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  1. Europe faces HIV surge

    Europe and the former Soviet Union countries are failing to turn the tide of the HIV epidemic, according to stark new figures published yesterday.

    In ten years the number of cases in central Asia and eastern Europe has doubled - largely, it is thought, because of abuse of injecting drugs.

    To the west, the countries of the European Union and its allies have also failed to turn the tide, according to the World Health Organisation.

    Across Europe and central Asia some 136,000 new cases of HIV were diagnosed last year, according to WHO - an increase of 80% in ten years.

    This included some 105,000 in eastern Europe and central Asia together with 29,000 in the European Union and the European Economic Area.

    WHO regional director Zsuzsanna Jakab said: “Europe has not managed to reach the 2015 Millennium Development Goal target to halt and reverse the spread of HIV/AIDS, and time is running out.

    "While we are increasingly facing emerging health threats, this reminds us that we cannot afford to drop our guard on HIV/AIDS."

  2. Drug treatment progress slowing

    Drug addiction services in the NHS show disturbing signs of losing momentum, health officials warned yesterday.

    About 200,000 people a year receive treatment for addiction and fewer than 30,000 are recorded as recovering from addiction.

    Public Health England said there had been little change in these rates in the last year - together with the first increase in the number of people starting treatment for heroin or crack cocaine in six years.

    Some 46,001 people began treatment in the last year for heroin or crack cocaine addiction compared with 45,739 the previous year. There were also increases in those treated for cannabis and for powder cocaine.

    The figures show a total of 193,198 people in treatment during the year and 29,150 reported as recovering.

    But the figures conceal the growing age of addicts. There were more over the age of 40 and fewer under the age of 25.

    Rosanna O'Connor, of Public Health England, said: “The clear message we’re hearing from these figures is that drug treatment is working well for many, but there are early signs that recovery rates are slowing.

    "There is a continuing need for increasingly tailored approaches to support a range of complex needs among some drug users."

  3. Physicians oppose assisted suicide laws

    Physicians yesterday maintained a tough stance against assisted suicide - although there are signs of a shift of opinion.

    Nearly two thirds of members of the Royal College of Physicians said a change in the law was not needed - and slightly fewer opposed any legal change to permit doctor-assisted suicide.

    Nearly 7,000 doctors took part in the consultation and 37.5% backed a change in the law.

    The college said this was a significant shift since 2006 when 26% supported a legal change.

    The vote means two of the key organisations representing the doctors who might be involved in assisted dying remain opposed to it.

    The British Medical Association earlier this week launched a major research project on the care of the dying and concerns about assisted dying, stressing it wanted to explore "emotional" as well as ethical concerns.

    The college consultation found that some 21.4% of physicians would be prepared to participate in assisted dying - although 20.1% declined to say what they would do. These proportions have increased fractionally since 2006 when 18.9% said they would participate.

    Its members also failed to give majority support to the college being publicly opposed to assisted dying. Some 31% said it should be neutral while 44.4% said it should be opposed.

    Dr Andrew Goddard, from the college, said: "These results give us a basis for our position on assisted dying and for responding to proposed legislation, now and in the coming years. 

    "Whilst there is still a majority against a change in the law, we recognise there has been a shift in opinion over the past eight years, and will continue to engage with members and fellows on this issue."

  4. Innovation law under fire

    The Medical Innovation Bill tabled by Lord Saatchi risks “opening the door to the use of less proven, or unproven, approaches such as complementary or alternative medicine”, leading British doctors claimed last night.

    An editorial in The Lancet Oncology warned that the Bill, which is going through the House of Lords, struck at the heart of evidence-based medicine.

    It says although it would be laudable if – as its proponents say – patients’ lives could be saved by use of innovative medical practice, allowing doctors to abandon conventional medical treatment without fear of litigation and outside of clinical trials.

    However, it is untrue, continues the editorial.

    “Doctors are already able to innovate outside the context of trials. Many oncology drugs are used off-label (especially towards the end of life), and equally, many medicines are only approved for adults and must be used off-label for children.”

    In fact, the Bill could ultimately harm to patients, says the editorial.

    Although doctors can access drugs that are in early-stage clinical trials, provision of these agents are “on a desperate whim”. In an unmonitored environment, it could lead to patient harm, it warns.

    This is because appropriate dosage may be unknown, which could cause medical problems.

    “Even if the drug had advanced to later testing, but is not yet licensed, pharmaceutical companies would be required to disclose data about toxicities to national licensing agencies only.

    “Doctors could end up prescribing drugs that hurt their patients, only to find later that the toxicities were known, but undisclosed. Not only would this cause otherwise preventable harm to patients (clearly at odds with the founding tenet of medicine to “do no harm”), but could cause immeasurable psychological pain for doctors who believed they were providing the best care for their patients.”

    Undermining the Hippocratic Oath: the Medical Innovation Bill. Lancet Oncol 28 November 2014.



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