Obesity-related cancers rising, threatening gains in U.S. cancer rates

CHICAGO (Reuters) – The rates of 12 obesity-related cancers rose by 7 percent from 2005 to 2014, an increase that is threatening to reverse progress in reducing the rate of cancer in the United States, U.S. health officials said on Tuesday.

According to the U.S. Centers for Disease Control and Prevention, more than 630,000 people in the United States were diagnosed with a cancer linked with being overweight or obese in 2014.

Obesity-related cancers accounted for about 40 percent of all cancers diagnosed in the United States in 2014. Although the overall rate of new cancer diagnoses has fallen since the 1990s, rates of obesity-related cancers have been rising.

“Today’s report shows in some cancers we’re going in the wrong direction,” Dr. Anne Schuchat of the CDC said on a conference call with reporters.

According to the International Agency for Research on Cancer, 13 cancers are associated with overweight and obesity. They include meningioma, multiple myeloma, adenocarcinoma of the esophagus, and cancers of the thyroid, postmenopausal breast, gallbladder, stomach, liver, pancreas, kidney, ovaries, uterus and colon and rectum (colorectal).

In 2013-2014, about two out of three U.S. adults were considered overweight or obese. CDC researchers used the U.S. cancer statistics database to see how obesity was affecting cancer rates. Although cancer rates rose in 12 of these cancers from 2005 to 2012, colorectal cancer rates fell by 23 percent, helped by increases in screening, which prevents new cases by finding growths before they turn into cancer.

Cancers not associated with overweight and obesity fell by 13 percent.

About half of Americans are not aware of this link, according to Schuchat. The findings suggest that U.S. healthcare providers need to make clear to patients the link between obesity and cancer, and encourage patients to achieve a healthy weight.

“The trends we are reporting today are concerning,” Schuchat said. “There are many good reasons to strive for a healthy weight. Now you can add cancer to the list.”

She said the science linking cancer to obesity is still evolving, and it is not yet clear whether losing weight will help individuals once cancer has taken root.

What is clear is that obesity can raise an individual’s risk of cancer, and that risk may be reduced by maintaining a healthy weight, Schuchat said.

Reporting by Julie Steenhuysen; Editing by Jonathan Oatis

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EU drugs head fears delays, health hazards as agency uprooted

LONDON (Reuters) – Access to new medicines and safety checks on existing treatments will be jeopardized if politicians pick a new home for Europe’s London-based drugs regulator that is unacceptable to staff, its executive director told Reuters.

Cancer drugs and therapies for rare diseases could be particularly affected by an exodus of key scientific and administrative staff during the move, which has been triggered by Britain’s decision to leave the European Union. The European Medicines Agency (EMA) must be headquartered in an EU country.

“Oncology is a good example. The pipelines are very promising for new cancer options and if there is severe disruption those might be delayed or prove impossible to approve,” said EMA chief Guido Rasi.

Based in London since 1995, with a staff of around 890, the EMA acts as a one-stop-shop for approving and monitoring the safety of drugs across Europe.

Now it is about to be uprooted as a result of Brexit and a staff survey last week found that between 19 percent and 94 percent of employees were likely to leave after the move, depending on which of 19 possible locations is chosen.

At stake is not only the smooth-running of the European Union’s drug approval process – vital for both patients and companies – but also public safety, if regulators fail to react to a side-effect problem or quality issue in a timely fashion, Rasi said.

The EMA deals with more than a million reports of adverse drug reactions every year. It also inspects manufacturers worldwide and in recent years has suspended hundreds of drugs that fall short of testing standards.

Most recently, the agency’s safety role was highlighted when it held a high-profile hearing on links between Sanofi’s epilepsy drug valproate and birth defects.

“Europe now is called on to decide not where to relocate an agency but how to protect an activity that is crucial for public health,” Rasi said in an interview.

NO BACK-UP PLAN

FILE PHOTO: The headquarters of the European Medicines Agency (EMA) is seen in London, Britain April 25, 2017. REUTERS/Hannah McKay/File Photo

Because the work of regulating medicines is delegated by EU member states to the EMA, there is no back-up plan if the agency is relocated from 2019 in a city where it is impossible to operate effectively due to staff losses.

Rasi said that in a worst-case scenario, the agency would simply no longer be able to function. Drug approvals would grind to a halt and Europe might have to import medicines – something that would require new legislation.

Picking Amsterdam, Barcelona, Vienna, Milan or Copenhagen as the new headquarters would be the best option for retaining staff, according to the survey of its workers. Any of the other 14 sites would spark large staff losses.

All of the top five candidate cities favored by EMA staff are in countries that already host one or more EU agencies. Some of the lower ranking cities are in Bulgaria, Croatia, Slovakia and Romania, where there are none.

Rasi said the scale of the potential staff exodus was “much worse than anticipated” but reflected the upheaval facing employees, many of whom have children established in London schools and working spouses in the city.

“This has not been reflected upon enough,” he said.

The European Commission on Saturday published its assessment of different locations for the EMA and the smaller European Banking Authority, which will also have to leave London because of Brexit.

The Commission did not rank the rival bidding cities, many of which have lined up sweetheart deals to lure the two agencies.

EU leaders will make the final location decision on Nov. 20, but the need to ensure business continuity could clash with another cherished ambition of spreading the bloc’s agencies more evenly across Europe, particularly in eastern member states.

Relocating the EMA before Britain leaves the EU in March 2019, as current plans dictate, involves a very tight schedule. In 2014, the agency moved just 800 meters to a new office block within London’s Canary Wharf financial district – a shift that took three years from signing a lease to moving in.

Rasi, at least, is committed to go wherever his political masters send him. “The captain is the last to abandon the ship,” he said.

Reporting by Ben Hirschler, editing by Peter Millership

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A More Accurate Predictor for Alzheimer’s?

Quick Guide to Dementia

News Picture: A More Accurate Predictor for Alzheimer's?

FRIDAY, Sept. 29, 2017 (HealthDay News) — A new test that checks for multiple gene variants linked with Alzheimer’s disease may be more effective than testing for a single genetic variant, a new study suggests.

Latest Alzheimers News

The genetic variant APOE E4 is regarded as the strongest genetic predictor of whether a person is likely to develop the memory-robbing disease. But it’s present in only 10 to 15 percent of people. And recent research suggests its impact has been overestimated, the study authors said.

They developed a test that estimates the risk of Alzheimer’s in the 85 to 90 percent of people who don’t have at least one copy of APOE E4 but still have other gene variants that put them at risk of Alzheimer’s. The test is called the polygenic hazard score (PHS).

The researchers reviewed five years of data from nearly 1,100 Americans without dementia. They concluded that the new test could predict how long it would take the study participants to progress to Alzheimer’s disease and the speed of their mental decline.

“Beyond APOE E4 by itself, our polygenic hazard score can identify cognitively normal and mildly impaired older folks who are at greatest risk for developing Alzheimer’s-associated clinical decline over time,” said study first author Chin Hong Tan. A postdoctoral scholar at the University of California, San Francisco, Tan made the comments said in a school news release.

Autopsies on people who had Alzheimer’s found that a higher PHS was associated with more Alzheimer’s-related amyloid plaque in the brain. These people also reportedly had faster declines on tests of mental skills while living.

Older people with the highest PHS had the highest rates of Alzheimer’s, regardless of their APOE E4 status, the study authors said.

“Our findings have strong implications for [research] trials in Alzheimer’s, as well as direct-to-consumer genetic tests, some of which have recently received FDA clearance,” said study co-author Anders Dale, a professor of neurosciences and radiology at the University of California, San Diego.

The study was published recently in the Annals of Neurology.

— Robert Preidt

MedicalNews
Copyright © 2017 HealthDay. All rights reserved.

SOURCE: University of California, San Francisco, news release, September 2017

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Latest Snag In ACA Sign-Ups: Those Who Guide Consumers Are Hitting Roadblocks

While health care uncertainty roils Washington, the rest of the country is coasting toward Obamacare season.

Open enrollment is just about a month away. But the current landscape is marked by funding cuts and other White House efforts to pull back on Affordable Care Act outreach, which has led some people to brace for what they foresee as the toughest season yet.

And the latest wrinkle? In states that use the federal marketplace, healthcare.gov, many navigators — nonprofit groups and workers who receive federal funding to help consumers enroll — are hitting snags completing a mandatory certification course. Those credentials are required before they can formally advise consumers or organize educational events about getting coverage.

To be sure, the training — which involves buggy, not-so-user-friendly software — has never been a smooth process.

But this year, many say they’re experiencing more technical glitches and — in a critical shift — getting less help from the Centers for Medicare & Medicaid Services, the federal agency tasked with supporting them.

“It used to be … you got the impression they were trying to help you,” said Randal Serr, director of Take Care Utah, a navigator organization based in Salt Lake City. “Now it seems, passively, this is not their priority.” He reports that he has experienced firsthand the slow responses to these technical difficulties.

CMS did not provide comment for this story.

Chief among the complaints are repeated error messages and lost or unsaved work after sections of the training are completed.

Based on interviews with navigators as well as advocates and experts who work with their organizations, when these problems arise, they compound an already uphill climb to sign people up for ACA health coverage.

“I don’t know how much icing we need on this cake, but it’s more icing on the cake,” said Shelli Quenga, director of programs for the Palmetto Project in South Carolina, whose federal grant was cut by more than 50 percent.

Software problems are occurring more frequently than in the past at her organization, Quenga said. Meanwhile, she added, it can take weeks before CMS resolves the issue — a delay she didn’t recall experiencing in previous years. On top of the funding cuts and administration’s messages that undermine enrollment, it’s “a new circle of Dante’s hell,” she said.

But even as navigators from a number of states report problems, others say their experiences haven’t differed from other years.

Adam VanSpankeren, a Wisconsin-based navigator, said he faced a few bugs in completing his training, but nothing unusual. When he sought technical support, he added, he received quick and thorough help. Amalia Benvenutti, a Georgia-based insurer, reported a similar encounter.

“There has always been the occasional odd bug with a particular module not saving or the site crashing — the interface is a bit clunky — but nothing that I would describe as more restrictive or onerous than previous years,” VanSpankeren said.

Daniel Bouton, who organizes the marketplace program at a Dallas-based navigator group and has already experienced some of these problems, sees a larger pattern. He worries that will almost certainly affect how many consumers can both access information about their insurance options and how many actually get covered.

Together, these challenges underscore the impact of the Trump administration’s broader disinterest in maintaining much of Obamacare’s vast apparatus.

“Local organizations are feeling the cut on funding. Then you move to, ‘OK, I’m not going to have enough funds for a strong marketing campaign. I’ll utilize my navigators, and go back to grass roots, and do door-to-door marketing.’ But then you go back to, ‘I can’t send my navigators out because they’re not certified,’” Bouton said. “I have this feeling of having our hands tied.”

And there are other potential delays. Many navigator groups saw their federal funding cut this year — a change that required them to submit new working budget proposals to CMS by last Wednesday. It’s unclear if or when they will receive federal approval, which some said could further cut into planning and outreach efforts.

Meanwhile, these challenges come as open enrollment — which starts Nov. 1 — for the first time lasts only six weeks compared with three months in previous seasons. CMS also indicated it will for the first time be shutting down the healthcare.gov website on most Sundays of open enrollment, which officials say is for maintenance. Sundays, though, have typically been a prime time for consumers to sign up.

And at the same time, the learning curve is steeper. Many consumers aren’t aware that the enrollment period is shorter, Quenga said. Because of congressional back-and-forth, she added, some aren’t even sure if Obamacare is still in effect.

“People need that in-person assistance to understand the subtleties and nuances of a very complicated system,” she said. “You’re cutting these people off at the knees.”

Categories: Insurance, States, The Health Law

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Do Pharma’s Claims On Drug Prices Pass The Smell Test? We Found 5 Stinkers.

Drug companies launched an ad and publicity extravaganza this year right after President-elect Donald Trump said they “are getting away with murder” on sky-high pill prices.

More than it has in years, the pharmaceutical industry fears major legislation that would curb prices and shrink profits. TV spots lauding drug companies, quoting poet Dylan Thomas and showing heroic scientists have been hard to escape.

But the narrative from the Pharmaceutical Research and Manufacturers of America (PhRMA), a trade group, is only the rosiest, most self-serving version of the tale, say critics, and numerous independent authorities question its assertions.

This KHN story also ran in HuffPost. It can be republished for free (details).

They say the campaign is misleading in these five ways:

1. Lowballing drugs’ cost to society.

For years, PhRMA said retail prescription drugs account for only 10 percent of America’s enormous health care bill. Lately, the group has been using a figure of 14 percent, counting chemotherapy and other drugs delivered in hospitals and doctor offices.

Both numbers downplay the expense of prescription meds. Arriving at the industry’s estimates requires lumping drug costs in with billions in public health spending, such as checking water and animals for pathogens, as well as nursing home care and other categories only loosely connected to the day-to-day job of healing the sick.

Retail drugs alone were 21 percent of the cost in 2014 for employer-sponsored health plans, often exceeding costs for inpatient hospital treatment. Add chemotherapy and other non-pharmacy drugs, and the portion is higher.

At CareFirst, a BlueCross BlueShield plan with members in Maryland, Virginia and the District of Columbia, total drug costs when chemotherapy and other hospital-administered medicines were added became a thumping 34 percent of the expense in the first half of 2017, says CEO Chet Burrell. By contrast, inpatient care, traditionally the most expensive health service, is about 20 percent of CareFirst’s costs.

“That tells you about the power of what’s going on with the drug prices and the degree of use of the drugs,” Burrell said.

2. Exaggerating drug development costs.

Inventing, testing and launching a drug costs $2.6 billion, calculates the Tufts Center for the Study of Drug Development. The industry substantially finances the center’s work, leading many to question its credibility. Drug companies use its conclusions to justify high prices and cite this figure at every turn.

Outside authorities criticize the research, saying it comes from untestable data, ignores enormous tax subsidies that reduce costs and inflates results with imaginary expenses, such as profits that could have been earned if drug companies invested research dollars elsewhere.

“These estimates are all based on secret, unverifiable numbers of unknown reliability from unknown companies about unnamed drugs,” said Donald Light, a health policy professor at Rowan University in New Jersey.

The Tufts results line up with publicly available data, counters Joseph DiMasi, economic analysis director for the Tufts Center. “If anything, they suggest our estimates are conservative,” he said.

But an independent study published in September using public filings found the median cost of developing 10 cancer drugs was $648 million, while the median revenue per drug was $1.7 billion.

Light and other critics especially object to counting, as part of development costs, the theoretical profit firms might have earned if they put research money into something other than inventing drugs — such as buying extra ads for existing products. That adds more than $1 billion to the supposed cost.

What settles the argument is drugmakers’ audited financial statements, which show that costs of all kinds are far below what they collect in revenue. Ten of the top publicly traded U.S. drug companies earned profits of $83.6 billion last year on revenue of $306 billion, regulatory filings show. That’s a 27 percent pretax profit margin — accomplished even after spending billions on TV ads and salespeople.

3. Cheering too loudly about a slowdown in drug costs.

Fueled partly by hepatitis C medicine costing as much as $1,000 a pill, retail prescription drug spending soared by 12 percent in 2014 and another 9 percent in 2015, according to government data. That was the biggest two-year increase in a decade.

So it’s no surprise growth is reverting to the mean now that there are fewer new blockbusters. Government figures aren’t in yet for 2016. But QuintilesIMS, which tracks wholesaler sales, says drug spending grew 4.8 percent last year.

“The slowest rate in years,” brags PhRMA, quoting a magazine. Actually, drug-spending growth was even lower from 2010 to 2013 before roaring back.

In any case, 4.8 percent is still twice the inflation rate for 2016 and greater than economic growth, which determines what the country can afford over the long term.

New drugs arriving to market, often involving living cells and gene therapy, look more expensive than ever. The announced cost for Novartis’ Kymriah therapy for kids with leukemia is $475,000 for a one-time treatment.

Drug companies seem to show concern about high prices only when there’s a danger Congress might do something about them. In January, AbbVie loudly promised to keep price increases under 10 percent this year. Now that political pressure has subsided, company executives said recently they have more “flexibility” to revert “to double-digit increases in 2018 and beyond,” according to a Sept. 22 report from Leerink, an investment research firm.

AbbVie subsequently said Leerink “incorrectly characterized” the remarks. The drugmaker promised to make “one, single-digit price increase” for 2018.

4. Exaggerating the role of generics.

“Nearly 90 percent of all medicines dispensed in the United States are generics,” says PhRMA, trying to argue drugs are cheap.

The group doesn’t mention that brand-name medicines are responsible for 74 percent of prescription costs and that drugmakers do everything in their legal power to keep pills from going generic after patents expire.

“PhRMA has fought for years to keep generics off the market,” said Robin Feldman, a law professor who researched the subject for a book, “Drug Wars,” published in June, which she co-authored. “The brunt of the pain of that is felt by U.S. citizens,” who pay more for medicine than anybody in the world, she said.

Industry tactics have included paying makers of generics not to make pills; filing dubious petitions opposing generics that cause months of delay; withholding samples that generics companies need to launch their own pills; and changing dosages or delivery mechanisms in tiny ways to get a new patent, Feldman said.

5. Exaggerating benefits from new drugs.

“Since 2000, biopharmaceutical companies have brought more than 500 new medicines to U.S. patients, resulting in significant progress against some of the most costly and challenging diseases,” says one of PhRMA’s promotions.

Rather than being breakthroughs, however, too many new drugs are “me-too” substances based on previous research, critics say. Many aren’t demonstrably better than cheaper, already available drugs yet get heavily promoted through expensive ads and salespeople.

Bernard Munos worked for years at Eli Lilly and now is a consultant and sits on the board of several small, drug-related companies. He credits the industry with creating drugs that “are superb and make a difference,” such as Gleevec, Novartis’ blood-cancer drug.

But there are not nearly enough of them, he says.

“One of the challenges of the industry is that, despite all of its efforts, it has not been successful in producing more of the really transformative drugs,” he said. “Mediocre drugs are starting to price themselves at almost the same level as the really innovative drugs. And this is a market failure.”

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Categories: Cost and Quality, Pharmaceuticals

Tags: Drug Costs, Prescription Drugs

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How we tick: U.S. ‘body clock’ scientists win Nobel medicine prize

STOCKHOLM/LONDON (Reuters) – U.S. scientists Jeffrey Hall, Michael Rosbash and Michael Young won the 2017 Nobel prize for medicine on Monday for unraveling molecular mechanisms that control our internal body clocks.

These help explain how people experience jet lag when their internal circadian rhythms get out of sync, while also having wider implications for disorders ranging from insomnia to depression to heart disease.

Chronobiology, or the study of biological clocks, is now a growing field of research thanks to the pioneering work of the three scientists, who explained the role of specific genes in keeping fruit flies in step with light and darkness.

Today, scientists are exploring new treatments based on such circadian cycles, including establishing the best times to take medicines, and there is an increased focus on the importance of healthy sleeping patterns.

“This ability to prepare for the regular daily fluctuations is crucial for all life forms,” Thomas Perlmann, secretary of the Karolinska Institute Nobel Committee, told reporters.

“This year’s Nobel prize laureates have been studying this fundamental problem and solved the mystery of how an inner clock in our bodies can anticipate daily fluctuations between night and day to optimize our behavior and physiology.”

Rosbash said the news that the trio had won the Nobel prize, which is worth 9 million Swedish crowns ($1.1 million), was “a little overwhelming”.

“It took my breath away, literally. I was woken up out of deep sleep and it was shocking,” he told Reuters.

“It’s great for basic science. It hasn’t had a tremendous amount of practical impact yet, so it’s really a very basic discovery … It’s good to have the attention on this kind of basic work.”

Hall, most recently of the University of Maine, collaborated with Rosbash while they both were at Brandeis University in Waltham, Massachusetts. They split the prize with Young of Rockefeller University in New York City.

Scientists were already pondering the concept of body clock genes in the 1960s and 1970s.

Michael W. Young (C), a joint winner of the 2017 Nobel Prize in Physiology or Medicine, walks to a press conference at The Rockefeller University in New York, U.S., October 2, 2017. REUTERS/Shannon Stapleton

Then, in the mid-1980s, the three laureates used fruit flies to isolate a gene called period that controls the normal daily biological rhythm and showed how it encodes a protein called PER that accumulates in cells during the night and degrades during the day. Further research revealed the role of other genes in the complex system.

“We were hopeful what we did in the fly would pertain more widely,” Young said in news briefing at Rockefeller University on Monday, but added that “it has unfolded in a way that just couldn’t be imagined at the beginning.”

Young said the trio could not have anticipated that the whole system could be revealed in their lifetimes, but new scientific tools helped accelerate the work.

“Just like puzzle pieces, the genes fell out and the way they work together provided this beautiful mechanism that we now appreciate.”

Slideshow (10 Images)

Their discoveries help explain how plants, animals and humans adapt their biological rhythm to be in synch with the Earth’s revolutions.

“Before you’ve got the genes, everything is a black box,” Michael Hastings of the MRC Laboratory of Molecular Biology in Cambridge, England, told Reuters: “Once you’ve got the genes, everything is possible.”

Scientists now understand that body clocks influence alertness, hunger, metabolism, fertility, mood and other physiological conditions. And researchers have begun to study the implications of erratic sleeping and working patterns or children who stay up late.

“We are learning more and more what impact it has to not follow your clock,” Nobel committee member Christer Hoog told Reuters. “If you constantly disobey your clock, what will happen? Medical research is going on with regards to that.”

Medicine is the first of the Nobel Prizes awarded each year. The prizes for achievements in science, literature and peace were created in accordance with the will of dynamite inventor and businessman Alfred Nobel and have been awarded since 1901.

Nobel medicine laureates have included scientific greats such as Alexander Fleming, the discoverer of penicillin, and Karl Landsteiner, whose identification of separate blood types opened the way to carrying out safe transfusions.

The prize has not been without controversy, especially with the benefit of hindsight, such as the 1948 award for the discovery of DDT, a chemical that helped battle epidemics but was later banned due to its harmful environmental impact.

(For Nobel Prize winner graphic, click tmsnrt.rs/2y6ATVW)

Additional reporting by Julie Steenhuysen, Scott Malone, Anna Ringstrom, Simon Johnson, Daniel Dickson, Helena Soderpalm and Johannes Hellstrom; Editing by Gareth Jones and Andrea Ricci

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U.S. FDA moves to smooth path for complex generic drugs

WASHINGTON (Reuters) – The U.S. Food and Drug Administration on Monday announced a series of measures designed to speed to market generic versions of complex drugs such as Mylan NV’s emergency EpiPen in an effort to address the rising cost of pharmaceuticals.

The measures, announced in a blog post by Commissioner Scott Gottlieb, stray into an area that has not previously been the FDA’s purview: drug prices. The agency has typically made its decisions based on safety and efficacy without regard to cost.

Gottlieb said the measures are designed to increase competition in the market by enabling generic competition to complex drugs, something he has long argued for.

“Drug access is a matter of public health concern,” Gottlieb said. “We know that enabling more generic competition, where Congress intended, helps reduce prices, enable more access, and improve public health.”

Complex drugs include medicines like metered-dose inhalers to treat asthma that have at least one feature difficult to copy under existing rules, which means those drugs can face less competition.

“In some cases, costly, branded drugs that are complex drugs have lost their exclusivity but are subject to no generic competition,” Gottlieb said.

Mylan, which faced an uproar over the escalating price of the EpiPen last year, culminating in a congressional hearing on the matter, has itself complained about getting its own versions of complex drugs onto the market, including its copy of GlaxoSmithKline Plc’s Advair asthma treatment.

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Health experts zero in on camels to fight deadly MERS virus

GENEVA (Reuters) – The fight against the deadly Middle East Respiratory Syndrome (MERS), which has killed at least 722 people over the past five years, is honing in on its target: camels.

MERS coronavirus (MERS-CoV), a member of a virus family ranging from the common cold to Severe Acute Respiratory Syndrome, appears to have emerged in humans in Saudi Arabia in 2012, but has now been traced back in camels to at least 1983.

Almost all the outbreaks so far originated in the Arabian Gulf, but MERS-CoV could infect humans wherever there are one-humped dromedary camels – two-humped bactrians are not affected.

That means people across a swathe of Africa, the Middle East, Pakistan and South Asia are potentially at risk. So the hunt is on for vaccinations – both for humans, and camels.

“The virus is in camels everywhere. The virus is in Qatar, it’s in United Arab Emirates, it’s wherever we look,” said Maria Van Kerkhove, a disease outbreak expert at the World Health Organization (WHO), where 130 experts gathered last week to collaborate for the first time on tackling the disease.

“I know so much more about camels than I ever thought I would,” she said.

People have probably caught MERS in Africa but the absence of outbreaks recorded there may be due to poor disease surveillance, less contact with camels, or lower rates of underlying conditions like obesity and heart problems that make MERS more severe.

Saudi Arabia has been heavily criticized for not being transparent about MERS, but Van Kerkhove said that had totally changed. It is now testing 70,000 human samples a year and generating a vast amount of research.

DRIVE-THRU

MERS is hard to spot, and far more deadly than other acute respiratory infections, killing one in three sufferers.

It has a habit of infiltrating Saudi hospitals via patients visiting for regular dialysis or cardiac appointments, causing outbreaks that have killed patients and health workers alike.

Hospitals are raising their game.

“One hospital even has a drive-thru. Literally a drive-thru in their emergency department,” said Van Kerkhove, explaining how patients are vetted before being allowed in.

“You drive up in the car to the person in the booth and they ask you three questions. It takes less than 13 seconds.”

A dozen human vaccines are in development, with vaccine coalition CEPI expected to announce soon which it will fund.

But the key to stopping human deaths is controlling MERS in camels. Two camel vaccines have been developed, but only one, developed by the Jenner Institute, is in field trials.

The other, developed at the Erasmus Medical Centre, is still seeking funding. The WHO MERS program is also under-funded, Van Kerkhove said.

At last week’s meeting, hosted by the WHO, animal health body OIE and the U.N. Food and Agriculture Organization, Saudi and Qatari experts were “happy to talk to each other” despite their governments’ diplomatic friction, she said.

Collaboration is vital, because camels must be diagnosed, quarantined and vaccinated as they enter the Gulf from the Horn of Africa. The virus must be tracked like bird flu is in birds, Van Kerkhove said.

But there is a long road ahead.

“I’ve never seen a really good map showing where camels move,” she said.

Reporting by Tom Miles; Editing by Mark Potter

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Have you gotten your yearly mammogram?

Over 220,000 women are diagnosed with breast cancer each year, making it one of the most common cancers in women. Getting a yearly mammogram is the best way to find breast cancer early.

Mammograms are breast cancer screenings that can detect a lump up to 3 years before you or your doctor can feel it. This helps to detect breast cancer early, when it’s most treatable. All women between the ages of 50–74 should have a mammogram every 2 years—and Medicare covers mammograms at no cost if your doctor accepts assignment. Talk to your doctor about the benefits and risks and to schedule your next screening.

October is Breast Cancer Awareness month—help fight breast cancer and get your yearly mammogram!

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