An Indian student at a World Cancer Day event donates her hair to make wigs for cancer survivors who lost their hair during treatment © AFP
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World Cancer Day highlighted the world’s second leading cause of death, killing almost 10m people in 2017 — a rise of 25 per cent over a decade.

Given that some 97 per cent of cancer drugs fail, there is perhaps no surprise that snake-oil cures are still with us. Cancer patients in poorer countries suffer the most: many do not get the pain relief they need because of opioid addiction fears.

There are some reasons to be optimistic. Scientific breakthroughs such as immunotherapy continue apace, immunisation is helping the fight against liver and cervical cancer; and screening regimes are improving.

But a focus on new cancer medicines should not obscure the need for greater funding of research into other more neglected diseases. Nor should it divert attention from the need for much greater focus on prevention.

Persuading governments to raise taxes on tobacco is the prime example: lung cancer death rates in men have dropped by nearly 60 per cent over the last 40 years.

New research showing a rise in obesity-linked cases among the young is a reminder that although up to half of all cancers are preventable, much more needs to be done.

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Three questions

Hugh Pullen, president of the European Medicines Verification Organisation, whose new system involving the whole meds supply chain across Europe goes live on Saturday (February 9).

Why does Europe need a new system?

The legitimate supply chain is already very secure but there have been instances of falsification in the past and the technology is now available to permit this end point verification, so it's a further step in making the supply chain secure. We have the technology and the ability to do that, so it's the right thing to do.

Why did it take so long?

There was a period of developing and implementing regulations by the Commission and the EU institutions . . . Let's not underestimate the complexity of this: you're talking about 2,000 manufacturers, 140,000 pharmacies across Europe and to build a system that can manage all of that there was a certain number of years built into the legislation to enable it to be built and implemented.

What effect will Brexit have?

In Theresa May's current [proposed] agreement the transition period is due to end at the end of 2020. So if the deal is agreed between the UK and the EU, then the UK is basically a part like every other country in the system. I think in the case of a no-deal Brexit then it's very uncertain, as everything else.


Chartwatch

Measles marches on More children in Europe are being vaccinated against measles but immunisation gaps mean the disease has hit a decade high. US officials are increasingly worried about an outbreak in Washington State: “If you have a population that is unvaccinated, it’s like throwing a match into a can of gasoline.” The “anti-vaxxer” movement was described as a “worldwide pandemic”. An outbreak has killed dozens in the Philippines. (WHO, NYT, BBC, LA Times)


News round-up

Trump's priorities US President Donald Trump's State of the Union speech was heavy in health content. He pledged to end HIV in the US by 2030, pleaded with drug companies to cut prices, and attacked “late-term” abortions. Abroad, his decision to restrict the use of US aid for abortion services is causing severe problems in countries like South Africa. (NPR, Kaiser, Quartz, Mother Jones). 

China uproar A new vaccines scandal hit China as up to 18 children were given the wrong injections. Confusion also surrounded a batch of human blood plasma treatments found to be contaminated with HIV. The incidents are the latest in a series of medical mishaps and follow protests in Jiangsu province over out-of-date polio vaccines given to children. (South China Morning Post)

Fighting FGM The UN secretary-general was among those condemning female genital mutilation as part of an international day of action. It is estimated that up to 200m girls and woman alive today have undergone some form of FGM. A London woman became the first person to be convicted of FGM in the UK. (UN News, BBC, Guardian)

Mental health matters UK ministers used Mental Health Awareness Week to launch “the largest mental health trials in the world” in schools across England. Austerity cuts in local services mean however that parity of esteem for mental and physical health is still far away. The UK published its first official guidance on children's screen time and social media use. (Gov.UK, Private Eye audio, BBC) 

Road accidents Africa has the highest rates of road traffic deaths in the world — 27 in 100,000 people — despite having less than 3 per cent of the world’s vehicles. The problem, also prevalent in south-east Asia, is almost certainly under-reported. (Devex)

Urbanisation and health The total number of people living in cities is set to hit 2.5bn by 2050, with most of this growth in Africa and Asia. With deaths due to “diseases of density” declining, this rapid urbanisation holds out hope of better health services for the masses. (Council on Foreign Relations)

Dame Sally bows out Dame Sally Davies is leaving her post as Chief Medical Officer for England and Chief Medical Advisor to the UK government for a new role at Trinity College, Cambridge. Her key achievements include domestic and international campaigning against antimicrobial resistance. (Department of Health)

VR advances Virtual reality is still mainly thought of as a gaming technology but it has important clinical uses including in operating theatres and for cervical smears. It can also help reduce the pain of childbirth. (Times, WSJ)

DNA downsides Healthcare providers and private companies are encouraging patients to take genetic tests and help create databases for research, but the practice raises serious questions around consent and how data are sold on. (The Conversation)

Medical cannabis Cannabis for medical use has been legal in many US states since 1996 but reliable data on its usage are scarce. Chronic pain is the most common qualifying condition. UK MPs launched an inquiry into medical cannabis use while the WHO is considering changing its long-term position. New York officials cracked down on restaurants selling foods containing cannabidiol (CBD), the cannabis derivative. (Health Affairs, UK parliament, WHO, NYT).

Best from the journals

Suicides and medication Annual deaths from suicide hit 817,000 in 2016, a 6.7 per cent increase over 1990. However, when adjusted for age, the death rate dropped by almost a third. Men are disproportionately affected. An opinion piece explains why disabled people fear legalisation of assisted suicide. A ketamine-based drug could be used for treatment-resistant depression — and eventually to deter suicidal thinking. (BMJ, Bloomberg)

China scandal A damning report called for the retraction of more than 400 scientific papers on organ transplantation on fears that the organs were obtained unethically from Chinese prisoners. It has been alleged that the enormous trade in transplants in China is fuelled by prisoners of conscience having their organs forcibly removed. (BMJ Open, WSJ)

Women in global health Women make up 75 per cent of the global health workforce, but only a small proportion of leadership positions. A Lancet special examines gender bias in funding, the failure of universities to improve gender diversity and why male bias leads to less rigorous research. (The Lancet) 

Tackling knife crime British hospital doctors are being severely tested by the recent rise in knife crime. Treating horrifying wounds is bad enough, but dealing with traumatised victims and families is making frontline roles especially difficult. (BMJ)

Diabetes drug delivery High-tech pills that inject insulin directly into the stomach wall could give people with diabetes an alternative to injecting themselves through the skin. The system was inspired by the shape of a tortoise. (Science, FT)


Podcast of the week

The people who help you die better A network of volunteers in Kerala, India is helping the terminally ill end their days at peace and at home. (Mosaic, 28m


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Final thought

Grape and grain but never the twain? A new study has debunked the adage “beer before wine and you’ll feel fine; wine before beer and you’ll feel queer”. If you drink too much, a hangover is inevitable whatever the order. (American Journal of Clinical Nutrition.)

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