FT Health: HIV — reasons to be cheerful

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The UN Aids agency announced this week that nearly 21m people with HIV were now receiving antiretroviral treatment, a number that has doubled over the past five years, raising hopes that the target of eliminating the virus by 2030 can be met.

Research breakthroughs and philanthropic initiatives mean individuals can now be treated for as little as $75 a year. On Tuesday the US Food and Drug Administration gave the green light to GSK’s ViiV Healthcare for Juluca, the first two-drug HIV regimen. Increased testing has also been important.

The battle is far from over. More than 17m people — including 919,00 children — lack access to treatment. Some communities have higher rates of the disease than others, and many victims are unaware they even have HIV. As Yusef Azad of the UK’s National Aids Trust told an FT audience this week, there are still problems with additional diseases coinciding with HIV, mental health support, social care and a lingering stigma and discrimination for those affected.

Nevertheless, as the remarkable drop in HIV diagnoses in London recently illustrated, there are reasons enough to be optimistic.

Listen to our discussion with Yusef Azad and Viiv’s Deborah Waterhouse at the FT event on HIV and the future of medicine. (1hr 15m)

Three questions

We spoke to former US president Jimmy Carter, co-founder of The Carter Center and supporter of a new neglected tropical diseases fund unveiled in the Gulf.

Why are you interested in fighting Guinea worm?

One of the premises when [my wife] Rosalynn and I started our centre was to not duplicate what others were doing adequately but to fill vacuums in the world. We were lucky enough to identify a way to eliminate Guinea worm, which has fallen from 2.5m cases in the world to 25 a year. I have complete confidence we will succeed in the next few years. When we finally do away with it, we will leave behind tens of thousands of volunteers trained in the rudiments of public health.

Should the Gulf states have been providing support for longer?

[UAE founder] Sheikh Zayed was a contemporary of mine in office and proved to be quite generous for a long time. The Gulf has had an interest in helping poor countries in Africa — especially those with a Muslim population. Their new contribution is quite important and opens up publicity and knowledge to others.

Are you worried about aid funding cuts from the UK and US?

I heard Theresa May’s recent speech where she said the UK would adhere to giving 0.7 per cent of GDP. The UK has continued its generosity. The US has never been anywhere near equal to what has been done in the UK and Scandinavia. It’s near the bottom, so I don’t think it will get much worse.

FT seasonal appeal

This year's cause is Alzheimer's Research. FT writers share stories  of how dementia has affected their family, while Monty Python star Terry Jones is interviewed in a piece about how a new movement aims to break the silence over a little-understood disease. (FT)

Chartwatch

European health survey A two-year research initiative, the State of Health in the EU looks at member states’ risk profiles and health systems. It calls for more emphasis on health promotion and disease prevention; a beefing up of primary provision; a more “joined-up” approach to patient care; better planning and increased use of digital technology for a more patient-centric approach.  

News round-up

Going Dutch The European Medicines Agency will move from London to Amsterdam after the UK leaves the EU, creating new regulatory headaches and disrupting supply chains. “Unpicking something as complex as this and putting it together again in less than two years is nigh on impossible,” said one industry leader. Read our interview with the EMA chief in last week’s newsletter here. (FT)

Radioactive alert Brexit is not just a problem for business. Supplies of the radioactive isotopes used in cancer treatment are also under threat. A survey highlights the post-Brexit demands of research scientists. (FT, Elsevier/Ipsos Mori)

Malaria fears A new drug-resistant strain of the mosquito-borne disease in Vietnam could spread as far as Africa. Artemisin and another popular drug with which it is frequently paired, piperaquine, seem to be ineffective, threatening years of global eradication efforts. (NYT, The Lancet)

Africa health A report on development in Africa shows a large rise in antiretroviral treatment. The number benefiting has risen from less than 1 per cent in 2000 to 54 per cent last year. (Devex, Mo Ibrahim Foundation)  

Trump and opioids A report by President Donald Trump’s Council of Economic Advisers puts the cost of the US opioid crisis in 2015 at $504bn or 2.8 per cent of GDP — more than six times recent estimates. The FT says the “forgotten” communities most hurt by the crisis are precisely those Mr Trump pledged to help during his campaign and calls on the president to keep his promises. (White House, FT) 

Beijing and biotechs Chinese-developed drugs are heading to the US and Europe as innovation increases. China’s biotechs are on target to raise about $10bn this year from venture capital funding, initial public offerings and licensing deals with overseas pharma companies. (FT)

Price gouging Britain's competition watchdog slammed Concordia, a Canadian pharma company, for increasing the price of its hypothyroidism drug by 5,500 per cent. Some argue the case shows the free market in pharmaceuticals is a myth. (FT, Independent)

Big Brother in the belly? The decision by the US FDA to approve the world’s first digital pill means patients can be monitored to check they take their medication as prescribed, although some argue that tracking consumption has implications for civil liberties. Up to 60 per cent of patients with depression do not take medicines as prescribed. Nor do more than half with asthma and two-thirds with HIV. (FT)

Combating cancer More than 40 per cent of cancer cases in the US come from preventable causes. The American Cancer Society estimates 1.7m will be diagnosed with the disease in 2017. In the UK cancer tests are being introduced in supermarket car parks. (NBC, Telegraph)

American smoke signals Court-mandated TV ads showing the harmful effects of smoking begin in the US this weekend after 11 years of legal wrangling. Viewers will hear that “more people die every year from smoking than from murder, Aids, suicide, drugs, car crashes and alcohol, combined” and that “cigarette companies intentionally designed cigarettes with enough nicotine to create and sustain addiction.” (ABC News)

Gender bias Women get short shrift for medical treatment and are more likely to be serially misdiagnosed. Old stereotypes of men as “silent stoics” and women as “hysterical hypochondriacs” still abound. Women are more likely to be given sedatives for their pain while men are prescribed medication. The WHO has launched a manual to improve the treatment of female survivors of violence within health systems. (The Guardian, WHO)

Sanitation safety World Toilet Day shone a light on the 60 per cent of the world’s population who lack a household toilet that safely disposes of waste and the 892m that still practice open defecation. (WHO/YouTube, NPR)

Best from the journals

WHO’s last chance The World Health Organization is a “struggling organisation with perhaps one last chance to prove its value in a now-crowded arena of high-performing global health initiatives.” Its new emphasis on operations over guideline-setting could mean conflict with its donors. (The Lancet, Devex)

Grab that coffee Three or four cups of coffee a day do you more good than harm, a study suggests. The only harmful associations are related to pregnancy and the risk of fractures for women. (BMJ)

Bittersweet The US sugar industry in the 1960s hid data showing its harmful effects, reminiscent of moves by Big Tobacco. (PLoS)

Medical ethics Being a doctor is not “just a job” — the declarations in the Hippocratic oath and calls for integrity, moral vigilance and standards are as relevant today as ever. (BMJ)

Squirrels and stroke Lessons on treating stroke can be learned from hibernating squirrels. Blood flow is drastically reduced during hibernation — as with stroke victims — but the animals emerge without harm. (FASEB Journal, Eureka)

Online consulting A few notes of caution for champions of online consulting: the practice is only of “limited use,” adding to GPs’ workload and not justifying — at least not yet — significant financial investment. Some patients have been “gaming” an NHS chatbot to get appointments quicker. (Journal of General Practice, The Independent).

Avatar therapy Psychotics who hear voices can be helped by talking to a digital representation of their persecutor, voiced by the therapist. The avatar responds by becoming less hostile and gradually conceding power. (Lancet Psychiatry, BBC)

Podcast of the week

Healthy body, healthy mind? A discussion on the links between the immune system and schizophrenia and other mental health disorders. (Guardian Science podcast, 28m)

In case you missed it

Previous edition: Gulf steps up on neglected diseases

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Final thought

Hounds and health Everyone knows cats make the best pets, but a new study suggests dogs may have a use after all: owning a four-legged friend may reduce the risk of cardiovascular disease. (Nature)