Bill Gates, center top, speaks during a High Level Meeting on Tuberculosis at U.N. headquarters, Wednesday, Sept. 26, 2018. (AP Photo/Andres Kudacki)
Bill Gates addresses the UN meeting on tuberculosis in New York © AP

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Beyond the usual frustrations with hollow rhetoric and New York gridlock caused by the gathering of world leaders at the UN General Assembly this week, the hyperbole of Donald Trump’s speech — including the view that negotiating US healthcare was harder than peace in the Middle East — was not the only unusual twist.

For the first time, there was a special high-level session on tuberculosis, although few heads of state attended and additional pledges of financial support were scant. There was at least progress on the scientific side, with encouraging news on a new vaccine and on the use of genome sequencing to tackle drug resistance.

There was also renewed commitment from world leaders to tackle the non-communicable diseases — such as cancer, diabetes and heart problems — responsible for seven out of every 10 deaths worldwide. The World Health Organization unveiled a new plan to clamp down on alcohol consumption, and said a new package of broader measures could generate $350bn in growth in low and lower-middle-income countries between now and 2030.

Campaigners remain sceptical, criticising the “interference and undue influence of health-harmful industries over a few countries who were prepared to shamelessly block progress for all.” The danger is a repeat of the previous high-level meeting on NCDs in 2011, which failed to deliver much money or action.

Three questions

Francis Gurry is director-general of the World Intellectual Property Organisation, which this week launched Pat-Informed, the Patent Information Initiative for Medicines to show details of medicine patents around the world.

What is the purpose of Pat-Informed?

Only in Canada, South Korea and the US is there currently publication of all approved medicines and the patent expiration dates. People struggle to discover these patent rights in the rest of the world. It was something that has been requested by the non-governmental sector for some time. We worked with 20 leading research-based pharmaceutical companies to make their data available and for us to put it in searchable form. I hope this will be received well and encourage others to make their data available.

What will the impact be?

This is a good advance. It is not going to change the question of access overnight. That’s a huge, complex tension between the right incentives for innovation and the right possibilities for distributional justice for access. This will ensure that patent data are linked so procurement agencies know with some certainty and predictability whether they will confront any patent rights. We tested it with one group in the Netherlands which said it improved efficiency of procurement by 30 per cent.

Is there a contradiction between patents and access to medicines?

You need an innovation incentive, which gives control over the commercial exploitation of a drug and restricts access to allow the recovery of the sunk costs of R&D. There’s not much good in having innovation if you can’t have the social benefit, but I’m very much against the simplistic approach that there is a contradiction. In a world of complexity you have many tensions. The policy challenge is to manage them.


Booze battles Alcohol is responsible for 5 per cent of the world's burden of disease and 13 per cent of deaths among 20-39 year-olds, according to new WHO data. Another report “debunks misconceptions” about alcohol use such as the benefits of moderate drinking and attacks industry marketing tactics. Is treating alcohol as a drug the way forward? (WHO, Vital Strategies, BMJ)

News round-up

Superbug struggles The UN gathering in New York also saw new commitments to fight antibiotic resistance as part of the US's AMR Challenge. Action was agreed to reduce and improve antibiotic use; develop new vaccines and diagnostic tests; improve infection prevention; and enhance data collection. Separately, fears were raised that Brexit could undo EU efforts to cut antibiotic use in farming. (Pew Trusts, CDC, Guardian)

‘Perfect storm’ for Ebola  Attacks in the Beni region of DRC have added to the “perfect storm” facing the WHO’s response to Ebola. Despite promising developments with a new vaccine, there is a fear the epidemic could jump the border to other countries. (Vox) 

Child obesity growing The number of obese school-age children and adolescents worldwide has increased 10-fold over the last 40 years to hit 124m. Another 216m were classified in 2016 as overweight but not obese. Proposed remedies include improved early-years nutrition; better food environments and labelling; and sugar taxes. (WHO/World Obesity)

US healthcare under fire Despite White House rhetoric about stopping drug companies “getting away with murder,”there were 96 price rises for every cut over the first seven months of the year, according to a new investigation. Ban Ki-moon, former UN chief, said the US health system was “morally wrong” and accused pharma companies, hospitals and doctors of blocking universal healthcare. (Associated Press, Guardian)

Brexit fears ease Concerns about disruption in the EU to supplies of more than 100 drugs made only in the UK have eased, according to the European Medicines Agency, thanks to pharma companies stepping up planning. British doctors however warned that current drug shortages in the UK could worsen. (FT, BMJ)

Lessons from 1918 A BBC documentary combines witness accounts with dramatisation to tell the story of the global flu pandemic of 1918 that infected up to a third of the world’s population and killed more than 50m people. (BBC iPlayer) 

Bad blood A public inquiry began into the UK contaminated blood scandal. About 5,000 people were given infected blood products over more than 20 years from the 1970s and nearly 3,000 have died. (BBC)

Data dilemmas A UK minister called for a “profound rethink” on the use of health data. “People increasingly view the data that is held about them as . . . a reflection of some part of their human capital and, therefore, if it is being invested to create something with economic value, there ought to be some return.” Data breaches are on the rise in the US. (FT, Jama)

Life chances For the first time in decades, young people in the UK are less likely to live longer than their parents. Some blame austerity policies but researchers point to poor lifestyle, widespread obesity, seasonal flu and earlier gains in heart disease tailing off. Life expectancy is also slipping in the US, most likely due to drugs, alcohol and suicide. (FT, CDC)

DNA detectives Why do cancer hotspots occur in different parts of the world? Scientists are examining cells from thousands of tumours to build up a global database of mutations — likened to Interpol’s fingerprint bank — to try and match causes to cancers. (Mosaic) 

Measuring wellbeing The UK's official statisticians continued their quest to quantify personal wellbeing, with new methodology showing the influence of health, access to services and crime levels, with the aim of helping local authorities better target their services. Can building design contribute? (ONS, FT)

Best from the journals

Human capital The first ever scientific ranking of countries by human capital — “the sum total of a population’s health, skills, knowledge, experience, and habits” — shows positive links between investment in health and education and a nation's economic performance. Finland tops the table with Niger, South Sudan, and Chad ranked lowest. (The Lancet, IHME) 

Combating cancer More countries are developing cancer plans but there is scant evidence of implementation. This podcast discusses the research. A new initiative from the WHO and a US hospital aims to cure at least 60 per cent of children with six of the most common kinds of cancer worldwide by 2030. (The Lancet, St Judes)

China and Africa Chinese interventions in African health are growing but operate very differently from traditional aid programmes. Despite scepticism about China’s political motives, it is investing in projects often overlooked by the international donor community including the strengthening of health systems. (The Lancet)

Social determinants of health Ten years after the WHO declared “social injustice is killing people on a grand scale,” improvements have been slow to materialise. Post-crisis austerity policies in Europe have also slowed progress. (The Lancet) 

Junking the junk food Healthy eating — such as the traditional Mediterranean diet — can offer some protection against depression, says a study that suggests dietary interventions from doctors could help prevent the illness. (Molecular Psychiatry)

Podcast of the week

Shining a light on the brain We discuss the science of brain imaging and its potential applications — from diagnosing developmental disorders to reading our thoughts and moods. (FT, 11m) 

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Final thought

Birth control World Contraception Day this week shone a light on those countries where women still struggle to get safe access to birth control. The pill may have “rearranged the furniture of human relations” but is just one point in the surprising history of contraception. (Guardian, Time) 

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