River close to Asubende where black flies breed. Black flies transmit the onchocerciasis parasite to humans. People from Asubende rely on this water to drink or irrigate their farming.
© Cristina Aldehuela for the FT

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From photography and video to health bots and computer apps, the International Society of Neglected Tropical Diseases 2018 festival this week showed that even some of the world’s most obscure conditions can inspire vast creativity and innovation.

There were sculptures of antimalarial compounds and knitted mobiles of trypanosomes in the blood from the University of Dundee, the giant yellow inflatable schistosomiasis worm of the #MakingSchistory campaign, and the EU-funded Worm Hunters project to tackle deworming in Colombia with a quiz and cartoon book for children.

Alongside the advice from participants to respect and reflect cultural differences, there was a reminder of how scientific research and medical expertise can be combined with skilful communications and art to improve lives.

And of course the FT was delighted and honoured to pick up an award for its reporting on NTDs, including FT Health’s curation of content from elsewhere and its role as a forum to bring together different voices from around the world.

Read our magazine from last year on neglected tropical diseases.


Three questions

Jonathan Quick, senior fellow emeritus at Management Sciences for Health, and author of The End of Epidemics.

What is the message of your book?

To tackle the growing threat of epidemics — from flu and Aids to Sars and future as-yet-unidentified natural and bioterror attacks — we need at least three things. First, strong decisive leadership and a rapid response. Second, a basic public health system in all countries to detect and rapidly respond. Third, innovation. It is stunning to me that 80 years after the first flu vaccine was made, for instance, that we’re still developing one each year in the same slow, trial and error way.

Why has the international community not done more to prepare?

There is a cycle of panic and complacency that we have seen over and over again. Once Europe and North America had eradicated smallpox by 1950, they didn’t think about it any more. It took three World Health Assemblies over 15 years before leaders decided to commit the world to eradication and then another decade. Up to 40m people died in that period. We saw the same around Aids. Sars created a big panic and lots of promises were made but once the headlines were gone, it was back to business as usual. We also have to balance the benefits of the market with good regulatory oversight and good practices, such as in the agro-food industry. 

Are you optimistic of more progress?

There are new organisations like the Coalition for Epidemic Preparedness Innovations and the Pandemic Emergency Fund and 60 countries are working together on the global health security agenda. There are business people speaking out, and groups like Global Citizen and the One Campaign. I am hopeful because the fire has been lit in so many places, but cautious because we still have leaders — particularly in the US — living under the illusion that it’s possible to [just] protect yourself and not realise we are only as safe as the least protected country.

Chartwatch

Philanthropy in health Health is by far the biggest recipient of global philanthropy, accounting for 53 per cent of the total given in 2013-15. Africa with 24 per cent and Asia with 13 per cent were the most-targeted regions and infectious diseases the most popular focus. (OECD)


News round-up

US aid fears abate President Trump signed a new spending bill that seemed to ameliorate some of the worst fears of the development community on US aid, including $10m to help Haiti tackle cholera. (Devex, Miami Herald) 

Health collapse in Yemen An International Rescue Committee report detailed the collapse of public health systems in Yemen, where almost 80 per cent of people need humanitarian aid and more than two-thirds lack access to basic healthcare. Unicef is predicting a fresh outbreak of cholera in the country (IRC, Guardian).

‘Aids is (still) political’ Two entirely different narratives of HIV are unfolding across the world, says the International Aids Society's annual letter. “Where political commitment on Aids is strong, we have allowed science to guide our response. However, in many other settings, ideology seems to be outweighing science in the HIV response.” The US CDC chief discusses the agency's HIV/Aids strategy. (IAS, Washington Post)

Pharma frenzy Takeda, the Japanese pharma group, said it was considering a bid for Ireland's Shire as part of its strategy to become “a truly global, value-based Japanese biopharmaceutical leader”. Novartis said it would sell to GSK its stake in their consumer health joint venture. Dealmaking in the healthcare sector has already hit $140bn this year. (FT)

NHS funding Theresa May, UK prime minister, heralded a “multiyear” funding plan for the NHS as fears of a cash crisis mounted, while a parliamentary report warned of post-Brexit problems with reciprocal healthcare in Europe. A BBC documentary series shows life in a modern hospital during one of the worst winters on record. (BBC)

Obesity stigma People with obesity are stigmatised as lazy, greedy and unintelligent — although this is not supported by research. The condition is still climbing among American adults although plateauing among youth. And here’s a look at how fast-food chains use interior design tricks to keep customers hungry. (The Conversation, Jama, Marketwatch)

Lessons from Sars A short film looks back at the panic that engulfed Hong Kong as Sars spread through the city in March 2002. Some survivors are still suffering. (South China morning post video)


Best from the Journals

Antibiotic overuse A study on global trends in antibiotic use from 2000 to 2015 showed consumption increased by 65 per cent to hit 35bn daily doses and grew fastest in poorer countries. If this continues to increase, the challenge posed by antibiotic resistance is likely to get worse. (PNAS)

Detecting disease A collaboration between the Ugandan government, local researchers and the US CDC has created a unique programme to contain the spread of viral diseases such as Ebola. (The Lancet Infectious Diseases)

Hepatitis fail Just ten per cent of hepatitis B sufferers are diagnosed and just 5 per cent are getting antiviral treatment, making the WHO target of elimination by 2020 unlikely without drastic action. Less than 1 per cent of expectant mothers — at high risk of passing on the virus — are receiving treatment. (The Lancet Gastroenterology & Hepatology)

Mapping mortality A 30 year county-level study showed declines in deaths in the US from most infectious diseases but a rise in mortality from diarrheal diseases. Rates vary significantly across county borders: high HIV/Aids deaths for example may betray the presence of a large prison. (Jama)

FTA fears The 1989 Canada-US Free Trade Agreement — and consequent increases in US food and drink exports — was associated with increased calorie intake in Canada. “The study raises concerns about potentially detrimental impacts of US FTAs and the need for greater coherence between nutrition and trade policy.” (American Journal of Preventive Medicine)

Dine out dangers A study warns of the high amounts of phthalates, a potentially harmful chemical, in restaurant food and shop-bought sandwiches. The substance, common in packaging and processing materials, can disrupt hormones and is linked to other health problems. (Environment International)

E-cig debate still smouldering A study casts doubt on ecigarettes' use as a bridge to stop smoking, while another said exposure to e-cig advertising increased the odds of youth taking up cigarette smoking. As does smoking marijuana. (American Journal of Preventative Medicine, Jama Pediatrics, Journal of Clinical Psychiatry)


Podcast of the week

Doctors and diet Doctors say more time at medical schools should be spent on studying the effect of nutrition and lifestyle on health. Simple advice to a patient could help bring down costs of ill health to the taxpayer as well as reducing pressure on the system. (BBC Food Programme, 28m)


Join the debate

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Previous edition: Time for action on tuberculosis

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Final thought

Smart messaging Smartphones and apps have had a bad press for encouraging addiction and for their effect on mental health, but here's a reminder of their huge potential for public health messaging. The Grindr dating app, which says it has more than 3m daily users in every country, is sending men HIV test reminders and pointing out their nearest clinic. (NYT)


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