Modest Expectations – Geometric Progression

I rarely post on Facebook, but I feel compelled to comment on the large number of unvaccinated people there are. Many think that is awful. But the more I have thought about it, the more I conclude it may be the best thing that has happened to the human race in several centuries.

Those who choose not to vaccinate are, and will continue to be, the vast majority of those who contract COVID-19, as well as the majority of those who die. While I feel sorry for the friends and families of those people, in the long term that may be the best thing that has happened to the human race in a long time.

By weeding out the dumbest of our people, the average intelligence of our race will clearly improve!! So look on the bright side—the human race will be better off in the long term with the dumbest of our people being the largest bloc of deaths!!!

So wrote my American mate.

It demonstrates that the ferocity, which is consuming American society, being played out between those in favour of vaccination and the antivaxxers. Thinking about this invective I am reminded that my forebears survived the Black Death. But so did those of everyone who is living at present, even the progenitors of the anti-vaxxers. On this basis, some of these survivors proliferated, so stupidity is never totally extinguished.

Do I disapprove of anything sent above? Well, I do think the multiple exclamation marks are a bit over the top.

Seriously, despite the robustness of the comments, I genuinely worry about any suggestion of eugenics, for whatever reason, even in the case of America given the action of the disgusting Trump in dumbing down the community over the past four years and dismissing the seriousness of this pandemic.

Tales from the South Seas

South Sea Islanders have always seemed to me to get the rough end of the pineapple, as it were.  This mob is largely confined to the sugar growing areas of Queensland. Mostly, they have been ignored, despite the appalling way their ancestors were treated. Their forefathers were the victims of blackbirding, the trade in men mostly, from modern day Vanuatu and the Solomon Islands, who were kidnapped, transported to Queensland and northern NSW, where they cut sugar cane.

South Sea Islander flag

Most were repatriated in the early years of our Federation, but a number remained – the actual figure being a subject of conjecture. From a peak of 60,000, the estimate now is about 5,000 although how rubbery that figure is, who knows.

When South Sea Islander leaders, Faith Bandler and Dr Evelyn Scott, died, politicians, the media and the wider community labelled both as Indigenous activists and gave no recognition to their South Sea Islander heritage.

Later, on other hand, when Dr Bonita Mabo died, she was widely recognised as a leading Australian South Sea Islander activist, also involved in Indigenous activism.

Therefore, the recent very public apology by the Mayor of Bundaberg, Jack Dempsey, to the South Sea Islanders reinforced the success of the Islanders over the last generation or two in educating their fellow Australians about their existence.

Australia flies both the Aboriginal and Torres Islander flags widely, but who recognises the South Sea islander flag? The argument may be that they are an insignificant number, but then if you apply that rule, the Aboriginal population and even more so the Torres Strait Islanders would be similarly considered given their respectively small percentages of the whole population.

The root problem goes back to the 1975 report of Australian Law Reform Commission where South Sea Islanders’ claims for recognition were dismissed contemptuously.

I am sure that Rugby League fans would dispute this, given that one of the greatest Rugby League players ever was Mal Meninga, himself of South Sea Islander heritage. He is not the only one.

In my 2017 book I wrote about the experiences of a young Philip Morey, when he had worked on the then New Hebrides island of Erromanga between 1932 and 1934. Here he had encountered a man who had been taken to Queensland as a youth who, after 40 years, returned to his village on Erromanga. The exchange between the young Australian and the old native needs no further commentary. It is nevertheless instructive. The extract starts with Morey asking a question while the old man was harvesting his plot of sweet potato.

The Sheep of Erromanga – Messages from the Martyrs Isle, Jack Best

“What was life here like when you were a small boy?” 

The dreaminess reappeared in the old man’s cadence. “Son, that was a long, long time ago.” The dreaminess vanished as quickly as it had come and edginess came into his voice. “I was less than twenty years old when the boat took me to Queensland. It was not even Australia then — just a group of colonies where you white men wanted me to make you some money. And I did. You know, I cut cedar and kauri for a shilling a hundred foot. I even worked on cattle stations.”

The old man drew a circle in the dirt.

“The pay wasn’t much, but I made enough money to rent fifteen acres and a farm in Northern New South Wales — on the Clarence. Married a white woman.” He stopped.

Philip thought he expected a question about mixed marriage, but miscegenation did not trouble Philip. He had read too much French literature to share the English fear of mixing skin colours. The French were very much more tolerant. He wondered whether there was a Creole culture in this strangely governed group of islands. 

Philip was quiet as he pondered this old fellow who had lived forty years among white people and who, after twenty years back on the island of his birth, could still speak fluent English. He had lived and worked under white men’s rule in a white man’s house with a white woman as his wife. He had seen and enjoyed the comforts and pains of civilization. Now he was living in a dirty and dilapidated old native hut wearing a dented old hat and a dirty threadbare loincloth.

He thought, so much for forty years in Australia!

The old man turned as if he felt Philip’s final thought as a laceration. 

“Son, civilization is not only in the eye of the white man.” His clouded eyes belied the directness, the clarity of the comment.

“You know what made me come home?” The old man continued without waiting for any acknowledgement. “I had learned enough about the way you white men handle your riches — you are always selling that lie to others to make even more for yourselves. I found out what civilization was all about. I lived as a white man — I saved and then I gambled money that I had earned on making money that would come without me earning it. What do you call it? Dividends? Interest? It has taken a long time for me to forget the words of deceit.” 

Philip thought that the way he said “deceit”, with his teeth clenched, was an expression of repugnance at a life he had once tried to embrace. 

“I lost my money,” the old man continued. “Any money I had got over that first twenty years went in the 1891 bank crash. Lost my farm, lost my living — lost my wife. Went back to the cane fields. But that life is for a young man, and my back started to give out. In the end, in my last ten years in your newly created country, I made enough to live on, but when I came home I left every penny in there — in your Australia.

What this man did not say, because there is no record of him having any children, was when the descendent of the first wave of South Sea islanders was repatriated, many of them were the product of mixed marriages, particularly with Aboriginal women. They suffered discrimination from the locals, who were of Melanesian stock. Strange world. Nevertheless, when I visited the Torres Strait, the comment was made that Torres Strait Islanders discriminated against those who lived on Horn Island, who were predominantly Aboriginal.

During World War 11 for instance, as an example of interracial discrimination, it was reported that while only earning one-third pay compared to whites, Torres Strait Islanders were compensated at a higher rate than Aboriginal soldiers. The Australian army viewed Torres Strait soldiers equal in combat with white soldiers, while they considered Aboriginal soldiers to be liabilities.

The experience the Erromanga man had in Australia from his first-hand account does not mention any discrimination – only that he lost all his money and his wife, and yet had returned home, content with obvious wisdom gained.

Captain Robert Towns

Nevertheless, even today, one matter rankles with me. At a time when the world is dishonouring slave traders, there is no move to change the name of Townsville away from one of the most notorious slave traders of the South Pacific, Robert Towns. He was British born and now is buried on Castle Hill. There has been some protest, but that has been ignored. Just imagine if Towns had been associated with an Aboriginal massacre.

I suppose it is a part of the Australian diaspora that we have a large regional city named for a mass murderer.

On what was the Vanuatu National Day, the last word should go Waskam Davis, whose forebears came from Tanna, one of the southern islands of Vanuatu. In response to the apology from the Bundaberg Mayor, she said: “We’ve grown up watching this struggle for recognition, and also working alongside our Aboriginal Torres Strait Islander families for greater recognition, greater inclusion, better outcomes for our collective communities”. 

Well, they could start by renaming Townsville. After all, we were once New Holland.

God, I am sick of these people

One source has suggested that vaccine supply logistics has been a form of a Ponzi scheme, although in this case there was a lot of smoke and mirrors about non-existent stores of vaccines or those sitting, waiting to be validated, coupled with much encouragement to “book a vaccination”. 

Such a comment displays a dangerous lack of confidence in Government.

Soldiers are joining police on the streets to ensure compliance, which has been sadly lacking in those suburbs where there has been a high immigrant population.  Those who have used their migrant groups to establish their petty satraps in local government, these so-called community leaders, have failed to accept the responsibility of both reassuring the population and reinforcing the compliance message. These community leaders should be accompanying the police and the soldiers in walking the streets, instead of braying from the sidelines.  Instead of explaining that Australia is at war with a Virus, which has killed or maimed millions of people across the World, and that this involves everyone making hard decisions about their lives in the short term, these so-called community leaders are selling this confected tripe that these people have fled from war torn countries and these immigrants will be totally blown out of their minds if they see soldiers on their streets.

Why are they doing this? Why are they sabotaging the State Government?

There are a number of reasons. I would hate to say that it is easy to whinge and in effect do bugger all. After all, do people go into local government primarily to help others?

There is a lack of leadership. The face of a Prime Minister who acts like a Cheshire cat with that very distinctive smirk, but whose default button is the media release and blame shifting.

Then there is the Premier, who is completely hapless, talks too much, has had a pet albatross called Darryl still bobbing around in this ocean of discontent, and an expertise in document shredding to list some of her achievements.  Perhaps I have missed something but there is nothing Churchillian in her desperation.  Her default button is “on the best medical advice”.

Therefore, the blame is shifted onto Kerry Chant who has shown, as I have said previously, remarkable resilience. However, everybody has his or her breaking point, especially if the contact tracing system, however well organised, is being overwhelmed.

It should be recognised that one positive outcome in NSW has been the QR code, originally devised in Japan in 1994, which was introduced after a month-long trial in Dubbo last year.

All Ministers of Health should be ensuring that the rest of the health system is working, and there are worrying signs. The problem is that all health bureaucracies are steeped in people who may know the regulations, but as I have written before, “health” is a separate language. In time, bureaucrats learn to speak “pidgin” health. While the NSW Health Minister is suitably authoritarian, he gives the impression he is not across his portfolio despite being the Minister for four years.

The key quality of a strong health minister is being able to speak fluent Health, as this is the major defence against the central agencies always wanting to trim the health budget. The problem for health ministers is that on most occasions the central agencies “plant” their own bureaucrat in the health portfolio to do their bidding. As an example, you don’t have to look past Jane Halton when she was Secretary of the Commonwealth Health Department.

As for the current Federal Minister of Health, he has presided over a failed app, a failed social marketing advertising strategy and a collection of mates getting jobs in relation to the failed logistics of distribution of the vaccine. The result is that there has been a series of poor decisions in choosing vaccines, a disjointed rollout of vaccines and, in regard the aged care portfolio, just a schemozzle when, with little additional effort, the workforce could have been vaccinated at the time of the vaccination of the residents. It does not help when the general in charge of the vaccine distribution looks as if he is about to cry at any moment.

There are so many opinions flying about that it is time to call a halt. Instead of this so-called national cabinet as seeming to be an exercise in shoring up fiefdoms and ensuring every political leader has their own pet scapegoat, it is time for political games to stop for the good of Australia.

As an example of this is the numbers flying about from the modellers about the percentage of those vaccinated which will enable Australia to move through the putative phases. The Doherty mob were asked by Government to provide an indicative figure to minimise lockdown. Fair enough – clear direction. But it seemed to let loose a storm of academic babble.  It is time for the academics to stop thinking this pandemic is a research conference.  The problem in a world of imperfect information is to know what to believe, leaving a confused community which eventually stops listening.

The country needs now:

  • A national contact tracing system. Here I agree with Stephen Duckett’s opinion piece in the SMH. Those of both NSW and Victoria have been tested. The initially woeful Victorian system was rectified; the NSW system has been resilient. If we had a national system, then it would signal that the Federation lives. Those who are starting to question the NSW system must recognise that if enough stress is put on a system, it will break. It needs continual engineering not scapegoating.
  • Custom made quarantine facilities, along the lines of Howard Springs, where there have been no recorded breaches, are essential. Its success was evident from the very start with the repatriation from Wuhan. Of course, whenever the profit motives intrude, as they did with the hotel quarantine, disaster follows, and thus the decision to look after one sector may end with the whole business sector compromised. The absurdity of continuing to talk about building them while doing virtually nothing is breathtaking. Endless useless contracts have been given to consultants over the past year; if the private sector as epitomised by the Wagner Brothers had been contracted to construct quarantine facilities they would have been in operation months ago.
  • The logistics of timely supply of testing materials and vaccines needs to be properly organised so it isn’t used as a conduit to just give taxpayers’ money to mates. Maybe somebody should take a lesson from Essington Lewis’ playbook from World War 11. If we had these turkeys in charge then, each State would have raised its own militia and Tasmanians would be making sake instead of gin.
  • The evidence of the best venue/s in which to distribute the vaccine and the need to have a national disaster plan using the evidence gained from this pandemic, particularly in the use of masks and hand sanitiser.
  • The QR code system, which has been an example of success, should be made uniform and compulsory across Australia. The communication strategy, the failure to acknowledge the app dud, and instead of subjecting the whole community communication strategy to public scrutiny, it will be buried from scrutiny to the overall national detriment. There have been some spectacular successes in social marketing campaigns in the past. Remember the success of the NSW anti-drink driving campaign orchestrated by the incomparable John Bevins.
  • Recognition of the danger of the lockdown and border closures where there is no uniform national control by the Federal Government. Say NSW decides to loosen all restrictions a lá Boris, in conflict with the other States with harsher restrictions, then there is the potential for community chaos and a fractured Federation presided over by an impotent Federal government. The actions of the West Australian Premier in particular fill me with a sense of foreboding; Australia does not need a re-enactment of the 1890s.

One of the great successes Wooldridge had when he was Commonwealth Minister of Health was improving the vaccine rate across Australia. I recognise he has had a chequered history since he left that job, but it has not stopped him from advising Hunt, particularly in the way the Pharmaceutical Benefits Scheme can be nuanced.

I wonder whether he would agree with “jab” as part of the politician’s lexicon, and if there is hesitancy, the best place to test this in schools is to make it compulsory for all children, say at 12, to be vaccinated against COVID-19. Once you introduce a program into schools, then it is a perfect road to eradication – rubella and polio are prime examples, or have the current policymakers forgotten about those scourges? Such a decision would reinforce some of the calls to redirect inoculation to the young.

In the interim, give the residue of children aged between 12 and 18 the vaccine. It is only a matter of organisation to get them all vaccinated – and incidentally a good way to identify those among the parents who are avowed anti-vaxxers and those who are just hesitant.

While it has been admirable that the Government has concentrated on the elderly, the assumption being we are the most vulnerable, and therefore vaccination is a community anodyne for not clogging the acute hospitals with the most unproductive sector of the community, particularly applying to the intensive care units. Any COVID-19 patient admitted to hospital can spread the nightmare.

Another matter is the long-term morbidity, which will contribute to the cost on the system. The post-viral syndrome is protean in its manifestations and it seems that COVID-19 can be particularly severe. Then there is the murky world of the auto-immune disease, and having a chronic auto-immune disease myself, I would not flirt with the disease, with preferably having a choice of vaccine. My second injection is due tomorrow.

The overarching concern, despite much work being done in relation to SARs vaccine development in the past 15 years, none of them have had the usual level of testing that most vaccines undergo before being approved for usage. This is the baggage which Australia has, given investment in the Queensland dud and the almost exclusive Governmental preference for the AstraZeneca vaccine.  That is the risk one takes when there is urgency, and where hindsight is a wonderful attribute.

Hence, with long-term morbidity, there will always be the search for a cure. Given the nonsense in relation to bleach, zinc, ivermectin and hydroxychloroquine and whatever, it is still important that all treatments are not dismissed.  The example of the nucleotide, remdesivir with the associated use of cortisone has received attention and seems to have some role in the most serious cases, but there needs to be more convincing data.

Finally, one area which has remained relatively untouched in the mountain of commentary is the Therapeutic Goods Administration (TGA). It should not be forgotten in any national review. Here Australia is in a pandemic and there is the spectacle of national chemist chains peddling the usual remedies for the common cold and other respiratory complaints on national television every night. Most remedies have been shown not to work, and normally can be tolerated, but this is a pandemic, and mixed messaging needs to be eliminated – not gaily spouted on national television. The medical advice is to be COVID-19 tested if you have “the most minimal of symptoms”. Yet the advertisements are full of contradictory advice encouraging use of ineffective patent medicines that are likely to delay being tested for COVID-19.

The problem is that the Commonwealth Department of Health’s Health Products Regulation Group needs a large shakeup. The current deputy secretary in charge, John Skerrett, is in a long line of bureaucrats who, in the words of the Health Department, contribute to the stewardship of Australia’s health system. Exactly! It was one area which, in hindsight, I should have weighed in when I had some influence in the area.

In all, public health specialists sit uneasily with business community. There are few bridges. An American view was that the public health specialists are Democrats and Business Republicans. It has been shown in the unfortunate politicisation of this pandemic, particularly in the United States.

There’s business, and then there’s seriously good business.

Victoria, with its vocal proponent Peter Doherty, is pushing ahead with plans for an mRNA research and production capacity in Australia. Of course, the race is on internationally.  After the spectacular success of the Pfizer and Moderna vaccines, Sanofi announced on June 29th that it will invest more than USD475 million a year to develop mRNA vaccines against other diseases, and much of the work will be done in Cambridge, a suburb of Boston in Massachusetts

Sanofi is creating a vaccines mRNA Centre of Excellence that will employ 400 people both there and in Lyon, France. The French pharmaceutical firm has about 4,200 employees in Massachusetts. Sanofi hopes to have at least six potential vaccines to test in clinical trials by 2025 against a range of diseases.

While Johnson & Johnson and AstraZeneca both vowed to sell their vaccines on a non-profit basis during the pandemic, Moderna, which has never made a profit and has no other products on the market, decided to sell its vaccine at a profit, as did Pfizer, notwithstanding that it didn’t need the profits because of its already healthy bottom line. Last year Pfizer showed USD9.6bn in profits, before the COVID-19 vaccine. In the first three months of this year the COVID-19 vaccine delivered USD3.5bn of revenue.

And that is just the start. Like the eponymous Magic Pudding, the vaccine is expected to keep generating significant revenue, especially because of the likely need for regular booster shots, already before the FDA. Pfizer has said it expects its vaccine to generate USD26bn in revenue this year and the company has been signing supply deals with governments as far out as 2024. Nice work if you can get it.

Just an addendum

I could not agree more with Gideon Haigh’s comment made last Sunday about the nature and future of the Olympic Games, much in the same vein as I wrote about last week. The euphoria generated by the number of Australian gold medals in the first week made those who reckon that the Olympic Games is now in need of a thorough overhaul seem like the Grinch. The Games have provided a degree of fairy tale theatre for those of us caught in the lockdown.

The problem is that life has many airheads, often former Olympians who “are on the tit” directly or living a life that they once had in amongst the gaiety of the Games, not to mention the close contacts that some have made and persisted.  What do they call it?  Yes, the Olympic Family.

Apart from hubris, there is no reason for that appalling decision of the Queensland Premier to commit to the same contract which has left the IOC again wallowing in cash, when it was clearly on its knees. Here, the host city and, on this occasion because we have a drongo Federal Government prepared to cough up 50 per cent, every taxpayer in Australia will be saddled with debt. A form of neoliberal communism, you may ask. Don’t bother.

It was interesting to note that the residual Sydney Games debt is still bouncing around 20 years after the end of those Games.

The country, particularly Queensland, may come to curse Coates, who will be 82 when the Games come around – or dead.  Coates may think he has fenced his legacy, but as I said last week, in 2032 there will be a different World. Indeed, fire-fighting may have become an Olympic sport by then.

And by the way, that winner of the mens’ 100 metres the other day, from the vantage point of mia sedia in salotto, appeared to have the physiognomy of the Canadian Ben Johnson.  He certainly has made massive strides, as they say, over a short time, as distinct from the IOC. Could have been something in the tagliatelle.

Mouse Whisper

As my cousin Camundongo from Lisbon has warned me that before entering the swimming pool remember to circumflex since:

If in Maio

You want on whim

To decide to swim

Remember to wear your Maiô

Portuguese water dogs

Modest Expectations – Twenty of dark chocolate

Neale Daniher

Neale Daniher is a very brave man. I admire him greatly as the epitome of all that is great about being an Australian. He fully deserves the Order of Australia recently bestowed on him; he also deserves to be invested with it as soon as practical while he can still walk.

For seven years his health has progressively deteriorated. He has motor neurone disease (MND), yet he has maintained a defiance against this progressively incurable disease.  Today, he has almost lost his ability to speak. It is a terrible disease, and I know that when I developed my own disease one of the differential diagnoses, soon discounted thankfully, was MND.

The symbol for what Daniher describes as “The Beast”, with inadvertently or not its Biblical imagery, has been the ice bucket, the ice bath, the ice pool – a plunge in order to raise funds for research.

The problem is that research into the cure for motor neurone disease is at the same level as it was when I was born. Getting nowhere substantially is not restricted to MND.  I have known researchers who have spent their lives trying to develop a malaria vaccine or find a cure for Duchenne’s muscular dystrophy – to no effect. Honourable failures – the dilemma for those seeking more money for such research. That is problem personally I have in contributing money for research into this disease – poor return on investment.

Lou Gehrig

Around the time I was born, a famous baseball player died of amyotrophic lateral sclerosis (ALS), the most common form of motor neurone disease. The disease was given his name, Lou Gehrig. He too was a brave man; a film starring Gary Cooper was made of his life. Lou Gehrig died about three years after the onset when he was only 37 years old in 1941.

Now 80 years on Neale Daniher, in his time a very gifted footballer whose playing days were foreshortened by knee injuries, is dying of the same disease. The onset of his disease was when he was 53. Over seven years survival is testimony to something innate.

Increasingly, auto-immunity is being ascribed as the culprit. Auto-immunity, the tendency of the body to destroy itself when the immune system goes rogue, is the battlefield. It is an area where the disease has been victorious up to now, particularly in the case of this disease, which causes the destruction of the nerve cells that control voluntary muscular movement.

There are a few inconclusive drugs and conservative measures which may prolong life; and as long as Neale Daniher remains optimistic, then his will to live deserves every support. After all, more than 2,000 people have the disease in Australia, and the total cost of therapeutic support per person averages out as $1m. Two are diagnosed every day; two die every day of the disease.

When there is no longer Neale Daniher around fighting against destiny, let us make sure those with this terrible disease do not die alone, paralysed, slowly suffocating. In other words, strengthen palliation, help strengthen family support but do not – I repeat – do not raise false hopes of a cure.

A muddy Saturday

This is a very simple story about a group of University students who, in 1958, won the Juniors Premiership in the Victorian Amateur Football League. It was a time when there was only one university in Victoria and therefore most of the teams that we played reflected the division between “town” and “gown”, even though the diversity of the team list reflected the normal cross-section of society. The only bond between us was a desire to play football and being under 19 we were consigned to the Juniors.

The two adult teams were the University Blacks and Blues, which were in the top grade and produced a number of players for the pinnacle, the then Victorian Football League (VFL) where you got paid. The other University team for those who just wanted a game was the University Reds.

There was a hierarchy; even as 18 year olds there were a few university students who just played VFL. which, in those days, had an Under 19 nursery as well. They were just too good to play amateur football. Many were in fact champions, not just making up the then “twenty”.

There also was the Victorian Football Association which headed a cascade of suburban and country teams where footballers who had had enough of the paltry returns from playing under the then Coulter Law in the VFL, left to play and/or coach a country team. These players would receive a generous wage and were often set up as the licensee of the local pub.

Then there were the “lily-whites” – the amateurs. In the University hierarchy, this was the place where the cohort of youngsters who were not drafted into the Blues and Blacks played. Some went straight into the top teams; some oscillated between the top teams and the Juniors.

Nevertheless, the Juniors won the Grand Final, and three members of our winning team climbed onto the roof of the University Union Building. They were said to be in a jolly state when they climbed up and affixed the Premiership flag. As one said later, they did not know how they managed to climb onto the roof given the ethanol haze that surrounded them. The flag was returned early the next week neatly folded and nothing more was said.

After that year, the team went their various ways, but one person stuck in my mind and obviously the minds of many of the others, who had known him better. He was a few years older than us and had played for the University team. He was always immaculately dressed, with his signature furled umbrella, given the grounds we played on barely afforded any shelter from the Melbourne winter. He was in direct contrast to the coach, Peter Kelliher, who was a knockabout fellow who acted, as all coaches do, with a mixture of encouragement and invective.

Ian Hamilton Munro was different. He was almost the pastoral adviser to the team – a very kind and compassionate man who was always around when you were injured, when you were having a lousy game. He was a counterpoint to the coach – one person I could always picture on the side lines – often a solitary spectator on a windswept oval.

Somebody suggested that, as we approached the 50th anniversary of the Premiership, the survivors of that year should meet annually for lunch. The first, in 2005, was deemed such a success that it was decided we would have one every year, so that has occurred every year, including 2020. This cohort, then in their youthful sixties when the lunches started are now in their eighties. Our coach, having had a stroke a decade before, was an infrequent participant from early into the lunch cycle.  The immaculate Ian Munro was a regular attender, until he fell victim to old age several years ago – and then he too was gone.

Such a small group, men now who are bonded by a football premiership gained so long ago and all accepting their mortality, has now decided to establish the immortality of their achievement and to honour their paterfamilias by donating a cup in his name for annual presentation by the Melbourne University Football Club for an annual match between the now two Melbourne University Juniors teams.

The cup is made from spun brass, silver-plated. It sits on a dark tallowwood plinth around which is collar of silver-plated nickel with enough space to engrave the annual winners for the next 80 years. It was made by the silversmiths and goldsmiths that make the solid gold Melbourne Cup each year for “that race which stops a nation” – the first Tuesday in November; these same trophy makers also create the trophies for the Australian Tennis Open; they are the last such company in existence in Australia.

Munners Cup

Ian Munro might have been embarrassed, like all good generous persons who give much, but never expect recognition. However, he would have liked the enamelled crossed furled umbrellas – one black, one blue – under his name on the trophy – the Munners Cup.

Even to us well aged, he was still always Munners – not Ian Hamilton Munro. However, that name is the cup’s pseudonym inscribed on the reverse side of the plinth. A simple story with hopefully a long nostalgic tail.

Morrison – A Description in One Word

What struck me was the stony-faced Prime Minister who had been persuaded by his Mate, Mat Cormann, to attend a West Coast Eagles match. The boos around the ground when he was introduced were universal. As part of a meet and greet in the morning, he had been persuaded by one of his consigliere, the irrepressible Mr Forrest, to partake in morning PT. It was a more typical photo-opportunity to show off his eminently “daggy” self.

He does not like to be booed. I notice that he has not turned up at any of the football matches in Victoria.

The other fact about the Prime Minister is that he is not that intelligent; yes, smart in the ways of the Molonglo swamp but not particularly well read or thoughtful. Like all people not blessed with any real sense of personal identity, he is totally versed in public relations, and therefore takes the temperature of his quarry – be it Liberal Party pre-selection or Australia before doing anything; hence he leads from the rear.

His problem, and his is not unique in this regard, is to have as the rule of thumb that you never have any Ministers and advisers more intelligent than he is.  The Prime Minister has succeeded in that endeavour, with one exception. That is the recently departed German-Belgian-West Australian, a chameleon of great skill, Mathias Cormann. There is a genus of politician who, when the master rings a bell, will argue without any shame but on cue that black is white – and too many do it persuasively, all the time knowing where the career escalator is located. Cormann has shown himself to be such an engaging man.

Morrison does not brook dissent; he just cannot take it. Part of this is explained by his reliance on a Christian belief system that does not take criticism easily. Much of the Pentecostal beliefs are couched in uncompromising, simple terms, which require no thought but a belief in a literal interpretation of the Bible. This is a Book where the ambiguities of the authors have been reduced to cartoons. His father was one such believer, and here is a person who has been coached in what some would say is a heretical belief system.

Morrison’s trip overseas has been not unexpectedly revealing. The Prime Minister of Singapore, Lee Hsien Loong, gently chided him about his aggression in relation to China; and even in the matter of mask wearing he seemed to guide our uncertain Prime Minister.

The Prime Minister has been hoping to amble the world stage but having been relegated to a landing slot at an airport distant from the G7 meeting it should have warned him at the start. There are no better people than the Poms in insulting one and then being able to smooth it over once everybody recognises that the insult was deliberate, if nuanced.  The perfect word for British diplomacy – nuance!

The daggy “Scomo” image which he believes is the basis of his rural popularity – in Queensland and New South Wales – seems not to have translated as well into International Prime Minister. Here is a guy who not only threw himself at the feet of Trump but has an old friend with connections with the dark side of the web – one of those peddling those conspiratorial beliefs, which are so much of the Trump madness.

If he were to have someone close who is visionary, with ideas that he could sample, then he may not be in his current predicament – and if he did not have an adviser called Stewart.

Biden has proved not to be the doddering front man that some of us wrongly feared, but at the centre of some hard-nosed advisers, who probably worry that Morrison is a security risk – hence the intrusion of Johnson into the Biden-Morrison meeting. It would be a problem for our relations if his words “ritual sex abuse” get wide currency in the corridors of the White House. Can Biden trust that anything he says to Morrison will not appear somewhere as an unacceptable comment?

When Howard extracted special treatment in the Kyoto Protocols for our fossil emissions, the United States owed us for our support in the Bush War Coalition of the Willing; Biden owes Morrison nothing.

In relation to the domestic scene, obviously if your Government’s handout to Big Business is essentially little more than to further enrich, then the recipients of such largesse have every reason to support the current regime. It is not an unusual situation when both sides of politics are compromised, but there is a limit which the community, however rendered compliant by the Virus, will tolerate. Australia sliding into plutocracy is not a pleasant sight.

It is also helpful for Morrison that the Murdoch newspapers’ unceasingly support him, bolstering him in a constituency of flag wavers for fossil fuels and where the environment is being progressively degraded by climate denialists.  For the moment these Murdocistas are spooking the rest of the community.

However, this strange remnant from the Trump days has found the world stage somewhat guarded. As one would have expected, he was greeted in France with all the warmth that the appalling submarine contract with the French can muster. Whatever he may think privately, Macron has been polite; it will be interesting to see if he speaks to Morrison through an interpreter – or in English.  If the first, and from afar hard to know, Macron is maintaining distance so that any communications between the two can be properly interpreted, n’est-ce pas.

Another problem for Morrison is that not all the electorates in Australia are obsessed with maintaining coal mining. There are certain electorates in Queensland and NSW where urgent steps must be taken to transfer the workforce to other industries, not to bolster coal which has to be phased out if the world is to survive beyond the end of this century.

Unfortunately, Australia has a Prime Minister who is only concerned with his re-election, and his only response to climate change and the need to reduce carbon emissions is an underlined word “technology” – as if Technology is a God like Baal to be worshipped not defined. Here a throng of happy clapping followers with arms outstretched towards this Solution and repeating over and over again, “Technology. For thine is the Answer.”

Maybe I’ll wake up and blame all this on something I ate.

Aduhelm 

“I had no sense of where to turn for help, support, or even how to express the diagnosis with family, friends or co-workers. I was lost and crept further inward. There is no single handbook one can read to prepare; each journey is different, each course of the disease takes different, meandering turns—no two are alike, the experts will tell you, an observation that is clearly numbing in so many ways.”

The drug is called Aduhelm. It has just been given the all-clear by America’s Food & Drug Administration (FDA) to be prescribed for people with early Alzheimer’s dementia. As one correspondent said, for many people Alzheimer’s disease has passed through the early stage of memory loss and is not recognised until the cognitive abilities have declined significantly.

The quote above is from Mary, the wife of a journalist, Greg O’Brien who has written On Pluto: Inside the Mind of Alzheimer’s, which follows his own decline from the early onset of the disease. Her cry is clear; and there is no wonder that those families where there is Alzheimer’s disease in their midst want a cure. No wonder that news of a drug with any prospect for improvement will generate clamour for its availability – now.

Much of the excitement generated by this drug is that it is the first since 2003 to show any promise and it has cleared a path through the FDA, not without controversy, which resulted in some members of the committee overseeing its approval resigning in protest. The method of approval has also instilled a feeling of uneasiness in this blogger.

The drug is supposed to attack amyloid-beta, the protein which appears in the nerve tangle of the Alzheimer brain. However, nobody really can say whether it is the amyloid deposits which cause the disease or whether they are waste, the result of a process which leaves this protein functionally inert in the brain. Amyloid disease is one of those differential diagnoses for unexplained disease which my generation of doctors grew to know about and recognised with its distinct histological appearance on staining.

The problem is this drug, which is defined as an amyloid-beta-directed antibody reducing the number of plaques of amyloid, is that the benefits are minimal against its downside.

This is where the drug company, Biogen, which is set to make a “motza”, begins what I call the drug company gavotte. Immaculately arrayed in elaborate steps the gavotte dancers move around in intricate steps, a spectacle of elegant circles, arms waving, legs crossing, all to produce a mannered tableau.

Even the drug company’s paid expert, in a beautifully executed twirl, said the drug “potentially prolongs patients’ independence by several months, even a few years, as demonstrated in long-term study”. She said it is a “stepping stone for our next advances” gracefully executing a series of fluttering steps.

The consumer is transported into a trance, ignoring any side-effects, asking the government to make it universally available. Biogen proposes a charge of USD4,312 per infusion “for a patient of average weight”, or USD56,000 per year.

The Institute for Clinical and Economic Review, in a somewhat bizarre statement, has said Aduhelm should cost no more than USD8,300 per year, given the “insufficient” evidence supporting its benefits in clinical trials.

Dancing the gavotte …

Biogen has defended its pricing strategy, noting that the U.S. dishes out about USD600 billion in direct and indirect costs for the disease that affects roughly six million Americans. Now that is a beautiful sideways gavotte movement by the drug company.

Biogen plans to target between one to two million patients with early onset symptoms, executives said last week. The company, generous to a fault, says it won’t raise the price over the next four years.

It should be noted that this drug can only be given as an infusion in a healthcare facility; and then there are the side effects of brain swelling and bleeding, all factors to be integrated into the patient’s health status, a patient status which is directed only one way – down.

When the gavotte is transferred to Australia, it will be greeted by a solid history of successful lobbying for drugs of questionable benefits. First, there is the special pleading, which is always highly personal as one would expect. Ron Walker, the flamboyant businessman, was an influential example of this in his quest to have an experimental drug, Keytruda included for the treatment of melanoma, of which he was a sufferer. His influence on the then Minister saw the placement of this drug on the Pharmaceutical Benefits Scheme (PBS) for his particular indication at a per patient cost of $4,500 every three weeks for two years.

He achieved his goal; he died in 2018 with the benefit of an average life expectancy increase of 12 months over the cheaper chemotherapy. Not sure about the quality of that life extension. Nevertheless, the drug can now be prescribed to other cancer patients following the largesse of the current Minister, who provides a taxpayer subsidy of $120,000 annually per patient so entitled. Has Ron Walker’s intervention been cost-effective – or just costly?

The drug companies and their shareholders have a different requirement – profit at all costs. Lobbyists hang round drug companies like flies round questionable food, as one of my less than kind associates has said, ever ready to help with selling the product whatever its effectiveness; whatever its cost to the community.

Objectivity is the casualty. Hopefully, the Aduhelm saga will not get to his level, but sometimes I wonder whether governments have lost their sense of smell.

However, the cry from the wife still echoes. Yet will her husband, the author of On Pluto: Inside the Mind of Alzheimer’s, take Aduhelm?

My mind drifts back to Neale Daniher, and the need to ensure that while we wait for a cure the palliative services are not ignored, nor the family, and most importantly, that even the person with lowest profile dies with someone holding his or her hand.

Mouse Whisper

In recognition of my friend from Dalarna, Kyrkomus, I am reminded of Carl Linnaeus, the great Swedish botanist, who sometimes got it wrong. He said that potatoes were poisonous, because he noted that the vegetable was related to deadly nightshade. However, the first woman inducted in 1748 into the Swedish Academy in Sciences, Countess Eva Ekeblad, was so recognised by showing that potatoes were essential in the manufacture of wig powder, and more importantly that cool liquor, aquavit.

Skol!

Countess Eva Ekeblad