Modern lifestyles increasing risk of NCDs

Modern lifestyles and demographic changes are increasing the risk of noncommunicable diseases (NCDs): cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.  Each year they account for 60% of all deaths or some 35 million people. (Source:  World Health Organization)

The four most prominent NCDs – cardiovascular diseases, cancer, diabetes and chronic lung diseases – were recognized as the key health priority in the WHO European Region at a recent WHO European Region meeting.  NCDs account for 77% of the disease burden and 86% of all deaths in the 53 countries in the WHO European Region.

The WHO notes that in addition to their impact on public health, NCDs constitute an economic burden, with health care costs, lost working time, and early death and disability threatening economic growth and productivity.

Booming trade in counterfeit medicines

An article in the November 2010 issue of The Lancet

According to Paul Newton, who is part of the Wellcome Trust-Mahost Hospital-Oxford Tropical Medicine Research Collaboration, “The main consequences (of counterfeit medicines)…are increased mortality and morbidity, endangering drug resistance and loss of medicine efficacy, loss of confidence in health systems and health workers, economic loss for patients, their families, health systems, and the producers and traders in good-quality medicines, adverse effects from incorrect active ingredients, a waste of enormous human efforts and financial outlay in the development and manufacture of medicines…”

Steve Allen, Senior Director of Pfizer Global Security, emphasised the importance of international collaboration among regulators, the pharmaceutical industry and political representatives, and thinks this strategy will have the best chances of tackling counterfeiting. “This is not just an issue for one company, it is not an issue for one country, it is an issue for all of us.”

GAVI offers new opportunity to apply for life-saving vaccines

The GAVI Alliance has issued a new call for applications from developing countries keen to protect more of their children from disease with new vaccines.

Studies have shown that immunisation not only saves lives, but also boosts economies, acting as a key driver of development.3  Increasing immunisation rates is vital to meet the health Millennium Development Goals, particularly MDG 4 on reducing child mortality.

GAVI estimates that a fully-funded programme would prevent approximately 4 million future deaths by 2015, and enable the introduction of new vaccines including importantly those that tackle major causes of the world’s two biggest killers of children, pneumonia and diarrhoea.

To continue its mission to save lives and protect people’s health by increasing access to immunisation, GAVI needs to raise approximately US$3.7 billion more within the next five years.

WHO calls for better monitoring of anti-malarial drugs

According to the UN, only 34 per cent of countries with endemic malaria are complying with World Health Organization (WHO) recommendations to routinely monitor anti-malarial medicines.

The WHO’s “Global report on anti-malarial drug efficacy and drug resistance: 2000-2010” calls on countries to be more vigilant in drug monitoring to allow for earlier detection of resistance to anti-malarial treatments.

Artemisinin is currently the most effective treatment against malaria, but resistance to the drug when used alone to treat the disease was found in February 2009 on the Cambodia-Thailand border.

The use of artemisinin monotherapy is considered an important factor in the survival and spread of drug resistant strains. If the efficacy of the artemisinin component continues to decline, the risk grows of increased resistance to other drugs used in the combination.

Clot drug to help AF patients

Hundreds of thousands of heart patients would benefit from new type of blood thinning drug to cut their risk of stroke, say UK experts (BBC News).  Patients with atrial fibrillation (AF), an erratic and sometimes fast heartbeat, can reduce their risk by a fifth when taking rivaroxaban rather than the most popular existing treatment, warfarin.

One in five people over the age of 70 is likely to be diagnosed with an irregular heartbeat, which can lead to blood clots and cause strokes.  AF affects around 800,000 UK people and is equally prevalent in Canada, United States and many other developed countries.

Access to these new therapies can often be a challenge for patients, however.  Professor Peter Weissberg, medical director at the British Heart Foundation, said: “The rate at which these new drugs are introduced into routine clinical practice will be determined by the extent to which regulators believe their benefits justify their additional cost.”

The data comes from a study of 14,000 patients and was presented at the American Heart Association conference.

India launches project to reduce transport emissions

According to the UN Daily News, India has launched a new United Nations-backed project to reduce emissions and develop a low-carbon transport system.

While India’s per capita emissions are below the global average, they have the world’s second largest population – ranking the country as the world’s fourth largest greenhouse gas emitter.

In 2007, around 13 per cent of its emissions came from the transport sector.  That is expected to rise due to population growth, a rapid growth in the number of privately-owned vehicles and the switch from rail to road transport in the freight and passenger sectors.

The project is part of a National Action Plan on Climate Change (NAPCC) and involves designing low-carbon transport plans for major Indian cities.

Polio outbreak in Congo kills nearly 100

Polio has killed nearly 100 people, mainly young adults, in the Republic of Congo and paralyzed more than twice as many in the past six weeks, according to the World Health Organization (WHO) and a report from Reuters.

The crippling viral disease normally strikes children under five years of age, making the acute, fast-spreading outbreak unusual, the U.N. agency said.

“Most of the cases have involved young adults aged between 15 and 29. This illustrates that populations are at risk because they have not been exposed to a full immunization,” it said.

184 cases of acute flaccid paralysis and 85 deaths have been reported from the site of the acute poliomyelitis outbreak centred in Pointe Noire, Republic of Congo.  The mortality rate is higher than normal for the disease, which attacks the nervous system.

The virus comes from a strain from India, one of four remaining endemic countries — where the virus survives and its spread has never been interrupted — along with Afghanistan, Nigeria and Pakistan.

A first wave of mass polio vaccination campaigns, targeting 3 million people of all ages, is set to begin on Friday in Congo and parts of Angola and the Democratic Republic of Congo.

The WHO, UNICEF, Rotary International and the U.S. Centers for Disease Control and Prevention have been working together since 1988 to eradicate polio, which infected at least 350,000 people in 125 endemic countries each year at the time.

Opinion: Knowledge-based jobs for health, wealth and security

The following opinion editorial on the future of knowledge-based economies was published by The Cameron Institute and raises some interesting thoughts in terms of how innovation can fuel economic growth while also helping improve patient outcomes and society as a whole.

What do miracle blood clot-busters, cold water detergents, chlorine-free coffee filters, lighter-weight motor vehicles, vaccines, disease-resistant shrimp, and bio-degradable plastics all have in common?  They are all products of knowledge-based industries.

Knowledge-based jobs are transforming the North American economy and society.  Increasingly, economies are measured by the contribution of knowledge to the gross domestic product; economic growth is being driven by innovation.

During the first decade of the 21^st century in Canada, 2.25 million jobs went to persons with postsecondary education and 139,000 jobs went to those with only high school.  On the other hand, almost a million individuals with primary or little education lost their jobs in the same period.

A similar situation exists in the United States where there is projected to be a 57% decline in employment in the textile industry between 2008 and 2018, 34% in electronics manufacturing, and 25% in newspaper printing.  Meanwhile jobs will grow in science and technology, healthcare, and information technology.

Many countries are aggressively investing to build their knowledge-based economies.  Jurisdictions that are successfully building knowledge-based economies have created fiscal, investment and regulatory environments in which firms can flourish.  They have not attempted to “choose winners” or save those “too big to fail” as in North America; rather, European and other foreign governments have removed the tax, regulatory and other punitive measures from innovative industries and let market forces populate their economies with high-value companies and jobs.

High wage, high-tax countries such as France, Germany and the United Kingdom, as well as low-wage, low-tax countries such as China and South Korea have all invested heavily in innovation.  Brazil, Ireland and Singapore – mid-income nations – have earmarked billions of dollars for knowledge-based jobs.  Australia leads the world in public expenditure on R&D as a percentage of gross expenditure.

Yet only five U.S. states have made a significant foray into building knowledge-based employment (California, Maryland, Massachusetts, New Jersey, and Washington) with Ontario being the only Canadian province that has even come close.

Innovation-based companies, once their products have been commercialized, have shown to produce a tax recovery ratio, over a decade, of $8.00 for every $1.00 invested.  For every direct job created, 4.5 indirect and induced jobs are created.  (This is compared to the multiplier effect of 1 for government spending and government jobs.)

NICE to lose powers to reject new drugs

The British government is expected to strip the National Institute for Health and Clinical Excellence, or NICE, of its ability to reject new drugs.

Currently, NICE “scrutinizes the cost and clinical benefits of new drugs to determine whether the state health-care system should pay for them,” The Wall Street Journal reports. “If NICE decides that a drug isn’t worth its price tag, it advises doctors not to prescribe it, which effectively results in a ban. But Britain’s new coalition government, led by the Conservative party, is planning to strip NICE of the ability to reject drugs, the Department of Health said in a written response to questions Monday. Conservative Party leaders are both trying to limit the size and reach of government and put power in the hands of doctors, rather than administrators, when it comes to treatment decisions. In the future, NICE will advise doctors on the best approaches to treating various diseases” and decisions about payment for new treatments ”will be made through ‘a new system of value-based pricing,’ the statement said” (Whalen, 11/2).

Nature.com: In value-based pricing (VBP), “fees are negotiated with companies on the basis of a scientific assessment of the drug’s clinical value. Countries such as Canada and Australia already use versions of VBP, but Britain has an enormous influence on the rest of the world, says Karl Claxton, a health economist at the University of York, UK. Other countries, for instance, use NICE guidance to help make healthcare decisions. … Some though have already warned of adverse consequences if industry does not feel the prices offered adequately reward the development of new drugs” (Cressey, 11/1).

Courtesy of Kaiser Health News’ Daily Report.

Pharmaceutical innovation and data protection – WTO forum discussion

An interesting discussion was recently started in the World Trade Organization’s community forum on a complex topic — data protection and pharmaceutical innovation.

Posted by KMLybecker

Generating the data necessary to secure regulatory approval has become more extensive and more expensive. Clinical testing has become more difficult and laborious. These regulations and associated costs play an increasingly important role in the pharmaceuticals and agricultural chemical industries, sectors in which product safety and efficacy are of utmost importance. As such, it is necessary to incentivize data generation by providing protection for the investment in data generation. Regulatory data protection serves to protect originator firms against free riding, and safeguards the substantial financial investment involved in drug discovery and regulatory approval.