Ghosts across cultures

The Old Burial Ground at the Boston Commons. Photo by Smallman

I’ve long loved Japanese ghost stories, ever since I came across the stories of Lafcadio Hearn. As the epitome of modernity, with its vast urban metropolis of Tokyo, sophisticated infrastructure, and advanced education, you might expect that these supernatural traditions would be fading in Japan. After all, Hearn recorded his stories in the nineteenth century. Instead, the traditions are evolving, as Christopher Harding has described in an article, “Ghosts on the Shore.” In the aftermath of the 2011 tsunami, ghosts didn’t disappear, but their role changed, as they comforted the living. Harding’s well-written and thoughtful piece is worth reading, particularly to hear the thoughts of one Zen priest who has an interesting take on the divide between the living and the dead. …

Sea level rise in Asia

Casinos in Macau, China.
中国澳门的赌场 Photo by Shawn Smallman

I think that we have reached the point with global warming where we can no longer pretend that we’re going to meet our goals. That doesn’t mean that citizens globally can stop the effort to limit climate change. There is a vast difference between the worst scenarios and the best. There are also reasons for hope, from the plunging cost of solar power, to the rapid development of offshore wind power. At the same time, in the end it’s not enough. Given the amount of carbon dioxide in the atmosphere, the changing albedo of the Arctic due to declining ice cover, and the warming of our oceans, global warming will be continuing for centuries. At this point, human societies will be adapting to climate change far into the future, especially coastal communities. …

Will Jakarta be lost to the waters?

Globally, sea level rise will challenge coastal cities such as Miami, New Orleans, New York and Shanghai. All of these cities face overwhelming challenges, especially those located in developing nations. For a good look at the debates in one such city, Jakarta, I recommend Chris Bentley’s article in PRI, “Trying to confront a massive flood risk, Jakarta faces ‘problem on top of problem.'” While engineering solutions are possible, they come with their own moral and political issues.

Shawn Smallman, 2017

MERS continues to spread

"Virus" by renjith krishnan at
“Virus” by renjith krishnan at

The news regarding the respiratory virus MERS-COV continues to be worrying. A second case of MERS has now been reported in the United States in Orlando, Florida. This individual is a health care worker from Saudi Arabia who traveled to the U.S., as was the previous case. This fact raises serious concerns about infection control measures in Saudi Arabia’s hospitals, as I discussed in an earlier post. Fortunately, he seems to be recovering. Equally significant, two Indonesians have recently fallen ill with the disease. The first died on April 29th, and the second is seriously sick. This man had gone to Saudi Arabia on pilgrimage. Given that there is no vaccine for MERS, nor is one likely to be developed in the near future, the continued appearance of MERS amongst health care workers from Saudi Arabia, and its spread outside the Kingdom’s borders, is a worrying sign. There are also concerns in the United Kingdom, given that both of the recent cases in the United States arrived after transiting through Heathrow. …

H7N9 Influenza and the WHO’s Pandemic Influenza Plan

Photo courtesy of hyena reality and
Photo courtesy of hyena reality and

Like many of you, I’ve been carefully following the news about H7N9. A few of my favorite blogs or sites for this are Avian Flu Diary, Virology down under, the Center for Infectious Disease Research and Policy, and the Bird Flu Report. A couple of thoughts about what we know so far. First, it is always difficult to make a vaccine for an H7 virus. For this reason, it’s unlikely that sufficient vaccine could be ready in six months, even in the United States. It is true that some newer vaccine technologies are now proving their potential. But we aren’t in a fundamentally different position than in 2009, when most vaccine became available too late for swine flu. …

Vaccines and Global Health: Indonesia, the World Bank and Pandemic Influenza

Pandemic preparedness is a tricky question in global health governance. How do you create a framework that will ensure the global public good, in a context in which if every country follows its national interest, all nations may wind up in a worse position than if they cooperated? What makes influenza a challenging problem to address is its episodic nature. The last highly lethal pandemic was in 1918. In 2007 the mortality from avian flu in Indonesia was 87%. This means that the global community needs to prepare for this threat, but it cannot know when a pandemic may begin. For other diseases –malaria, tuberculosis, and HIV/AIDS- there is an alphabet soup of non-governmental organizations that advocate for those who are ill or at risk. These don’t exist for influenza, because of its episodic nature, which makes influenza a distinct global health governance issue. For this reason, the World Health Organization may not be able to prepare for a pandemic on its own, although it would certainly have authority once a pandemic had begun. Within the current framework, there seems no way to address the current stand-off regarding viral seed stock sharing, which threatens to create “rogue states” out of nations such as Indonesia. In this sense, a rogue state is a nation that acts outside the framework of international law and practice, although this definition is always also political. Currently, the United States is trying to identify next-generation vaccine technologies that will create more vaccine in a faster fashion. This will help, but there is no technological solution to this ethical and political problem.

Influenza Virus by renjith krishnan at

One example illustrates this point. In order to create pre-pandemic vaccines, global health authorities need access to virus samples from regional outbreaks. But countries that have avian flu outbreaks may not benefit from the vaccine, which means that they are sometimes unwilling to share this seed stock. In 2007 Indonesia decided to not share viral samples with the World Health Organization, and instead to make a private deal with a vaccine manufacturer.  Indonesia was frustrated that viral samples it had shared with the World Health Organization had been shared with pharmaceutical companies to create vaccines, and that some companies allegedly intended to patent sections of the virus’s genome. For this reason, the nation tried to reach an arrangement with Baxter Healthcare, in which Indonesia would exchange viral samples in return for inexpensive access to vaccine, as well as other assistance to prepare the nation for a pandemic. Developed countries harshly criticized Indonesia’s decision,  which was depicted it as a “rogue state” in the global health system. But Indonesia argued that the 1992 Convention on Biological Diversity gave it control over genetic material from within its borders, thus creating the idea of “viral sovereignty.” From Indonesia’s perspective, they were cutting out the middleman, the World Health Organization, as part of an effort to ensure better access to vaccine for their population. …

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