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 Often considered a "social disease" HIV/AIDS can be linked to certain social groups and subsequent behaviors within these groups. Taking this a step further, poor prognosis in treatment can be linked to social stratification. In the early 90's in Baltimore, a study was performed that linked race to reception of timely medical intervention. Modifications to the programs, such as removing insurance status as a determining factor for care, drastically reduced racially-biased outcomes. In the Rwandan campaign, Partners in Health instituted proximal care to rural regions-- the areas where care was most significantly lacking. This, in turn, can greatly mitigate the effects of social violence. Moreover, structural interventions (such as changing the accepted and prescribed practices of international bodies) can greatly reduce the effects of disease within a population. This includes such things as when and how drugs are administered, who is receiving medications, and changing conventional practices proven to enhance the spread of disease. 

The article primarily argues that, although there are interventions and steps in place, "biosecurity" is not currently a viable or stable entity. The four main areas stated in this article (emerging infectious disease, bioterrorism, cutting-edge life sciences, and food safety) are not formerly understood or controlled enough to make a feasible and honest plan that ensures safety. While steps can be taken and measures used, the dynamic nature of these fields and the human condition prevents us from establishing a truly flawless safety net at this time. One only has to look at the re-emergence of previously extinct diseases such as measles, the prevalence of pertussis, or the assertion of chemotherapy's deadliness  to see we do not have a full handle on any of these fields.

Dr Knowles examines three historical structural disasters: the burning of the Capital Building (1814), the Hague Street boiler explosion (1850), and the Chicago Iroquois Theater fire (1903). The Capital Building burning (henceforth noted as CBB), and the subsequent investigation by engineer Benjamin Latrobe provided numerous insights into the disaster. These are discussed, but Dr. Knowles pays particular attention to the major scrutiny endured by Latrobe. As a major player during the planning and building of the Capital Building, the CBB was painted as his failure (despite indications otherwise). More than anything, the report highlights Latrobe's inability to prevent and evaluate disaster; although an employee directly of the president and senate, he was powerless to enact change. Similarly, the Hague street boiler seemed to be fraught with issues. Yet, those who came to present in the ensuing investigation had no true standing to alter future events. It  again follows this pattern of disaster, difficult investigation, and minimal substantial response by those in power. The Iroquois Theater Fire investigation seemed to finally deviate from this norm. Multiple fire experts, engineers, and public officials involved themselves in the case. However, ultimately, the investigation's findings were not put to use. Some advances occurred, yet so many other technical progressions were ignored.