'We are managing HIV with a selective lenacapavir roll-out, not ending it...'
Our latest in health-e on SA's drip feed LEN-LA roll out - with @africanalliance.bsky.social
- @hji-sa.bsky.social
LINK: 📲
health-e.org.za/2026/04/20/m...
In latest Medicine & Science @bmj.com Podcast-I join my co-author @mattherder.bsky.social & @kamranabbasi.bsky.social to discuss our recent Analysis (w. Andy Hill & @roojinhabibi.org) calling for WHO to declare USG a PHEIC also due to its 'unhinged nationalism'.
📲
podcasts.apple.com/ca/podcast/t...
While there is debate about that and other modelling studies, they all point to deaths in the millions in the years ahead.
Which is why we argued that the US' actions amount to a public health emergency of international concern in @bmj.com
www.bmj.com/content/392/...
On the contrary, it’s a public health emergency of international concern.
www.bmj.com/content/392/...
Today, MSF is going public with something we've been fighting behind closed doors for months: Gilead will not sell us their new HIV drug, lenacapavir.
The sticking point isn't even price, they just refuse to sell.
Open letter linked + explainer 🧵1/
www.doctorswithoutborders.org/latest/gilea...
WHO first recommended use of a 3HP (3 months of weekly rifapentine and isoniazid) short course of treatment for TB infection in 2018
Health Canada approved rifapentine this year!
No drug company cared to apply for registration until now... TB not "profitable"
www.stoptbcanada.com/news/respons...
ICYMI - Our analysis published in @bmj.com makes the case for @who.int to declare that the actions of the US under President Trump amount to a 'PHEIC' under the International Health Regulations.
CC @roojinhabibi.org @fatimahassan.bsky.social @gavinyamey.bsky.social @jocalynclark.bsky.social
MUST READ:
'The United States is driving a public health emergency of international concern'
@mattherder.bsky.social
@fatimahassan.bsky.social
A Hill and
@roojinhabibi.org
Via @bmjmedicine.bsky.social
www.bmj.com/content/392/...
Title: "The United States is Driving a Public Heath Emergency of International Concern"
www.bmj.com/content/392/...
New analysis published in @bmj.com where @roojinhabibi.org Fatima Hassan, Andy Hill & I argue the US -- through its actions -- creating a 'public health emergency of international concern'.
Multiple epidemics are expected, so we call upon @who.int to act decisively.
www.bmj.com/content/392/...
So up in Canada's North, the government will spend:
$35,000,000,000 to defend against theoretical military threat
$ 27,000,000 to defend against real ongoing threat of TB
Thinking of this comment on the #tuberculosis funding announcement:
Screenshot of the abstract of the linked paper, reading "Public health policy and practice are often described by means of a metaphor that depicts interventions as “upstream” efforts to prevent people from falling into a river, from which they must be rescued “downstream” by overwhelmed healthcare services. The upstream-downstream metaphor has been described as public health’s defining metaphor. We apply a commercial determinants of health lens to re-engage with the initial intentions of McKinlay’s seminal 1975 essay from which this metaphor emerged, and to critique its current uses. We examine how the upstream-downstream metaphor has come to be used in ways that depart radically from its original intent, which was to characterise the practices of powerful commercial actors who profit from the production of harm and disease. The subtle but important shift in language from people being pushed, to falling into the river, among other depoliticising processes, contributes to an individualising and victim-blaming approach to health harms, deflecting from the role of commercial power and practices. There is a pressing need to reclaim public health’s defining metaphor as part of the wider agenda to address commercial determinants as the major public health challenges of our time."
This is a neat paper.
"“Who the hell is upstream pushing them all in?” Reclaiming public health’s defining metaphor to counter the commercial determinants of health"
journals.plos.org/globalpublic...
Hope the study looks at significant policy changes that are under consideration right now, such as the proposed Order on Foreign Regulatory Reliance -- a move that's hardly consistent with sovereignty, as I argued in @thestar.com
www.thestar.com/opinion/cont...
Interesting study underway @ #HESA. Sure hope the committee hears from a broad range of stakeholders, not only industry perspectives which appear to comprise almost the entire first meeting today.
ICYMI
True. The joint review mechanism proposed is fine IMO & sharing info between regulators is good. Canada doesn't have the capacity to do foreign inspections at scale.
But that's not equivalent to rubber-stamping new drug approvals thru the 'general deeming' pathway envisioned in the proposal tho.
If you are concerned about this proposal, you can find its details and comment directly on its text via this link:L
gazette.gc.ca/rp-pr/p1/202...
The deadline to weigh in is Feb 28 @ 11:59 pm ET.
One thing I can tell you for certain is that at least some scientists inside Health Canada are alarmed by this proposal.
And given that it's part of the GoC's 'red tape initiative', I'm very worried that this mechanism will be used to justify job cuts to Health Canada's core scientific staff.
It's impossible to know what the intent of this proposal is unless GoC is more transparent about the list of eligible drugs and foreign regulators they plan to include within its scope.
Instead, I worry that this kind of process will be used by sponsors of new drugs that have been fast tracked in other countries, such as #aducanumab (often on the basis of surrogate endpoints) and have limited evidence of effectiveness but high prices.
My theory, tho, is that those + other products aren't here because of our relatively small market size and disinterest from sponsors.
I doubt, in other words, that this reliance procedure will attract those manufacturers to Canada.
I agree those medicines are needed in Canada as @healthlawadamh.bsky.social & co explain here:
www.cmaj.ca/content/195/...
How you view this proposal to rubber-stamp foreign decisions all depends on which kind of cases you are worried about.
As @healthlawadamh.bsky.social points out in this story in @theglobeandmail.com it *could* help effective #TB drugs to finally reach Canada
www.theglobeandmail.com/canada/artic...
I also explain how this mechanism, if in place in 2021, could have allowed the entry of #aducanumab into Canada. A drug USFDA approved for Alzheimer's disease but which our regulator + the European Medicines Agency effectively rejected due to its poor effectiveness and significant safety risks.
Which is why I draw the comparison in @thestar.com to the "tainted blood scandal" of the 1980s when Canada relied on the US for blood products (and USFDA licensed for export to Canada) and thousands of Canadians suffered harm as a result.
On its face, this mechanism - if implemented - would allow Health Canada to rely on the decisions of the US Food & Drug Administration.
That's the same agency that has been going to hell under President Trump and the anti-vaxxer RJK Jr. that he put in charge of the body that oversees USFDA.
It's especially troubling that the list of drugs and foreign regulators that are within the scope of this proposal have NOT been made public.
The GoC is consulting on the proposal till Feb. 28. But how can we comment intelligibly on the proposal when we have no idea of its scope!
But other parts of the proposal, esp. the provision that would allow certain classes of drugs that have received approval in another country to enter the market through a 'General Deeming' (read: rubber stamping) process is completely novel.
Some of what's being proposed has happened for the past several years. Health Canada already collaborates with regulators in other countries to review products. We've written about that here, for eg.:
www.sciencedirect.com/science/arti...
Just before the holidays, the GoC introduced a proposal that *could* create a pathway for new drugs (+ generics) to enter the Canadian market without the regulator vetting their evidence of safety & effectiveness.
That's a landmark change in Cdn law and creates risks to Canadians' health.