Malevolent Design or Evolution?

Carla Cerami, M.D., PhD., is the lead scientist on the study and said its results reveal the relationship between anemia, iron supplementation and malaria risk.

Anemia Offers Stronger Protection Than Sickle Cell Trait Against the Erythrocytic Stage of Falciparum Malaria and This Protection Is Reversed by Iron Supplementation - EBioMedicine

I've yet to find an intelligent (sic) design advocate who doesn't believe their putative designer is anything other than the god they purport to believe in, whether they call it God, Allah, Dios, Gott, Yahweh or any other of the names for the god of the Bible and Qur'an.

It's fair to assume therefore that this putative intelligent designer, in the minds of its advocates, has all the characteristics they assign to their particular version of this god. This includes having made humans as it's special creation with everything else there merely to serve the needs of these special human creations. So this open-access paper presents intelligent (sic) design advocates with a special problem. If it was intelligently designed, there is no way these findings can be presented as anything more than a work of extreme malevolence and mendacious sadism.

A team of researchers based at the University of North Carolina and including colleagues from the Medical Research Council Unit in The Gambia, Africa, and the London School of Hygiene & Tropical Medicinehas, found that not only does iron-deficiency anaemia in children give them a degree of protection against malaria but that that protection is much higher than the protection given by sickle-cell anaemia. The team also propose that this probably has a genetic basis. Humans in areas where malaria is endemic may have a genetic predisposition to iron-deficiency anaemia!

Highlights

• P. falciparum laboratory and field strains invade and grow less efficiently in RBCs from anemic children.
• Deficits in invasion and growth for erythrocytic stage P. falciparum are reversed when RBCs are used from anemic children receiving iron supplementation for 49 and 84 days.
• The population level impact of protection against malaria from anemia was greater than that for sickle-cell trait.

The long-term consequences of anemia are severe, and it is easily treatable. However, concerns remain about the safety of iron supplements, particularly for children in malaria-endemic countries lacking adequate access to health services. We used RBCs from Gambian children before, during, and after 12 weeks of daily iron supplementation for in vitro P. falciparum assays. P. falciparum invasion and growth was decreased in anemic RBCs and increased after 49 days of iron supplementation relative to baseline (p < 0.001), paralleling increases in young RBCs, which the parasite prefers. The parasite growth protection from anemia was substantial, providing greater population level impact than sickle-cell trait.

Abstract

Background
Iron deficiency causes long-term adverse consequences for children and is the most common nutritional deficiency worldwide. Observational studies suggest that iron deficiency anemia protects against Plasmodium falciparum malaria and several intervention trials have indicated that iron supplementation increases malaria risk through unknown mechanism(s). This poses a major challenge for health policy. We investigated how anemia inhibits blood stage malaria infection and how iron supplementation abrogates this protection.

Methods
This observational cohort study occurred in a malaria-endemic region where sickle-cell trait is also common. We studied fresh RBCs from anemic children (135 children; age 6–24 months; hemoglobin <11 g/dl) participating in an iron supplementation trial (ISRCTN registry, number ISRCTN07210906) in which they received iron (12 mg/day) as part of a micronutrient powder for 84 days. Children donated RBCs at baseline, Day 49, and Day 84 for use in flow cytometry-based in vitro growth and invasion assays with P. falciparum laboratory and field strains. In vitro parasite growth in subject RBCs was the primary endpoint.

Findings
Anemia substantially reduced the invasion and growth of both laboratory and field strains of P. falciparum in vitro (~10% growth reduction per standard deviation shift in hemoglobin). The population level impact against erythrocytic stage malaria was 15.9% from anemia compared to 3.5% for sickle-cell trait. Parasite growth was 2.4 fold higher after 49 days of iron supplementation relative to baseline (p < 0.001), paralleling increases in erythropoiesis.

Interpretation
These results confirm and quantify a plausible mechanism by which anemia protects African children against falciparum malaria, an effect that is substantially greater than the protection offered by sickle-cell trait. Iron supplementation completely reversed the observed protection and hence should be accompanied by malaria prophylaxis. Lower hemoglobin levels typically seen in populations of African descent may reflect past genetic selection by malaria.

M.M. Goheen, R. Wegmüller, A. Bah, B. Darboe, E. Danso, M. Affara, D. Gardner, J.C. Patel, A.M. Prentice, C. Cerami. Anemia Offers Stronger Protection Than Sickle Cell Trait Against the Erythrocytic Stage of Falciparum Malaria and This Protection Is Reversed by Iron Supplementation. EBioMedicine, 2016; 14: 123 DOI: 10.1016/j.ebiom.2016.11.011

Crown Copyright © 2016 Published by Elsevier B.V. (Open access)
Reprinted under terms of a Creative Commons Attribution 4.0 International license (CC BY 4.0)

Sickle-cell anaemia has long been recognised as a problem for intelligent (sic) design advocates, especially those who still hope to get away with pretending it isn't creationism dressed up but a real science. Although it is a debilitating and often fatal disease and has no benefits whatsoever away from areas where malaria is endemic, it survives in malarial areas because it gives carriers a degree of protection. Why an intelligent designer would deliberately create a harmful organism in the first place is difficult enough without abandoning the pretence of science and invoking 'The Fall' from Christian mythology. When it comes to explaining why this intelligent (sic) designer would then design a partial workaround for the problem it designed in the first place, creationists tie themselves in knots if they try to confront the problem.

Our finding that anemia offers greater natural protection against blood-stage malaria infection than sickle-cell trait has led us to formulate the interesting hypothesis that the widespread prevalence of anemia in people of African descent is a genetic signature of malaria.

Morgan Goheen, Ph.D. Lead author
(Quoted in UNC Press Release)

Now we have this evidence that, still assuming there is an intelligent designer at work, it has actually come up with a genetic predisposition to iron-deficiency anaemia as a partial workaround to the problem it designed in the first place in the form of Plasmodium falciparum and it's mosquito delivery system. The only way to rationalise this in terms of intelligent design is to assume the designer is malevolent and intends making children sick. This is, of course, completely at odds with the omni-benevolent Christians and Muslims tell us created us because it loves us.

So, concerned medical workers now have to balance the benefits of giving iron supplements to counter the debilitating effects of dietary iron deficiency in children against the increased susceptibility to malaria that this would produce and whichever choice is taken, children will inevitably be less than optimally healthy. And yet creationists also argue that their designer works to maximise the good in the world. Oh! Of course! The pseudo-science of intelligent (sic) design then invokes 'ineffable mystery' as part of their 'scientific' explanation! Anyway, the children must have done something to deserve it - or their parents did, or something...

There is no problem here for evolutionary biology of course because evolutionary biology gives a perfectly logical reason for this state of affairs to have evolved in a mindless, amoral and entirely utilitarian process of natural selection and survival of the fittest. For an intelligent (sic) design creationist (are there any different sort?) the problem looks insurmountable within the current view of the nature of this putative designer. It also offers no solution to the moral questions involved in this conundrum.

Perhaps creationists would like to state how they see this.

1. Should medical researchers continue to treat iron deficiency in (especially) West African children and so remove some of their protection against malaria?
2. Should they continue to look for solutions to malaria and so go against the intelligent (sic) designer's clear intention of making children suffer?
3. Should they deal with both problems and so oppose their intelligent (sic) designer's plans?
4. Should they just ignore both problems because their intelligent (sic) designer intended children to have both medical problems?

Answers below please.

It's notable how the supposed moral compass provided by the 'object morality' in holy books offers no moral solutions here whereas the amoral process of evolutionary biology and an essentially atheistic approach to the problem offers very ready and obvious solutions - we should do what we can to alleviate and prevent suffering because we are ethical human beings who have evolved a predisposition to care.

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