Making Medicines for People, Not for Profit – TEDxTerryTalks – Mike Gretes

29 Tuesday May 2012

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Some open source health links

WHO publish the World Medicines Situation Report (also Drug Regulation History, Present and Future), mentions that

inequity and discrimination in access to essential medicines remain the key public health challenge of our times. A recent study found that in 36 low- and middle-income countries public sector facilities had essential medicines in stock only one third of the time, and in the private sector availability was only two thirds of the time (27).

This first exact measurement of access, combined with the results of recent household surveys, comes uncomfortably close to the longstanding WHO intuitive estimate that one third of the world’s population have no access to essential medicines (and less than half in some areas).

Inequity in access to medicines is part of inequity in health care. In relying on medicine supply through the private sector and financing through out-of-pocket payments, many governments choose to ignore the fact that this policy largely excludes the poor and vulnerable from obtaining even the most basic essential medicines.

Those who need essential medicines the most include the poor, women and girls, the elderly, the internally displaced, people with disabilities, religious or ethnic minorities, and prisoners. Key evidence to document such inequities through disaggregated statistics or targeted surveys is rarely collected, again reflecting a lack of interest in these groups.

This very interesting talk from Mike Gretes in 2008 below, more recently their Global Health statement

Walking and cycling up bits of hills

27 Sunday May 2012

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I have seen an osteopath twice recently who also happens to be a jujitsu master and is a little scary – but excellent also with grabbing hold of people and doing things to various bits of them. After the first session I noticed more rotation in the bottom of my spine than there has been for a couple of years. He also thinks whatever happened with discs was not the whole story but pelvis from previously mentioned multiple bounce down the stairs one Christmas Day. He said that it however hard I tried with taekwondo kicks I would not have been able to achieve the rotation without the manipulation as it was totally locked up.

He told me that we were going to re-educate my muscles and bones and did some serious crunching at the first session. I did taekwondo three times the following week – it was sore but I noticed a very visible improvement for roundhouse kicks especially – there wasn’t a low creaking sound when I tried to move and I wasn’t trying to force myself to get into the position. After this week’s session he did some more crunching and said that he wanted me to push myself and try anything that I couldn’t do previously and see what happened. So I did taekwondo yesterday then walked to Box Hill then made it up the steep steps route in about 15 minutes.

bike on the grass whilst having a short break cycling up a hill in Norbury ParkToday I went on my bike for the first time in 2+ yrs and cycled into Norbury Park, mostly via a cycle path – I went early to avoid traffic on roads (Surrey very different to peaceful roads in Richmond Park or Highlands). In order to get up to the Sawmill there is a longish hill. I made it up to the first bend – couldn’t do the bend, got back on and made the next bit then couldn’t do the really short steep third bit – tried pedalling about 4/5 times but got nowhere. Got back on again at the fourth bend and cycled round some less steep road for a few minutes but as it got towards the final fifth steep bit, I ran out of stamina completely and had to push the rest of the way. Managed to fall off once but I don’t think any major damage has been done.

May go swimming later, then back to taekwondo tomorrow, Wed, Saturday. After our first trial of the Tuesday/Sunday venue, Master Rowley has decided to look around at additional venues in the local area because the floor is thinly carpeted. It was a great session though and he explained each kick and application in very useful detail. We were upstairs in a room above a bar which looks out onto some beautiful lawns. A funny moment when we were doing drills and Master Kelly who is a very experienced tkd & karate Dan was moving backwards holding a pad as someone was kicking towards him and nearly went straight out the large open window. Hopefully he would have had a soft-ish landing. I hope to go Sundays and maybe drop Mondays again when his new club officially starts in a few weeks time. We had a nice Sunday club before our instructor went to teach diving in Bali and it will be fun to go again. The spine flexibility continued in yesterday’s taekwondo session so now its a case of not dropping head forwards on any of the kicks which have had a tendency to do, increase fitness and stamina and see where it all leads.

Introduction to Pharmacokinetics

25 Friday May 2012

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I listened to part of a session today and was able to follow most of it – based on previous anatomy study. Some of the diffusion aspects I couldn’t quite keep up with the pace of the discussion but in principle.

One of the leading researchers in pharmacokinetics is Professor Malcolm Rowland

Also From Physiologically Based Pharmacokinetic Modelling toward System Biology

Intro to Pharmacokinetics

Norbury Park Sawmill Open Day this Sunday

21 Monday May 2012

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It’s still a live Sawmill in a beautiful part of Surrey. As the road winds up, there are fabulous views of Mole Valley and Dorking area, across to Box Hill (and Olympic cycle route to be).

You can take the tour and also eat Norbury Park Blue Cheese. Nick also brought some lambs up last year from Swanworth Farm and there were some other healthy living stalls. The smell of kiln just wafts over as you approach the entrance.

Its a great day out, more details: Sawmill Open Day

something old, something new

20 Sunday May 2012

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It had been a warm but cloudy day. As evening approached the sun broke through and glittered across the sand. ’Custard’ and ‘Mustard’, two of Mrs Bailey’s thirty cats had decided to stretch their legs and stroll down towards the promenade.

tree-lined sandy beach with blue cloudy skyA few waves were gently seeping up the beach. The white cliffs were beginning to etch out small triangles which became sails of few yachts that were making their way towards the back of the island.

Nick and Rick set up the wooden pallets and walked across the pebbles towards the fishing boats. They hauled the buckets back up and began unloading. Mustard was too busy licking one his paws to pay much attention until Custard clawed one of his whiskers “Inspection!”. They lightly padded towards Nick and Rick to see if there was anything suitable on the early evening menu.

Mick emerged from the trees and made his way onto the sand then started vacuuming the sand with his metal detector. The hum slowly faded into the rhythm of the rippling waves and surfing seagulls. Then a very low beep came from beneath the sand. Custard turned half-round to look, nudged Mustard and they padded back along the promenade and sat expectantly. Mick started to brush away the sand and picked out a tin of Chicken Whiskas. He was just about to throw it away in disgust when he heard a rattling sound, so peeled back the lid and to his astonishment found his missing garden shed key inside. He had spent months driving the neighbours mad by methodically taking his detector over each blade of grass on the street.

Whistling, he stuffed the key in his jacket and set off across the sand again. He circled around for about another twenty minutes but that appeared to be the find of the night. As he leant down to switch it off, he heard another low beep. This appeared to be a little further down so he dug down with his arm and felt his fingers enclosing another square. This time Tuna Whiskas emerged from his hand in the sand which also had its lid intact. Hmmm.

He carefully peeled back the lid and did a double take. Well that’s ridiculous…but there it was, his brand new garden shed key that he had bought last Tuesday. He looked up and swore he could see Mustard grinning at Custard, or maybe the sun was just casting a strange shadow from the overhanging branches of the trees. He glanced at the key again, shook his head then stuffed it into his other pocket and wandered over to Nick and Rick.

Mustard and Custard looked at each other and strolled back into the trees.

Vaccines – disentangling threads of correlation and causation

19 Saturday May 2012

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In the recent outbreak of measles in Liverpool, over 90% of the patients had not received vaccinations (and video in full)

A study in 1993 in Liverpool questioned whether was a gap between completions and consent in primary immunisations, citing papers that have mentioned socioeconomic deprivation being linked to low immunisation rates.

Liverpool also had an anti-vaccination movement at the beginning of the 20th century, several other cities also had similar societies regarding smallpox in particular.

David Gorski in Science Based Medicine explained in 2009 how causation and correlation can easily become confused, especially as people are overwhelmed with information or taking sources from the internet without further investigation and concluding that vaccines should not be taken.

You have to show that there is an incidence of that adverse event significantly greater than what could be predicted by chance alone. The same applies to the claim that vaccines cause autism. If you have a child who regresses within a day or so of vaccination, it will appear all the world to you that the vaccine caused the regression. In that case, it is then very difficult even for highly educated parents to accept the results of science, namely that epidemiological studies do not find an elevated incidence of autism after vaccination.1

And a commenter mentioned how her friends were nervous about becoming immunized for flu whilst pregnant.

It is very difficult to not jump to causation with insufficient practical scientific experience, I have failed with this one. I was talking with Master Mark about this a few months ago and he mentioned the shark attack and ice-cream sales fallacy.

Its really sad to see measles back again, there are enough diseases which need treating and cost of researching cures is always challenging, we don’t need major outbreaks of measles on top of them.

1. Gorski D (2009), Pseudo-expertise versus science-based medicine, Science Based Medicine.com, available at
http://www.sciencebasedmedicine.org/index.php/pseudo-expertise-versus-science-based-medicine/

Yay – regulatory approval for a stem cell drug

18 Friday May 2012

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Health Canada have given regulatory approval for Osiris Therapeutics based in the US, to market a stem cell drug – Prochymal for the treatment of GvHD, with Osiris becoming the first company in the world to receive regulatory approval for a stem cell drug.

The approval was based on the results from clinical studies evaluating Prochymal in patients with severe refractory acute GvHD.

Prochymal demonstrated a clinically meaningful response at 28 days post initiation of therapy in 61% to 64% of patients treated.

The drug also resulted in a statistically significant improvement in survival when compared to a historical control population of paediatric patients with refractory GvHD.

Via Pharma Tech,

Interestingly, Michael J Fox has mentioned that they are considering other possibilities beyond stem cell research too at the moment in an interview today. In Always Looking Up, Michael J Fox talks about the many issues including political resistance to supporting stem cell research during the 2000s. Exciting times!

Previous blogpost with resources on stem cells

http://www.hc-sc.gc.ca/ahc-asc/pubs/hpfb-dgpsa/access-therapeutic_acces-therapeutique-eng.php

Connecting commuters with local food options

16 Wednesday May 2012

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We were briefly talking about this tonight at Transition Bookham, we were discussing buying as well as growing local food and in the commuter belt that is Surrey, some people were saying that the reality of their jobs and travel means that they won’t go to a nearby village which has local market/greengrocer etc because its much easier to click online and get a supermarket delivery, even though in some cases the greengrocer will also deliver.

Transition Dorking has a food float and we talked about the following – going to where commuters are and providing alternatives.

  • The refreshments service trolley on the train (as well as trying to source locally), if someone could take local orders for food/grocery shopping too. They could probably attract commission and asking people to fill out something whilst they are in a train for up to an hour would be great. (although if trains are too packed they might not get very far – but worth asking a train company if possible which I am taking away as an action point.)
  • Providing food float/stall outside the station so people leaving can quickly select what they need and would be much more likely to cook with it.
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