Friday, January 25, 2008

Bill Gates challenges world leaders at Davos to adopt "Creative Capitalism"

It's great to see the richest man in the world Bill Gates, at the World Economic Forum in Davos, Switzerland, talk about finding ways "to make the aspects of capitalism that serve wealthier people serve poorer people as well."

The Wall Street Journal has a good write-up of his speech here, and a video of the full speech is available here. I think Gates' idea of "creative capitalism" deserves a more in depth look, especially the thoughts about harnessing the best of business, government and charities to tackle the enormous problems of healthcare and poverty.

When so much of the news in healthcare these days is about corporate apathy and malfeasance, it is wonderful to hear someone who has been treated so well by capitalism speak up for people who have not.

It is also wonderful to see the Davos Question so popular on YouTube.

Here are some highlights from the Science forum at Davos.

Friday, January 4, 2008

An Intel Approach to Meds.

I came across this Newsweek article a little while ago and I thought I would share it with you along with my thoughts:

According to the article, former Intel CEO Andrew Grove commented that the pharmaceutical industry could learn a lot from the semiconductor industry. Please read the article for details.

While I agree with the spirit of some of what Mr. Grove is saying, I believe that the comparison between the medical device and pharmaceutical industries with the semiconductor industry is flawed and a bit unfair.

Besides, of course, the moral and ethical responsibility to ensure as best as possible that a medical product will not maim or kill the patient, the largest hurdle to getting a product onto the market is the lengthy and costly government approval process it has to undergo to be approved for legal human use.

Just a little background - in the United States, the approval process is regulated by the Food and Drug Administration (FDA). The FDA drug approval process is summarized here and the FDA medical device approval process is described here.

If all this sounds to you like huge amounts of work, it is. But remember that it is this way for good reason - to protect patients' health and public safety.

Even with the regulatory process as it is, things slip through, medical products are recalled and people still die. Remember the cox-2 inhibitor drugs like Celebrex and Vioxx that were recalled because some of the people who took this drug for arthritis were dying from myocardial infarction and stroke.

In the medical world, you don't get a second chance. If a product has hurt or killed someone, it is very hard to regain the trust of doctors to give it another go, even if it has been vastly improved by the developing company.

In some cases, the faulty device doesn't even have to come from your own company. One company I worked for was developing a staple for heart bypass surgery that had some great pre-clinical data. A smaller company that got to clinical trials faster ended up with dead patients, which put surgeons off of the entire class of device. Talk about poisoning the well.

Also, remember that large corporations stand to lose a lot due to product liability lawsuits if their product results in unexpected damage or death. So companies tend to be very thorough with their testing and approval submissions. And they tend to be very, very slow and conservative in nature.

I believe it also makes them inclined to bet on the "safe projects" that provide the best predicted return-on-investment rather than on products that potentially are the most efficacious, or the ones that might have the most impact on global health.

I'm not trying to defend these companies or justify the decisions they make. But I think it is important to understand the preconditions that might help to explain why the companies behave as they do. Things are always more complex than they at first seem.

I agree that things do happen too slowly, especially for those whose hopes for health and survival depend on breakthroughs that these companies promise to deliver.

Academia at times does seem too focused on obscure academic things, and corporations seem too focused on risk reduction and maximizing the bottom line. In the mean time, the public at large seems to be losing out. Big time.

So what do we do? Anyone have any thoughts?

Thursday, January 3, 2008

Funny moments for doctors.

All right. Maybe I should continue to alternate between serious blog entries and more light-hearted goofy ones. Here is a list of funny medical moments submitted by doctors.

Now while I can't vouch for whether these are real submissions by real doctors, I can verify that they are all pretty funny. Remember to always consider your sources when reading something, but in this case, it doesn't really matter because, heck, this might actually make you crack a smile.

(MILD CAUTION: Some of these are of a mild sexual nature, so don't click on the link if that's not your cup of tea. But then again, if that's you, you probably shouldn't be surfing the internet anyway.)

Here it is:

How It All Ends.

While not about health care per se, I found this series of videos on Global Climate Change to be intelligent and fascinating. And if the worst case scenarios of GCC were to come to fruition (God forbid), we will have, amongst myriad other disasters, a health care crisis like none the world has ever known.

Definitely watch the first video "How It All Ends" and pick and choose others that you think you might like. I found "Nature of Science," "Risk Management," "Mechanics of GCC" and "Scare Tactics" to be particularly interesting.

In a show of utter procrastination, I watched all six hours of videos, but you don't have to do the same. Be aware though that the videos are addictive, and you may end up clicking on link after link until six hours have passed by, and then your wife or girlfriend turns to you and asks you what the heck you are watching on the internet at two in the morning.

Here it is -- the link to a website that has all the videos in sequence:

And here is the first video "How It All Ends" on YouTube:

Oh my!

And here you thought this was going to be a serious blog. No seriously.

This is the strangest Christmas present idea I've seen all year. Give the gift that keeps on giving - send your loved ones herpes (in plush toy form) here.

The website has an entire section on venereals (other choices include gonorrhea, chlamydia and syphilis), as well as calamities (such as ebola, typhoid and mad cow). Or how about sending your loved ones some staph, MRSA or toxic mold? Don't you wish all microbes were so cute and cuddly?

Tuesday, January 1, 2008

Happy New Year!

On this the first day of 2008, I wanted to wish everybody a Happy and Healthy New Year! Cheers from London! Be well and be safe.