Hillary Clinton's private emails reveal how she schools the experts on diarrhea science
And at least some of the time, an email thread from May 2010 suggests, she thinks like a scientist.
The details of the exchange with Megan Rooney, a speechwriter, are hard to tease out (an attachment is not included in the document dump, updated on August 31). But Clinton shows she's attuned to the latest research, catching an apparent mistake that was missed by - in Rooney's words - "the experts."
The exchange begins when Rooney sends Clinton an updated draft of a speech, which the Secretary would deliver later the next day at the national conference for CARE, an organization that fights global poverty.
The speech "focuses on a chronically overlooked issue (nutrition)," Rooney writes, adding: "This is a speech that only you could give and a number of constituencies will be delighted by it."
In her reply, Clinton appears happy with the speech: "It is so much better-thank you," she writes. But then Clinton raises a number of questions. Most interesting, she catches what appears to be an error: "Is the Vitamin A research on p. 8 accurate given recent research that raised doubts about it [sic] efficacy?"
Hours later - and only minutes before Clinton was scheduled to speak - came a reply: "You were right about Vitamin A, no surprise (although a bit surprising that none of the experts noticed it)," Rooney writes. "I've changed it to oral rehydration therapy."
Without seeing the draft copy of the speech, it's hard to know exactly what "the Vitamin A research on p. 8" was, and it's even harder to know what the error was. But the "oral rehydration therapy" detail is a big clue.
In the final transcript of Clinton's speech, the phrase "Vitamin A" does not appear at all. What we suspect is Rooney's correction appears in this sentence (emphasis ours): "Some of the worst effects of under-nutrition can be alleviated through simple interventions, like giving pregnant women iron to prevent anemia or giving children oral rehydration salts to manage diarrhea."
Diarrhea is a major cause of death among infants and children in developing countries. It's not clear from the Clinton emails whether the speech mentioned Vitamin A as a way to manage diarrhea or in another context entirely (Vitamin A deficiency remains a serious public health problem on its own).
If it was mentioned in passing as a way to manage diarrhea, however - which seems likely - Clinton was right to flag it.
In a 2007 paper published in the journal Clinical Infectious Diseases, researchers from the Johns Hopkins Bloomberg School of Public Health noted that Vitamin A supplementation can help children stay alive in general, but Vitamin A is not an effective way to treat a case of diarrhea. "When given for the treatment of diarrhea, vitamin A appears to have no effect on the duration of the diarrheal episode and is not recommended for routine treatment of diarrhea," they wrote. (Later research offered further support for this conclusion.)
Oral rehydration therapy, meanwhile - which involves a special solution of salts and sometimes glucose and other minerals mixed with water - remains a gold standard for managing diarrhea in developing countries. Oral rehydration solution "is effective against diarrhoea mortality in home, community and facility settings," Hopkins researchers concluded in the International Journal of Epidemiology in 2010.
While it's impossible to say whether the changes made to Clinton's speech were small or large, Clinton's comment suggests a sharp attention to the nitty-gritty details of public health research, and a commitment to getting it right.
The full exchange is below, with highlights in yellow.
