NEWSWEEKLIES: Time And U.S. News Cover Stories

      This week's Time magazine cover story on herbal medicine traces America's love affair with St. Johns Wort, echinacea and the like to "the fears and desires of 80 million aging baby boomers who are eager to seize control of their medical destinies." The magazine reports that "the perceived coldness and remoteness of conventional medicine and red-tape-tangled managed care make readily available herbs and other supplements seem particularly appealing." Marketing also plays a key role, with consumers seeing dietary supplements as "natural" when compared with "synthetic" pharmaceuticals, despite the fact that "the substances in an herb are chemicals just as they are in medicine made by pharmaceutical companies." Though there is growing concern about the largely unregulated herbal supplements industry and possible adverse effects from untested substances, Time reports that there is little research being done because drug companies have no incentive to foot the considerable bill for clinical trials. Furthermore, many herbal enthusiasts would not want to see the Food and Drug Administration take a larger role even if better clinical data were available. One patient who takes herbs for fatigue said, "I would be horrified if this little bit of autonomy were taken away."

Caveats
      Time's Christine Gorman lists important precautions when taking herbs:

• "Don't assume that 'natural' means safe."
• "Make sure what you're taking is pure."
• "Look for standardized preparations."
• "Buy from companies that research their products."
• "Be sure to tell your doctor what you're taking."
• "Don't let herbal preparations lull you into ignoring serious problems." (Greenwald, 11/23 issue).

Don't Vaccilate, Vaccinate!
      The U.S. News and World Report cover story warns that parents who think vaccines are "old news" -- a throwback to Salk and Sabin -- "should think again." In addition to the 70,000 vaccine-preventable deaths that occur in the U.S. each year, researchers predict that within 10 years, molecular biology and genetic research may be able to produce vaccines for AIDS, strep throat and even cancer. The scientific revolution that is making these giant strides possible is "the ability to make recombinant DNA," which allows scientists to engineer altered pathogens that the body can kill, or actually teach the body to manufacture antibodies through "DNA vaccines." As the National Academy of Sciences' Institute of Medicine prepares to release a list of "vaccines the federal government wants on the market within a decade," here's a look at two major disease areas being targeted by vaccine researchers:

• AIDS: HIV is both the "most urgent priority among immunologists" and "the toughest challenge [they] have ever faced." U.S. News reports that "after years of false starts, researchers now say an AIDS vaccine is possible." Scientists are currently focusing on two-stage vaccines that prime the immune system, and on mucosal vaccines that "prevent infection altogether by stimulating immune cells that live in the nose, mouth and genital tract." National Institute of Allergy and Infectious Diseases Director Anthony Fauci said, "We won't have the perfect vaccine for AIDS available next year or the year after, but we will have vaccines that are at least partially effective within a decade."
• Cancer: Using a variety of methods to stimulate the immune system to recognize cancer antigens, clinical trials of vaccines to prevent melanoma, prostate and lung cancer are underway. Researchers at Rockefeller University may have made a substantial advance in cancer vaccine research with the discovery that some people carry a gene that makes them immune to breast and ovarian cancer. However, "[p]reventive cancer vaccines for people who are healthy are not likely to be in wide use for at least 15 years."

Rolling The Dice
      Parents who choose not to vaccinate their children because of worries about safety "play a risky game." Health experts say that the risk of an adverse vaccine reaction is minimal compared to the risk of the actual disease. For example, "a child has a 1 in 2,000 chance of suffering encephalitis, which causes fever and transient mental disorientation, from the measles, compared with the 1 in a million chance of suffering encephalitis from the vaccine." A separate story reports that although the vaccination rate in developing countries has risen from 5% of children in 1980 to 80% today, "reaching the remaining children is a formidable task" (Schrof, 11/23 issue).