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A consumer backlash against sugar, salt and artificial ingredients is putting pressure on the food business to respond to public health concerns. “There’s probably more change today than at any time in my history in the industry,” Kellogg chief John Bryant told investors recently.
Industry and free-market criticism of government acting as a “nanny state” is being questioned. MPs in the UK this week demanded ministers get tough on obesity and stop supermarkets offering deals on unhealthy foods, while public health chiefs issued new targets for companies to cut sugar content by 20 per cent by 2020.
New evidence from Mexico shows taxes can be effective in curbing consumer behaviour. Are we moving towards greater acceptance of subsidies for healthy foods as a price worth paying to tackle obesity? (Health Select Commitee, Guardian, FT, The Conversation, Health Affairs)
David Nabarro, candidate for the post of director-general of the World Health Organization.
What is the strongest argument to vote for you rather than the other DG candidates?
The World Health Organization needs a DG with a track record of robust, impartial and consistent leadership, who has worked on the front lines of healthcare in different regions, who has been successful at the top table leading and raising finance for global responses to complex challenges, who can enable the multilateral system to work effectively, and who is trusted as a transparent and accountable professional. I have these capabilities. I am a skilled transformer who has successfully led global responses to wicked challenges including malaria control, food insecurity, avian influenza and Ebola.
What is the one activity of WHO you would scale up and the one you would de-prioritise?
I would seek and respond to priorities from countries and from the regional offices. I intend to encourage WHO to evolve as a catalytic organisation and to diminish the number of small projects for which it acts as an implementation agency. I will ensure it scales up a catalytic approach to disease outbreaks, working through governments, non-governmental organisations and other actors. Non-communicable diseases such as cancer, diabetes and obesity can be prevented at low cost and others effectively be treated if diagnosed early, so I will lead WHO in catalysing prevention, preparedness and early action. All these issues require a strong focus on health systems accessible to all, especially women and children.
Is it not time for the WHO to have a leader from a lower or middle income country?
The DG has to convince local communities and world leaders that s/he understands and can represent the very different needs and concerns of people of countries at all stages of development. This is a function of experience, exposure and empathy, not the country of origin of the DG. My varied clinical and public health background as a medical doctor is firmly based in the reality of people’s lives, of the work of health professionals and the responsibilities and challenges faced by health ministers and their heads of state in all regions. I have worked in 50 countries and have the drive, experience, openness and passion needed to contribute to a healthier future for everyone, everywhere. When elected, I will be a DG for the world.
Read our interview with Sania Nishtar, another DG candidate, in our March 17 edition.
China donor drive The country is facing a severe shortage of organ donors thanks to a ban on its traditional source: executed prisoners. The authorities have recruited 2,000 facilitators to encourage families to approve transplants. Donation rates are just 2.98 per million people, a fraction of EU rates. (FT)
Pandemic preparedness A report for Pandem, the EU’s pandemic project, said risks were greater than ever because of an increase in influenza viruses and antibiotic resistance, and fears of bioengineering mishaps and bioterrorism. Security, defence and crisis management specialists offer lessons on how to mitigate the impact of outbreaks. (NYT, NUI Galway, Pandem)
Private R&D funding Vietnam and South Africa are the most effective at attracting and using private investment in health according to a new Health Governance Index. The study recommends more transparency, lower tariffs on medical products, faster drug regulation, investment in infrastructure and targeted spending. In the UK, the FT found half of the extra money given to the NHS has gone to the private sector. (Brookings, FT)
Mending medicine Medication errors cost $42bn a year worldwide — almost 1 per cent of total global health spending. A new World Health Organization campaign aims to halve the problem in five years by improving the way drugs are prescribed and consumed and making patients more aware of the risks of improper use. (WHO)
Tackling opioids President Trump picked New Jersey Governor Chris Christie to tackle the growing US opioid epidemic. Two-thirds of US drug overdoses in 2015 involved prescription opioids such as OxyContin and Vicodin or illegal drugs including heroin. (CBS, Stat, Dept of Health)
Zika fears grow Florida is stepping up its battle with the virus ahead of the rainy season, with extra lab resources and an increase in anti-mosquito workers. This map shows how the disease is spreading across the world. Five million people in Puerto Rico are living with the virus. (Miami Herald, NPR, CDC)
Nigerian double blow The country is not only dealing with a meningitis outbreak which has killed 140 but also polio in its conflict-hit north-eastern zone. Health workers are preparing to vaccinate more than 116m children across West and Central Africa to try to contain the polio outbreak. (BBC, Reuters)
Syrian tragedy Conflict is fuelling health fears after the World Health Organization expressed concern at the plight of the 300,000 people trapped in war-torn East Ghouta, just outside Damascus. (WHO)
Measles moves There has been an outbreak of measles across Europe, where many countries are struggling to reach the 95 per cent vaccination rate deemed necessary to protect populations. The populist Five-Star Movement has been blamed for an increase in Italy, where it campaigned on an anti-vaccination platform. (BBC, Guardian)
Immunisation in India A government-led campaign to vaccinate 35m children against measles and rubella is being taken up across the country, as well as new initiatives against rotavirus. A drive against pneumococcal disease follows. (India Times)
Regulatory fears EU regulators suspended hundreds of drugs tested by India’s Micro Therapeutic Research Labs. The European Medicines Agency was itself criticised by national authorities for plans to speed up drug approvals but which they fear could put patients at risk. (Reuters)
Battling superbugs CARB-X — or Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator — is a new US-UK alliance of 11 biotech companies developing antibiotics to take on drug-resistant infections which kill 700,000 people a year. (Reuters)
Brexit begins As the UK triggered divorce talks with the EU, doctors called on the government to grant permanent residence to their EU colleagues. The call came as new figures showed a record number of citizens from other EU countries leaving the NHS. (OnMedica, Guardian)
NHS cuts its cloth Patients will have to wait for longer for operations as Britain’s NHS reorganises its finances. Hospitals will also have to save £250m on medicines in 2017-18 but drug distribution will be speeded up by a new commercial unit that will negotiate directly with pharma companies. The NHS will also stop prescribing items such as sun cream and painkillers that cost the country £400m a year. (FT)
Deportation despair Resignation syndrome — or uppgivenhetssyndrom — is an illness said to exist only in Sweden, and only among refugees. Patients have no underlying sickness but seem to lose the will to carry on when faced with the trauma of deportation. Swedes refer to them as de apatiska, the apathetic. (The New Yorker)
Best from the journals
Brain power A man paralysed from the shoulders down has been able to feed himself using the power of thought. The milestone in neurotechnology achieved by scientists in Ohio works by a brain implant transmitting signals to sensors in the patient’s arm and enabling movement. (FT, The Lancet).
Research funding More than 30 per cent of biomedical studies funded by the US through the National Institutes of Health are subsequently cited in commercial patents, according to a study of 27 years of data. (Science)
Health finance Performance-based incentives do not automatically improve clinical processes as they mainly measure items not necessarily linked to quality. In the UK, a report argues that cuts to public health budgets are a “false economy” as every £1 spent returns an extra £14 on the original investment. (Global Health: Science and Practice, BMJ)
Tetris therapy Playing a video game with strong visual elements such as Tetris can help mitigate post-traumatic stress disorder. Playing soon after the incident can block disturbing memories taking hold and reduce the risk of flashbacks as the patient recovers. (BBC, Molecular Psychiatry)
Podcast of the week
What can the Amish teach the rest of us about modern medicine? The autonomy and thrift central to the lives of the “Plain Peoples” may provide lessons on the balance between communal support and individual responsibility. (Mosaic Science, 29m)
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April 2-8: World Health Worker Week
April 7: WHO World Health Day
Wide-awake club “Patient autonomy” is increasing those wanting to stay awake during surgery. Local anaesthesia has fewer complications, is less expensive and recovery time is swifter — but can surgeons keep up the small talk for several hours? That’s one thing they don't teach in medical school. (NYT)