The country has also taught us that it is easier to get condom use up than keeping the sex industry down, the author adds. “The proportion of men buying sex halved over four years in Thailand. The proportion not using condoms when buying sex halved in just a year and a half. As condom factories get busier, the workload in the VD clinics falls.”

Where condoms have been promoted without let or hindrance, they tend to get used, especially in the riskiest encounters, observes Pisani. “In Thailand and Cambodia, in Vietnam and China, in Nepal and the South Indian State of Tamil Nadu, in Brazil and Australia, in the Netherlands and Britain, condom use in commercial sex is the norm, and condoms are very frequently used in casual partnerships too.”

A study in contrast is Africa, where HIV prevention failed initially because most countries didn’t try very hard, the author frets. “As late as 1999, when 23.3 million Africans were estimated to be HIV-infected, foreign agencies provided Africa with 500 million condoms. That’s just over three condoms per year for each man aged 15-49.” Quite bizarrely, if you were to add the number of all condoms that African governments paid for, “it takes it up to a grand total of 4.6 condoms per man, enough to have protected sex once every three months.”

We could damp down HIV across vast swathes of the globe just by being honest about who is infected and why, and by giving them the information and services they need to interrupt transmission, assures Pisani. “And we could probably do it for less money than we already have for prevention.”

Important insights.

Few diseases have had as great a social, economic, and personal impact as Alzheimer’s, the most common form of dementia, says Robert N. Butler in ‘The Longevity Revolution: The benefits and challenges of living a long life’ ( www.publicbooksaffairs.com).

“Destroying the mind, devastating the family, and making considerable demands upon the health — and social-care systems, it also robs society of important contributors,” he bemoans.

Contrary to traditional belief, brain cells do not simply die off as people grow older, although dendrites, the branches of brain cells, do thin out, the author explains. What then is Alzheimer’s disease? “A synaptic failure,” defines Dennis J. Selkoe of Harvard. Nerve impulses pass across the junctions called synapses that join nerve cells with each other, with muscle cells (to produce movement), and with gland cells (to produce hormonal secretions), elaborates Butler.

“The best way to determine the extent of mental impairment is by measuring synaptic density, which is the extent of communications among neurons and was first observed by the neuropathologist Robert Terry. The more advanced the disease, the fewer the nerve impulses…”

Crucial read.

D. MURALI

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