Protest against compulsory vaccination in Rome

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The message for World Immunisation Week was simple: vaccines work. And they make good economic sense: for every dollar invested in immunisation, there is an estimated return of $16.

If only translating this into policy were as straightforward. “Anti-vaxxer” sentiment has contributed to serious gaps in coverage in richer countries — even for pets. There are well-documented problems in poorer countries too.

Take Italy. Between 2013 and 2016, immunisations declined as rising populist parties, including the Five Star Movement and the League, fuelled scepticism about mandatory vaccinations. 

Last year the country suffered one of the worst measles outbreaks in the EU, affecting 5000 people and killing four. The centre-left government responded by raising the number of mandatory vaccines from four to 10 — and this week it claimed success as immunisation rates climbed again for the first time in five years.

But the threat has not gone away: the law could be scrapped if Five Star or the League enter government after the current frenzied negotiations are over. In the face of such scepticism, global health authorities will need more than one week a year to get their message across.

Test your knowledge of immunisation and vaccine-preventable diseases in this WHO interactive quiz.

Three questions

Lisa Anson, outgoing president of the Association of the British Pharmaceutical Industry, who gave her final annual address on Thursday.

What is the industry view on Brexit?

There are some real challenges posed by Brexit, starting with the regulation of medicines around trade and integrated supply chains. Most parties agree it is absolutely critical to have continuity for UK and EU patients. Disruption could be avoided if there is early clarity. Life sciences is complex and critical to the UK economy. We have to work with the government, the NHS and other parties to make sure the industry can flourish. There are short term critical issues around regulation.

What do you want in the longer term?

Medicines regulation covers everything from basic clinical trials to medicines supply, licences and manufactured products. We are calling for a level playing field as far as possible, to maintain a regulatory framework coherent with the EU. We don’t want to be in a position where the country has delays in the approval [of medicines]. Keeping coherence is very beneficial to patients in getting access, on safety reporting and access to trials.

Does the UK offer a healthy environment for pharmaceuticals?

It needs to continue to attract investment. A top priority is that the government should continue to invest in the science base, with the NHS as an early adopter of cost effective medicines. Clinical trial regulation could certainly be simplified. The share of the UK in big Phase 3 development trials has declined. The NHS has great strengths . . . but the reality today is you are five times more likely in France or Germany to get a newly-approved medicine [rapidly and widely prescribed] than in the UK.

Air pollution and health

London, May 21: Join FT journalists for drinks and discussion with guests including Laurie Laybourn-Langton of the UK Health Alliance on Climate Change; Ian Mudway, air toxicity specialist from the world-renowned environmental research group at King's College London, and Darran Messem, Chairman of the Low Carbon Vehicle Partnership. Details and tickets here. Use discount code FTHEALTHREADER.


Mosquito menace Amid the debates about funding and prevention on World Malaria Day, a simple reminder of the power of the world's deadliest animal and how it puts half the world's population at risk of the disease. (Bill Gates blog)

News round-up

Environment and health Health campaigners used Earth Day to focus on environmental causes of ill health and health equality, including how the poor are more likely to suffer water and air pollution. A new study shows Chinese commitments on emissions will pay for themselves in lower health costs. (Brookings, WHO, Nature)

Junking fast food Two-for-one deals on junk food and other products high in fat, sugar or salt are set to be banned in a new drive against UK obesity. A Dutch study showed people living near fast food outlets were significantly more likely to suffer heart disease. British doctors want them banned from opening within 400m of schools. (Times, European Journal of Preventative Cardiology, Telegraph)

Ecig debate lights up US authorities cracked down on sales of the popular Juul vaping devices to under 21s. The industry disputes that the devices are addictive and argues that ecigs help smokers quit. Here's a debate between doctors on whether they should be recommended to patients. (NYT, BMJ)

Opioids in perspective Fears have been raised that the opioid crisis will go global as drug companies turn to Asia and Europe after the backlash in North America. The current crisis is not a first: opioid epidemics of the past were also largely created by the medical community. (Foreign Affairs Today, NYT)

Dementia dangers Researchers found a 30 per cent increase in the relative risk of developing Alzheimer’s and other forms of dementia among those taking “anticholinergic” medicines for depression and problems such as Parkinson's disease. A report expresses concern about the treatment patients with dementia receive when admitted to hospital with another acute condition. (FT, Cardiff University)

Lobby love Big Pharma spent nearly $10m lobbying Washington in the first quarter this year, the most since lobbyists began filing quarterly reports a decade ago, led by Bayer ($3.5m), AbbVie ($2.9m) and Sanofi ($2m). (Politico)

Health history Newly discovered photos show medical care in Britain from 1938 — 1943, providing an extraordinary insight into healthcare just ahead of the introduction of the NHS. (Historic England)

Britain's fat fight A BBC series challenges food companies, restaurant chains and government to address Britain's status as the fattest nation in Europe. It includes an attempt to change the eating habits of a whole city by asking the people of Newcastle to lose 100,000lbs in a year. (BBC iPlayer) 

Lords lash out over life sciences A parliamentary report says the implementation of the UK's life sciences strategy is “incoherent and wholly inadequate.” One of the authors of the plan said: “It is not clear who is driving the bus. Whoever is driving the bus, the windscreen wipers do not work, and the exhaust is falling off.” (UK parliament, BMJ)

Hay fever horrors Spring may be celebratory for some but spare a thought for those in Tokyo suffering from Japan's “national disease” thanks to the types of tree used to reforest the country after the war. The city is replanting with low-pollen varieties but at the current speed this would take 500 years. A new report links hay fever and other allergic diseases with psychiatric disorders. (FT, Frontiers in Psychiatry)

Mainstreaming marijuana Prospects for legalising marijuana at US federal level are closer than ever, thanks to its growing use in medicine, encouraging tax revenues at state level, and changing public opinion. (Politico)

Baby blues The FT was the only big British news outlet not to cover this week's addition to the royal family. We make an exception to show this study comparing private sector costs of giving birth around the world. “Saddled with the worst maternal healthcare in the West,” it is pricier to give birth in the US than the Duchess of Cambridge's stay at the Lindo Wing of St Mary's in London. (Foreign Policy, Economist graphic)

Best from the Journals

Antibiotic dilemma Trials in Malawi, Niger and Tanzania showed mass distribution of antibiotics — including to healthy children — reduced childhood deaths by 14 per cent. But side effects could include some diseases becoming resistant to those drugs in future. (NEJM)

Malaria mass medication Mass drug administration has support from a test that dosed a whole population — healthy or not — with anti-malaria drugs. Cases of the disease dropped significantly. (The Lancet)

Mapping depression New research sheds more light on the genetic aspects of depression and could have significant neurobiological, clinical, and therapeutic relevance for sufferers. (Nature Genetics)

A brewing crisis Campaigners stepped up criticism of the link between The Global Fund to Fight Aids, Tuberculosis and Malaria and brewing giant Heineken. The Fund argues it is essential to partner with the private sector to achieve world development goals and build more resilient health systems but opponents say the alcohol industry is a driver of global ill health. (The Lancet)

Abortion agreement Campaigners are celebrating the 50th anniversary of legal abortion in England, Scotland and Wales at a time of a reduced provision in other parts of the world. An EU court decision also dealt a blow to anti-abortion campaigners. We speak to those fighting on both sides of the abortion referendum battle in Ireland. (BMJ, EU Observer)

Podcast of the week

Innovation in vaccines New delivery systems such as patches are making it easier to administer vaccines to children, especially in poorer areas where skilled personnel and equipment are scarce. (CSIS Take as Directed, 28m)

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Final thought

Cultural shifts As the young increasingly break with previous generations and spurn alcohol, are we entering a new era in which booze becomes as socially unacceptable as smoking? (The Guardian)

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