Sugar, Spice & this fortnight's IWD Podcast 💕

& an update on a medical condition that went viral because Kim Kardashian had it (just not visibly)

Mar 17, 2024

Dear Friend of Global Health Conversations,

How are you this evening? I’m hoping that you’re well and up for a little Sunday reading. :)

It was a busy fortnight and this is reflected in my fairly slim pickings of reading and listening recommendations. The Fortnight in Resources below has a few recent headlines from different areas. I spent time with those close to me both in London and Geneva, including rather dramatically watching the Love is Blind Reunion while enjoying baked goods with Leena.

I also got into my first ever full blown argument with an AI image generator, which, despite my explicit wishes, was absolutely fixated on incorporating rabbits into every image. This frustratingly culminated in an image absolutely strewn with rabbits hidden here and there in every corner. I could have made a game out of counting them. I eventually used up my quota which brought the whole thing to an end. We haven’t spoken since.

In light of International Women’s Day, today’s podcast episode focuses on cervical cancer and how it disproportionately affects women in poverty. I also read an interesting World Bank press release and article in the Guardian that found that inequities in the workplace were larger than predicted and exist in every country. It got me thinking about many of the ‘male-coded’ phrases that are common in workplaces - such as those referencing sports or war. And I wondered how we would fare with ‘women-coded’ phrases like ‘Let’s get some setting spray on that'.

A highlight of my weekend, apart from finishing two of my reads mentioned last fortnight in the Neglected Diseases issue, was interviewing Dr Ema Prohić, dentist, on the role of oral health in public health. Ema and I worked together on a public health project years ago wherein she encouraged the introduction of oral health education in primary care prenatal care programs. Our interview was super broad and will be released in two parts - covering health system challenges, incentivization systems, anaerobic bacteria in the mouth, proper brushing and the true public health cost of poor, population level oral health. The episode will be available on Sunday 31st March.

I’m always contactable in response to this email and I love every time someone writes to me with feedback, an opinion or just to say hi!

Until next fortnight, Friend. 🙃

Today’s Episode:

Episode 16: Tackling Cervical Cancer: Health Equity in Focus (International Women's Day Special)

This fortnight, in recognition of International Women's Day, we talk about cervical cancer and discuss its significance as a symbol of global health disparities and gender inequality. Cervical cancer incidence is exacerbated by socio-economic factors and disproportionately affects women in poverty.

We discuss the importance of HPV vaccination, regular screening, and innovative prevention strategies like diagnostic tools to enable self-sampling. And the incredible toll of the devastating disease.

1. Recent R&D for Psoriasis Treatments

Many people hadn’t heard of the skin condition, Psoriasis, until Kim Kardashian revealed that she suffered with it on a 2011 episode of Keeping up with the Kardashians.

Arguably, the celebrity is the most famous plaque psoriasis patient; and has apparently claimed to rely on topical ointments, both prescription and herbal, home remedies such as breast milk applied topically and sea salt baths. Psoriasis is a serious skin condition that can have serious cardiovascular effects, alongside other physical and emotional ones. So here’s an update from the past fortnight on pretty exciting advancements in R&D for novel therapeutics.

Some recently published research promises to significantly advance the treatment of psoriasis, with long-term studies highlighting the efficacy of a few novel therapies. Deucravacitinib, a TYK2 inhibitor, has shown promising results in improving Psoriasis Area and Severity Index (PASI) scores over three years. This outcome was recently presented at the 2024 American Academy of Dermatology Annual Meeting.

Concurrently, TAK-279, another oral TYK2 inhibitor, demonstrated its ability to modulate psoriasis biomarkers and pathways significantly. This was evident in patients achieving clinical success in a phase 2b trial, where substantial correlations between PASI improvement and histological responses were observed. The trial showcased TAK-279's capacity to inhibit a critical inflammatory pathway in psoriasis, suggesting its utility in high-level clinical management of the disease.

And finally, Johnson&Johnson’s JNJ-2113, targeting the IL-23 receptor, reported high skin clearance rates over 52 weeks in a Phase 2b clinical trial, too. This investigational oral peptide offers a novel approach to psoriasis treatment by blocking a key receptor involved in the disease's inflammatory response. Together, these developments represent a shift towards targeted oral therapies in psoriasis treatment, promising improved long-term management and patient outcomes. And in due course, if all goes well; less reliance on the supposed topical application of breast milk.

2. AZ UK Update on building vaccine manufacturing capacity for pandemic preparedness

Currently, Belgium is the epicentre of biopharmaceutical manufacturing in Europe. In this fortnight’s update, AstraZeneca plans to invest £650 million in the UK to boost the Life Sciences sector and enhance pandemic preparedness. The investment includes £450 million for a new vaccine research, development, and manufacturing facility in Speke, Liverpool, aiming for operational net zero with renewable energy. Additionally, £200 million will go towards expanding AstraZeneca's presence in Cambridge, employing 1,000 people. This move, supported by the UK government and contingent upon regulatory approvals, signals confidence in the UK's Life Sciences capabilities and aims to improve the country's resilience against future health threats while generating high-skilled jobs and fostering innovation. I would say more, but I’m saving my biomanufacturing speech for later. :)

3. The Pandemic Accord

Check out these past newsletters: here & here for recent updates on the INB negotiations and the Pandemic accord. I haven’t gone into it here, but here is a video of WHO Director General, Dr Tedros Ghebreysus commenting on it in Azerbaijan this week. And click here for the most recent update on the next phase.

4. Highlighting the Mental Health Effects of Climate Change

The intersection of climate change and public health, including mental health, is drawing increasing concern. This an area that I didn’t know too much about; except, perhaps, a vague understanding of the concept of Climate Anxiety.

I was reading up on Climate & Health and fell down this rabbit hole. Research underscores the necessity for policy and decision-makers to act swiftly to mitigate the adverse health impacts of climate change. Despite clear evidence linking climate change to severe public health risks, including heightened mental health issues post-extreme weather events, increased rates of infectious diseases, and worsened air quality, decisive action remains lacking. Key to addressing this inertia is bridging the significant gap in context-specific evidence, especially in low- and middle-income countries, to inform effective policy and adaptation strategies.

Innovative solutions like the E-DENGUE digital tool, which aims to predict dengue outbreaks in Vietnam, signify a proactive approach to health crisis management amid climate change. Meanwhile, the Wellcome Trust is focusing on generating and disseminating scientific evidence on climate change's health effects. Emphasizing the health implications in climate change communications may spur more significant action than broader environmental or economic impacts.

Furthermore, rising global temperatures contribute to an increase in mental health challenges, such as heat-related stress and the spread of infectious diseases, which can exacerbate mental health conditions. There's also a growing acknowledgment of climate-related psychological reactions, like climate anxiety and ecological grief. These impacts are disproportionately felt by vulnerable populations, underscoring the need for comprehensive strategies that include mitigation, adaptation, and the promotion of mental health resilience amidst climate change.

Behind the scenes:

Listening to Adele’s 30 album on vinyl; hanging out with Alison and a truly London sized puddle! I also celebrated lovely friends’ birthdays. And spent the past two weeks with very full, but also fulfilling days. (No rabbits here, sorry to say. Boycott in progress)

Next Fortnight’s Podcast Episode:

Dental Dialogue: The Role of Oral Health in Public Health (ft. Ema Prohić)

In this episode we discuss oral health as a public health issue. Discussing system challenges, incentivisation and disincentivasation, dental caries as the most common infectious disease, bacteria and the use of antibiotics. Ema is a doctor of dental medicine from Croatia, currently undertaking her specialization in orthodontics and facial orthopedics in Barcelona, Spain. She started her professional career as a dentist in the UK after completing her MSc in International Health Management at Imperial College Business School and has continued working in the UK in several dental practices as an NHS and private practitioner.

Watch my cheeky behind the scenes video from the remote recording of this episode with Ema.

Part 1 of the full Podcast episode will be available on Global Health Conversations on Sunday 31 March.

Recent Podcast Episodes: In case you missed them! 💃🏾

Episode 13: Non Disease Related Causes of Death: Gender-Based-Violence, a public health issue

‘These are the ways in which women disproportionately die prematurely because of being women’. Throughout this episode, you will hear me use this phrase as I walk through the ways that gender based violence impacts the right to long and healthy life; as well as the real life stories of survivors told in their own words. Fortunate to have lived but with life long scars - physical and emotional.

Episode 14: What does Sustainability look like in the Pharmaceutical Industry? (ft Elisabetta Marani)

We talked about circular economy, greenwashing, net zero carbon emissions goals, the role of sustainability in Pharma, practical solutions and access to medicines as a key objective of the industry alongside furthering environmental sustainability aims. If you are a young professional interested in this area - be sure to listen to the end as Eli provides her expert advice for you. If you are not a young professional, be sure to listen to the very end for Eli's advice as to how we can all make a difference in our personal spheres of work.

Episode 15: Why do Americans pay (so much) more for healthcare?

In this solocast we discussed the cost of medical care. Particularly, I attempted to answer the question: Why do Americans pay (so much) more for healthcare? With my health economist hat on - I looked into transparency, drug prices and administrative costs. But are these only reasons that the US has the world’s third highest out of pocket health expenditure? And, moreover, how does this affect patients and patient outcomes?

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Yours,