An Example of Broken Discourse
Apparently there is a daily pill called Truvada that can help reduce (but apparently not prevent) the transmission of HIV through unprotected sex. Many public health agencies are promoting its use.
Apparently there is also at least one skeptic, a man named Michael Weinstein, who fears the pill may not be as effective as advertised, but more importantly is concerned that the pill's existence will reduce the use of condoms among at-risk men.
As I read the article (and I know zero about it on my own) the ranking in terms of effectiveness is: condoms+Truvada > condoms > Truvada > nothing.
The amazing thing to me is how broken the dialog about these issues appears to be. Truvada supporters claim that there is a consensus on Truvada and that Weinstein is alone in his criticism, and that he is as bad as a "climate-change denialist" (eek!)
Weinstein claims that many others believe as he does but have been silenced by intimidation by the Truvada supporters. Further, he argues that public officials who support Truvada are all paid off by the drug makers in one way or another.
Jeez, this all sounds so familiar to this veteran of the climate wars that it is just amazing. And the real tragedy of this broken discourse is that both sides have a totally valid argument. I have no doubt that Truvada provides incremental protection (even Weinstein's clinic proscribes it). On the other hand, it is fairly "settled science" in the safety world that an easier-to-use protection method can actually reduce total safety by undercutting a parallel protection mechanism -- the drop in seat belt use after air bags were added to cars is a classic example. Weinstein argues that Truvada use will reduce use of condoms, and thus undermine safety. Truvada supporters argue that condom use is so low already, even after 30 years of education efforts, that the drug is better. Essentially, Weinstein sees the baseline as men who use condoms and worry about them getting worse. The other side sees the baseline as men who don't use condoms and argues the drug makes things better.
It is a shame to see two groups of people who likely are motivated by good intentions devolve into name-calling and ad hominem attacks. Just read the quotes in the article - no one in the debate seems to acknowledge that the other side includes people of good will who simply disagree.