FT Health: High noon for the Pharma Seven

Concern over high drug prices is one of the few topics that unites US politicians, from President Donald Trump down. Seven executives from the world's biggest pharma groups were duly grilled by senators this week over who was to blame.

The companies were accused of “finger-pointing” rather than taking responsibility. Some promised to cut list prices for medicines if the federal government reformed the rebate system. The drugmakers accuse pharmacy benefit managers, which administer drugs for insurance plans, of not passing on savings to patients. Makers of insulin in particular are feeling lawmakers' wrath.

The end result means “the people who can least afford it are paying the most,” admitted K enneth Frazier, Merck’s chief executive. “That’s the biggest problem we have as a country. We have a system where the poorest and the sickest are subsidising others.”

The row over drug prices, which has been raging for some 60 years, is not the only point of contention between politicians and business. Health insurers' stocks sold off this week as investors digested proposals from Democrats for “Medicare for all”, where government schemes would replace private health plans.

A poll on Friday showed strong support for government action. With an eye on the 2020 elections, both sides are digging in for a year of ferocious argument.

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Three questions

Naisola Likimani, the new leader of the support unit for SheDecides, a movement for the rights of girls and women to have control over their own bodies.

Why is SheDecides necessary?

We were formed two years ago to organise resources to fill the gap left by the global gag rule [banning US federal funding for organisations linked to abortion]. The impact was instant. There was a chilling effect. Everybody became very nervous, and it began to isolate abortion as an issue from the rest of the health conversation. It weakened alliances, networks, programmes and services. Over the past year, we’ve seen organisations cutting back programmes especially in hard-to-reach areas and among the most vulnerable and adolescents.

Why did you decide to join?

I’m from Kenya and have worked on women’s rights. I feel we’ve made quite a bit of progress but sexual and reproductive rights remains a very contested conversation. I wanted to bring diverse partners to the table. At issue is the right of women and girls to make choices for themselves. We lose 2 per cent of global GDP because of violence against women and girls. That involves really significant losses to the economy, and tremendous human potential lost because of early marriage and unsafe abortion.

What are your plans?

We now have a permanent team, a governance structure and we’re really set to take off with an ambitious strategy. Resources have been mobilised, though we’ve still got a long way to go on filling the gap. We need to be rooted in the realities of people’s lives, with an increase in movements in countries and locally. We are not here to create a new organisation but to amplify what is happening and generate real policy change. Our language needs to be very accessible, so we can get the message out of the bubble: the importance of the rights of women and girls to fight for themselves.

Chartwatch

Source: UNAIDS

News round-up

Ebola alarm Ebola clinics in the Democratic Republic of Congo were attacked twice as distrust of health agencies grows. John Kerry, former US secretary of state, appealed to the US president: “Global pandemics are the real 'caravans' threatening to defy borders and destroy lives. They can’t be stopped with angry tweets, only with American leadership.” The World Health Organization appealed for more funding. The World Bank gave $80m. (New York Times, USA Today, WHO, FT)

Gene genies Crispr Therapeutics, the US biotech company, said it had treated its first human with its gene-editing technology. The news, together with Roche’s acquisition of Spark Therapeutics, led to one of the “top five most exciting days” for biotech investors in more than a decade. Here's a look at what comes next for human gene editing. (FT, Nature)

Drug delivery New technology that can deliver drugs deep into the brain to treat neurological diseases, from Parkinson’s to cancer, has had encouraging results in its first controlled clinical trial. The system bypasses the blood-brain barrier which makes it hard to target medicines inside the head. (FT)

The Mali model In the seven years since Mali's community health programme began, deaths of children under five have dropped from 148 per thousand, among the worst in the world, to seven — almost identical to the US. The initiative is a stark contrast to elsewhere in Africa where patients often pay “out of pocket” for medical care. (FT)

Rare diseases A report published on rare diseases day called on the UK to update its rare diseases strategy; improve diagnosis and early intervention; and protect and enhance the country's role in rare disease research. The government launched a National Genomic Healthcare Strategy. (Rare Disease UK, Gov.UK)

Antimicrobial alarm An EU report said antimicrobials used to treat diseases that can be transmitted between animals and humans were becoming less effective. Antimicrobial resistance kills 33,000 people in the EU each year, causes economic losses of €1.5bn, and is expected to become a bigger killer than cancer by 2050. (European Food Safety Authority, Euractive)

Mental health matters Does income equality affect mental health? Some argue poorer populations suffer more from problems such as chronic stress, anxiety, depression, bipolar disorder and addiction. Sufferers of mental ill health also experience financial discrimination. A new analysis looks at funding for mental health programmes. (FT, Lancet)

NHS under pressure An annual FT analysis into the winter strains on Britain's National Health Service showed some sustained improvements but increasing demands on the system from an older and sicker population, including a sizeable group of people suffering from “lifestyle” diseases linked to obesity. New proposals call for the private sector’s role in the service to be reduced. (FT)

First 1,000 days British MPs called for a “revolution” in support for children's early years when they are at their most vulnerable. Adverse childhood experiences can lead to heart disease, cancer and mental health problems in later life. (UK parliament)

Brexit beckons All forms of Brexit would be bad for Britain's health, concluded a study of the various possible outcomes, but a no-deal would be especially hard on the healthcare workforce, NHS financing, availability of medicines and vaccines, sharing of information and medical research. (The Lancet)

Life expectancy Improvements in life expectancy have slowed down over the past decade, particularly in the US, where it has actually fallen. Reasons include diseases of old age and an increase in deaths from respiratory diseases and dementia. There are also warning signs from rising obesity and diabetes. (OECD)

Food for thought B reakfast cereals with packaging that may appeal to children contain alarming levels of sugar and salt. From this week, all junk food ads are banned from London public transport as part of the mayor's drive against child obesity. Telling people to avoid processed foods without addressing the drivers that underpin those choices “is like fighting a bushfire with a garden hose”. (Action on Sugar and Salt, Mayor of London, ABC News)

Step away from the car Police and employers trying to prevent people from driving or working while high could soon use a marijuana breathalyser after a clinical study showed it could capture low levels of cannabis in breath. (FT)

Best from the journals

Children with cancer Nearly half of all children with cancer are left undiagnosed and without treatment according to new global estimates. More than 80 per cent of diagnosed cases are in low- and middle-income countries, often with inadequate diagnostics and treatment. (The Lancet Oncology)

Smartphone solutions By 2020, half the mobile phone connections in sub-Saharan Africa will be via smartphone, creating great potential for improved diagnosis, tracking and control of infectious diseases. (Nature)

Populism and measles There is a significant link between the proportion of Europeans voting for populist parties and those who believe that vaccines are not important. Both are driven by a distrust in elites and experts so attempts to curb vaccine hesitancy will only be successful if they address political disenfranchisement and economic marginalisation. (European Journal of Public Health)

Snakebite strategy Snakebite affects up to 2.7m people a year and kills up to 138,000. As these victims are mostly in the world’s poorest and marginalised communities, their voice has often not been heard, but an injection of funds could see treatment cutting mortality by up to 88 per cent. (PLoS)

Working woes Women working very long hours are more likely to be depressed than men. Both sexes are affected by working weekends. (Journal of Epidemiology and Community Health)

Sleep debt That nice lie-in you're planning for this weekend? It won't help you reverse the health risks from your lack of sleep during the week. (Current Biology)

Podcast of the week

Blood money An entertaining ABC Radio series charts the rise and fall of Elizabeth Holmes and Theranos, her blood-testing company which was dissolved following a fraud scandal. (ABC Radio)

FT event

The FT Digital Surgery Summit in San Francisco on March 21 will examine how next-generation surgical technologies are transforming performance in the operating room. For more information and to apply for a complimentary place visit the event website here.

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Final thought

Taboo-busting triumph “I'm not crying because I’m on my period, I’m crying because a film about menstruation just won an Oscar!” A good week for campaigners fighting against stigma began with Period. End of Sentence , Rayka Zehtabchi's film set in rural India, winning best documentary. This was followed by the announcement that it will become compulsory to teach about periods in English schools, described by an endometriosis sufferer as “massive”. (LA Times, YouTube trailer, BBC)