Jan 10
Posted by: nicholasswetenham  

Does it matter what swine flu is called?

The 2009 outbreak of non-seasonal influenza, which is classified as  A(H1N1) according to its type of core protein and surface antigens, has popularly been referred to as ’swine flu’ throughout the English-speaking world, and equivalent phrases in other languages – for example la grippe porcine in French.

In some countries, however, governments chose not to refer to the new influenza virus by this name in official publications, presumably because it was felt that the association with pigs was unhelpful to the average person since the transmission is not pig-to-human but human-to-human. In France, bizarrely, it has come to be know as la grippe A for short. To virologists, this merely muddles the issue because most normal seasonal influenza deaths are caused by what they term ‘influenza A’, which in simple terms is a family of flu viruses.

Then, I came across this interview in Le Monde with anthropologist Frédéric Keck of the CNRS, discussing France’s particularly low uptake of swine flu vaccination (<10% of the population). I thought I would summarise it in English for your reading pleasure.

Mr. Keck suggests that in addition to swine flu’s low virulence, a number of local factors explain poor uptake. He mentions ‘playing the precaution card’ which perhaps requires a bit of explanation. In France, health and safety measures and other risk aversion measures are often ascribed to the principe de précaution. This is just a fancy way of saying ‘better safe than sorry’. So perhaps that the public are wary of this overused phrase.

Secondly, he suggests that the act of changing the official name to A(H1N1) made the virus seems less alien and new by removing the reference to its animal origin, more like an ordinary flu virus. At the same time, the national communication campaigns stopped reminding people that it was a new virus about which little was known.

Finally, unlike flu vaccinations in the UK which are co-ordinated through GPs, family doctors in France (who are not as central to healthcare as UK GPs in any case) were not involved in the program.

For interest, let us furhter compare UK and French posters which I cam across this winter:

NHS Swine Flu Poster

Catch it, Bin it, Kill it

Les gestes simples

The UK approach is to have a dedicated telephone line about flu so that other medical enquires are not drowned out. The Catch it-Bin it-Kill it phrase has entered the household in the UK. By comparison, the French poster on the right appears to be a far less effective piece of communication. Small writing and long sentences, for a start. The advice reads “Wash your hand several times a day (with soap or a hydro-alcoholic solution) When you sneeze or cough, cover your hand and nose with your sleeve (or a single use tissue) In case of flu-like symptoms, call your primary care physician (Only call 15 in emergencies)”. The information conveyed covers largely the same topics, but I think here the UK posters (although there’s two of them) put it across far more quickly  and effectively.

Oct 21
Posted by: benvincent  

Today saw the release of the paper published in the New England Journal of Medicine containing the hotly awaited data concerning the HIV vaccine trial that took place in Thailand. There was already some discussion of the initial results, which were reported in September and discussed by Colin, amongst others. As has already been discussed, there is a very cautious consensus due to the statistical analysis of the trial only *just* falling on the side of significant. Also there were the issues that the efficacy (capacity to provoke an effect, in this case protection from HIV infection) was only calculated as 31.2% overall, and the non-intuitive fact that each of the two components of this vaccine – ALVAC (which contains a modified canarypox virus) and AIDSVAX – have been shown to offer no significant protection when administered alone.

Commentary on the full report is already being written of course (by people paid to do it, unlike me…) with the interesting points that vaccine efficacy may not only fall after the first year following inoculation but also seems to have a higher efficacy in trial members who are in low risk groups.  The point is an obvious one – a whole bucket more questions have been raised by this trial than have been answered. Even if we cautiously accept the significance of the findings and that the vaccine’s efficacy is real, we have sod all idea why or how.

But, as disheartening as this may sound, particularly to those people who have watched every other HIV vaccine project attempted over the years fail, this is certainly a positive finding. The reason for this is that in terms of how science is done and applied, the methodology doesn’t exist in a bubble. When important things like vaccine work get noticed, they also get noticed by activists, journalists, politicians. Policy can be affected, along with public opinion which can have more affect on an academic enterprise than may be obvious.  Funding into HIV vaccine research has been dropping which obviously has not been helped by all round economic belt-tightening at the moment, so this study may provide a much needed boost to a previously bleak field. Awareness is also raised amongst those people who sign the cheques. The global vaccine market is big money whichever way you look at it, though obviously investing in 16,000 strong trials that span years with no product to show at the end of it makes a sad face for any investor who might think it purely profitable. Big cash source, big cash sink. This study is the first indication that work on an HIV vaccine might not just be the latter. Many HIV activists are likely to want to push this too, as the head of IAVI Seth Berkley says:

Years of investment and dogged science are providing leads for solving one of today’s most pressing research challenges. Some 7,400 new H.I.V. infections occur daily throughout the world. Clearly we need better methods of preventing the spread of H.I.V., and no public health intervention is more powerful or cost-effective against infectious disease than a vaccine.”

Though cautious optimism should be present for communicators and advocates this is definite justification that HIV vaccine research is not flushing cash down some impossible non-route. it is a long and tricky path…but finally, a little evidence that it is a path. Paths have ends!

Further reading:

http://www.voanews.com/english/2009-10-20-voa35.cfm

http://www.earthtimes.org/articles/show/detailed-results-from-rv-144,1005065.shtml

http://www.voanews.com/english/Africa/2009-10-20-voa38.cfm

http://www.marketresearch.com/product/display.asp?productid=2284570

Oct 07
Posted by: colinhockings  

Telomere Caps

Most denizens of the interwebs (at least of this corner of the interwebs) will have heard the announcement that the 2009 Nobel Prize in Physiology or Medicine will be given to Elizabeth Blackburn, Carol Greider and Jack Szostak for their work on telomeres – the structures found at the ends of human chromosomes. You may already have read a little about the research behind it (if not, the NobelPrize.org press release is a very good place to start) so I’ll try to keep the background as short as possible. What I would like to do here is to explain the assertions that “cancer research has also benefited from the Nobel-winning trio’s work”.

Telomeres are necessary for several reasons, among them to act as ‘padding’ during cell duplication. Every time a linear DNA molecule is replicated it loses a few base pairs from the ends (the reason why is quite interesting, see this description of the end replication problem). The telomeric sequence is simply “TTAGGG” (in vertebrates) repeated several thousand times so it doesn’t matter when some sequence is deleted. But, I hear you cry, how is this important for cancer?

Most cells in the body do not replicate. A typical tissue, such as skin, has a thin layer of stem cells that divide to produce more stem cells, as well as cells that will differentiate into skin cells. These cells divide a few more times until they are ‘terminally differentiated’. In the case of skin that means that they are filled with keratin and die, and when they reach the surface they are sloughed off. In other tissues the non-replicating terminally differentiated cells have different functions, for example as nerve cells or muscle cells. Thus the only cells that need to replicate infinitely are stem cells (and germ line cells, the cells that become sperm and eggs), so they express a protein called telomerase which adds extra copies of the repetitive sequences to the ends of chromosomes.

Those of you who’ve read my first ‘Understanding Cancer’ post – and anyone who knows a little bit about cancer biology – will see why this system is a major inhibitor of carcinogenesis: when a cell starts to over-proliferate it can only divide a certain number of times before the telomeres are fully eroded. In order to continue dividing it has to accumulate further mutations that render it immortal. These mutations have to be very specific, making them rarer: there are thousands of ways to make a cell grow faster, but only very few ways to lengthen its telomeres. Around 90% of cancers (remember: a cancer is, by definition, a collection of cells that have jumped this hurdle) have mutations that cause them to produce telomerase. Most of the remaining cases of cancer have recruited a normal DNA repair mechanism to lengthen the chromosomes by a process called ALT (Alternative Lengthening of Telomeres).

On a short side note: when telomeres were first elucidated it was thought by some that we’d found the key to aging. Unfortunately upregulating telomerase in an attempt to stay young only leads to more cancer, because you’ve removed one of the hurdles that a nascent tumour has to surmount.

Does anyone see the further significance here? All cancers have to overcome a certain problem, and most of them do it in exactly the same way. This makes telomerase a very attractive target for new chemotherapeutic drugs or other types of intervention, and the field is bustling with new ideas. A few clinical trials are showing progress, using gene therapy and small molecule inhibitors (a.k.a. drugs): for a fuller account read this nice open-access review. The approach that strikes me as the most fascinating – and promising – is the idea of vaccinating against telomerase. Almost all cells in the body constantly chew up a sample of their own proteins and display them to the cells of the immune system as a defence against viruses. If you can tell the immune system to attack cells that express telomerase (not quite as straightforward as one might think) it will specifically attack cancer cells. This should be more specific (read: cause less side effects) than most anti-cancer therapies because most drugs attack all rapidly-replicating cells, whereas this would only target immortal cells, and just like you may have learnt from comic books: immortality is a very rare privilege.

ResearchBlogging.orgShay, J., & Keith, W. (2008). Targeting telomerase for cancer therapeutics British Journal of Cancer, 98 (4), 677-683 DOI: 10.1038/sj.bjc.6604209

Sep 24
Posted by: colinhockings  

AIDS_Red_Ribbon.svg

When HIV was discovered as the causative agent of AIDS in 1984 (and has since been repeatedly proven, despite denialists claims – see Ben’s post) scientists were relieved: “It’s a virus! Phew, viruses are something we can deal with. Alright, somebody go cook up a vaccine: problem solved”. According to wikipedia, senior figures in the US health system claimed that a vaccine would be ready in as little as two years. 25 years later HIV is getting the better of us like no other disease, and the vaccine front has seen failure after failure. It seemed to me that it was truly impossible to build a vaccine against HIV and our only hope would be some form of procedure where T cells are removed from the patient, ‘cured’ of HIV (not quite as easy as it sounds, surprisingly enough) and reimplanted into irradiated patients – or something similarly novel (read: impossible and/or impractical). Imagine my surprise then when I finished work to find a BBC article saying that an HIV vaccine had ‘reduced infection’, and after a little bit of surfing I check Twitter to see that ‘HIV’ is trending. Even the Huffington Post had some (relatively) positive things to say.

So what’s all the fuss about? It’s hard to give much detail because the study – beautifully named RV144 – hasn’t yet been published (as far as I can tell, and I’ve looked pretty hard [Update: see footnotes]). There’s several press releases around, from all the various organisations that were involved, including:

  • MHRP (U.S. Military HIV Research Program)
  • UNAIDS (Joint United Nations Programme on HIV/AIDS)
  • NIAID (National Institute of Allergy and Infections Disease)

The study had two (blinded) groups, one control group (receiving placebo injections) and one experimental group (receiving four ‘prime’ doses of ALVAC HIV and two boost doses of AIDSVAX gp120 B/E), with over 8,000 volunteers in each group, lasting from 2003 until now. AIDSVAX has been tested before, but showed no effect, and the ALVAC has only been evaluated for safety. The researchers were quite careful to make the study as ethical as possible, giving lots of good safe sex advice and promising free medication to anyone who contracted HIV during the course of the study (as well as testing the participants for HIV every six months). The impact this has on the infection rate is clear to see in the results: 74 people in the control group and 51 vaccinated volunteers caught HIV – in a country where approximately 1 in 100 people is HIV positive. Before you say ‘well that’s a tiny difference’, remember that there were 16,402 people, which gives the study a fair amount of power. One would, however, need to take a look at the original data to be sure that the statistical significance is really significant. On a side note, I get really annoyed at studies that are released to the press before anyone is allowed to check the data. In this case it’s a large, well-known, highly-anticipated trial run by several reputable institutions so I’m sure their methodology isn’t intentionally dodgy, but it’s still very bad scientific practice.

I found an interesting 2004 release from TAG, the Treatment Action Group, which campaigns ‘for larger and more efficient research efforts…towards finding a cure for AIDS’, saying that the Thailand trial (called RV144) is flawed for several reasons.

  • A single experimental arm won’t allow the relative effects of the two vaccines to be tested. At the time, there had been no clinical trials of ALVAC vCP1521 efficacy and I don’t think that that has changed since then. If it’s still true then they have a very valid point: the experimenters cannot tell how much of the effect is from the ALVAC vaccine alone. TAG also had some concerns that the AIDSVAX gp120 boost may neutralise the other vaccine, based on experiments in macaque monkeys. It is therefore quite possible that ALVAC vCP1521 worked much better, but we won’t know until another large trial is completed.
  • TAG also questioned the ethics of recruiting volunteers – who mostly claimed altruism as their motivation for joining – to a trial that would, at best, lead only to further trials (based on the arguments above).

The reason why such a large trial was performed that won’t actually answer any questions is fairly stupid. It was planned well before two clinical trials for AIDSVAX came back negative, and a trial for the ALVAC vaccine (called HVTN 501) was cancelled. Despite the drastically changed circumstances, RV144 went ahead, leaving us with tantalising evidence that we’re making progress, but not really changing the game much.

On the bright side,  at least we have proof that HIV isn’t invincible. This study follows hot on the heels of the first case of a man cured of HIV (published in February 2009), so I think the entire AIDS research field is looking a little more optimistic. While the number of HIV positive people in the world is still increasing, I think it’s fair to say that we have good cause to be hopeful.

***Update***

Martin Robbins of the Lay Scientist is not so impressed. Apparently the results are only barely significant (p = 0.048 i.e. there is a 4.8% chance that the difference between the groups is down to random fluctuation)

ERV has an interesting description of thesoft of immunological reaction they were trying to elicit with the Prime-Boost strategy

***Update***

Katie Stover (Media Representative for NIAID) told me that the study will probably be published in October, in NEJM, to roughly coincide with the AIDS Vaccine conference in Paris

Sep 14
Posted by: nicholasswetenham  
Source: Wikimedia Commons Author: Oxyman

Source: Wikimedia Commons Author: Oxyman

It’s been a month since the clamour and bustle about healthcare reform during the US Congress’ summer break in August. The British blogosphere was then alight with spirited defenses of the NHS, like this piece from David Colquhoun. As Congress gets back to work, Obama is countering his critics with speeches on several of his main policy areas. Now that the dust has settled, I’d like to take a closer look at it.

Firstly, it’s worth noting that the NHS is incredibly popular as an instution. People love the NHS, although they often criticise government decisions made about it.

What is bemusing to us in the UK medical field is the way in which the NHS has been held to be an example of

1) An inefficient system

2) An unfair system that restricts access to treatments

3) Socialist or communist

4) The fate that could befall the US if healthcare reforms are passed

None of these are true. Before discussing the merits and drawbacks of the NHS, let’s take point 4 – the US has an insurance-based system and it will in all likelihood remain that way. As Atul Gawande points out in this excellent New Yorker article the healthcare system is like the phone system: you can’t just turn it off for a few months to replace it with something better. Health insurance systems developed naturally at first, with a varying course depending on local context, but now that they are in place they are very difficult and expensive to change by whatever means. It is therefore both highly improbable and probably undesirable for the US system to become like the NHS.

Many valid criticisms can be made of the NHS. As such, it is strange that its US critics have often strayed so far from reality in order to criticise it. The advantages of the NHS of 2009 are simple: free treatment for all with relatively short waiting times and good health outcomes, at a modest national cost of 8% of GDP per capita. Its disadvantages are: patchy funding depending on region for high-tech treatments that have a poor cost-effectiveness or are purely elective (the ‘postcode lottery’), wards with little privacy, and high rates of hospital-acquired infection.

It is pretty efficient, then, and fair to all – since we all get charged the same – nothing (although there is regional variation in service provision, as mentioned above). Although it may have been founded on socialist principles, no-one in the UK ever calls the NHS ’socialist’ or ’socialised’, it is simply not considered as such. And in any case, unlike in the States, most countries in Europe call their mainstream left-wing politicians Socialists, who are considering far milder than Communists (which many in the US seem to consider identical). The NHS co-exists with private insurers, who are still able to sell premium services despite competing with an excellent government-run system. This should have been one of concrete factual argument used by the Democrats for the feasibility of a public option, rather than the counter-argument it became in a fact-free environment.

Then of course, there were the inevitable hilarious ideas such as “Stephen Hawking wouldn’t have been allowed to live under the NHS” when he in fact says he owes his life to it.

By contrast, the US system costs an exorbitant 16% GDP per capita, does not cover a large fraction of the population, and has very little in the way of measures guaranteeing fairness. Half of that 16% is already spent on Medicare and Medicaid – so actually, Americans are spending proportionally just as many of their tax dollars on national healthcare programs as we are already, and see how much more we do with it. So to counter the fears of ‘rationing’, we actually provide more care to more people at the same cost.

It’s a shame that truly intelligent discussion of healthcare has been derailed by scaremongering and one-liners in the US. While we could accuse anti-reform adovcates of disingenuousness, it’s also clear that the Democrats failed to make a clear riposte to their arguments and a convincing case of their own. Intelligent and informed analysis pieces, such as this FT column, have been few and far between.

Aug 26
Posted by: colinhockings  

If you’re a skeptic, particularly if you’re interested in the fight against pseudoscience and fuzzy logic in health care, Edzard Ernst is a man you should listen to closely. And if the name rings a faint bell you’ve probably heard of him as the co-author of ‘Trick or Treatment? Alternative Medicine on Trial‘ with Simon Singh. While there are hundreds of skeptical bloggers making a lot of noise about alternative medicine, Edzard Ernst’s full time job is to do it properly. With his group at the Peninsula Medical School (at the Universities of Exeter and Plymouth) he writes systematic reviews and meta-analyses of complementary medicine, as well as carrying out clinical trials (although apparently it’s been a while due to budget constraints) and writing books and articles for various newspapers. In short, he’s a very busy man, doing lots of important work – he’s published over 700 articles in peer-reviewed scientific journals!

In the last few weeks Edzard Ernst published two systematic reviews, one examining the utility of chiropractic spinal manipulation for asthma in children, and the other on chiropractic spinal manipulation for infantile colic. Those of you who are familiar with the ongoing trial of Simon Singh at the hands of the British Chiropractic Association will understand the significance. In short: Simon Singh is being sued because he pointed out that there was no evidence that chiropractic could help children with asthma or colic – among other pediatric complaints – and that the BCA promote it’s use for these conditions anyway.

I’ll give a quick summary of the two studies but I recommend reading them yourself (if you have access to the journals) because they are so short.

‘Spinal manipulation for asthma: A systematic review of randomised clinical trials’

They looked for every relevant study they could find on several databases as well as hand-searching references: a total of 35. Then they took out all the studies that weren’t randomised, didn’t study human patients (of any age), didn’t study chiropractic spinal manipulation (as opposed to other auxiliary treatments that are performed by chiropractors, or spinal manipulations performed by other professionals such as osteopaths), and didn’t study a clinical outcome. These criteria seem quite reasonable to me, but despite the bar being set so low only three studies were usable. Two of the studies concluded that there was no effect, and the third did not compare the control group with the experimental group ‘because of the high risk of committing type I and type II errors’. I don’t quite know if that is sufficient justification to avoid what most would consider the entire point of the experiment, but apparently they claimed to be a preliminary trial to determine the feasibility of a larger study. They did, however, deign to say that there was ‘little or no change’ between the patients before and after the manipulation.

Professor Ernst went on to say that the review wasn’t powerful enough (read: there aren’t enough strong studies) to prove chiropractic as being ineffective, but ’science in general and the RCT [Randomised Clinical Trial] in particular are not good tools for proving a negative’. Thus, and I think this is a very important point that applies to all claims by alternative medicine enthusiasts:

“[It is] the responsibility of those who claim spinal manipulation to be effective to demonstrate this beyond reasonable doubt. In the absence of such proof, any claim that spinal manipulation (or indeed any other therapy) is effective seems unjustified and irresponsible”

‘Chiropractic spinal manipulation for infant colic: a systematic review of randomised clinical trials’

This study was performed in much the same way as the other, however the trials that were considered to be of sufficient quality (3 out of 52) were still fairly poor, with low sample sizes and insufficient controls, as well as rubbish measures of outcome. Thus the conclusions that can be drawn are correspondingly shakier. The two slightly better trials reported no significant differences between the groups, and the methodology of the third trial, which reported a small change, was pretty dire to say the least. They didn’t report on the recruiting process, so it presumably consisted of asking parents to join a trial of chiropractic (and so probably selecting parents who believe that chiropractic will work), then they didn’t blind the parents as to whether or not their child had recieved chiropractic manipulation or a placebo drug, and then they relied solely on the parents evaluation of severity.

Colic is particularly interesting with regard to alternative medicine because we have very little idea about what causes it and no real idea about how to treat it. This sets the stage for lots of worried parents feeling powerless to help their children who are wracked with inconsolable crying, flushed faces, flatulence and ‘meteorism’ (drawing up their legs). The kicker is that it usually resolves spontaneously. It is easy to imagine parents who go their pediatrician being told not to worry, to just sit tight and wait, and when the disease has gone on for long enough they start hunting for alternative ‘remedies’ (here’s your regression to the mean). They may try a few different things and suddenly their child gets better. If I was an evil businessman representing chiropractic I would want to make sure that lots of parents come to see me for their baby’s colic because they’ll probably be converts for life once the child gets better on its own. To give you an idea of the magnitude of this effect, one retrospective study reported that 91% of colic patients showed a positive response to chiropractic.

One final note about these systematic reviews: anyone who would dismiss them as being written by Simon Singh’s friend to stack the evidence against the BCA has a tough case to argue. The point of a systematic review (as opposed to a run-of-the-mill, garden variety review) is to look at all the evidence on a certain topic, and evaluate it according to pre-defined criteria. In addition, the data-extraction and Jadad scoring (an assessment of the methodological quality) were performed by two independent reviewers.

Also highly recommended: Edzard Ernst published one of the best take-downs of the BCA ‘plethora of evidence’ in the BMJ a few months ago.

References:

This post was chosen as an Editor's Selection for ResearchBlogging.orgErnst E (2009). Spinal manipulation for asthma: A systematic review of randomised clinical trials. Respiratory medicine PMID: 19646855

Ernst E (2009). Chiropractic spinal manipulation for infant colic: a systematic review of randomised clinical trials. International journal of clinical practice, 63 (9), 1351-3 PMID: 19691620

—— Update ——

This post was chosen as an Editor’s Selection for ResearchBlogging.org

Jul 22
Posted by: colinhockings  

Leukemia. I’ve dropped a hint or two that I may be talking a little about leukemia on this blog, and I’ve found the perfect way to start. Today, my attention was directed to a video about a girl called Melisa Paskova, a nine year-old girl from Macedonia, who’s been diagnosed with a resurgence of the leukemia she thought she’d defeated a few years ago. If you speak German, I recommend you watch: it’s a heart-wrenching story.

Melisa came to Essen, Germany for a bone marrow transplant which represents her best hope of beating the cancer once and for all. Bone marrow transplants are life-saving for a variety of diseases, but it is sadly very rare to find an acceptable donor. Luckily for Melisa, her older sister (10) is a perfect match, so she has a very good prognosis. Unfortunately, the insurance company refused to foot the c. €100,000 bill, and she was on television essentially to ask for money. While everyone I watched this with immediately started trying to make a donation, it emerged that in the few days since she was on TV (RTL on the 15th, and WDR on the 18th) they’ve managed to raise more than enough money: €142,000 according to the fund-raising website!

Cancer is most commonly a disease of older people, which is what makes leukemia so terrifying. It strikes children and tears families apart. The speed with which so many people gave their support to this girl shows that it’s not just the leukemia researchers I’m working with that are touched by this, but I believe everyone can, in some way, picture their children losing their hair and dying slowly while they are powerless to help.

There’s been a great deal of research into leukemia, and the sort of operation that Melisa will undergo is a very recent development. Looking to the future, we are seeing breakthroughs in understanding the causes of leukemia that are going to make their way into the clinic, hopefully within the next 10-15 years. The reason that the people in my lab had been pointed to the video in the first place was that one of the scientists featured had previously worked here, a fact that really brought the story home to me. It’s very heartening to be reminded that what we do here will save lives, even the lives of children that haven’t been born yet.

Jul 21
Posted by: colinhockings  

Those of you that have been paying attention to PZ Myers may be aware that some humanists in Austria managed to put adverts on buses in Vienna. That’s not quite correct, but close enough: they weren’t able to find anyone willing to publish their adverts on buses, but were able to advertise on static billboards, so they didn’t have to stoop to renting their own bus and driving through the country, like the German equivalent did in May.

There are three messages displayed:

“Es gibt keinen Gott. Gutes tun ist menschlich. Auf uns kommt es an” (”There is no God. Doing good is human. It’s up to us”)

“There’s probably no God. Now stop worrying and enjoy your life” (the original message displayed in England)

And the absolutely genius:

“Gott ist mit an Sicherheit grenzender Wahrscheinlichkeit ein tschechischer Schlagersänger. Entspann dich. Er wird dir nichts tun” (God is almost certainly a Czech pop singer. Relax. He won’t hurt you)

Which plays on the Czech singer’s name ‘Karel Gott’.

The (abridged) story is that three atheist organisations in Austria wanted to follow in the footsteps of the British Atheist Bus Campaign, but were turned down because:

“Einer der Grundsätze der Wiener Linien ist, keine Werbung für politische Parteien oder religiöse Glaubensgemeinschaften auf den Fahrzeugen der Wiener Linien zuzulassen. Auch bei Werbung für atheistische Gruppen oder Glaubenstendenzen greift dieser Unternehmensgrundsatz. Insofern wurde das Ansuchen des Freidenkerbundes bzw. der AG-ATHE nach sorgfältiger Prüfung abgelehnt.”

Which translates approximately to:

One of the ground rules of the “Weiner Linien” [the company that runs public transport in Vienna] is to forbid advertisement for political parties and religious organisations on our vehicles. This rule also applies to atheist groups and organisations. For this reason, the Free-Thinker-association, i.e. the AG-ATHE [Atheistic and Agnostic women for a secular Austria], have had their application denied.

However, Florian at Astrodicticum Simplex (who did his PhD in Vienna) claims that this is quite a strange reason, saying that there are lots of adverts for political parties.

So the atheists turned to a company that runs static commercials, and, as you can imagine, there’s been some controversy. The advertising company (Gewista) that runs the adverts had checked with the Austrian advertising standards agency (Werberat) who gave them the thumbs up, but only just. The Werberat said:

“Wir sind mit einer sehr knappen Mehrheit zur Überzeugung gekommen, dass auch für den Atheismus das Prinzip der Religionsfreiheit gilt”

(”By a very small majority, we have reached the conclusion that the principle of religious freedom applies to atheism too”)

Very small majority!?! Well I guess some resistance was to be expected. It simply strikes me that the freedom of religion is the sort of right that applies to everyone automatically, and is only revoked if you’re murdering people in your rites.

At any rate, the adverts are now up and I guess they are having some degree of effect. I can’t feel the ripples here in Frankfurt, but it’s hard to get a feel for these things when you’re not there. There’s a few indignant newpaper article (in German), but according to a quick Google search this campaign has hardly been heard of in the English-speaking world.

Please let me know if you find any updates to this story.