The Land of Ire

I’ve just returned from a lovely tour of Ireland. The tour was informative, the people were friendly, and the scenery was bright and interesting, despite the drizzle and cloudiness.

I managed to snag one of the many Sunday newspapers, the Sunday Independent, and a front-page article caught my attention. Obviously while I was there, I was curious about the religiousness of the denizens. The Irish seem more practical, with a hint of harmless superstition, than many Americans. The American religious (“Real Americans”) seem obsessed with condemning everyone to hell. The working Irish seem more concerned with keeping themselves alive and having a decent pint. Of course, Irish history is full of religious turmoil (read up on Henry VIII and the eventual split of Ireland, which, up to recently, has been a very dark time for Ireland, indeed), but it doesn’t seem like the issue of religion pervades their everyday life.

The front-page article, though, hinted at the fact that there might be a religious-based element simmering beneath the politics.1 The article was about the HPV vaccine, and how Ireland had just recently implemented the HPV screening process for adult women. It seems that the Irish government was halting the vaccinations of girls (around the age of 12) because of funding issues. However, the proponents of government-backed vaccinations argued that the real reason was based on the false argument that having vaccinations leads to promiscuity — an argument echoed in the U.S. debate over the very same vaccinations. A prominent Irish politician noted that the antagonists were playing “sexual politics.”

Here’s an excerpt: (emphasis mine)

[A] memorandum, which was drafted in the Department of Health, also sets out various arguments against now going ahead with the vaccination programme by placing significant emphasis on the risk factors associated with the cause of cervical cancer.

It states: “The virus that leads to cervical cancer is transmitted by sexual activity. It is very rare that a girl or woman who has not been sexually active would contract cervical cancer from this virus. The risk factors for cervical cancer are: early onset of sexual activity; multiple sexual partners; and smoking. These risk factors are reduced by health promotion measures.”

The Sunday Independent has established that serious concern exists among several Fianna Fail TDs and senators at the highlighting of what one called “sexual politics” in the debate.

A Fianna Fail TD said: “The whole notion of so-called promiscuous women being linked, albeit subtly, to the withdrawal of the vaccination programme is worrying for many of us in the party — but not all, I should add.”

Another TD said: “There is a real risk here of actually stigmatising women with cervical cancer as some kind of ‘woman of loose morals’.”

James McDaid failed to vote with the Government on a Fine Gael motion critical of the Government’s decision to “abandon” the vaccination programme. Dr McDaid subsequently asked the Dail: “Is there anyone in this House who would not give the vaccine to their daughters today?

In a related article, it’s argued that, in light of the Irish minister’s assertion that cervical cancer screening obviated the necessity for vaccination, it’s better to have both that and an effective form of prevention rather than just the treatment.2

The vaccine prevents the great majority of these cancers and pre-cancers. It also prevents treatment and treatment side effects. That any serious authority could suggest that early detection is better than prevention is simply absurd.

Well, I suppose we’re not all that unlike, Ireland and America. How many Irish families will be able to afford the 600 Euro (about $758) private HPV vaccinations, now that the health minister has absolved the national vaccination program?3

The Irish government, the health minister in particular, used the “cost” excuse as its primary reason for halting the vaccine, but today, a letter to the Independent performed a simple cost/benefit analysis,4 which I think should put any government in its place when it weighs the value of a dollar over that of a life. Here’s an abridged version:

The value put on a life by the National Roads Authority is about €2m….

It is estimated that the cervical cancer vaccine would save 70 to 80 lives a year… a benefit of €150m per annum for a cost of €10m per annum for the vaccine.

The plan is to give the vaccine to 10 to 12-year-olds, but as the average age of onset of cervical cancer is 47, it can be argued that we may have to wait, on average, some 36 years to see the benefits.

This means we have to discount that benefit using the Department of Finance discount rate of 4pc per annum. For example, a benefit of €104 promised for next year, is only worth €100 to us this year, and so on.

Doing this calculation over 36 years means we can only count about one quarter (0.24) of the eventual benefit of €150m. That leaves “only” €36m of benefit today.

Therefore, we would spend €10m every year and we would benefit by €36m every year. That is a benefit to cost ratio of 360pc, rather better than most of our public investments.

It’s necessary for a government to weigh the value of life — the government can’t save every life, and trying to spend the money to do so would end up likely killing more than it saves. However, if it’s purely economic, treat it as such. If it’s morality, on the other hand, based on a skewed, unsupported, and puritanical religious point of view, keep it out of the decision altogether. That goes for all governments, please.

StOP

  1. http://www.independent.ie/national-news/sexual-politics-in-vaccine-move-1541454.html [<]
  2. http://www.independent.ie/opinion/analysis/true-loyalty-put-to-the-test-with-cancer-vaccine-vote-1541334.html [<]
  3. http://www.ippf.org/en/News/Intl+news/Ireland+Cervical+cancer+vaccine+withdrawal+is+a+setback.htm [<]
  4. http://www.independent.ie/opinion/letters/cost-and-benefits-of-cancer-vaccine-1541950.html [<]

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2 Responses to “The Land of Ire”

  1. Nam says:

    Didn’t expect to read an entire article on the Health service (of a particular point of it) in this; I thought I was going to read about your trip to Ireland; or some such; which I did. But I agree, most other places go through the same tribulations as any other place, including the U.S. — the religious in the United States are a bit fruity over their religion more so probably than anywhere else; except perhaps countries ruled by Islam; and the Vatican. Anyway…

  2. Procrustes says:

    Well, Nam, I didn’t want to bore everyone.

    Here’s a synopsis, anyway:

    I flew into Dublin. Dublin is a decent size, very modern, great weather that never gets too cold (not too cold for me, anyhow), and has enough mix of touristy plus historical stuff to make it worth spending a few days (or longer), which I didn’t have. I went to the Guinness storehouse, which is basically a commercialized “museum” of sorts where the old brewery was. It was interesting, but somewhat disappointing, since what I really wanted to do was see them brewing Guinness, and to drink some from the source. I did do the latter, and I’ll say that the Guinness in Dublin tastes different from the Guinness in the states (incidentally, it also tastes different from the Guinness served in pubs mere miles from the brewery). Those friends of mine I met in Dublin indicated it was because of Dublin’s notorious water supply.

    I visited a few villages here and there, saw the peat bogs, learned a lot about Ireland’s land and history, eventually got to the west, where I saw a very nice beach and the Cliffs of Moher, which are just amazing (though unfortunately mostly covered in fog).

    I was warned that there was some anti-American sentiment, but it wasn’t strong from where I stood, and it didn’t affect the mood too much when it was noticeable. I think the Irish are a bit depressed that their economy has begun to decline greatly after a number of years of success.

    I wish I could go back and spend more time in each place, without a tour, but that will probably have to wait till after all the other places I’d like to go in the meantime.

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