Drug companies should give up their patent rights to HIV medicines to help prevent the deaths of millions of people in poor countries, a British government minister will say this week.
The international development minister, Mike Foster, will call on pharmaceutical companies to put lives before profits, as the all-party parliamentary group on Aids publishes a report this week detailing the scale of the "treatment timebomb". By 2030, they estimate, 50 million people will need new drugs, which are currently prohibitively expensive, to keep them alive.
Three million people are on cheap, basic HIV drug combinations, but they are only a third of those in need and resistance is growing to these drugs both in the developing world and in the west.
New and improved drugs are urgently required, but they are expensive, and cheap generic copies of the newest drugs can no longer easily be made and sold because of tightened intellectual property rules in India and China.
The UK generally has a very close relationship with the drug companies, which regard patents as the means of recouping the substantial costs of researching and developing new drugs.
But Foster says they must change their stance on HIV. He wants companies to contribute to a "patent pool", which the international drug-purchasing facility, Unitaid – set up by a number of donor countries, including the UK – is trying to establish.
"While it is absolutely vital that we work to reduce the human cost of HIV by focusing our efforts on preventing new infections, we must also face up to the stark reality of the treatment challenge we face. The pharmaceutical industry has an opportunity to act now to help prevent future human catastrophe. It is time for them to state their clear commitment to make new HIV medicines affordable to those who need them most."
According to the all-party report, if HIV patents are put in a pool, generics companies – which make the cheap combinations now used in Africa – will be permitted to make low-cost copies of newer drugs and devise new combinations in a single pill, which is important for people living in poverty.
The report lays out in stark terms the coming crisis. "It took political activism almost a decade ago to make life-saving drugs available to the poor in developing countries," it says. "Only a third of those who need it are on treatment and this treatment will not work for them forever. Political activism is needed once more to ensure that the next generation of drugs is available to the world's poorest in future."
MP David Barrow, who chairs the group, said: "We are sitting on a treatment timebomb. We must reduce the price of second-line medicines and less toxic first-line medicines before millions need them. We cannot sleepwalk into a situation where we can only afford to treat a tiny proportion of those infected."
The only way to end the HIV/Aids epidemic is to prevent infection, the report says, but because the drugs suppress the virus, those receiving treatment are much less likely to pass it on.
Sarah Boseley, health editor
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Monday, 13 July 2009
International development minister urges firms to pool HIV patents
Michael Jackson coroner's drug report
MICHAEL Jackson had lethal levels of powerful painkiller Demerol and heroin substitute methadone in his body when he died, The Sun can reveal.
Tests show the tragic star had taken a cocktail of drugs strong enough to have killed any normal person instantly.
This is it ... narcotic note written by doctor to tragic Jackson
But he had been on vast quantities so long his body became tolerant to huge doses - until his fatal collapse on Thursday of last week.
The shock findings are in preliminary toxicology reports submitted to the Los Angeles county coroner’s office.
The contents were revealed as sources predicted Jacko’s death could result in manslaughter or even MURDER charges.
A case insider told The Sun: “Michael Jackson was a walking drug store when he died — he never stood a chance.”
'Walking drug store' ... what Jacko was taking
As well as lethal levels of DEMEROL and METHADONE, blood tests found high levels of antianxiety drug XANAX.
Also present were lower levels of PROPOFOL — an anaesthetic for hospital use only, but which Jackson used as a sleeping draft.
A significant amount of narcotic DILAUDID, normally used to numb post-surgery pain, was discovered.
Found ... detox info at Jackson's house
In addition there were “therapeutic” levels of FENTANYL, another post-op painkiller 100 times more potent than morphine, plus prescription painkiller VICODIN, anti-anxiety pills VALIUM and the sleeping drug AMBIEN.
The insider said: “The body can build up extreme tolerances to huge doses of drugs but eventually it overloads and just shuts down. That is what happened to Michael.
Pressure
“Tests showed that as well as Demerol and methadone, he had taken four more painkillers and anaesthetics plus anti-anxiety pills.
“This is sure to increase pressure on police to establish exactly how one man obtained so many prescription medications — and which doctors were responsible.
“There is increasing talk of manslaughter charges if it can be shown he was given drugs without proper regard for his safety.”
Police Chief William Bratton said he was waiting for the final toxicology reports, currently weeks away.
He added: “Based on those, we will have an idea what we are dealing with. Are we dealing with a homicide or are we dealing with accidental overdose?”
The early findings support The Sun’s exclusive revelation that 50-year-old King of Pop was given an injection of Demerol about 40 minutes before his heart stopped.
Jackson’s dermatologist Dr Arnold Klein — the close pal rumoured to be the father of two of the star’s three children — has already admitted occasionally giving Jackson Demerol after surgery.
But he insisted he had warned him about Propofol, also known as Diprivan.
'Quit' ... Dr Arnold Klein
Pacific Coast News
Klein said: “I knew at one point he was using Diprivan was on tour in Germany. I told him he was absolutely insane. I said, ‘You have to quit it. This drug, you can’t repeatedly take’.”
Jackson last toured Germany in 1997 — indicating he may have been taking the potentially lethal medication for at least 12 years.
At least four doctors are at the core of the investigation. One, personal physician Dr Conrad Murray, was with Jacko when he collapsed.
Yesterday a letter from a Dr Alex Farshchian and dated July 21, 2002, emerged suggesting Jackson trade his dependence on Demerol for injectable painkiller Buprenex.
Said to have been found at Jackson’s rented house and published on a US website, it said: “Buprenex is the potent narcotic I told you about last week. It is just like the D but better.” The letter suggests a five to seven-day program “that offers you the solution”.
The doctor adds: “I have everything ready. This is it.”
Eerily, seven years later This Is It would be the title Jackson chose for his comeback shows.
A scribbled note found near his drug stash, possibly written by Jackson, said: “Buprenex does the same as Demerol, the only difference is you can’t become an addict on Buprenex.”
Evidence ... painkiller note, perhaps scrawled by Michael Jackson
Another letter — headed Outpatient Detoxification Sheet — names methadone as the most common way to treat drug dependency.
Meanwhile documents and snaps from the Santa Barbara County Sheriff’s department also emerged showing the depths of Jackson’s drug habit were uncovered in 2003.
Officers raided his Neverland home while probing child abuse claims — and found powerful narcotics, syringes, vials and IV bags.
Jackson had been so desperate to score prescription drugs that he even used his best friend’s identity.
Among the police snaps is one showing a bottle of anti-anxiety drug Alprazolum, also known as Xanax, in the name Frank Tyson — prescribed by Dr Klein.
Tyson’s real name is Frank Cascio. He is a pal’s son who Jackson befriended as a toddler and put on his payroll when he turned 18.
Prescription ... pills for 'Frank'
Frank hung out with him at Elizabeth Taylor’s Swiss chalet in Gstaad in September 1993. And Jackson often sought sanctuary in Frank’s New Jersey home — once spending three months there.
It is thought Frank, now 30, had no idea Jackson was using his name like this — though the star frequently begged aides to get him prescription drugs to top up his own legal supply.
In 2004 bodyguard Chris Carter told investigators he used several names to get prescriptions, including those of ranch manager Jesus Salas and employee Joe Marcus.
Carter also claimed Jacko was once so “spaced out” he fell flat on his face in a hotel — but still continued the drug binge which five years later would lead to his death.
The progress of the drug addictions is to be mapped by a battery of tests — to Jackson’s BRAIN.
Shock ... Sun front pages on Jackson
The Sun
It was removed before Tuesday’s memorial service and slices will show when he first suffered drug reactions.
Renowned pathologist Dr Michael Baden said: “Everything from whether he was beaten as a child to any small tumours, or previous overdoses that he may have suffered, will show up.
“The brain results will determine if he was given improper medication, and how authentic statements provided by his physicians were.”
THE human body can build up a startling tolerance to morphine-based and tranquilliser drugs, writes Health and Science Editor Emma Morton. The phenomenon, tachyphylaxis, means larger and larger doses are needed to have an effect. This puts massive pressure on the heart, triggering heart failure.
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Non-Drug Therapies
When people talk about "alternative therapies" or "alternative medicine" they are talking about kinds of treatment that are different from the medicines or surgery usually prescribed by MDs and other mainstream health professionals. Some people even define alternative medicine as treatments that aren't taught in U.S. medical schools and aren't available at U.S. hospitals. Conventional American health professionals are becoming more interested in these treatments, however.
Some alternative therapies have long histories in other parts of the world and some are recent developments. What they have in common is that the safety and effectiveness of most of them have not been proven by well-designed scientific studies. Some of them may be very helpful, but they must be chosen and used with care.
The list of alternative therapies changes over time as new approaches emerge and others are proven safe and effective and become part of conventional health care. In epilepsy, for instance, the ketogenic diet began as an alternative therapy but has been scientifically tested and is rapidly being accepted as a conventional therapy for certain kinds of patients.
Precisely defined, alternative medicine is used in place of conventional medicine. In actual practice, however, most people who use so-called alternative therapies also receive conventional treatments from a physician. In this situation, better terms might be "complementary" or "integrative" medicine.
Are alternative therapies the same as complementary and alternative medicine (CAM)?
Another popular term for these therapies is "complementary and alternative medicine" (often shortened to CAM). When two things are complementary, they work together, with each one making up for the shortcomings of the other. Complementary therapies, therefore, are used in addition to conventional therapies to try to improve results or quality of life. For instance, people with epilepsy who are taking seizure medicines prescribed by their doctor may also use CAM to try to achieve better seizure control or to reduce side effects.
Therapies listed as CAM are generally the same ones indicated by the term "alternative therapies." The difference lies in whether the person also uses conventional therapies.
What is integrative medicine?
Some people who are interested in CAM, including many doctors, want to emphasize that complementary and alternative therapies can be a valuable addition to conventional medical care. They use the term "integrative medicine" to emphasize that both types of treatment are combined (integrated) in the patient's care. Practitioners of integrative medicine generally emphasize those CAM therapies that have been the most thoroughly tested.
Where can I find out more?
The United States government has had an agency working in the area of alternative therapies since 1993. The current name of this agency (which is part of the NIH, the National Institutes of Health) is the National Center for Complementary and Alternative Medicine (NCCAM). The NCCAM website is a reliable source of up-to-date information and links to other resources.
Topic Editor: Steven C. Schachter, M.D.
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Alzheimer's disease drug treats traumatic brain injury, report GUMC researchers
They say the findings cement relationship between the two brain disorders
Vienna, Austria – The destructive cellular pathways activated in Alzheimer's disease are also triggered following traumatic brain injury, say researchers from Georgetown University Medical Center (GUMC). They say this finding suggests that novel therapy might successfully target both conditions.
In an oral presentation at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease, the scientists will show that deactivating these pathways in part by using a gamma secretase inhibitor - a class of Alzheimer's disease drugs currently being tested - reduced loss of neurons in animal models of traumatic brain injury and protected the animals against motor and cognitive deficits.
"The goal for both diseases is to prevent neuronal cell death, and this study suggests that one therapy could possibly work for both," says the study's lead author, neuroscientist Mark Burns, PhD, an assistant professor at GUMC.
Both disorders are associated with build-up of beta amyloid, a toxic brain peptide. This substance is commonly found in the brains of elderly patients who died from Alzheimer's disease, but has also been found in a third of traumatic brain injury victims, some of whom are children, Burns says. It is also known that people who experience such a brain injury have a 400 percent increased risk of developing Alzheimer's disease.
Burns says that buildup of beta amyloid occurs in a second wave of damage that follows immediate "necrotic" death of nerve cells after traumatic brain injury. This secondary injury can last months, if not years, resulting in large holes within brain tissue.
Amyloid peptides are produced when a long brain protein known as the amyloid precursor protein (APP) is cut in two by the enzyme beta secretase, and then cut once again by a second enzyme known as gamma secretase. Agents that inhibit the activity of gamma secretase are now being studied as treatment for Alzheimer's disease.
In this study, researchers used mice that were either treated with DAPT, an experimental gamma secretase inhibitor, or mice which were "BACE knock-outs" – so called because they were genetically altered in such a way that they could not produce beta secretase. In unaltered and untreated "normal" mice, brain injury resulted in a rapid accumulation of beta amyloid, along with cognitive and motor deficits. But DAPT and BACE knock-out mice had brain lesions that were as much as 70 percent smaller than control animals and they experienced minimal impairment.
The findings further cement the connection between Alzheimer's disease and traumatic brain injury, Burns says, and show that "modulation of beta and gamma secretase may provide novel therapeutic targets for the treatment of traumatic brain injury."
The study was funded by grants from the National Institutes of Health and by the Klingel Family Foundation. The scientists report no potential financial conflicts in this research. Georgetown University has filed a patent application for the technology involved in this research.
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through Georgetown's affiliation with MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO), home to 60 percent of the university's sponsored research funding.
Contact: Karen Mallet
km463@georgetown.edu
215-514-9751
Georgetown University Medical Center
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WHO likely to give H1N1 jab guidance on Monday
Source: Reuters
* WHO expert set to give briefing on flu vaccine Monday
* H1N1-resistant cases have raised interest in jab
(updates with WHO spokeswoman saying briefing likely on Monday)
The World Health Organisation (WHO) will probably hold a media briefing on Monday to issue guidance about the need for a H1N1 influenza jab, a WHO spokeswoman said on Friday.
"The recommendations are still in the process of being developed," Fadela Chaib told a news briefing in Geneva, where the United Nations agency is based.
"The press conference will probably be on Monday," she later told Reuters.
Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research, would give a news briefing once the recommendations emerging from the closed-door WHO meeting on Tuesday are approved by WHO Director-General Margaret Chan.
The WHO raised its influenza pandemic alert to the highest level on June 11 in response to the worldwide spread of H1N1, a newly discovered virus strain commonly known as swine flu.
Vaccine makers such as Sanofi-Aventis
The discovery of three isolated cases of H1N1 flu in Denmark, Japan and Hong Kong that resisted treatment with the anti-viral drug Tamiflu, made by Roche
The WHO said earlier this week that Tamiflu-resistant H1N1 flu does not appear to be spreading in a sustained or worrisome way. All patients with the resistant variety have recovered fully, and their viruses were sensitive to treatment with the other anti-viral recommended by the WHO, the inhaled drug Relenza made by Glaxo under license from Biota
(Reporting by Laura MacInnis and Stephanie Nebehay; Editing by Louise Ireland)
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U.S. Moves Forward With Preparations For H1N1 Vaccination Campaign
The Obama administration on Thursday said a nationwide vaccination program could begin as early as mid-October to protect Americans from the H1N1 (swine flu) virus and pledged $350 million to help prepare communities across the country for this effort, the Washington Times reports (Ward, 7/9).
"I think it's clear that although we were fortunate not to see a more serious situation in the spring when we first got news of this outbreak, the potential for a significant outbreak in the fall is looming," President Obama said, speaking by phone from the G8 summit in Italy to U.S. health officials who gathered in Maryland for a daylong flu summit organized by his Cabinet, AFP/Yahoo! News reports. "We want to make sure that we are not promoting panic, but we are promoting vigilance and preparation," he said.
"The White House has drawn up a battle plan for taking on the virus when influenza season returns to the northern hemisphere in several weeks' time," contingent on the development of a viable H1N1 vaccine. Clinical trials on the first H1N1 vaccine are scheduled to start next month, according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "We know that a safe and effective vaccine is the best means of both preventing the disease in individuals and stopping the community spread of the virus," HHS Secretary Kathleen Sebelius said (Zeitvogel, 7/9).
"The federal government should get about 100 million doses of vaccine by mid-October, if the current production by five companies goes as planned," the Washington Post writes. "But enough vaccine for wide use by the 120 million people especially vulnerable to the newly emerged strain of H1N1 influenza virus will not be available until later in the fall" (Brown/Hsu, 7/10).
Sebelius told the group gathered at the summit that children, pregnant women, people with chronic illness, the elderly and health workers and will be the first to receive the vaccine, CNN reports.
Reuters reports: "The government is also considering buying even more antiviral drugs, including more of GlaxoSmithKline's inhaled drug Relenza and pediatric doses of Roche AG's Tamiflu" as well as a drug nearing the end of clinical trials, which "would help address the issue of resistance," the news service writes (Fox, 7/9).
The Washington Times writes: "HHS is making $350 million in grants available to state and local governments to get ready, with $260 million slotted to help communities prepare for a vaccination program, and $90 million to help hospitals plan for a surge of patients" (7/9). "The federal government has spent about $1 billion so far on pandemic flu vaccine, with about $7 billion available for further purchases and other pandemic countermeasures," according to the Washington Post (7/10).
H1N1's Impact On World GDP; Zimbabwe's Vulnerabilities
Dow Jones Newswires/NASDAQ examines the impact H1N1 is having on the world gross domestic product and the ongoing fear of the devastating effects the virus could have on developing countries (Quinton, 7/9). VOA News explores conflicting reports over whether or not the H1N1 virus has arrived in Zimbabwe, a country just beginning to rebound after a cholera epidemic has claimed the lives of more than 4,000 since August 2008 (Nyaira, 7/8).
This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.
© Henry J. Kaiser Family Foundation. All rights reserved.
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Dramatic drop in deaths from most common cancers
The death toll from three of the UK's most common cancers has dropped to its lowest level for almost 40 years* - according to new figures released by Cancer Research UK.
Mortality rates for breast, bowel, and male lung cancer** are at their lowest since 1971 even though more than 100,000 people are now diagnosed with these kinds of cancers every year.
Breast cancer deaths peaked in 1989 with 15,625 women dying from the disease. The latest figures for 2007 show that figure has dropped to 11,990 which is equivalent to a drop in mortality rates of 36 per cent.
Bowel cancer deaths peaked in 1992 with 19,598 men and women dying from the disease. In 2007 16,007 died - equivalent to a drop in mortality rates of 31 per cent.
And the number of men dying from lung cancer peaked in 1979 at 30,391 but dropped to 19,637 in 2007 - a drop in mortality rates of 53 per cent.
Although more people are getting cancer because the population is living longer, Cancer Research UK believes that fewer are dying from the disease because new and better treatments and screening are making a real difference. And deaths from lung cancer have been falling as more people give up smoking.
While the new figures show that great progress is being made in the battle to beat cancer, there is still much more to be done. And that is the theme of the charity's new national TV advertising campaign launching on Sunday July 12th to improve awareness of the disease and to raise money for further research.
Appearing in the TV advertisement is Audrey Williams - a 50 year old artist and mother of two from Streatham in London who was diagnosed with breast cancer in 2002.
"I just feel so lucky to be here," she said. "I want everyone to know that more and more people are surviving cancer thanks to the work being done by Cancer Research UK. I found a lump in my breast when I was having a shower. After a mastectomy I had reconstruction but my body rejected the implants. It was a difficult time but I think it helps to stay cheerful and to try and keep your sense of humour to get through.
"The important thing about the TV advertisement is that we aren't actors; we are all real people who have gone through cancer and we can reach out to others and tell anyone who is worrying about symptoms to make that trip to the doctor because if they do have cancer the chances of surviving it are greater than ever."
Harpal Kumar, chief executive of Cancer Research UK, said: "Years of research are behind the dramatic progress being made in the fight against Britain's common cancers. Survival rates have doubled in the last thirty years and the work of Cancer Research UK has been at the heart of that progress.
"Our research is behind 19 of the top 20 drugs used to treat cancer patients worldwide today. Our work has underpinned the huge progress we are now seeing in preventing more deaths from lung cancer. And our progress over decades has helped to develop radiotherapy as a major form of treatment for half of all cancer patients.
"But research is expensive and - because we rely completely on donations from the public - we can only continue this vital work with people's support."
Scientists at Cancer Research UK have been responsible for vital discoveries in the quest to understand how cancer develops and how best to treat the disease.
Cancer Research UK funded large trials that proved the benefits of tamoxifen for breast cancer patients and other trials have shown how to prevent the disease in high risk post-menopausal women. In 1995, the charity showed that two X-rays were better than one in detecting more breast cancers and reducing recall rates. This contributed to a widespread change in clinical practice with two-view mammography now used by all the national screening centres.
The charity's laboratory work is behind many life-saving drugs, such as Herceptin, which has given hope to thousands of women with a particular type of breast cancer. Early work on aromatase inhibitors paved the way for anastrozole, a new gold standard of care for the most common type of breast cancer.
Cancer Research UK scientists contributed to key trials of the drug capecitabine, used to treat both bowel and breast cancer. And they showed that Taxol is an effective treatment for breast cancer; it is now also used for advanced lung cancer.
Cancer Research UK has also made a series of breakthroughs pinpointing new regions of the genome linked to breast, bowel, prostate, lung and brain cancer as well as funding more than 100 clinical trials in the UK at any time.
The charity's chief scientist, Professor Sir David Lane, discovered the p53 protein which is faulty in many cancers and this paved the way for many treatments being tested in clinical trials today.
Cancer Research UK scientists helped to develop the drug cisplatin and later discovered carboplatin which has fewer side effects than cisplatin and is widely used in treating ovarian, lung and head and neck cancers.
Temozolomide, now used worldwide to treat the most common form of brain cancer, is another drug discovered in the charity's laboratories and developed through early clinical trials.
Notes:
* *UK figures routinely collated by Cancer Research UK since 1971
* Breast cancer deaths in women were 12,472 (rate = 37.5 per 100,000 women) in 1971; 15,625 (rate = 41.6) at the peak in 1989; and 11,990 (rate = 26.7) in 2007.
* Bowel cancer deaths were 18,110 (rate = 28.9 per 100,000 persons) in 1971; 19,598 (rate = 25.5) at the peak in 1992; and 16,007 (rate = 17.7) in 2007.
* Male lung cancer deaths were 28,395 (rate = 106.9 per 100,000 men) in 1971; 30,391 (rate = 108.5) at the peak in 1979; and 19,637 (rate = 51.5) in 2007.
* **Lung cancer mortality rates in women under 75 increased by seven per cent over the last 30 years but have fallen by four per cent in the last 10 years.
* The difference in lung cancer trends between men and women reflect variations in past smoking behaviour.
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