THE HIGHLY charged discussion about what role, if any, race plays in medicine has taken a quiet but significant turn. The pharmaceutical company Schering-Plough has begun testing a hepatitis C drug, codenamed SCH 503034, and has specifically excluded African-American patients from the Phase 2 trial — the stage that attempts to find the right dosage. The exclusion has led two patient groups to accuse the company of racism.

For reasons unknown, black patients have a lower response rate than whites to standard therapies for hepatitis C. Schering-Plough says the exclusion will make the drug trials “more prudent and scientifically valid”, and that African-Americans can come on board as the study advances (and as the law requires). Patient groups respond that, since the exclusions cannot be justified on safety grounds, they cannot be justified at all. “The bottom line is that African-Americans have been left out of this study to make the drug look good,” says Judith Dillard, of the Community HIV/Aids Mobilisation Project. The Hepatitis C Action and Advocacy Coalition has joined the chorus of condemnation, saying that the exclusion is based on expediency.

The company is baffled by the criticisms, but it shouldn't be. It seems perverse that a drug targeted at “non-responders” should initially not be tested on the very patients who are being failed by current medication. If there are valid scientific reasons for this approach, these should have been discussed frankly with patient groups at the outset.

• AMERICAN researchers have started building a “virtual Baghdad”, a highly sophisticated computer simulation of the city that not only pinpoints the ages, religious views and socioeconomic status of its citizens, but also attempts to predict how they may behave.

  Six students at Purdue University in Indiana are scanning English-language websites that provide an Iraqi perspective on the occupation. The US Defence Department has given the students 700 keywords to search for, and anything that turns up is added to a massive database. The end result will be a “war game” that should allow the US military to spot the green shoots of insurgency, or to predict how a neighbourhood may respond to a military operation.

  “We want to be able to get into the head of the regular Iraqi person in Baghdad,” says Stacy Holden, assistant professor of history at Purdue. She is working on the project with Simulex, a company that specialises in creating computer simulations of environments. Simulex plans to deliver the war game to the military in June.

  The level of attention to detail is astonishing — spooky even. Researchers can build up profiles of individuals. “As I go through information about different quarters or neighbourhoods, any time I find a description of a resident I mark it down,” says Holden.

  She says that the game is not only about weeding out troublemakers, however, but also about identifying the day-to-day concerns of Baghdad’s residents: “Maybe ideology isn’t important to them, but food supply is.” In which case food subsidies, offered with a side-helping of diplomacy, might be received more cordially than bombs.

• MAY I prescribe a tea dance at the Waldorf? Or a shuffle around an art gallery with a friend? Such activities will ease your loneliness, and could thus lower your blood pressure. For researchers at the University of Chicago have found that being solitary can shift normal blood pressure into the hypertensive zone. The difference in blood pressure between lonely people and sociable individuals is not very much at 50 years old, but magnifies with age. Among pensioners, social isolation appears to raise blood pressure by as much as 30 points.

  The academics suggest that encouraging social activity may be as effective a public health measure as getting people to lose weight or give up smoking. “I’m surprised by the magnitude of the relationship between loneliness and hypertension in the study,” admits Richard Suzman, associate director of the behavioural and social research programme at the National Institute on Ageing, which helped to fund the research.

  The study, published in Psychology and Aging, suggests that health officials find ways of perking up the social lives of older men and women.

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