Obama’s Plan to Contain Health Care Costs for Health Care Reform May Hit a Snag

Obama has pledged to reduce health care costs by $2 trillion over the next decade as part of his proposal to reform the United States health care system.

Obama’s pledge may have hit a snag in the form of U.S. antitrust laws, which prohibit unfair business practices (including collusion to set prices).  To read more about it, click here.


US Court of Appeals Affirms 2006 ruling that found Big Tobacco guilty of fraud

False descriptors-"light", "mild" and "low tar"

False descriptors-"light", "mild" and "low tar"

The verdict is in on the landmark “Racketeering” Appeals Court case- US v Philip Morris. The US Appeals Court has unanimously upheld a 2006 landmark federal court ruling that found tobacco companies  including Philip Morris USA (Altria) guilty of  fraud, deceit  and violated civil racketeering laws by falsely denying the dangers and addictiveness of cigarette smoking, falsely denying that they marketed their deadly products to children and misrepresenting that “low tar” and “light” cigarettes had fewer health risks.

According to the Appeals court ruling: “Defendants knew of their falsity at the time and made the statements with the intent to deceive.”

The tobacco companies implicated were Philip Morris USA (and Altria), British American Tobacco, R.J. Reynolds Tobacco Co, Brown & Williamson Tobacco Corp and Lorillard Tobacco.

Liggett was excluded from the ruling after admitting in the 1990’s that smoking causes disease and is addictive and cooperating with investigative authorities. Also excluded from the judgement were the Council for Tobacco Research-USA and Tobacco Institute  as they had not made or sold tobacco products.

The 2006 ruling banned deceptive labels such as “mild”, “low tar,”  and “light” and required the companies to publish “corrective statements”, however, this was not put into effect due to the appeals process.


“Fighting the Flu with One Hand Tied” – op-ed by Prof. Gostin in the Washington Post

The excellent op-ed by Prof Lawrence Gostin*, “Fighting the Flu With One Hand Tied” in the May 1, 2009 edition of the Washington Post highlights the legal and financial limitations of two of the world’s key public health agencies- the World Health Organisation (WHO) and US Centers for Disease Control and Prevention (CDC).

In reference to the revised 2005 International Health Regulations and the experience with SARS, Prof Gostin points out:

…the frightening truth is that the WHO has no real power. It lacks an effective mechanism for monitoring and enforcing national reporting. Its recommendations to countries are expressly “non-binding.” Countries do not even have to share virus samples with it. Indeed, despite painful negotiations over the past two years, the agency has not been able to persuade Indonesia to share samples of avian influenza, threatening vaccine production and public health preparedness.

Professor Gostin also highlights the grim reality of how the world’s poor are also the most vulnerable to, and the least capable of coping with public health emergencies of international concern.

Perhaps more worrying is the lack of capacity in poor countries to detect and respond to emerging threats. This is of particular concern because influenza often emerges in Asia, where crowded cities and close proximity between animals and humans can breed infectious disease. Although Mexico is the likely center of the current outbreak, the genetic material in the swine flu virus is of Eurasian origin. Many poor countries lack adequate surveillance, early warning systems and modern laboratories; they also have negligible public health infrastructures. Although the revised International Health Regulations urge capacity building, Western governments have donated precious little funding, and the WHO has no mechanism or resources for expanding public health capacities within individual countries.

After shedding some light on CDC’s limited legal authority and resources to effectively respond to swine flu -influenza A (H1N1), Prof. Gostin concludes:

The WHO and the CDC are our frontline defense against infectious diseases that can rapidly mutate and travel across continents. It is easy to criticize these agencies and deprive them of resources. It is much harder, but necessary, to build strong public health agencies to do the vital work that we all rely on, especially in the face of an international public health emergency.

*Professor Gostin is a professor of global health law and faculty director at Georgetown University Law Center’s O’Neill Institute for National and Global Health Law, as well as a member of the World Health Organization International Health Regulations Roster of Experts and director of the WHO Collaborating Center on Health Law.

International Public Health Law Consultation Urges Strengthening of National Public Health Laws

Participants of the Public Health Law Consultation, IDLO Headquarters, Rome.

Participants of the Public Health Law Consultation, IDLO Headquarters, Rome.

As the world continues to be threatened with headline-grabbing, cross-border public health risks of the likes of Severe Acute Respiratory Syndrome (SARS), bird flu and the more recent swine flu outbreak, it is becoming increasingly clear that law can and should play an important role in curbing the spread of these infectious disease outbreaks both within national borders and globally.

Although an international legal framework like the International Health Regulations (which were revised in 2005 largely because of the 2003 SARS epidemic) is available to governments to prevent and control the international spread of disease, there is need to generate regional and international institutional networks and partnerships, particularly to build capacity in the area of national public health law, especially in low and middle-income countries.

It was therefore timely that an expert consultation meeting on public health law, held in Rome, Italy on 26 – 28, was co-convened by the O’Neill Institute for National and Global Health Law (Georgetown University), the World Health Organisation (WHO)  and International Development Law Organisation (IDLO). The consultation meeting which drew 22 health law experts from around the world, aimed to identify gaps and opportunities for health within the broader international legal arena and within national legal frameworks, consider the roles and activities of respective institutions and develop future approaches for networking and capacity building.

One key result of the consultation meeting was a decision to begin the process of drafting guidelines for national public health laws, led by the O’Neill Institute for National and Global Health Law, with the support of IDLO and WHO.

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Gates Foundation Awards Grants to “Unconventional” Global Health Initiatives

On May 4, 2009, the Bill & Melinda Gates Foundation announced grants of $100,000 to 81 unconventional global health initiatives as part of the Foundation’s Grand Challenges Explorations initiative.

These “bold” and “unproven” global health research projects have the goal of improving health in developing countries. The projects focus on the prevention and treatment of infectious diseases, such as HIV, malaria, tuberculosis, pneumonia, and diarrheal diseases.  The grants were awarded to researchers in 17 countries.

2009 winners included:

  • Luke Savage and Dave Newman of the University of Exeter in the U.K. will attempt to build an inexpensive, battery-powered instrument to diagnose malaria by using magnets to detect the waste products of the malaria parasite in human blood samples.
  • Boitumelo Semete at the Council for Scientific and Industrial Research in South Africa will attempt to develop “sticky nanoparticles” that attach to tuberculosis-infected cells and slowly release anti-TB drugs. The new therapy could shorten treatment time and reduce side effects, using existing medications.
  • Eric Lam at Rutgers, the State University of New Jersey in the U.S. will work to develop a tomato that delivers antiviral drugs when eaten.

Applicants were selected from more than 3,000 proposals in the second round.  The first round of 104 Grand Challenges Explorations grants was announced in October 2008.

If you have a bold or innovative global health research proposal and you think you have what it takes, the Gates Foundation is accepting applications for Round 3 of Grand Challenges Explorations through May 28, 2009.

Round 3 topics include:

  • Create Low-Cost Diagnostics for Priority Global Health Conditions
  • Create New Ways to Induce Mucosal Immunity
  • Create New Vaccines for Diarrhea, HIV, Malaria, Pneumonia and Tuberculosis
  • Create New Tools to Accelerate the Eradication of Malaria

Health Ministers Accelerate Goals to Diagnose and Treat Drug-Resistant TB

After last week’s World Health Organization (WHO)-sponsored meeting, health ministers from countries with a high disease burden of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) committed towards accelerated goals for the detection, prevention, and treatment of MDR- and XDR-TB. 

The governments present issued a Call for Action asserting that all countries would take action to meet the following goals:

  • universal access to M/XDR-TB diagnosis and treatment by 2015;
  • removal of financial barriers to TB care;
  • development of a comprehensive M/XDR-TB management and care framework;
  • sufficient staff are trained and deployed;
  • strengthen laboratory systems;
  • collaboration with all partners;
  • development and implementation of airborne infection control policies;
  • sufficient supply of high-quality anti-TB drugs;
  • strengthen mechanisms to ensure availability of TB medicines is regulated;
  • develop the new tools needed to combat M/XDR-TB.

The Call for Action is a major step in coordinating plans for M/XDR-TB prevention, treatment and care and a commitment to achieve universal access to diagnosis and treatment for MDR-TB patients by 2015.

Learn more facts about MDR-TB and XDR-TB after the jump. Continue reading

Bill Gates partners with Chinese government to fight TB


bill-gates-china-tb-partnership1At a global meeting in China, of health ministers from 27 countries affected by the rise of multi-drug resistant (MDR) TB, Bill Gates and the Chinese Minister of Health Chen Zhu announced an innovative partnership to help fight a serious tuberculosis epidemic in China.  The 5 year initiative will be led by the Chinese Ministry of Health and funded by a grant of $33million from the Bill & Melinda Gates Foundation.

Bill Gates, co- chair of the Bill & Melinda Gates Foundation said that the rise of drug-resistant TB worldwide has created a new urgency to combat the disease, while scientific innovation is leading to new technologies. He explained in his speech, the foundation’s choice of China for this partnership:

“China is taking the threat of TB very seriously, and we’re excited to support its efforts.” He added, “Because of its skill, its scale, its TB burden, its love of innovation and its political commitment to public health, China is a perfect laboratory for large-scale testing of new tools and delivery techniques to fight TB.”

“If China leads in the fight against TB – developing new approaches here in China and demonstrating them to the world – we can see a dramatic drop in the number of TB deaths in the next decade.”

According to the Bill & Melinda Gates Foundation, the goal of the partnership was “to improve detection and treatment of the estimated 1.5 million TB cases that occur each year in China, drawing on the latest innovations in TB control.”

The Chinese Minister of Health, Chen said that the new tuberculosis prevention and control program was a continuation of the successful cooperation between the Chinese Ministry of Health and the Gates Foundation that began on the issue of HIV/AIDS. 

Minister Chen added, “It aims to establish an effective TB prevention model through the exploration of new diagnostic tools and methods. This will not only benefit TB prevention and control efforts both in China and throughout the world, but it also sets an excellent example of the partnership between government and private sectors that is widely promoted by the international community, and we hope it will accelerate the progress of reaching the United Nations Millennium Development Goals.”

Funding from the Gates Foundation will help China introduce new TB diagnostic tests, patient monitoring strategies, drug regimens and health delivery approaches that could significantly improve the effectiveness of TB diagnosis and treatment across the country.

The initiative will be implemented in 6 provinces in China. During the first two-and-a-half years, innovative tools and delivery approaches will be pilot-tested to determine their effectiveness and feasibility. Following the completion of the first two-and-a-half years of this partnership, China will determine how to progressively expand the innovations that have been proven to be effective into 20 cities, diagnosing and treating 50,000 TB patients each year.

The new technologies and innovative delivery methods to be piloted include:

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