What we’re reading . . . A wish list, lessons from the last century, and the inequity of agony

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MSF’s 2018 Wish List – From stopping the preventable toll of the world’s leading infectious disease killer by accelerating access to the treatments that cure tuberculosis, to protecting generic drugs, to putting vaccines within reach of children who now die from pneumonia at a rate of one every 35 seconds, this wish list from Médecins Sans Frontières envisions a world in which life-saving medicines are equally available to all who need them.

We’re not ready for a flu pandemic – Lessons from the impacts of the 1918-1919 Spanish flu epidemic linger, but in spite of a century of medical progress since, have not driven measures to contain the next outbreak the authors of this New York Times op-ed write. Instead, on a planet both more densely populated and closely connected a century later, we stand more vulnerable to an airborne epidemic than ever before, with vaccines of limited effectiveness and even more limited availability. The current flu season highlights those deficits, as well as the need for the development of a durable and universal vaccine. The authors call for a “Manhattan Project-scale effort” to defend against a scenario they say is both unthinkable and, without concerted commitment, inevitable.

The NHS at 70 and Alma Ata at 40 – This editorial celebrates two events driven by the aim of medical access based on need, rather than resources, and built around patients rather than diseases, while it notes challenges to both the United Kingdom’s National Health Service and the Alma Ata Declaration have demonstrated that accomplishing — and sustaining — systems of universal health care means building and retaining a well-trained and well-compensated work force as well as ongoing commitments from policy makers.

Prisoners of pain – The statistics cited early in this article are harrowing — with just 14 percent of the 40 million people getting medicine needed to manage pain at the end of their lives, about 25.5 million people experience agonizing deaths unnecessarily. Costs and the accompanying need to prioritize life-saving care are two of the reasons, but another is “opiophobia,” particularly in countries with developing economies with fears that the medicines will be abused leading to tight restrictions on their use and failures to train for their proper administration.

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