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The 10-year plan for Britain's National Health Service, unveiled this week, promises a big change in the delivery of healthcare.
More money will go in, the role of prevention will be amplified and primary care in local practices will be expanded to ease the burden on the nation’s hospitals. There is also a welcome higher profile for mental health.
There are however several serious challenges ahead.
Brexit could deliver a severe blow to NHS staffing; an ageing population and expensive new drugs will continue to squeeze finances; and ministers have yet to find a solution to the growing crisis in care provision for the elderly and disabled.
Ministers must also be ready to act against interest groups fighting the changes needed to promote healthier lifestyles, argued the FT’s editorial board.
“Much of what Britain eats and drinks now ends up as a direct charge on the NHS. If producers refuse to cut harmful levels of ingredients such as sugar and salt, or to raise the price of cheap alcoholic drinks, the government must be ready to legislate.”
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Mark Feinberg, president and CEO, International Aids Vaccine Initiative
What are your priorities?
IAVI is not only focusing on HIV vaccine development but also TB. There are a lot of efforts to figure out public-private partnerships. The most robust, effective model, leveraged with public and private resources, has yet to be developed but is something we are very committed to advancing. The real expertise for vaccine development and sustainable supply resides in the private sector but it needs ways of de-risking and minimising opportunity cost.
When will we have an HIV vaccine?
It’s hard to answer. There are two large efficacy trials taking place that will read out in the next few years. People hope they will work, but right now we don’t know. I think we will have significant developments in efficacious approaches to prevent HIV infections developed in advance of a vaccine, like long-acting antiretroviral drugs and prophylaxis; and broadly neutralising antibodies delivered by a subcutaneous injection every six months.
How concerned are you about growing vaccine scepticism?
That’s a really vexing issue. It’s really unfortunate people are sceptical based on incomplete or inaccurate information. I think setbacks — whether the increase of measles outbreaks or other serious cases of vaccine-preventable disease such as children dying of influenza — are all tragedies. I hope the public who are concerned could be reached by effective, accurate messages about what we know about vaccine safety and the benefits.
STDs on the march After decades of progress, the US is experiencing steep and sustained increases in sexually transmitted diseases. “We have let our public health guard down,” said one expert. In the UK, health officials have announced the first case of homegrown “super gonorrhoea”. (Jama, Telegraph)
Kim quits World Bank The surprise resignation of Jim Yong Kim, an expert on epidemiology and former HIV/Aids chief at the World Health Organization, raises questions about the future strategy of the Bank around health. (FT, World Bank)
Pollution peril A new study analyses the international nature of health risks from pollution. Poorer countries suffer most but their richer counterparts also feel the effect: pollution does not stop at political borders. Another report found pollution inside London Underground stations much more damaging than on the city's roads. (Pure Earth, COMEAP)
Cancer progress US cancer deaths have dropped by more than a quarter over the last 25 years, thanks to reductions in smoking and better detection and treatment. The news is less good for the poor. (American Cancer Society, Bloomberg)
Palm oil in focus Palm oil is the world’s most widely-produced vegetable oil but a new WHO study hits at its impact on human (and planetary) health and draws parallels between the behaviour of processed food industries and alcohol and tobacco companies. (WHO)
Nigeria faces cliff-edge Nigeria's improving economic performance means it is no longer eligible for certain aid programmes — but foreign donors are often the only source of finance for problems such as polio, malaria and HIV/Aids. (Devex)
Drugs that make you sick A Kaiser Health investigation shows how drugs that are badly manufactured or contaminated can still reach consumers. (KHN)
Data gold mine The treasure trove of genetic data made freely available from UK Biobank means researchers around the world can build on each other's work with unexpected dividends in a wide range of fields. Here's our recent podcast with its chief scientist. (Science, FT audio)
Protein power? Food companies are cashing in on protein's reputation as a new “super elixir” despite little evidence it is lacking in our diet. The global market for whey protein, once merely a waste product of cheesemaking, is set to top $14bn by 2023. (Guardian)
Medical ethics The furore over the Chinese genome-edited babies is just the latest in a long list of “unethical” medical experiments, from Nazi atrocities to experiments on prisoners. (CNN)
Cannabis and health UK medical use of cannabis was legalised last year but MPs said a “cultural block” was hindering its prescription. Some argue the rush towards legalising recreational use of marijuana ignores serious health risks. One online marijuana company has become an unconventional case study taught at MIT. (Guardian, The New Yorker, FT)
Constant cravings Sex addict. Porn addict. Social media addict. What is driving the apparent rise in compulsive behaviour and how should it be treated? (Guardian)
Mind matters Read FT Weekend's special edition on the mind, covering everything from psychedelic drugs for depression to coding the cortex to lunch with sleep expert Matthew Walker. Here's our recent podcast with him on why we need more shut-eye. (FT)
Best from the journals
Big Food and China Coca-Cola and other western food and drink giants have been influencing Chinese policy on obesity and diet for decades, say two new reports, helping fight off more regulation and soda taxes. (BMJ, Journal of Public Health Policy)
Hepatitis struggle A new commission on viral hepatitis examines progress against an illness that kills 1.34m people a year — comparable with deaths due to HIV/Aids, malaria and TB. WHO member states have committed to a global reduction in hepatitis-related deaths by 65% and new infections by 90% by 2030. This chart shows the most-affected countries by disability-adjusted life years. (Lancet)
Diet and disease A large WHO-commissioned review on the effect of carbohydrates says diets rich in fibre and whole grains can cut the risk of illnesses such as heart disease, type-2 diabetes and bowel cancer. (The Lancet)
Drone delivery While western attention of late has focused on damage caused by drones at airports and war zones, Africa is at the forefront of using them to deliver essential medicines. Their aerial view has also proved effective in monitoring mosquito habitats and in spotting victims of drowning. (The Lancet)
Medical marketing US spending on healthcare marketing doubled between 1997 and 2016 to top $30bn a year. Two-thirds of this was marketing to professionals and the rest direct to consumer. US drug companies are more interested in satisfying shareholders than treating patients, argues one commentator. (Jama, LA Times)
ATM for pills South Africa is the first country in the world to introduce pharmacy dispensing units. The machines dispense drugs for illnesses such as HIV, hypertension, and diabetes. (Bhekisisa)
Medical milestones Healthcare anniversaries in 2019 include the 200th birthday of the stethoscope and 250 years since the first hip incision. (BMJ)
Podcast of the week
Tackling loneliness The BBC examines the history of UK policy on loneliness and how scientists are beginning to understand its effects on people’s health and the cost to society. (BBC Health Check)
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Dry January “What seems like a harmless annual challenge is another reminder of the growing harms associated with alcohol consumption, which sadly public health is no match for.” (BMJ)
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