Access barriers to medicines and health: Op-Ed

Canadian MP Keith Martin recently wrote an interesting Op-Ed for the Edmonton Journal on the challenges of providing access to medicines and health for the world’s poorest.  He notes that lack of infrastructure, access to trained health workers, potable water and sanitation are the real barriers to access to medicines and care — not patents.

98.6 per cent of ‘essential medicines’ are generic or are not patented in developing countries, but for those living on $2 a day even generic drugs are too expensive (when available).

Tinkering with patent laws won’t get medicine to world’s poorest

The debate around enabling the world’s poorest people to acquire life-saving medications is coming to a head. This week, Parliament votes on a bill that will modify Canada’s Access to Medications Regime (CAMR). If the bill becomes law, it will enable Canadian generic manufacturers to produce and sell medications that are currently under patent protection to developing countries. On the surface this makes sense. But are patents really the obstacle proponents of the bill claim to enabling the poor to access drugs for AIDS and other diseases?

Every year, the World Health Organization (WHO) convenes an independent panel of experts, chosen equally from developing and developed countries, to draw up a list of essential medicines. Currently, 319 drugs are on this list.

Of these, 98.6 per cent are generic or are not patented in developing countries. Thus, the life-saving medications the poor needs are already off patent. Generic manufacturers can make them today if they wish. Therefore, patents are not the problem.

Alternative health treatments hinder asthma management: study

As reported by the National Post, a new Canadian study suggests that a sizable minority of child asthma patients rely on alternative treatments like acupuncture and homeopathy, and are more likely to have poor outcomes as a result.

The research by doctors associated with the University of Montreal looked at 2,000 children who came to the Montreal Children’s Hospital asthma centre between 1999 and 2007. About 13% were regular users of alternative therapies, the most common being vitamins, homeopathy and acupuncture. The most concerning finding was that those being treated with such methods were twice as likely to have poor control over their asthma. And the the children most likely to be under alternative care were less than six years old, the scientists’ paper in the Canadian Respiratory Journal says.

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.)

Canada launches one of world’s largest health studies to gain insight into disease prevention and management

The largest population-based health study ever conducted in North America was launched this past month in an effort to help better understand the causes, prevention and treatment of diseases such as cancer, heart disease, asthma, and diabetes.

The Ontario Health Study (OHS) will be the biggest community-based health study ever done in Ontario and is also part of the Canadian Partnership for Tomorrow Project, made up of five regional health studies across the country.

Medical researchers at universities, research institutes and hospitals across Ontario are conducting this study. The governments of Ontario and Canada are funding the Study.

The Study began with an initial phase in which more than 8,000 adults living in three communities in Ontario took part. The main phase of the Study has begun, and is now open to all residents of Ontario who are at least 18 years old.

Altogether, aggregate data from hundreds of thousands of Canadians over time will help build one of the world’s largest profiles of risk factors for diseases.

Source:  World Health Advocacy.

Health Canada considers changes to orphan drug approvals

After years of lobbying by patient groups, Health Canada is preparing to change the way drugs are approved to accommodate rare diseases and the “orphan drugs” needed to treat them (Montreal Gazette).

Later in October, Health Canada will launch consultations on broad drug-regulation reforms and, for the first time, how orphan drugs should be treated differently and incorporated into the regulatory framework will be part of those conversations.  The department hasn’t committed to implementing a formal orphan drug policy but the changes that will eventually be made as part of wider modernizations to Health Canada rules are considered major progress and a departure from previous positions.

There are thousands of rare disorders that affect only small groups of people, but altogether, an estimated one in 12 Canadians has a rare condition and many people are undiagnosed.

Unlike other countries, Canada doesn’t have a standard definition of rare diseases, let alone a national plan to deal with them. The United States has had an orphan drug policy since 1983 and the European Union has also implemented changes to their regulations to accommodate orphan drugs.

Canada needs to follow their lead, say groups such as CORD and BIOTECanada, because the absence of a policy means patients and researchers here are at a disadvantage.

The potential revisions could first include defining a rare disease as a condition that affects one in fewer than 2,000 people, and beyond that, may change the way drugs for rare diseases are developed, approved and brought to the market.

If the American and European models are followed, there will be more incentives for drug companies to pour money into research and development — a challenge considering the customer base for orphan drugs is so small. Those incentives could include more tax credits and funding grants for research, extending patent protection, and reducing drug-approval application fees or dropping them altogether.

Clinical-trial protocols might also be modified to accommodate the challenges associated with testing drugs for rare diseases, said David Lee, head of the Health Canada branch that is in charge of updating the regulations.

Lee said Health Canada is carefully studying how other countries handle orphan drugs with an aim to see what could be implemented here.

After the consultation period, which will last several months, draft regulations will be proposed for overhauling the drug-regulation system.

New study highlights the importance of partnerships in improving public health.

The Cameron Institute – a Canadian not-for-profit public policy think-tank – released a report highlighting the importance of public-private partnerships and of intellectual property protections to improving global health.  The evidence in this report (Pharmaceutical Access in Least Developed Countries: on-the-ground barriers and industry successes) strongly supports North-South, public-private partnerships as the preferred means by which to improve access to care and public health outcomes in least-developed countries.

Sustainable development is the way of the future for both North and South.  In order for there to be sustainable healthcare enterprise and optimal health outcomes in the least-developed countries, there must also be the necessary infrastructure, health human resources, political stability, and professional administrative legal structures.

– Dr. D. Wayne Taylor Ph.D., F.CIM, Executive Director of The Cameron Institute

The 200-page report shows that the research-based pharmaceutical industry has sponsored or participated in over 150 public-private partnerships that have successfully improved access to drugs – as well as health outcomes – for the 50 least developed countries.

Click here to download the full report.

Preventing September asthma peak

Courtesy of the Asthma Society of Canada:

Canadian researchers have found that the September back-to school period brings a dramatic increase in hospitalizations for children with asthma. This increase starts when students return to school and will peak in the third week of September and continue into October.  This year, it is expected to peak between Sept 20 and 26th.

What can you do?

1. Speak with your Certified Asthma Educator and/or healthcare provider to:

• assess your child’s level of asthma control
• have their inhaler technique checked (www.asthmameds.ca)
• perform spirometry (breathing test – usually can be performed age 6 and older)
• review your Asthma Action Plan

2. Speak to your child’s school about their policy on asthma inhaler use and advocate that your student carry their rescue inhaler with them

3. Ensure your child is on their asthma controller medication throughout the year (if prescribed) , even when symptom free.  Many students stop their daily asthma controller medications during the summer months and as a result their airways may be inflamed, leaving them more susceptible to the cold virus triggering their asthma during the September Asthma Peak

4. Monitor your child for asthma symptoms daily

5. Identify your child’s triggers (anything that can make their asthma worse) and take steps to minimize trigger exposure

6. Speak to your child about the importance of hand washing to avoid catching and spreading the cold virus

For more information please visit http://asthma.ca/adults/control/septemberPeak.php

Chronic conditions on the rise – new health challenges facing children

More than a quarter of all U.S. children have a chronic health condition, according to research recently published in the Journal of the American Medical Association.  Over the past 30 years, the prevalence of chronic conditions in children and adolescents has increased, particularly for asthma, obesity, and behavior/learning problems.

Other research shows that one in three people (in Ontario, Canada) can expect to be diagnosed with asthma at some point in their life.

The growing prevalence of chronic conditions is not limited to rich countries, as data shows that cases of diabetes, asthma and other conditions are on the rise in many developing countries.

Interestingly, the JAMA report doesn’t suggest that children are less healthy, but rather that the health conditions themselves have changed.  Thanks in large part to advances in medical science (vaccines, medicines, devices, etc) fewer children today are affected by infectious diseases, congenital defects or other conditions common 50 years ago.

Health Canada warns people not to buy unauthorized products to fight H1N1 flu

Federal authorities are warning Canadians not to buy unauthorized products from the Internet or other sources that claim to fight the H1N1 virus.  The Competition Bureau and Health Canada issued a statement Wednesday saying that only three products are authorized for use against the virus: the vaccine from GlaxoSmithKline called Arepanrix, which is available at flu clinics and doctors’ offices, and the antiviral drugs Tamiflu and Relenza.

“Taking unapproved or counterfeit drugs could pose serious risks to health,” the advisory says.  “These products may contain ingredients not listed on the label or dangerous additives, and could cause serious side effects.”

The warning says vaccines should only come from a qualified health care provider, and antivirals should only be purchased with a prescription from a health care practitioner who has examined the patient.

The advisory says there are legitimate Canadian Internet pharmacies, but consumers need to be aware of the risks associated with buying drugs online.

Health Canada says it will monitor the Internet and take action against websites selling unauthorized products for the treatment or prevention of the H1N1 flu virus, or any other health condition.

200,000 doses of the unadjuvanted H1N1 vaccine called Panvax have also been imported from Australia for use in pregnant women.

Google Flu Trends tracks real-time spread of influenza

Google Flu Trends, a flu-tracking Web tool, has expanded to cover Canada and 16 other countries.  First launched in the United States last November, Mexico was added in April and in Australia & New Zealand in June.

Google Flu Trends gathers data from the company’s search engine and analyzes it to create a near real-time picture of the level of influenza infection in a given area.  According to Google, Web users often turn to the Internet as a first source of information about signs and symptoms of influenza when they begin feeling sick.  The charitable arm of Google developed Flu Trends to provide public health agencies with a new means of tracking trends during flu season as a way of preventing outbreaks.

Google Flu Trends - United States

Before Google first launched the service in the United States last fall, the company’s engineers realized that when they compared their own data with that of the U. S. Centers for Disease Control and Prevention, distinct similarities were found between the frequency of specific search terms and the number of patients in an area suffering flu-like symptoms in a given week.

The countries currently covered by Google Flu Trends include:

• Australia
• Austria
• Belgium
• Bulgaria
• Canada
• France
• Germany
• Hungary
• Japan
• Mexico
• Netherlands
• New Zealand
• Norway
• Poland
• Russia
• Spain
• Sweden
• Switzerland
• Ukraine
• United States