modulating them might also be involved in generating the placebo
response,’ says Don Price, an oral surgeon at the University of Florida who
studies the placebo effect in dental pain.
F ’But
endorphins are still out in front.’ That case has been strengthened by the
recent work of Fabroizio Benedettil of the University of Turin, who showed that
the placebo effect can be abolished by a drug, naloxone, which blocks the
effects of endorphins. Benedetti induced pain in human volunteers by inflating a
blood-pressure cuff on the forearm. He did this several times a day for several
days, without saying anything, he replaced the morphine with a saline solution.
This still relieved the subjects’ pain: a placebo effect. But when he added
naloxone to the saline the pain relief disappeared. Here was direct proof that
placebo analgesia is mediated, at least in part, by these natural opiates.
Still, no one knows how belief triggers endorphin release, or why most people
cannot achieve placebo pain relief simply by willing it.
G Though scientists do not know how exactly how placebos work, they have
accumulated a fair bit of knowledge about how to trigger the effect. A London
rheumatologist found, for example, that red dummy capsules made more effective
painkillers than blue, green or yellow ones. Research on American students
revealed that blue pills make better sedatives than pink, a colour more suitable
for stimulants. Even branding can make a difference: if Aspro or Tylenol are
what you like to take for a headache, their chemically identical generic
equivalents may be less effective.
H It matters, too, how
the treatment is delivered. ’Physicians who adopt a warm, friendly and
reassuring bedside manner’, reports Edzard Ernst, professor of Complementary and
Alternative Medicine at Exeler University, ’are more effective than those whose
consultations are formal and do not offer reassurance.’ Warm, friendly and
reassuring are also alternative medicine’s strong suits, of course. Many of the
ingredients of that opening recipe—the physical contact, the generous swathes of
time, the strong hints of supernormal healing power are just the kind of thing
likely to impress patients. It is hardly surprising, then, that aroma
therapists, acupuncturists, herbalists, etc. seem to be good at mobilising the
placebo effect.
—New Scientist 4.填空题You should spend about 20 minutes on Questions 1-13, which are based on
Reading Passage 1 below.
Malaria Kills Twice as Many People as Previously
Thought
Malaria kills twice as many people every
year as formerly believed, taking 1.2 million lives and causing the deaths not
only of babies but also older children and adults, according to the research
that overturns decades of assumptions about one of the world’s most lethal
diseases. The research comes from the highly respected Institute for Health
Metrics and Evaluation (IHME), and is published in the Lancet medical journal.
It has reanalysed 30 years of data on the disease using new techniques and will
force a rethink of the huge global effort that has been under way to eliminate
malaria. That ambition now looks highly unlikely by the UN target date of
2015.
It also raises urgent questions about the future of the
troubled global fund to fight Aids, TB and Malaria, which has provided the money
for most of the tools to combat the disease in Africa, such as
insecticide-impregnated bed nets and new drugs. The fund is in financial crisis
and has had to cancel its next grant-making round.
Dr.
Christopher Murray and colleagues have systematically collected data on deaths
from all over the world over a 30-year period, from 1980 to 2010, using new
methodologies and inventive ways of measuring mortality in countries where
deaths are not conventionally recorded. The work on malaria is part of a much
bigger project which has already led to new estimates of the death rates of
women in childbirth and pregnancy and from breast and cervical cancer. Their
figure of 1.2 million deaths for 2010 is nearly double the 655,000 estimated in
last year’s World Malaria Report.
The good news is that they
have confirmed the downward trend that the World Health Organisation’s report
showed, as a result of efforts by donors, aid organisations and governments to
tackle the disease. The bad news is that the decline comes from a much higher
peak—deaths hit 1.8 million in 2004, they say. That means the interventions such
as better treatment and bed nets are working, but there is much further to go
than everybody had assumed.
’You learn in medical school that
people exposed to malaria as children develop immunity and rarely die from
malaria as adults,’ said Murray, IHME director and the study’s lead author.
’What we have found in hospital records, death records, surveys and other
sources shows that just is not the case.’ Most deaths are still in children, but
a fifth are among those aged 15 to 49, 9% are among 50- to 69-year-olds and 6%
are in people over 70, so a third of all deaths are in adults. In countries
outside sub-Saharan Africa, more than 40% of deaths were in adults.
In Africa, though, the contribution of malaria to children’s deaths is
higher than had been thought, causing 24% of their deaths in 2008 and not 16% as
found by a report by Black and colleagues, whose methodology was used in the
World Malaria Report.
That means that malaria needs a higher
priority if the millennium development goal of cutting child mortality by
two-thirds between 1990 and 2015 is to be achieved, say the authors. They add:
’That malaria is a previously unrecognised driver of adult mortality also means
that the benefits and cost-effectiveness of malaria control, elimination and
eradication are likely to have been underestimated.’
There is a
need, they say, to pay attention to the risks malaria poses to adults and they
support the recent strategy to hand out insecticide-impregnated bed nets to
protect all members of the household against mosquitoes carrying malaria
parasites, instead of insisting they are only for babies and pregnant women, as
was originally the case.
Malaria deaths have come down by 32%
from 1.8 million in 2004 to 1.2 million in 2010 because of the sustained effort
to get bed nets into homes, indoor spraying and new artemisinin combination
drugs—older anti-malarials do not work in many areas because the parasite has
developed resistance to them. More than two-thirds of this has been paid for by
the Geneva-based global fund, which has suffered from donors’ unwillingness to
invest more money.
Professor Rifat Atun, director of strategy,
performance and evaluation at the fund, said more than $2.5bn (￡1.6bn) had been
disbursed for malaria control between 2009 and 2011. By the end of 2011, 235m
bed nets had been distributed. Money that had been pledged was still coming in,
he said, which meant it would be able to invest substantially this year and
next. ’What we are not able to achieve is the rate of increase in investment of
the last few years. The trajectory we have been able to establish will not be
realised,’ he said. ’Given the new burden that Christopher Murray has been able
to show, we really need to ramp up investments in malaria and that really needs
more funding. The mortality figures are much, much larger. We need to double our
efforts to address the burden that we have.’ The Department for International
Development said: ’We are committed to helping halve malaria deaths in at least
10 of the worst affected countries. We will do this by increasing the number of
bed nets used by women and children; improving the diagnosis and treatment of
malarial; and strengthening health information systems to better monitor
progress and target interventions.’
—GuardianMany actions will be taken to reduce malaria deaths in at least 10 countries. 5.填空题Health in the Wild: Animal
Doctors
Many animals seem able to treat their
illnesses themselves. Humans may have a thing or two to learn from
them.
For the past decade Dr. Engel, a lecturer in
environmental sciences at Britain’s Open University, has been collating examples
of self-medicating behaviour in wild animals. She recently published a book on
the subject. In a talk at the Edinburgh Science Festival earlier this month, she
explained that the idea that animals can treat themselves has been regarded with
some skepticism by her colleagues in the past. But a growing number of animal
behaviourists now think that wild animals can and do deal with their own medical
needs.
William Karesh, of the Wildlife Conservation Society, in
New York, for example, has studied the health of a wide range of wild animals,
including anaconda snakes, macaws, penguins, guanacos (South American beasts
related to camels), impala and buffalo. The animals were mostly in good physical
condition, which is not surprising, since the weak quickly go to the wall in the
wild. But blood tests showed that many had encountered nasty viral and bacterial
diseases in the past—including diseases that are often fatal in captive animals,
even when treated by vets. Moreover, if healthy wild animals are brought into
captivity, their health often deteriorates unless great care is taken over their
living conditions. Such observations suggest that wild animals can do something
to keep themselves healthy that captive animals cannot.
Hearty animals
One example of self-medication
was discovered in 1987. Michael Huffman and Mohamedi Seifu, working in the
Mahale Mountains National Park in Tanzania, noticed that local chimpanzees
suffering from intestinal worms would dose themselves with the pith of a plant
called Veronia. This plant produces poisonous chemicals called terpenes. Its
pith contains a strong enough concentration to kill gut parasites, but not so
strong as to kill chimps (nor people, for that matter; locals use the pith for
the same purpose). Given that the plant is known locally as ’goat-killer’,
however, it seems that not all animals are as smart as chimps and humans. Some
consume it indiscriminately, and succumb.
Since the
Veronia—eating chimps were discovered, more evidence has emerged suggesting that
animals often eat things for medical rather than nutritional reasons. Many
species, for example, consume dirt—a behaviour known as geophagy. Historically,
the preferred explanation was that soil supplies minerals such as salt. But
geophagy occurs in areas where the earth is not a useful source of minerals, and
also in places where minerals can be more easily obtained from certain plants
that are known to be rich in them. Clearly, the animals must be getting
something else out of eating earth.
The current belief is that
soil—and particularly the clay in it—helps to detoxify the defensive poisons
that some plants produce in an attempt to prevent themselves from being eaten.
Evidence for the detoxifying nature of clay came in 1999, from an experiment
carried out on macaws by James Gilardi and his colleagues at the University of
California, Davis.
Macaws eat seeds containing alkaloids, a
group of chemicals that has some notoriously toxic members, such as strychnine.
In the wild, the birds are frequently seen perched on eroding riverbanks eating
clay. Dr. Gilardi fed one group of macaws a mixture of a harmless alkaloid and
clay, and a second group just the alkaloid. Several hours later, the macaws that
had eaten the clay had 60% less alkaloid in their bloodstreams than those that
had not, suggesting that the hypothesis is correct.
Rough and ready
A third instance of animal
self-medication is the use of mechanical scours to get rid of gut parasites. In
1972 Richard Wrangham, a researcher at the Gombe Stream Reserve in Tanzania,
noticed that chimpanzees were eating the leaves of a tree called Aspilia. The
chimps chose the leaves carefully by testing them in their mouths. Having chosen
a leaf, a chimp would fold it into a fan and swallow it. Some of the chimps were
noticed wrinkling their noses as they swallowed these leaves, suggesting the
experience was unpleasant. Later, undigested leaves were found on the forest
floor.
Dr. Wrangham rightly guessed that the leaves had a
medicinal purpose—this was, indeed, one of the earliest interpretations of a
behaviour pattern as self-medication. However, he guessed wrong about what the
mechanism was. His (and everybody else’s) assumption was that Aspilia contained
a drug, and this sparked more than two decades of phytochemical research to try
to find out what chemical the chimps were after. But by the 1990s, chimps across
Africa had been seen swallowing the leaves of 19 different species that seemed
to have few suitable chemicals in common. The drug hypothesis was looking more
and more dubious.
It was Dr. Huffman who got to the bottom of
the problem in 1999. He did so by watching what came out of the chimps, rather
than concentrating on what went in. He found that the egested leaves were full
of intestinal worms. The factor common to all 19 species of leaves swallowed by
the chimps was that they were covered with microscopic hooks. These caught the
worms and dragged them from their lodgings.
Following that
observation, Dr. Engel is now particularly excited about how knowledge of the
way that animals look after themselves could be used to improve the health of
livestock. People might also be able to learn a thing or two—and may, indeed,
already have done so. Geophagy, for example, is a common behaviour in many parts
of the world. The medical stalls in African markets frequently sell tablets made
of different sorts of clays, appropriate to different medical conditions.
Africans brought to the Americas as slaves continued this tradition, which gave
their owners one more excuse to affect to despise them. Yet, as Dr. Engel points
out, Rwandan mountain gorillas eat a type of clay rather similar to
kaolinite—the main ingredient of many patent medicines sold over the counter in
the West for digestive complaints. Dirt can sometimes be good for you, and to be
’as sick as a parrot’ may, after all, be a state to be desired.
—Economist
Human beings have already known how to use clay in medicines as animals do. 6.填空题The Power of
Nothing
Want to devise a new form of alternative
medicine No problem. Here is the recipe.
A Be warm,
sympathetic, reassuring and enthusiastic. Your treatment should involve physical
contact, and each session with your patients should last at least half an hour.
Encourage your patients to take an active part in their treatment and understand
how their disorders relate to the rest of their lives. Tell them that their own
bodies possess the true power to heal. Make them pay you out of their own
pockets. Describe your treatment in familiar words, but embroidered with a hint
of mysticism: energy fields, energy flows, energy blocks, meridians, forces,
auras, rhythms and the like. Refer to the knowledge of an earlier age: wisdom
carelessly swept aside by the rise and rise of blind, mechanistic
science.
B Oh, come off it, you are saying. Something
invented off the top of your head could not possibly work, could it Well yes,
it could—and often well enough to earn you a living. A good living if you are
sufficiently convincing, or, better still, really believe in your therapy. Many
illnesses get better on their own, so if you are lucky and administer your
treatment at just the right time you will get the credit. But that’s only part
of it. Some of the improvement really would be down to you. Your healing power
would be the outcome of a paradoxical force that conventional medicine
recognises but remains oddly ambivalent about: the placebo effect.
C Placebos are treatments that have no direct effect on the body,
yet still work because the patient has faith in their power to heal. Most often
the term refers to a dummy pill, but it applies just as much to any device or
procedure, from a sticking plaster to a crystal to an operation. The existence
of the placebo effect implies that even quackery may confer real benefits, which
is why any mention of placebo is a touchy subject for many practitioners of
complementary and alternative medicine (CAM), who are likely to regard it as
tantamount to a charge of charlatanism. In fact, the placebo effect is a
powerful part of all medical care, orthodox or otherwise, though its role is
often neglected or misunderstood.
D One of the great
strengths of CAM may be its practitioners’ skill in deploying the placebo effect
to accomplish real healing. ’Complementary practitioners are miles better at
producing non-specific effects and good therapeutic relationships,’ says Edzard
Ernst, professor of CAM at Exeter University. The question is whether CAM could
be integrated into conventional medicine, as some would like, without losing
much of this power.
E At one level, it should come as no
surprise that our state of mind can influence our physiology: anger opens the
superficial blood vessels of the face; sadness pumps the tear glands. But
exactly how placebos work their medical magic is still largely unknown. Most of
the scant research done so far has focused on the control of pain, because it’s
one of the commonest complaints and lends itself to experimental study. Here,
attention has turned to the endorphins, morphine-like neurochemicals known to
help control pain. ’Any of the neurochemicals involved in transmitting pain
impulses or modulating them might also be involved in generating the placebo
response,’ says Don Price, an oral surgeon at the University of Florida who
studies the placebo effect in dental pain.
F ’But
endorphins are still out in front.’ That case has been strengthened by the
recent work of Fabroizio Benedettil of the University of Turin, who showed that
the placebo effect can be abolished by a drug, naloxone, which blocks the
effects of endorphins. Benedetti induced pain in human volunteers by inflating a
blood-pressure cuff on the forearm. He did this several times a day for several
days, without saying anything, he replaced the morphine with a saline solution.
This still relieved the subjects’ pain: a placebo effect. But when he added
naloxone to the saline the pain relief disappeared. Here was direct proof that
placebo analgesia is mediated, at least in part, by these natural opiates.
Still, no one knows how belief triggers endorphin release, or why most people
cannot achieve placebo pain relief simply by willing it.
G Though scientists do not know how exactly how placebos work, they have
accumulated a fair bit of knowledge about how to trigger the effect. A London
rheumatologist found, for example, that red dummy capsules made more effective
painkillers than blue, green or yellow ones. Research on American students
revealed that blue pills make better sedatives than pink, a colour more suitable
for stimulants. Even branding can make a difference: if Aspro or Tylenol are
what you like to take for a headache, their chemically identical generic
equivalents may be less effective.
H It matters, too, how
the treatment is delivered. ’Physicians who adopt a warm, friendly and
reassuring bedside manner’, reports Edzard Ernst, professor of Complementary and
Alternative Medicine at Exeler University, ’are more effective than those whose
consultations are formal and do not offer reassurance.’ Warm, friendly and
reassuring are also alternative medicine’s strong suits, of course. Many of the
ingredients of that opening recipe—the physical contact, the generous swathes of
time, the strong hints of supernormal healing power are just the kind of thing
likely to impress patients. It is hardly surprising, then, that aroma
therapists, acupuncturists, herbalists, etc. seem to be good at mobilising the
placebo effect.
—New Scientist 7.填空题You should spend about 20 minutes on Questions 1-13, which are based on
Reading Passage 1 below.
Malaria Kills Twice as Many People as Previously
Thought
Malaria kills twice as many people every
year as formerly believed, taking 1.2 million lives and causing the deaths not
only of babies but also older children and adults, according to the research
that overturns decades of assumptions about one of the world’s most lethal
diseases. The research comes from the highly respected Institute for Health
Metrics and Evaluation (IHME), and is published in the Lancet medical journal.
It has reanalysed 30 years of data on the disease using new techniques and will
force a rethink of the huge global effort that has been under way to eliminate
malaria. That ambition now looks highly unlikely by the UN target date of
2015.
It also raises urgent questions about the future of the
troubled global fund to fight Aids, TB and Malaria, which has provided the money
for most of the tools to combat the disease in Africa, such as
insecticide-impregnated bed nets and new drugs. The fund is in financial crisis
and has had to cancel its next grant-making round.
Dr.
Christopher Murray and colleagues have systematically collected data on deaths
from all over the world over a 30-year period, from 1980 to 2010, using new
methodologies and inventive ways of measuring mortality in countries where
deaths are not conventionally recorded. The work on malaria is part of a much
bigger project which has already led to new estimates of the death rates of
women in childbirth and pregnancy and from breast and cervical cancer. Their
figure of 1.2 million deaths for 2010 is nearly double the 655,000 estimated in
last year’s World Malaria Report.
The good news is that they
have confirmed the downward trend that the World Health Organisation’s report
showed, as a result of efforts by donors, aid organisations and governments to
tackle the disease. The bad news is that the decline comes from a much higher
peak—deaths hit 1.8 million in 2004, they say. That means the interventions such
as better treatment and bed nets are working, but there is much further to go
than everybody had assumed.
’You learn in medical school that
people exposed to malaria as children develop immunity and rarely die from
malaria as adults,’ said Murray, IHME director and the study’s lead author.
’What we have found in hospital records, death records, surveys and other
sources shows that just is not the case.’ Most deaths are still in children, but
a fifth are among those aged 15 to 49, 9% are among 50- to 69-year-olds and 6%
are in people over 70, so a third of all deaths are in adults. In countries
outside sub-Saharan Africa, more than 40% of deaths were in adults.
In Africa, though, the contribution of malaria to children’s deaths is
higher than had been thought, causing 24% of their deaths in 2008 and not 16% as
found by a report by Black and colleagues, whose methodology was used in the
World Malaria Report.
That means that malaria needs a higher
priority if the millennium development goal of cutting child mortality by
two-thirds between 1990 and 2015 is to be achieved, say the authors. They add:
’That malaria is a previously unrecognised driver of adult mortality also means
that the benefits and cost-effectiveness of malaria control, elimination and
eradication are likely to have been underestimated.’
There is a
need, they say, to pay attention to the risks malaria poses to adults and they
support the recent strategy to hand out insecticide-impregnated bed nets to
protect all members of the household against mosquitoes carrying malaria
parasites, instead of insisting they are only for babies and pregnant women, as
was originally the case.
Malaria deaths have come down by 32%
from 1.8 million in 2004 to 1.2 million in 2010 because of the sustained effort
to get bed nets into homes, indoor spraying and new artemisinin combination
drugs—older anti-malarials do not work in many areas because the parasite has
developed resistance to them. More than two-thirds of this has been paid for by
the Geneva-based global fund, which has suffered from donors’ unwillingness to
invest more money.
Professor Rifat Atun, director of strategy,
performance and evaluation at the fund, said more than $2.5bn (￡1.6bn) had been
disbursed for malaria control between 2009 and 2011. By the end of 2011, 235m
bed nets had been distributed. Money that had been pledged was still coming in,
he said, which meant it would be able to invest substantially this year and
next. ’What we are not able to achieve is the rate of increase in investment of
the last few years. The trajectory we have been able to establish will not be
realised,’ he said. ’Given the new burden that Christopher Murray has been able
to show, we really need to ramp up investments in malaria and that really needs
more funding. The mortality figures are much, much larger. We need to double our
efforts to address the burden that we have.’ The Department for International
Development said: ’We are committed to helping halve malaria deaths in at least
10 of the worst affected countries. We will do this by increasing the number of
bed nets used by women and children; improving the diagnosis and treatment of
malarial; and strengthening health information systems to better monitor
progress and target interventions.’
—GuardianThe death rates of children caused by malaria in Africa is much higher than had been thought. 8.填空题Health in the Wild: Animal
Doctors
Many animals seem able to treat their
illnesses themselves. Humans may have a thing or two to learn from
them.
For the past decade Dr. Engel, a lecturer in
environmental sciences at Britain’s Open University, has been collating examples
of self-medicating behaviour in wild animals. She recently published a book on
the subject. In a talk at the Edinburgh Science Festival earlier this month, she
explained that the idea that animals can treat themselves has been regarded with
some skepticism by her colleagues in the past. But a growing number of animal
behaviourists now think that wild animals can and do deal with their own medical
needs.
William Karesh, of the Wildlife Conservation Society, in
New York, for example, has studied the health of a wide range of wild animals,
including anaconda snakes, macaws, penguins, guanacos (South American beasts
related to camels), impala and buffalo. The animals were mostly in good physical
condition, which is not surprising, since the weak quickly go to the wall in the
wild. But blood tests showed that many had encountered nasty viral and bacterial
diseases in the past—including diseases that are often fatal in captive animals,
even when treated by vets. Moreover, if healthy wild animals are brought into
captivity, their health often deteriorates unless great care is taken over their
living conditions. Such observations suggest that wild animals can do something
to keep themselves healthy that captive animals cannot.
Hearty animals
One example of self-medication
was discovered in 1987. Michael Huffman and Mohamedi Seifu, working in the
Mahale Mountains National Park in Tanzania, noticed that local chimpanzees
suffering from intestinal worms would dose themselves with the pith of a plant
called Veronia. This plant produces poisonous chemicals called terpenes. Its
pith contains a strong enough concentration to kill gut parasites, but not so
strong as to kill chimps (nor people, for that matter; locals use the pith for
the same purpose). Given that the plant is known locally as ’goat-killer’,
however, it seems that not all animals are as smart as chimps and humans. Some
consume it indiscriminately, and succumb.
Since the
Veronia—eating chimps were discovered, more evidence has emerged suggesting that
animals often eat things for medical rather than nutritional reasons. Many
species, for example, consume dirt—a behaviour known as geophagy. Historically,
the preferred explanation was that soil supplies minerals such as salt. But
geophagy occurs in areas where the earth is not a useful source of minerals, and
also in places where minerals can be more easily obtained from certain plants
that are known to be rich in them. Clearly, the animals must be getting
something else out of eating earth.
The current belief is that
soil—and particularly the clay in it—helps to detoxify the defensive poisons
that some plants produce in an attempt to prevent themselves from being eaten.
Evidence for the detoxifying nature of clay came in 1999, from an experiment
carried out on macaws by James Gilardi and his colleagues at the University of
California, Davis.
Macaws eat seeds containing alkaloids, a
group of chemicals that has some notoriously toxic members, such as strychnine.
In the wild, the birds are frequently seen perched on eroding riverbanks eating
clay. Dr. Gilardi fed one group of macaws a mixture of a harmless alkaloid and
clay, and a second group just the alkaloid. Several hours later, the macaws that
had eaten the clay had 60% less alkaloid in their bloodstreams than those that
had not, suggesting that the hypothesis is correct.
Rough and ready
A third instance of animal
self-medication is the use of mechanical scours to get rid of gut parasites. In
1972 Richard Wrangham, a researcher at the Gombe Stream Reserve in Tanzania,
noticed that chimpanzees were eating the leaves of a tree called Aspilia. The
chimps chose the leaves carefully by testing them in their mouths. Having chosen
a leaf, a chimp would fold it into a fan and swallow it. Some of the chimps were
noticed wrinkling their noses as they swallowed these leaves, suggesting the
experience was unpleasant. Later, undigested leaves were found on the forest
floor.
Dr. Wrangham rightly guessed that the leaves had a
medicinal purpose—this was, indeed, one of the earliest interpretations of a
behaviour pattern as self-medication. However, he guessed wrong about what the
mechanism was. His (and everybody else’s) assumption was that Aspilia contained
a drug, and this sparked more than two decades of phytochemical research to try
to find out what chemical the chimps were after. But by the 1990s, chimps across
Africa had been seen swallowing the leaves of 19 different species that seemed
to have few suitable chemicals in common. The drug hypothesis was looking more
and more dubious.
It was Dr. Huffman who got to the bottom of
the problem in 1999. He did so by watching what came out of the chimps, rather
than concentrating on what went in. He found that the egested leaves were full
of intestinal worms. The factor common to all 19 species of leaves swallowed by
the chimps was that they were covered with microscopic hooks. These caught the
worms and dragged them from their lodgings.
Following that
observation, Dr. Engel is now particularly excited about how knowledge of the
way that animals look after themselves could be used to improve the health of
livestock. People might also be able to learn a thing or two—and may, indeed,
already have done so. Geophagy, for example, is a common behaviour in many parts
of the world. The medical stalls in African markets frequently sell tablets made
of different sorts of clays, appropriate to different medical conditions.
Africans brought to the Americas as slaves continued this tradition, which gave
their owners one more excuse to affect to despise them. Yet, as Dr. Engel points
out, Rwandan mountain gorillas eat a type of clay rather similar to
kaolinite—the main ingredient of many patent medicines sold over the counter in
the West for digestive complaints. Dirt can sometimes be good for you, and to be
’as sick as a parrot’ may, after all, be a state to be desired.
—Economist
Captive animals know how to take care of themselves as wild ones. 9.填空题The Power of
Nothing
Want to devise a new form of alternative
medicine No problem. Here is the recipe.
A Be warm,
sympathetic, reassuring and enthusiastic. Your treatment should involve physical
contact, and each session with your patients should last at least half an hour.
Encourage your patients to take an active part in their treatment and understand
how their disorders relate to the rest of their lives. Tell them that their own
bodies possess the true power to heal. Make them pay you out of their own
pockets. Describe your treatment in familiar words, but embroidered with a hint
of mysticism: energy fields, energy flows, energy blocks, meridians, forces,
auras, rhythms and the like. Refer to the knowledge of an earlier age: wisdom
carelessly swept aside by the rise and rise of blind, mechanistic
science.
B Oh, come off it, you are saying. Something
invented off the top of your head could not possibly work, could it Well yes,
it could—and often well enough to earn you a living. A good living if you are
sufficiently convincing, or, better still, really believe in your therapy. Many
illnesses get better on their own, so if you are lucky and administer your
treatment at just the right time you will get the credit. But that’s only part
of it. Some of the improvement really would be down to you. Your healing power
would be the outcome of a paradoxical force that conventional medicine
recognises but remains oddly ambivalent about: the placebo effect.
C Placebos are treatments that have no direct effect on the body,
yet still work because the patient has faith in their power to heal. Most often
the term refers to a dummy pill, but it applies just as much to any device or
procedure, from a sticking plaster to a crystal to an operation. The existence
of the placebo effect implies that even quackery may confer real benefits, which
is why any mention of placebo is a touchy subject for many practitioners of
complementary and alternative medicine (CAM), who are likely to regard it as
tantamount to a charge of charlatanism. In fact, the placebo effect is a
powerful part of all medical care, orthodox or otherwise, though its role is
often neglected or misunderstood.
D One of the great
strengths of CAM may be its practitioners’ skill in deploying the placebo effect
to accomplish real healing. ’Complementary practitioners are miles better at
producing non-specific effects and good therapeutic relationships,’ says Edzard
Ernst, professor of CAM at Exeter University. The question is whether CAM could
be integrated into conventional medicine, as some would like, without losing
much of this power.
E At one level, it should come as no
surprise that our state of mind can influence our physiology: anger opens the
superficial blood vessels of the face; sadness pumps the tear glands. But
exactly how placebos work their medical magic is still largely unknown. Most of
the scant research done so far has focused on the control of pain, because it’s
one of the commonest complaints and lends itself to experimental study. Here,
attention has turned to the endorphins, morphine-like neurochemicals known to
help control pain. ’Any of the neurochemicals involved in transmitting pain
impulses or modulating them might also be involved in generating the placebo
response,’ says Don Price, an oral surgeon at the University of Florida who
studies the placebo effect in dental pain.
F ’But
endorphins are still out in front.’ That case has been strengthened by the
recent work of Fabroizio Benedettil of the University of Turin, who showed that
the placebo effect can be abolished by a drug, naloxone, which blocks the
effects of endorphins. Benedetti induced pain in human volunteers by inflating a
blood-pressure cuff on the forearm. He did this several times a day for several
days, without saying anything, he replaced the morphine with a saline solution.
This still relieved the subjects’ pain: a placebo effect. But when he added
naloxone to the saline the pain relief disappeared. Here was direct proof that
placebo analgesia is mediated, at least in part, by these natural opiates.
Still, no one knows how belief triggers endorphin release, or why most people
cannot achieve placebo pain relief simply by willing it.
G Though scientists do not know how exactly how placebos work, they have
accumulated a fair bit of knowledge about how to trigger the effect. A London
rheumatologist found, for example, that red dummy capsules made more effective
painkillers than blue, green or yellow ones. Research on American students
revealed that blue pills make better sedatives than pink, a colour more suitable
for stimulants. Even branding can make a difference: if Aspro or Tylenol are
what you like to take for a headache, their chemically identical generic
equivalents may be less effective.
H It matters, too, how
the treatment is delivered. ’Physicians who adopt a warm, friendly and
reassuring bedside manner’, reports Edzard Ernst, professor of Complementary and
Alternative Medicine at Exeler University, ’are more effective than those whose
consultations are formal and do not offer reassurance.’ Warm, friendly and
reassuring are also alternative medicine’s strong suits, of course. Many of the
ingredients of that opening recipe—the physical contact, the generous swathes of
time, the strong hints of supernormal healing power are just the kind of thing
likely to impress patients. It is hardly surprising, then, that aroma
therapists, acupuncturists, herbalists, etc. seem to be good at mobilising the
placebo effect.
—New Scientist 10.填空题You should spend about 20 minutes on Questions 1-13, which are based on
Reading Passage 1 below.
Malaria Kills Twice as Many People as Previously
Thought
Malaria kills twice as many people every
year as formerly believed, taking 1.2 million lives and causing the deaths not
only of babies but also older children and adults, according to the research
that overturns decades of assumptions about one of the world’s most lethal
diseases. The research comes from the highly respected Institute for Health
Metrics and Evaluation (IHME), and is published in the Lancet medical journal.
It has reanalysed 30 years of data on the disease using new techniques and will
force a rethink of the huge global effort that has been under way to eliminate
malaria. That ambition now looks highly unlikely by the UN target date of
2015.
It also raises urgent questions about the future of the
troubled global fund to fight Aids, TB and Malaria, which has provided the money
for most of the tools to combat the disease in Africa, such as
insecticide-impregnated bed nets and new drugs. The fund is in financial crisis
and has had to cancel its next grant-making round.
Dr.
Christopher Murray and colleagues have systematically collected data on deaths
from all over the world over a 30-year period, from 1980 to 2010, using new
methodologies and inventive ways of measuring mortality in countries where
deaths are not conventionally recorded. The work on malaria is part of a much
bigger project which has already led to new estimates of the death rates of
women in childbirth and pregnancy and from breast and cervical cancer. Their
figure of 1.2 million deaths for 2010 is nearly double the 655,000 estimated in
last year’s World Malaria Report.
The good news is that they
have confirmed the downward trend that the World Health Organisation’s report
showed, as a result of efforts by donors, aid organisations and governments to
tackle the disease. The bad news is that the decline comes from a much higher
peak—deaths hit 1.8 million in 2004, they say. That means the interventions such
as better treatment and bed nets are working, but there is much further to go
than everybody had assumed.
’You learn in medical school that
people exposed to malaria as children develop immunity and rarely die from
malaria as adults,’ said Murray, IHME director and the study’s lead author.
’What we have found in hospital records, death records, surveys and other
sources shows that just is not the case.’ Most deaths are still in children, but
a fifth are among those aged 15 to 49, 9% are among 50- to 69-year-olds and 6%
are in people over 70, so a third of all deaths are in adults. In countries
outside sub-Saharan Africa, more than 40% of deaths were in adults.
In Africa, though, the contribution of malaria to children’s deaths is
higher than had been thought, causing 24% of their deaths in 2008 and not 16% as
found by a report by Black and colleagues, whose methodology was used in the
World Malaria Report.
That means that malaria needs a higher
priority if the millennium development goal of cutting child mortality by
two-thirds between 1990 and 2015 is to be achieved, say the authors. They add:
’That malaria is a previously unrecognised driver of adult mortality also means
that the benefits and cost-effectiveness of malaria control, elimination and
eradication are likely to have been underestimated.’
There is a
need, they say, to pay attention to the risks malaria poses to adults and they
support the recent strategy to hand out insecticide-impregnated bed nets to
protect all members of the household against mosquitoes carrying malaria
parasites, instead of insisting they are only for babies and pregnant women, as
was originally the case.
Malaria deaths have come down by 32%
from 1.8 million in 2004 to 1.2 million in 2010 because of the sustained effort
to get bed nets into homes, indoor spraying and new artemisinin combination
drugs—older anti-malarials do not work in many areas because the parasite has
developed resistance to them. More than two-thirds of this has been paid for by
the Geneva-based global fund, which has suffered from donors’ unwillingness to
invest more money.
Professor Rifat Atun, director of strategy,
performance and evaluation at the fund, said more than $2.5bn (￡1.6bn) had been
disbursed for malaria control between 2009 and 2011. By the end of 2011, 235m
bed nets had been distributed. Money that had been pledged was still coming in,
he said, which meant it would be able to invest substantially this year and
next. ’What we are not able to achieve is the rate of increase in investment of
the last few years. The trajectory we have been able to establish will not be
realised,’ he said. ’Given the new burden that Christopher Murray has been able
to show, we really need to ramp up investments in malaria and that really needs
more funding. The mortality figures are much, much larger. We need to double our
efforts to address the burden that we have.’ The Department for International
Development said: ’We are committed to helping halve malaria deaths in at least
10 of the worst affected countries. We will do this by increasing the number of
bed nets used by women and children; improving the diagnosis and treatment of
malarial; and strengthening health information systems to better monitor
progress and target interventions.’
—GuardianThe scheme that can estimate the death rates of pregnant women has already been carried out.