Obesity is a chronic and relapsing disease. Since 1975 its prevalence has nearly tripled. Over 1bn people worldwide are obese, according to the World Health Organization, with the number expected to almost double by 2035. More sedentary lifestyles, combined with the rising availability of cheap processed foods, mean it is a problem for both rich and developing countries. Overweight and obesity is the fifth leading risk for global deaths, and results in a higher prevalence of knock-on illnesses including diabetes, heart disease, certain cancers and more severe symptoms of Covid-19. The social stigma that comes with it can also lead to mental illness.

The effectiveness of a new class of weight-loss drugs such as Wegovy, so-called GLP-1 receptor agonists, underscores the vital and innovative work of pharmaceutical scientists. The injection works by suppressing appetite and slowing the movement of food through the gut. In clinical trials, those on semaglutide, the chemical used in Wegovy, lost 15 per cent of their body weight. US company Eli Lilly has also applied for regulatory approval to use its diabetes drug Mounjaro to treat obesity.

The financial dividends will be vast. Investors will be focused on the projected $200bn market value within the next decade. But the potential to reduce the strain on government budgets will be most significant, just as demands for health spending rise more generally. The World Obesity Federation expects the economic cost of overweight and obesity to reach 3 per cent of global gross domestic product annually by 2035 — on par with the impact of Covid-19 in 2020. This includes the impact on healthcare expenditure, reduced productivity at work, and premature retirement or death.

For all the benefits, there are risks that need to be carefully managed. First, there is limited understanding of the drug’s long-term impact and this will need to be closely monitored. Second, the drug will initially be expensive. Private patients in the UK are expected to pay up to £300 per month. As more companies come into the market, and patents expire, prices will fall. But, in the interim, governments need to ensure that the most needy, including those on lower incomes and at a higher health risk, are prioritised for subsidised access — while those using it for cosmetic purposes should pay the market price.

Above all, the drugs must be considered a complement rather than a replacement for broader weight-loss measures. There is a risk that both health and cosmetic users fail to make other important lifestyle adjustments. Users in trials often put weight back on after stopping treatment.

As the drugs become more prevalent, public information campaigns on poor diet, exercise and the misuse of weight-loss medication will be essential, alongside informative food labelling and access to gyms. For the less well-off, who may be priced out of superfood diets or fitness memberships, this will have greater significance. Wider access to effective weight-loss drugs will be a boon for global welfare. But it should not become an opening to less healthy habits.

This story originally appeared on: Financial Times - Author:The editorial board

Britons are showing signs of losing faith in the service to deliver for them. An annual attitudes survey last autumn — even before a crippling winter crisis — found satisfaction with the NHS had slumped from a record 70 per cent in 2010 to 29 per cent; dissatisfaction was at 51 per cent. Little wonder: the aftermath of the pandemic pushed the waiting list for elective treatment in England to 7.4mn in April (the four UK nations each run their own NHS). But the UK has long been in the bottom half of OECD countries on numbers of doctors, nurses, or scanners by population, though it is in the top half on spending. Five-year survival rates for common cancers are among the worst in wealthy countries.

The government’s workforce plan seeks to reduce NHS vacancies running at 8 per cent in England, and its reliance on overseas recruitment, by doubling training places for doctors and nearly doubling them for nurses by the decade’s end. Extra spending of £2.4bn over five years is promised. The NHS could then have 60,000 more doctors and 170,000 more nurses by 2036-37. Yet filling vacancies and retaining people will also require progressively reversing the past decade’s erosion in real pay and working conditions. Today’s NHS operates in a far more global market than in 1948. And though hiring more managers is less popular with voters, the NHS also has too few for a staff of 1.4m.

Relieving pressure on the NHS needs action in two key areas beyond the service itself. One is a push to improve public health and illness prevention, to reduce numbers needing treatment. Public health is the responsibility of local authorities in England, but — while the NHS itself was partially shielded — their funding plunged in the “austerity” years of the past decade.

The other is large-scale reform of social care funding and organisation, to fill vacancies and expand provision. Too many hospital beds are “blocked” by patients who do not clinically need to be there but cannot be accommodated in community or social care.

The NHS has been debilitated by a squeeze on spending growth for much of the 2010s, compounded by post-Covid burnout. But capital spending on its fabric has been inadequate for much longer. Sustained investment is now needed in people, buildings and technology, when Britain’s tax burden is already approaching a postwar high. All political parties need to be honest with voters about the trade-offs.

The Financial Times has advocated a no-taboos review, on a cross-party basis, to examine how the UK health system is organised and funded, and what it might learn from overseas models. This should be tightly time-limited, and clearly focused on patient outcomes and how the system should be structured to meet them. The Pensions Commission set up by the Labour government in 2002, which took the political heat out of raising the state pension age, offers a possible model.

A 75th birthday is a moment to celebrate the NHS’s many achievements. It is a time to reflect, too, on how it needs to adapt for a very different era.

This story originally appeared on: Financial Times - Author:The editorial board

European asset managers Legal & General Investment Management and Amundi are among those targeting the fast food giant McDonald's at its annual meeting on Thursday. They are pushing the company to stick to World Health Organization guidelines on antibiotics use across its supply chain.

This story originally appeared on: Financial Times - Author:The editorial board

Vapes are still relatively new products, and their long-term effects on health are unclear. Evidence suggests their vapour can contain substances that can cause lung disease, heart disease and cancer, though in far smaller quantities than cigarette smoke. Nicotine can harm brain development in young people, and lead to mood and attention disorders. Research in animals suggests early exposure to nicotine might make users more susceptible to addictive substances — including tobacco — later on. Studies indicate, however, that smokers find them a lot more helpful in quitting smoking than nicotine gum or patches.

This story originally appeared on: Financial Times - Author:The editorial board

Drug companies are irked by big clawback payments they are facing after drugs spending bust healthcare budgets in the past couple of years — in large part due to Covid-19 and the post-lockdown demand surge. This is reducing net prices for pharma groups’ products even as they grapple with cost inflation — and when life sciences ingenuity produced the vaccines that tamed Covid.

There is annoyance that the UK is sticking firm to a voluntary cap agreed from 2019 that limited growth of the NHS bill for branded medicines to 2 per cent a year, however much it buys. If growth in the bill exceeds the cap, drugmakers pay back the extra. Pharma groups say this was never designed to cover a once-in-a-century health emergency; this year they will have to pay back £3.3bn, or 26.5 per cent of sales — up from 5 per cent two years ago.

This story originally appeared on: Financial Times - Author:The editorial board

While the world is now better prepared to deal with a wave of Covid cases from China, significant health risks remain. Strong vaccination rates means many nations are already learning to live with the virus. But in developing countries, where inoculation remains weak, there continues to be vulnerability. There are also concerns that China may again be lax in sharing data on evolving strains that could drive new outbreaks, and that health services could be stretched over the fluey winter months. Indeed, after years of seclusion, demand for international travel among China’s 1.4bn population is soaring.

The world needs to tread with care. In China, tens of millions are being infected daily. The death toll is obscured by Beijing’s recently narrowed definition of Covid-19 fatalities — but bodies seen at hospitals and crematoria paint a grimmer picture. Plans to lift quarantine requirements for inbound travellers, remove caps on flights arriving into China and ease outward travel bring significant risks from a country that under “zero-Covid” built up little immunity. Vaccination rates are low among the elderly too.

This story originally appeared on: Financial Times - Author:The editorial board

The enthusiastic response of Alzheimer’s experts — who are using terms such as momentous and game-changing — is understandable. For decades researchers have failed to find a way of altering the personality-destroying course of the disease. More than 50mn people worldwide are living with dementia and the number is projected to exceed 150mn by 2050.

The trial is an encouraging demonstration that the disease can be treated by removing beta-amyloid, the gungy protein that gums up the brain as Alzheimer’s progresses. It should inspire an intensified drive to develop drugs that work better than lecanemab and can be prescribed to millions.

A healthy flow of future drugs that could make a real impact on Alzheimer’s and other forms of dementia will depend on nourishing the scientific roots of research and then helping promising projects across the “valley of death” from the labs where they begin life to larger drugs groups whose medical, marketing and manufacturing muscle can guide them through the regulatory process and into patients. More initiatives like the Dementia Discovery Fund, a public-private partnership based in the UK, are needed.

This story originally appeared on: Financial Times - Author:The editorial board