Monday, March 13, 2006

Playing Offense in the Culture Wars

Matt Yglesias thinks that the HPV vaccine is the perfect moment for the democrats to play offense in the culture wars. I agree. Just get a load of this.

GlaxoSmithKline Plc's experimental cervical vaccine Cervarix provides 100 percent protection over four years against cervical lesions, according to data presented on Tuesday.

The findings, presented at a meeting in Atlanta of the Advisory Committee on Immunization Practices, maintain the results of earlier studies showing no evidence of waning protection against two key virus types, HPV 16 and HPV 18.

Glaxo is competing against Merck & Co. Inc. in the race to market a vaccine against a sexually transmitted infection called human papillomavirus (HPV), which causes most cases of cervical cancer, the second-most fatal cancer in women.

This is the sort of thing that pro-business conservatives and free-market conservatives should be out in the street whooping about. The triumph of private corporations in producing a cancer vaccine! (Bonus: Bill Gates provided a lot of grant money to fund its development too) There's only one problem: the social conservatives want to stop it. At least, stop it from the way it is most effective: from becoming mandatory. Something that could kill this disease and the prevalence of it, and Focus on the Family and Family Research Council (the NARAL of the Right, heh) oppose any mandatory vaccination regime. Sayeth, TNR:

Religious conservatives are posing the debate as a choice between abstinence and safe sex. "We feel people should have the choice of abstinence as a means to avoid HPV," a spokeswoman for Christian Medical & Dental Associations told me. "Our concern is this vaccine will be marketed to a segment of the population that should be getting a message about abstinence," says the Family Research Council. And in theory, that's fine. But, like communism, certain ideas have a hard time succeeding in the real world. Studies show that not only do abstinence programs have little to no effect on rates of sexual activity, they also tend to mislead or withhold information about practicing safe sex. That's why people who pledge abstinence are less likely to have safe sex and avoid STDs when they do find partners. So while, in theory, the choice of abstinence over Merck's vaccine would be fine, in reality, it too often would mean a choice to expose oneself to HPV--and the risk of cervical cancer.

And because HPV is so widespread--absent a vaccine, 80 percent of Americans will contract it at some point in their lives--the stakes in this discussion are high. It's true that most of the hundred or so strains of HPV are innocuous, so the fact that over 20 million Americans have it at any given point is not necessarily cause for alarm. It's also true that the annual number of cervical cancer cases is relatively small--10,400, a third of which are fatal. But each year, 4.7 million American women require one or more follow-up appointments for an abnormal pap result, and at least 3 million of these cases result from having HPV. The cost of these appointments to the individual (and to our already overburdened health care system) quickly adds up. A 2003 Stanford study suggested that the cost of inoculating people against the disease would be far smaller than the current cost to the health care system associated with HPV.

It's moments like this, when a clear political strategy is sharply in focus, that depress you more. While we get Democrats seething with hatred and gesticulating violent at Iraq and talking about National Healthcare, (or Democrats in Maryland forcing healthcare on Wal-Mart) this stuff creeps in under the radar. If liberals want to engage in the Culture Wars (which they more or less will have to), they need to be painting every FOF and FRC ally as against cancer vaccines, against public health, and (if you want to be truthful) against contraception too. Let's just lean on the whole bunch. We're really seeing a War on Sex right now, and that war is extending beyond the perimeters into public health issues like preventing cancer. It's something that will stick in the public's mind, if only people would call attention to it. And it's something that truly constitutes right-wing overreach in the Culture Wars, and will be perceived as such by ordinary Americans. If they can call liberals and Democrats part of the "culture of death", calling them "anti-health", "anti-vaccine", or even "pro-cancer" is fair play.