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Dementia costs an estimated $818bn a year and affects 50m people around the world — but there are no medicines which have any significant impact. That is why policymakers must focus on investment and innovation, as Alzheimer’s Research UK, the subject of the FT’s seasonal appeal for 2017, urges.

Effective drugs are a long way off, so fresh efforts are needed in other areas. These include greater study of prevention and how to slow progression, which have been linked in part to healthier lifestyles, companionship and mental stimulation. Just as important is redoubled innovation in funding and the provision of support and care.

The World Health Organization’s new Global Dementia Observatory highlights wide variations in countries’ attitudes and responses to the condition. More co-operation and lessons from promising approaches elsewhere will be essential.

Join us for a Facebook Live discussion Wednesday at midday GMT with David Reynolds from Alzheimer's Research UK and Tarun Dua from the Global Dementia Observatory. Watch it here and take part in the discussion.


Three questions

Christophe Weber, chief executive since 2015 of Takeda, the Japanese pharmaceutical company

How difficult was it for a foreigner to take on the Japanese corporate culture?

At the beginning there was some anxiety. The biggest fear was short-termism. I spend a lot of time engaging with employees. My style is collaborative, but not necessarily consensual. The majority of our decisions are by consensus but what matters is that if there is no consensus then it does not block the company. A good decision taken too late is a bad decision. We have had to restructure and reduce staff, which is hard — in cardio-vascular, respiratory and metabolic disease. But we have done it in a very supportive way through innovative partnerships and spin-offs. That shares the risk.

Why have you remained focused on depression drugs when others have pulled out?

Our pipeline is at an early stage but there is significant medical need. Neurology research is improving with more precise, targeted therapy. We have always tried to narrow the population and focus on treatment-resistant depression. The problem has been an undefined broader population, which includes a huge number of non-responders and a big placebo effect. 

What is your policy on access to medicines?

We focus on our most innovative patented and expensive drugs, not those which are off-patent and low-priced where the market is already most effective. An example is Adcetris for non-Hodgkin lymphoma. We address pricing based on ability to pay, and go as far as giving medicines away for free in partnership with governments and NGOs. We see that as part of our business operations.


Chartwatch

A flurry of reports have highlighted the global problem of obesity. More than 57 per cent of US youth will be obese by the time they hit 35 (above). In the UK, one in five young people is obese by the age of 14 with a further 15 per cent overweight and by the age of five, children in poverty are twice as likely to be obese. A quarter of nurses are also obese. Governments are targeting the food industry to play its part. (NEJM, Centre for Longitudinal Studies, BMJ, Centre for Social Justice, FT)


News round-up

US aid cuts At least 1,275 foreign NGOs and about $2.2bn in funding could be affected by President Trump’s decision to expand the “Mexico City policy” of stopping aid to organisations that offer abortion services. Some 92 per cent would not have been affected under the old rules. Domestically, the pace of US spending on health slowed in 2016 to hit $3.3tn in 2016. (Kaiser)

Dengue doubts The Philippines plans to sue Sanofi over Dengvaxia, its dengue vaccine, after the company said it could worsen the disease in some cases. The World Health Organization voiced concerns about the drug in 2016. (Guardian, WHO) 

Opiophobia in Africa Frightening “war on drugs” rhetoric against opioids is having a chilling effect on poorer countries and leaving many without painkillers; it is also the theme of a new BBC series. Africa, badly affected by the lack of these drugs, is a huge victim of counterfeits, spurring discussion of an African drugs agency. (New York Times, BBC, Reuters)

Austerity and public health Austerity programmes in Europe have caused a slowdown in improvements in life expectancy, a drop in subjective health among young people and reductions in preventive health programmes. UK campaigners are fighting cuts to anti-smoking services. (ILC, The Independent)

Poverty and depression A report on poverty in the UK from the Joseph Rowntree Foundation found nearly a quarter of adults in the poorest fifth of the population experience depression or anxiety and that 30 per cent of people in a family with a disabled member live in poverty. (JRF)

Treatment through play Prescriptions for video games took a step forward with positive trial results for Akili's ADHD aid. Unlike existing apps and games which can manage and monitor illnesses, Akili's game stimulates certain neural networks in the brain. (Stat)

Contraceptive success The UN's Family Planning 2020 initiative has helped prevent millions of unintended pregnancies, unsafe abortions and maternal deaths over the past year. More than 300m women in its target countries now use a modern form of family planning, an increase of 39m from when the campaign began in 2012. (Family Planning 2020)

Childbirth inequalities Black mothers in the US die at three to four times the rate of white mothers, one of the widest of all racial disparities in women’s health. (ProPublica/NPR)

Toxic tracker A new interactive is the first resource to map areas contaminated by toxic military waste and explosives across the US. (ProPublica)

Pharmacy deal CVS Health's proposed purchase of Aetna, one of America's largest insurance companies, could create a giant in prescription drugs and is likely to spark further consolidation. Analysts suggest it is a defensive move before the possible entry of Amazon into the pharmacy business. CVS hopes its stores will be a new "front door" to the US health system, but Democrats fear higher costs and less competition. (FT, Boston Globe, The Hill)

Brexit boost/bust The UK trumpeted a series of life sciences investments as proof that big pharma would not abandon the country after Brexit, even as industry told MPs of its concerns that drugs companies would flee and scientists would be harder to attract. Here are the documents submitted by relevant interest groups to the European Parliament’s inquiry into Brexit’s impact on public health. (FT, BMJ, European Parliament) 

Baltic boozers EU households spent €130bn — or more than €250 per person — on alcohol to drink at home in 2016. The three Baltic states are the highest spenders as a proportion of their household income and Spain, Greece and Italy the lowest. (Eurostat)


Best from the journals

Air pollution warning Nearly 17m babies live in areas where outdoor air pollution is at least six times higher than WHO guidelines, with the majority in south Asia. This kind of pollution is damaging for the old and yet-to-be-born alike: it is linked with an increased risk of underweight babies and, for older people, can cancel out the cardiorespiratory benefits of walking. (Unicef, BMJ, The Lancet) 

Flu fears Poorer countries are carrying a heavy burden of severe flu. The young, pregnant and those with HIV are particularly affected. Influenza viruses kill 250,000 to 500,000 people across the world each year. (Influenza and Other Respiratory Viruses)

Combating anti-vaxxers The emphasis in public vaccination campaigns on concepts such as harm and fairness is backfiring with opponents who are more likely to favour arguments around purity and liberty. Here is a look at the history of anti-vaccination campaigns. (Nature Human Behaviour, Wellcome Collection)

Edward Jenner among smallpox patients. Etching after J. Gillray, 1802 © Wellcome Collection

Revolving doors The recent moves of three big pharma figures into the UK government highlight the need for a substantial moratorium on hiring workers with close ties to industry. (BMJ).

Women in health Women comprise the majority of the world's health workers but remain a minority in leadership positions. Only 31 per cent of the world's health ministers are women and there is just one female chief executive among healthcare companies in the Fortune 500 ranking. (The Lancet)


Podcast of the week

Humanitarian aid Interview with Dr Joanne Liu, international president of Médecins Sans Frontières/Doctors without Borders on her experiences and the attacks on health and humanitarian operations around the world. (Global Dispatches, 45m)


In case you missed it

Previous edition: Nation states must do more to fight disease

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Latest news at www.ft.com/health and Twitter @FT_Health


Final thought

Shaming people about their health and habits is meant to induce change for the better, but there is little evidence that it works. It could mean patients lying to — or avoiding — their doctor and ultimately lead to incorrect or ineffective treatments being prescribed. (The Conversation)

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