[Nick HeyRee]

His party may want Romney to go to town on this policy clash but surely that only stands any chance if wrapped up in the general theme of the economy. And an actual alternative.

In any event, are we not having quite thr wrong debate here? Whether yiu favour a Republican vision for healthcare or NHS, which nation can claim to be prepared the needs of both an ageing and rising population?

[sunnykerr]

I agree that it would be counter-intuitive to anyone with half a brain to go on the attack without a counter-proposition.

I'm just not sure that'll stop them.

I'm sure they'll try to attack Obama's record on the economy, because the economy ain't good right now. But, if you look at what it was when he walked into Office and what it is now, there's been improvement. And this is despite the fact that the U.S. economy heavily relies on foreign involvement one way or another and the there is a global economic crisis going right now. And it has been going on since 2008.

Mind you... maybe this is the wrong debate to have... not sure why that would be, though.

It's hard to do a comparative analysis of national preparedness with regards to aging populations and related issues when I have no idea what the plans are for most nations. Also, I think the fact that those plans change whenever there's a change of administration in any one country makes it all the more difficult to ascertain with any credibility what these plans are.

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US approves first over-the-counter HIV home-use test A home HIV test is expected to go on sale in the US within months, after winning regulator approval. The OraQuick test checks saliva from a mouth swab for HIV and can produce results in 20 to 40 minutes. Government estimates suggest 1.2 million people in the US are HIV-positive, but 20% do not know they are. The Food and Drug Administration (FDA) has said it hopes the over-the-counter test will reach people who might not otherwise get tested. The test is expected to be sold in as many as 30,000 pharmacies and homeware shops, as well as online. The manufacturer, OraSure, has not said how much the test will sell for but confirmed it would cost less than $60 (£38). "We expect all the major retail outlets to carry this product," chief executive Douglas Michels said. The company is planning a "pretty massive effort" to market the test, Mr Michels added. 'Empowering people' Approval of the test has been praised by HIV/Aids awareness groups. "This test will allow anyone to empower themselves to know their HIV status when, how and with whom they want to," Tom Donohue, founding director of Who's Positive, told the Associated Press. But the FDA has highlighted in its announcement that the test may not be 100% accurate, and has stressed the need for additional testing by medical professionals to confirm the result. OraSure said that in trials the test was able to correctly detect HIV among people carrying the virus only 92% of the time. It was 99% accurate for negative results - or identifying that someone does not carrying the virus. Meanwhile, Dr Jonathan Mermin, director of the HIV unit at the Centers for Disease Control and Prevention, said people who receive negative results should take the test again after three months, because it can take weeks before antibodies to HIV appear. Healthcare professionals have been using a version of the OraQuick test since 2002. For the last two decades there have been about 50,000 new cases of HIV in the US each year. Source: BBC News - US approves first over-the-counter HIV home-use test

This sounds like a good thing to me - it might give some false positives (or, more worryingly, negatives), but if it makes determining whether you have HIV easier then that has to be good. Seems a bit like a home-pregnancy test then - something to put your mind at ease, but not something which should be 100 % trusted.

[sunnykerr]

And if professionals have been using a version of this since 2002, I have to believe that many of the kinks will have been worked out by now.

The only thing I can think of, aside from the very good point about false postives/negatives, is that perhaps there may be a need for a learning curve for non-professionals.

I'm not familiar with home pregnancy tests, but I presume there had to be some sort of learning curve there as well.

[sunnykerr]

HIV-prevention drug Truvada approved by US US health regulators have for the first time approved a drug to prevent HIV infection. Truvada can be used by those at high risk of infection and anyone who may engage in sexual activity with HIV-infected partners, said the Food and Drug Administration (FDA). Studies showed the drug reduced the risk of contracting HIV by up to 73%. Some health workers and groups active in the HIV community opposed a green light for the once-daily pill. There have been concerns the circulation of such a drug could engender a false sense of security. There have also been fears that a drug-resistant strain of HIV could develop. In a statement, the FDA stressed that the drug should be used as part of a "comprehensive HIV prevention plan", including condom use and regular HIV testing. In May, an advisory group of health experts recommended approval for the pill. Truvada, made by California-based Gilead Sciences, is already backed by the FDA to be taken with existing anti-retroviral drugs for people who have HIV. Studies from 2010 showed that Truvada reduced the risk of HIV in healthy gay men - and among HIV-negative heterosexual partners of HIV-positive people - by between 44% and 73%.

Source

I share the concerns of the health organizations who feel this may engender a false sense of security.

The findings show that the risk may be reduced by as little as less than half.

That's not nearly good enough for what this drug purports to offer.

And we're not even getting into the possible side effects of every drug in the world, up to and including this one.

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Yeah, I have to say I'm not too sure about this either. Especially since there is already something out there which is almost 100 % effective in preventing HIV - a condom.

[sunnykerr]

I mean, maybe if it's something that health professionals have been using for years, you could see how there could be some situational merits to a drug like this.

But health professionals are obviously way more educated about how to handle the actual impact of this drug, so I really don't think it compares with the expectations you can have of the general public.

Plus, I have no figures on this, but I have heard that we've been experiencing a bit of an upswing in new cases of AIDS diagnosed among youth, because they don't remember the 80's (not having been born, probably) and also because we do know that there are drug cocktails now that can allow people to live with HIV and AIDS quite a lot longer than they used to be able to.

So that's also built a false sense of security...

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Another new drug approved:

Weight loss drug Qsymia approved for use in US The US Food and Drug Administration (FDA) has approved a new weight-loss drug from the pharmaceutical company Vivus. The FDA approved Qsymia for patients who are overweight or obese and have at least one other weight-related condition. The approval comes after the FDA gave another anti-obesity drug, Belviq, the green light last month. The approvals are the first in the US for 13 years. The FDA said that two studies conducted on patients who took Qsymia, along with changing their diet and increasing exercise, showed an average weight loss of 6.7% and 8.9%. However, the drug can increase heart rate and will therefore not be recommended for patients with heart disease or who have recently suffered a stroke. Vivus will also have to carry our further trials to assess the impact of the drug on cardiac health. Pregnant women are another group who must not use the drug, as it can cause harm to foetuses, the FDA said. Qsymia is a combination of two drugs already approved by the FDA, phentermine and topiramate. Those drugs are marketed for aiding weight loss and preventing seizures respectively. Doctors in the US have urged health regulators to give the green light to new weight-loss treatments as obesity rates among American adults approach 35%. Source: BBC News - Weight loss drug Qsymia approved for use in US

I wonder if the test subjects wouldn't have lost just the same amount with just the lifestyle changes. And I think this drug, too, may lull some people into a false sense of security.

[sunnykerr]

Cardiac health is a very big concern with obese people, one way or the other.

The weight is a strain on their heart and losing it too rapidly also throws the heart into disarray.

So I think it's a good sign they're concerned about that.

As for the rest, I agree with you. Sounds to me like changing your diet and exercizing is the way to go.

Mind you, in this instance, the false confidence of the drug might enable those who just need a little push to actually make a significant change.

Anyone who thinks the job will do the work for them are likely to be in for a rude awakening.

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That's a good point ... if the drug pushes them towards the lifestyle changes too then that's a good thing. I just fear people will see it as a miracle cure and take it with no changes in lifestyle...

[sunnykerr]

Oh, I share that fear.

And, again, any drug has side effects. So anyone expecting that drug to do all the work for them will not only have a rude awakening, but they're opening themselves up to unknown medical consequences.

On the whole, though, I choose to be hopeful.

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And I choose to be cynical, because I've found that is, in my experience, what will happen. I hope you're right though.

[sunnykerr]

Well, I said "on the whole."

I do think the world is full of people who will try the shortcut. I know that.

But I also know there are a lot of people who have good intentions.

I look at my dad, who was diagnosed with diabetes at age... I don't know 68 or 69. He controls it with diet. The pills made him loopy and it's not enough of a problem right now that the doctor felt the pills had to be imposed.

So he controls it with diet and exercise. Which means my dad, who for 68 or 69 years knew that a meal was over because he'd had a sweet desert at the end of it, hasn't eaten much by way of desert in over a year. And he's doing well. He's walking four or five kilometres every day, and he's always hated walking. He's eating well. He only drinks a glass or two of wine a day.

If he can change his deeply engrained habits so late in life... I do think there's hope for just about everyone out there. Because this is not a man who changes.

[sunnykerr]

Drug-resistant HIV 'on increase' in sub-Saharan Africa Drug-resistant HIV has been increasing in parts of sub-Saharan Africa over the last decade, according to experts writing in the Lancet. Studies on 26,000 untreated HIV-positive people in developing countries were reviewed by the team. They said resistance could build up if people fail to stick to drug regimes, and because monitoring could be poor. A UK HIV organisation said resistance was a serious problem in Africa where alternative treatments were lacking. The researchers, from the World Health Organization (WHO) and University College London (UCL) found the most rapid increase in drug resistance occurred in East Africa, at 29% per year. In Southern Africa, it was 14% per year. There was no change in resistance over time in Latin America and in West and Central Africa. 'Early warning' Writing in the Lancet, authors Dr Silvia Bertagnolio from the WHO and Dr Ravindra Gupta at UCL said: "Without continued and increased national and international efforts, rising HIV drug resistance could jeopardise a decade-long trend of decreasing HIV/Aids-related illness and death in low- and middle-income countries." Dr Gupta told the BBC: "Drug resistance is a consequence of people not taking their medication properly. "We do expect to see drug resistance, and it's at around 10% in the UK and US. But here, we monitor people regularly and switch people to different drugs if they develop resistance." He said that quite basic measures could help people to better adhere to drug regimes in developing countries, such as access to food and clean water so they can take their drugs, and monitoring patients as effectively as possible. The researchers said no changes were needed to the drug regimes, but Dr Gupta said: "This work gives us an early-warning that things could get worse." Deborah Jack, chief executive of the UK's National Aids Trust (NAT), said: "In the UK we are fortunate that drug resistance is not a serious problem, and if a person has drug resistance there are other combinations of anti-retroviral therapy that we can use to address this. "Sadly in sub-Saharan Africa fewer treatment options are available. If drug resistance occurs there doesn't tend to be an alternative therapy. "We need further research into the causes of this drug resistance in Africa, and urgent action to support people daily access to their medication."

Source

So, I'm not one to be overly paranoid or anything.

But, couldn't a good reason for developing drug resistance is that the HIV virus in parts of Africa has been submitted to much testing of this drug and that drug by pharmaceutical companies that it has evolved and mutated into a drug-resistant strain?

Couldn't that also account for an increase in drug-resistant HIV cases?

I mean, I'm on board with large swatches of Africa lacking adequate health care in all sorts of ways, from facilities to personnel to materials and so forth...

But we also know that Africa's long been a testing ground in many ways as well.

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I think that might well be the case. Some good news:

Hope for more effective TB treatment Hopes of a new, more effective therapy for tuberculosis have been raised following the results of early trials. The study showed three drugs given in combination killed more than 99% of TB bacteria after two weeks of treatment. The therapy appeared to be equally effective on the drug-resistant form of the disease in the trials of 85 patients, a team led by Stellenbosch University in South Africa reported. Larger studies are now taking place to further test the technique. 'Better, faster' TB is one of the oldest and most deadly infectious diseases. About 1.4m people a year die each year from it, mainly in developing countries. Current treatments usually involve people taking drugs daily for six months. The drug-resistant strain is much harder to treat and can involve up to two years of therapy. Of the three drugs used in this study, published in the Lancet, one is new, while another is not yet licensed. Andreas Diacon, lead researcher for the trial, said: "The results of this study give healthcare providers on the front-lines of the TB epidemic hope for better, faster tools needed to stop this disease." Mario Raviglione, a TB expert at the World Health Organization, said: "The results look strongly promising from this early trial. "We could shorten drug regimens substantially for everyone, regardless of whether the form of TB is sensitive or multi-drug resistant." Source: BBC News - Hope for more effective TB treatment