Part of the problem is that none of these articles were
co-written by a Liberian scientist. The investigators
collected their samples, returned home and published
the startling results in European medical journals.
Few Liberians were then trained in laboratory or
epidemiological methods. Even today, downloading one
of the papers would cost a physician here $45, about
half a week’s salary.
Academic here. There is no reason why these articles should have to cost $45. Academics have to publish in name-brand journals to get recognized, and these high prices are pure rent-seeking on behalf of the publishers.
publishers need to make money too. i also dislike this anti 'rent-seeking' culture. if there is no reason for it to cost that much, start your own publishing company and give out the materials for free (or some lower price).
> start your own publishing company and give out the materials for free
There are many people that are moving exactly to this. As ever, the problem is that the market is not perfectly fluid and things like academic cultural biases, impressions of prestige, etc often do not follow the most efficient contours. Posts like the GP's are called for precisely because they call attention to this and try to shift perception.
I find the premise of this article very hard to believe. On one hand I am sure that the researchers shared their results with the responsible agencies at the time. I very much doubt that they would have just written up this article, submitted it to the journal and called it a day. These studies are usually done in direct collaboration with local doctors, and governments, even if they might not have been authors on the paper.
On the other hand the poor state of Liberia's (and the whole region's) health system and the threat of infectious diseases has been a known problem for a long time. I can't imagine that hearing about a small number of cases of people with Ebola antibodies in 1982 would have made any difference to Liberia's policies. They were already doing all they could to improve their health system and Ebola is/was far from the only threat.
You should look into the whole "open access" movement in research. There is a huge, HUGE disparity in access to journals and research between scientists in North America / Europe and developing countries.
Researchers in the US do not cite African journals and likely do not read them; African scientists often cannot afford journals from US universities -- journal access on SAGE or Taylor & Francis can run well over $10K per year.
The premise isn't hard to believe if you've spent any time in research institutions or academies in these countries, and it's extremely unfortunate.
Except that there are initiatives (Research4Life, HINARI, AGORA, etc) to get free access to researchers in the developing world, especially Africa. If you move to "open access," African scientists won't be able to get published.
I have no experience in the health science world, but in IT most scientists say it's only about publishing papers nowadays. Discoveries don't matter, making it useful doesn't matter. Write a paper, get it published, rinse, and repeat.
Health is a much much older area, so I would be pessimistic about finding more fresh and reasonable patterns there. So the article sounds very reasonable to me, but I really, really hope that what you write is true.
While the paper is quite specific, it is 30 years old. A pandemic that will kill millions is still just around the corner and overdue based on historical statistics.
Will I get to link to this comment and say "pandemic, I told you so" in 5 years?
In the same way many people predicted the sub-prime mortgage bubble bursting, saying how and when is the hard part.
I found an abstract of at least one article from 1986 discussing the 13.4% prevalence of antibodies against Ebola in Liberia (from a rainforest area) in 2 minutes using pubmed, which is free and open for all to use. It does not link to the full text (some abstracts do link to full text), but the basic information was easily found. You just have to look for it!
While it's true that "hindsight bias" is a thing, and should be guarded against, this kind of throw-away comment dismissing issues like this bothers me. We can similarly dismiss everything said by everyone prominent by referring to "Argument from Authority," as if that's a bad thing. But in truth, people with a great deal of experience sometimes rise to a position of authority purely because they tend to be right, and so Bayesian Analysis suggests that we really should give more weight to what they say.
Similarly here. Don't simply say "Oh, hindsight bias, this is completely irrelevant." If you don't provide some sort of evidence that this particular instance is "simply hindsight bias" then I will tend to dismiss what you say.
You may be right, but you have provided no evidence. Just a baseless accusation.
I was reluctant to say what follows, as I didn't want to be accused of an ad hominem attack, but I have decided to say it as I feel that it is information to be shared. In looking through your previous comments I see that you have a track record for providing a relentlessly negative response to things. There is value in that, as such critical and sceptical responses balance the relentless, boundless positive viewpoints of others, but it means that now I have a more informed context in which to interpret your contributions.
Hindsight bias is a nice broad stroke to dismiss an area in which you have no or limited expertise in.
It's like your management team saying "So what, we've been getting alerts for CPU above 50% utilization every day, but the site is still processing orders fine". To which your response would be "When did they start? How frequently are they occurring? Has CPU utilization stayed at 50% or is it steadily increasing? Why didn't anyone call me?"
Getting the right information to the right people is important for determining what should be acted upon.
Any region that has evidence of endemic Ebola will benefit from having an organized public health approach to combating it.
The warnings in the headline are papers published in the 1980s that contained evidence of endemic Ebola in Liberia.
The article is making the point that had knowledge of these papers been more widespread, especially among medical personnel in Liberia, that Liberia likely would have responded differently to the problem.
It isn't really about what readers of the American press should have done to prepare for Ebola in Liberia (which is the meaning I infer from your first sentence, maybe that's wrong).
Ebola is a very "clever" virus with its interferon-blocking properties. But still, out of the infections we still cannot vaccinate against, influenza has been the single most deadly one in the past, and sexually transmitted diseases are the real issue in the developed world. Why don't we encourage people to have flu shots and use condoms? Well, we do. But this is boring.
So I guess Ebola is big news because it is something new on the panic scene, sweating with blood sounds crazy dangerous, the fears have been accelerated by having the outbreak in a place that "has been forgotten by the god", devastated by wars being fought by children. As to why there is nothing to be afraid of, take a look at the CDC's data.
Obviously, with the importance of the mortality issues of this study, it is not comparable in terms of importance, but NY times promoting/warning me that I only have 10 free articles left is a little ironic.
This was my exact thought. In fact before reading the article I actually thought that this was just an article about Ebola that an HN admin had retitled after being annoyed by the NYT paywall.
The NYT paywall is easy to get around. (Copy/paste the title and search for it in Google) Of course that's the irony mentioned, since the article in question was paywalled.
I know but still. I've had to do this enough that I think I am going to just write a chrome extension that will modify the referrer to be google.com on every request on specified sites.
That's kind of beside the point. You should carefully consider the potential negative impacts of your own paywall (reduction in useful ideas that others could benefit from, such as ideas on liberty and government) before writing critical articles of others' paywalls.
What's really grating here is that that paper behind the paywall is one for which the 'online rights' have never been negotiated for so the paywalled version should really have been in the public domain. This goes for almost all scientific papers up to 1995.
Is that really true though? The right to distribute a work isn't tied to a specific medium. A contract between an author and a publisher can divide up the right by medium if it wishes but an unspecfied "right to publish" would include the web already. Seem like you'd need to read the specific contract in question and have a good knowledge of the relevant precedents to draw a conclusion here.
Even if you're correct, works after 1923 would not enter the public domain, because the author never relinquished their exclusive right to web publication.
Of course even for a public domain work, there's nothing to prevent a publisher from charging for it.
Yes, it really is. The chairman of the Royal Dutch Library paid a pretty expensive lawyer for a reasonably long amount of time to get this figured out once and for all, the rights did not automatically transfer from the author to the publisher so technically they still lie with the author or in applicable cases with their estate.
That's not the public domain though - the authors still own the work, the public has no right to it. Do you have a citation for the "figured out once and for all" information, I can't seem to find anything?
There are many non-Ebola viral hemorrhagic fevers across Sub-Saharan Africa. Not all might be quite as lethal as Ebola, but they have similar modes of transmission that you wouldn't need an Ebola specific warning to know not to touch dead people. I obviously think this shouldn't be behind a paywall, but I don't think that would help.
The title of the paper in question is presumably "A serological survey on viral haemorrhagic fevers in liberia".
(linked in another comment by DangerousPie)
So even if you take a step back from calling it a warning about Ebola, the question of why it was not well known in Liberia is still an interesting one.
So the main conclusions of the paper were not behind a paywall, just the full paper. And yet it still went unseen. Probably more because it was an old paper in a journal with a miniscule impact factor [1]. Even if it was open access, I really doubt that would have changed anything.
There are problems here, and I'm a huge open access supporter, but blaming this on a paywall seems like a red herring.
Yes, I'm an idiot. If you look in that paper I linked to, it shows the real impact factor is about 1. Which is still low, but not as crazy low as 0.122.
Also if you look up the original ebola paper there were actually several papers that cited it and discussed the results, and apparently nobody noticed those either.
The first sentence is (at least to me) obviously untrue -- their have been people clearly and publicly saying this is a serious problem since at least the mid-90's. The book "The Coming Plague" came out in 1995, and discusses almost this exact scenario:
http://www.amazon.com/The-Coming-Plague-Emerging-Diseases/dp...
There is little spending on public health issues, crumbling infrastructure, and, due to ease of travel and overcrowding, diseases spread faster then ever before.
Hurricane Katrina was also predicted with a detailed article in Scientific American explaining the outcome of the exact same scenario a few years before it actually happened. Naturally nothing was done to prepare.
I found the reference in someone else's blog, and followed the guidelines by submitting the original, and not the link to the blog. I kept the title as it was on the blog because that's what auto-completed when I used the bookmarklet, and it felt justified given the line:
Even today, downloading one of the papers
would cost a physician here $45, about
half a week’s salary.
The mods appear to agree with you, though, so even though the title I used was the title from where I first found it, and even though it matches one of the lines in the article, and even though it helps provide more information about the content/conclusion, it's been reduced to the less informative exact title of the original.
