FT Health: Gulf steps up on neglected diseases

A 10-year $100m fund launched in Abu Dhabi this week offers a fresh advance towards eliminating river blindness and lymphatic filariasis in Africa and the Middle East. The fund brings extra money and a new model of partnership around financing and research between donor governments and philanthropists.

The “Reaching the Last Mile” fund demonstrates growing regional interest in global health, including support on polio from the Islamic Development Bank, based in Saudi Arabia, and the periodic World Innovation Summit for Health in Qatar. Officials say Mohamed bin Zayed Al Nahyan, crown prince of Abu Dhabi, has personally donated $250m since 2011 to tackle diseases.

The actions are welcome, but there are caveats. The money has not yet all been raised. Abu Dhabi and the Bill & Melinda Gates Foundation have between them contributed $40m. There is the repackaging of existing support, including drug donations by pharmaceutical companies. And there is little indication of innovation in efforts to escalate existing programmes.

You can read our interview with former US President Jimmy Carter in the next issue of FT Health on Friday November 24. We have a bumper interview edition this week with Peter Sands and Guido Rasi.

FT Health event: last chance

Join us in London on November 21 for discussion, drinks and networking on HIV developments. Guests include Deborah Waterhouse of ViiV Healthcare and Yusef Azad of the National Aids Trust.

Three questions (1)

Peter Sands, the former banker named this week as head of the Global Fund to Fight Aids, TB and Malaria from next March.

What motivated you to apply for the job?

I had a very longstanding interest in global health since I joined the board of the Global Business Council on Aids, TB and Malaria in 2007. I made a very deliberate decision to focus our CSR at Standard Chartered on health: our biggest project was on avoidable blindness, and we supported Nets for Life on malaria and had quite an innovative, sustained HIV prevention programme for the workplace. I first focused on [the Global Fund] opportunity earlier this summer, when the headhunters came to me.

What will your priorities be?

I’ll want to make the organisation even more effective. A key part of the case to donors is the assurance that the resources they provide will be used to maximum impact. We need to get the economic cost of diseases better embedded into policymaking. There is a role for innovative finance but . . . much is about making donor finance more effective rather than producing more money.

Why did you withdraw your application and then suddenly change your mind?

It was a little inelegant on my part. My family, who had put up with my travel and work schedule for many years, motivated my decision to withdraw. The fact of making that decision brought home to me how excited I was about the role and how much I wanted it. I reflected with my wife and we decided we could make it work. Sometimes you make a decision and know almost immediately you made a wrong call. The right thing is to recognise that. I had no interaction with the board.

Chartwatch

Speculation is growing that Amazon will sell prescription medicines and drive down prices.

News round-up

Russian TB advance An international meeting in Moscow this week with 75 ministers from around the world highlighted a fresh focus from leaders, including President Vladimir Putin, on tackling tuberculosis, which remains a big killer. Despite the development of a better test, more investment is needed in health systems. (WHO, Nature)

The British war on aid The Department for International Development became a state within a state, but after a long period of winning cross-party UK political support it is coming under pressure from both its former and new minister. (Prospect)

Bacteria-killing viruses As anti-microbial resistance increases, researchers are looking again at bacteriophages long used in Georgia, which may have an important role in complementing or replacing antibiotics in tackling infection. (Cidrap)

Digital pills US regulators have approved the world’s first digital medicine: an antipsychotic pill with an inbuilt sensor, which will monitor adherence. But the pill raises concerns about data privacy. (FT, NYT)

How to survive a plague David France's book on the response to the Aids epidemic has won the Baillie Gifford non-fiction prize. (FT)

Untold pain Burn injuries are a hidden crisis which is under-reported, although estimates put annual deaths at more than 130,000 globally. The neglect means little funding or focus on prevention. (GlobalHealthNow)

Drinking limits Scotland will next year become the first country in the world to introduce a minimum price per unit of alcohol, following a Supreme Court ruling. (Scotsman)

Mysteries of sleeping sickness The parasite may infect the skin rather than the blood, allowing its transmission even when diagnosis has suggested people are free of infection. (Mosaic)

Mapping trachoma The results of a study in 2012-15 to map the impact of trachoma — the leading infectious cause of blindness — around the world have been published. (SciDev)

Three questions (2)

Guido Rasi, executive director of the European Medicines Agency, ahead of next Monday's decision on the new location outside the UK after Brexit.

What has been the impact of the decision to move the EMA?

It was very emotional and there was a sort of denial it was happening at first. There has been a smaller number of applicants for jobs than usual, and already good candidates are asking to postpone until after the decision on the new location. If there is pressure in a specific cluster of expertise, we are like an assembly line and it might disrupt the processes. We have to just hold our breath for a couple of years to get back up to speed.

Is the decision reversible?

Politically anything is possible. I don’t know what could be negotiated to stop the machine. If the new building is ready and staff have put their children into new schools, reversing the decision could be a problem. We will be ready within 24 hours [of next Monday’s decision] to be on site with all the people to help carry it out. The sooner we have the premises, the sooner we can enter and families can restart their lives. We will be relocated by March 30 2019.

What will be the impact on the UK and its medicines regulator (MHRA)?

There is no precedent for regulators leaving. If there is no agreement, the UK will be a third country like any other, and begin with even less [of a] relationship than the regulators with which we already have agreements like the US, Japan and Switzerland. We have a lot of ongoing work with the MHRA, which gets a third of its income from us. But we have redistributed that. In 2010, seven countries were given 80 per cent of our work. Now 80 per cent goes to 15-16 countries. Like Norway, Iceland and Lichtenstein, the MHRA could still contribute, participate and be remunerated for work.

Best from the journals

Frugal innovation Low-cost global ideas are gaining interest in the US: moving care into the home, alternative payment models and the use of community health workers. (Health Affairs)

Brush with care Many commercial toothpastes contain the antimicrobial compound triclosan, which helps to reduce plaque and gum bleeding. But a toothbrush’s bristles absorb the drug and release it in subsequent brushing, raising concerns over its circulation. (Environmental Science & Technology)

Taking tiredness seriously With growing evidence about the effects of fatigue, the medical sector should study approaches from other industries where safety is critical. (BMJ)

Mentored by a madman Andrew Lees describes how the novelist William S Burroughs' exposure of doctors' hypocrisy and his stress on art's role as a complementary source of truth inspired his neurological research. (JAMA)

Funding and death A regression analysis suggests budget cuts in England in health and social care in 2010-14 were associated with 45,000 more people dying than previous trends, and on current patterns there will be a further 120,000 excess deaths in 2015-20. (BMJ Open)

Victorian air pollution

New analysis on industrial consumption and workforce composition has allowed researchers to map the effects of coal burning and better understand the health impacts. (Economic Journal, The conversation)

Podcast of the week

Good side effects Statins to lower cholesterol could also help tackle pneumonia. (BBC World) 27 minutes

In case you missed it

Previous edition: Decision time at Global Fund

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Final thought

Healthy mind in a messy place Orderly environments lead people toward tradition and convention, while disorderly ones can encourage creativity and novelty. (Psychological Science)