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From snakebites to transfats, the World Health Assembly in Geneva this week tackled a varied range of diseases against the backdrop of a fresh Ebola outbreak in the Democratic Republic of Congo.

One year after his election, Tedros Adhanom Ghebreyesus, the director-general, called for fresh funding and partnerships as he stressed the agency’s bold “triple-billion goals” over the next five years: 1bn more people receiving universal health coverage, 1bn more better protected from health emergencies and 1bn more enjoying better health.

The price for international support, notably from the US, is to frame the discussion around “global health security,” a phrase endorsed in a speech at the meeting by Alex Azar, President Donald Trump’s health and human services secretary.

Yet threats of budget cuts, the recent scrapping of the global health security office within the US National Security Council, and the departure of its head, Rear Admiral Tim Ziemer, suggests the White House emphasis is more on security than global health.


Three questions

Sarah Neville spoke to Christophe Weber, CEO of Takeda Pharmaceutical, which has just bought Shire, the rare diseases specialist.

When did you first decide that you were interested in acquiring Shire?

We started looking at some Shire assets quite a long time ago, late last year, because Shire has some businesses in gastroenterology, oncology and neuroscience, where there is good overlap with our therapy areas. And then, progressively, we migrated, and we started looking at the entire company. We had done a lot of homework well before it became public.

How vital was it for you to do this deal?

Our standalone situation is good; we really have made a huge transformation in the last four years, which is delivering very strong results. We just announced our 2017 results, which are very strong, both in the short term but also in the long term, because our pipeline is progressing well. We see this acquisition as an acceleration . . . of our transformation. It's not a “must-do”, but it’s a true acceleration.

And in terms of Japan’s corporate history this broke new ground as the biggest ever cross-border transaction; did it take a Frenchman to do that?

Well, no, that was not the goal; it just happened that it is, but it’s really driven by . . . strategic fit. We realised later on that it is indeed the country’s biggest acquisition. [Political and corporate leaders in Japan are] are all very positive. They like to see a [Japanese] corporation trying to become a global leader and this is what we are aiming to do in our industry. With this acquisition, we can really accelerate and be among the top league of pharmaceutical companies.


Chartwatch

A comprehensive report laid bare the challenge for NHS finances on its 70th birthday of an ageing population and increasing prevalence of chronic diseases. It suggested a tax rise of £2,000 a year per household to fund the service. The government played down the idea of a large cash injection. (IFS, FT)


News round-up

Ebola and disease outbreaks The World Bank's emergency pandemic funding scheme was used for the first time in the Congo outbreak. Lessons could be learned from Japan's handling of the Fukushima nuclear disaster: contain the risk; communicate progress; and raise public awareness. A study floats the idea of a new global framework for coping with disease outbreaks. (FT, The Conversation, Harvard) 

Abortion battles As Ireland voted on whether to repeal its ban on abortion, President Trump proposed funding cuts to Planned Parenthood and other US family planning clinics. The moves by Mr Trump — dubbed this week “the most pro-life president ever,” echo those from the Reagan era. Meanwhile, restrictions on US aid are hitting family planning services in Africa. Here's Vice's take. (FT, CBS, Kaiser Health News, Reuters, Vice video 4m)

Obamacare clings on Despite a year of attacks and limitations on President Obama's Affordable Care Act, the overall number of Americans without health insurance held steady in 2017 at 9.1 per cent. About 19m people have gained coverage since ACA was signed in 2010. (LA Times, CDC) 

Obesity expanding Almost a quarter of the world’s population will be obese by 2045 and, on current trends, one in eight will have type 2 diabetes. Other studies from the European Congress on Obesity showed the caloric effects on the young of watching junk-food ads and the fact that the much-lauded Mediterranean diet is no longer followed in Mediterranean countries. The UK is targeting drinks served at coffee shops. (Eureka, Guardian, FT)

Healthcare under attack Some 23 countries in conflict suffered attacks on healthcare and health workers in 2017, with Syria the worst hit. “High-minded resolutions have not been accompanied by effective action,” notes this report. (Safeguarding Health in Conflict Coalition)

Healthcare for Palestinians The World Health Assembly discussed the acute shortage of financial and medical resources in occupied Palestinian territory. And in Palestinian refugee camps, services are in disarray, hampered by the US decision to freeze half of its annual payment to the United Nations Relief and Works Agency for Palestinian Refugees. (WHO, PS Mag) 

Air pollution peril The UK's clean air strategy includes plans to deploy legal action against car manufacturers that cheat emissions tests. A study showed the air inside London classrooms was more dangerous than outside. Hamburg became the first German city to ban old diesel vehicles. (FT, Guardian)

The bio-electronic pill Scientists have developed a prototype capsule packed with genetically-engineered bacteria that detects signs of disease inside the body and transmits details to a computer or smartphone. It is not the first digital pill but the first that can be swallowed — when shrunk sufficiently — to sense bodily conditions. (FT)

Vaccination scepticism Americans still largely support the principle of vaccination but scepticism is growing, possibly explaining outbreaks of measles and whooping cough. Experts say doubters can be won over if advocates avoid preaching and stress vaccinations are the norm in US society. (NBC)

Generic shenanigans The makers of the brand-name drugs cited by the Trump administration for “shenanigans” preventing generic competition, have increased prices by double-digit percentages since 2012, according to a new analysis. (Kaiser Health News)

Opioid litigation Settlement money from opioid litigation must be spent on mitigating the epidemic. Lessons can be learned from the tobacco battles of the 1990s. (Health Affairs) 

Work and sleep Working through the night can increase the risk of illness or early death. Neuroscientists are busy exploring the intermediate states between full consciousness and death. A new study suggests a weekend lie-in may help you live longer. (FT Magazine, Journal of Sleep Research)

Pharma firsts Is US-style pharma marketing on the way to the UK? The first TV ad for an erectile dysfunction drug was aired this week after Pfizer's Viagra became available without prescription. The pharma industry trade body outlines milestones in drugs and treatments over the last 50 years. (The Drum, IFPMA) 


Best from the Journals

Global progress Healthcare access and quality improved across the world from 2000-2016 as poorer countries showed large gains, although some are struggling with the rise of non-communicable diseases such as cancers. Iceland, Norway and the Netherlands scored best and Central African Republic, Somalia and Guinea-Bissaut worst. (The Lancet)

AMR and climate change A new study shows a link between higher temperatures and rates of antibiotic resistance, suggesting that current forecasts of AMR could be significant underestimates in a time of climate change. (Nature Climate Change)

Mapping malaria Researchers have traced the malaria parasite's family tree to show how changes about 50,000 year ago led to the deadly disease still prevalent today. (Nature Microbiology)

'Priming' immune systems A new analysis applies the “hygiene hypothesis” to leukaemia — namely that ultra-clean environments are bad for children because they stop them being exposed to the bugs that help build up their immune systems. (Nature Reviews Cancer)

Healthcare for migrants A conference in Edinburgh called for global efforts to tackle health disadvantages associated with migration, ethnicity, and race. “Doctors should challenge anti-migrant rhetoric that legitimises harmful government policies that deny migrants access to healthcare.” (BMJ)


Podcast of the week

Ditching the car A study of more than 350,000 people quantifies how walking or cycling to work can cut the risk of cardiovascular and other diseases. (Heart journal)


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Final thought

Warnings with teeth A study presented at the European Congress on Obesity showed the effectiveness of graphic health warnings on fizzy drinks. Should Big Beverage be forced down the same path as Big Tobacco?

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