14 April 2012 | NewScientist | 23

There are many barriers. The upfront costs of some measures can be prohibitive even when they eventually pay for themselves. But this can be overcome by mechanisms such as international financing of capital costs.

For other measures, the costs are typically borne by a few while the benefits accrue to everybody. In such cases civil society and governments must get involved.

Governments are starting to act. In February, the US, Canada, Sweden, Bangladesh, Ghana and Mexico launched the Climate and Clean Air Coalition to support implementation of measures like these. This coalition will hopefully expand and achieve rapid, widespread adoption of measures to cut black carbon and ozone.

While the climate benefits will be substantial, it is important to note that these measures cannot substitute for cuts in carbon dioxide. Black carbon, ozone, carbon monoxide and methane stay in the atmosphere for a fairly short time – a few days for black carbon and about a decade for methane. They thus respond quickly to emissions changes and give us substantial leverage over near-term climate change.

In contrast, carbon dioxide is very long-lived and so responds slowly to emissions changes. This means that cuts have little immediate impact, but it also means they must be made now to avoid disastrous changes later on.

Controlling short-lived climate pollutants is thus an issue of fairness. Much as failure to reduce carbon dioxide emissions soon would condemn future generations to disastrous change, failure to reduce near-term climate change condemns those alive today to suffer worsening effects of the sort already seen.

Some wonder if we really can do both. We can, and we must. n

Drew Shindell is a climatologist at the NASA Goddard Institute for Space Studies, and Columbia Earth Institute, Columbia University, New York

Comment on these stories at newscientist.com/opinion

What exactly is Darwinian medicine? It means we look at humans as being well-adapted, so we don’t just jump to the conclusion that signs and symptoms of illness need to be targeted. We don’t always think of them as the enemy. There are lots of subtle things that we do differently from conventional medicine.

What do you do differently from other doctors?One example is when a child twists an ankle playing soccer. Everyone rushes to offer ice and ibuprofen. As the father of a soccer player, I’ve seen this happen many times, and it didn’t take me long to earn the label “cruel and unusual”, by insisting that my son needed neither. As a Darwinian paediatrician, I think the pain and inflammation that made my son cry and his ankle swell are an evolutionary response to injury, which suggests that they are part of the solution rather than the problem. They exist to promote healing.

Do you have other examples?Fever is similar. It arises via the activation of exquisitely evolved mechanisms, suggesting that it is an adaptation every bit as much as pain and swelling, yet many physicians continue to tell their febrile patients to take a fever-reducer and call them in the morning.

However, just when you start to think that practicing Darwinian paediatrics is easy there is a complicating caveat. Although evidence indicates that fevers generally help children fight infections, exceptions are to be expected. The parasites that cause malaria, for example, appear to have adapted to fevers, so thrive as their host heats up.

So Darwinian medicine is nothing to do with survival of the fittest?Not in the sense of favouring the “strong” over the “weak” or endorsing reproductive competition.

Do you encounter resistance to your ideas? There is some. The Darwinian way is a bit harder. You certainly do feel better right away if you take a fever-reducer. All of us want to feel better now, we’re short-sighted, not quite as interested

One minute with...

Paul Turke

in what’s going to happen down the road. We are up against that.

You are writing a book for parents. Will it tackle any childhood medical controversies? Yes, many. I discuss giving vitamin K to babies in the first moments after birth. Most physicians assume that nature dropped the ball by producing infants with very low levels of the vitamin, but it is possible they could be low for a reason. I also discuss vaccines, which I believe are great inventions, but which could be done better, with more attention paid to how pathogens evolve along with our immune system. The book will also cover conditions like anorexia, depression and autism.

Do your ideas extend to other areas of parenting?Yes. Sometimes people don’t understand how child-centred we have evolved to be. I want to get the message out that it’s OK to make your children and grandchildren the centre of your life.Interview by Jon White

It’s time for evolution to take centre stage in the practice of medicine, says the world’s first “Darwinian paediatrician”

ProfilePaul Turke is a paediatrician in Ann Arbor and Chelsea, Michigan, with a background in anthropology and evolutionary biology. He is writing a book called Bringing Up Baby: A Darwinian view of pediatrics

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