For years, scientists have been trying to unravel the mystery of a chronic kidney disease epidemic that has hit Central America, India and Sri Lanka. The disease occurs in poor peasant farmers who do hard physical work in hot climes. In each instance, the farmers have been exposed to herbicides and to heavy metals. The disease is known as CKDu, for Chronic Kidney Disease of unknown etiology. The “u” differentiates this illness from other chronic kidney diseases where the cause is known. Very few Western medical practitioners are even aware of CKDu, despite the terrible toll it has taken on poor farmers from El Salvador to South Asia.

Dr. Catharina Wesseling, the regional director for the Program on Work and Health (SALTRA) in Central America, which pioneered the initial studies of the region’s unsolved outbreak, put it this way, “Nephrologists and public health professionals from wealthy countries are mostly either unfamiliar with the problem or skeptical whether it even exists.”

Dr. Wesseling was being diplomatic. At a 2011 health summit in Mexico City, the United States beat back a proposal by Central American nations that would have listed CKDu as a top priority for the Americas.

David McQueen, a US delegate from the […]