Sunday, August 25, 2013

Mike Huckabee Talks Cure Strategy

On his "Huckabee" show on Fox News just now, Mike Huckabee said that we need an Apollo Program against disease, or a Manhattan Project.   He didn't shy away from the issue of federal involvement--saying that yes, the government would have to invest more.   But at the same time, he emphasized that if such investment--coupled with tort reform and other streamlining--could lead to health breakthroughs, it would pay for itself.  After all, just about anything is cheaper than spending $1 trillion a year on Alzheimer's Disease by mid-century.

Speaking of illnesses such as Alzheimer's and diabetes and their costs, he asked, "Why don't we try to eliminate them?... It would be a magnificent effort. Not just treat disease, but eliminate it."   Inspiring words.  

He added of such an effort, "Think about what it could do for the economy."   That is, not just saving money for the government, health insurers, and individuals, but also creating jobs in new industries. 

To be sure, the whole hour of the "Huckabee" show was devoted to much more than just the Cure Strategy.  The former Arkansas governor offered a broad-ranging critique of the status quo, citing his own experience as executive of his state's Medicaid and other public health programs.

He sharply critiqued the Affordable Care Act, aka, Obamacare, and he emphasized the importance of healthier personal behavior and prevention.  All important issues, to be sure.

But most notably, he also introduced a new concept--a new concept, at least, to the political and policy world of Washington DC--and that is, cures.   A cure is better than care.  The Cure Strategy.

The Cure Strategy portions of the show appear at about 35 minutes into the hour--the show reruns tonight, Sunday, at 11 pm ET.   And clips should soon be available on the Fox News site.

Saturday, August 24, 2013

Alzheimer's Dementia Time Bomb--How 'Bout a Proactive Strategy of Treatment and Cure?

If the ravages of Alzheimer's Disease are a humanitarian and financial "time bomb," as UK Health Secretary Jeremy Hunt suggests, then perhaps it would be worth a national/international focus on better treatments and cures.   No matter what sort of financial arrangements are made, the impact is going to be catastrophic.  A cure is cheaper--and, of course, better--than care.

These points, from The Telegraph article, do, indeed, paint a dire picture.  But the strategy of helping workers rearrange their work schedules to deal with eldercare issues seems inadequate to the overall challenge.

We should be striving to do to AD what we did to polio: make it go away.  That's an argument that is sadly unheard in political circles. 

Tuesday, August 20, 2013

"The Immortality Financiers: The Billionaires Who Want to Live Forever"--But Just One Thing

The tech billionaires listed in this Daily Beast article--including Larry Ellison, Sergey Brin, and Peter Thiel--might find more success in their quest for immortality if that quest were more realistically defined.

That is, rather than shooting for the moon on immortality--with all the infinite moral and ethical quandaries that emerge therefrom--they might focus on a war against disease, including the as-of-now-invincible Hayflick Limit, which casts a dark pall on any bright hopes for significantly longer life. 

If so, then the optics of the struggle would shift from private to public.  That is, the better-health/longer-life issue should shift from private vanity to public policy.  And that's good news, ultimately, for all concerned. 

While a billionaire-boutique effort might be better than nothing--and as argued here many times, the drying up of the medical-cure pipeline is a serious and budget-busting issue--a true public-private partnership and a national or international mobilization beats everything else.   

The bigger the better.  Scale is your friend.  

The billion-and-first iPhone is better--and certainly more reliable--than the prototype of something different, no matter how grand its ambitions. 

As we were reminded with Mitt Romney's Orca get-out-the-vote program, one doesn't want to be the first to use something complicated and technical.  I would feel safer riding in a plane from Boeing--backed by a century of R&D, much of it financed by the Pentagon, as well as many millions of pilot hours--than in some contraption that just came out of the skunkworks.   Thrill-seekers and would-be record-breakers can get in anything they want, of course, but they know the dangers. And the statistics confirm that such dare-devilry is, indeed, dangerous.  

If Ellison, or any of these others, is willing to be the very first person to try the new potion, well, that's okay.   But the moment that he gets into testing it on anyone else--be it duped Third World peasants, unwilling Chinese prisoners, or even highly paid volunteers--that's when the trouble will come.   Issues of right aside, this is an NGO world, and an NGO world with cellphone cameras and Twitter.  

So billionaires are best off learning from the successes of the past.  If they study history, they will realize that the best way to truly get this done is the way the railroads got their way in the 19th century, or AT&T got its way in the early 20th century--or the polio vaccine in the mid-20th century.  That is, by building a robust political framework around their enterprise, shielding them from liability, rent-seekers, etc.    

That's the time-tested way to get this done.  I argued this historical point here, on August 2. 

Sunday, August 18, 2013

George Will on the Cure Strategy

George Will writes:

For Francis Collins, being the NIH’s director is a daily experience of exhilaration and dismay. In the past 40 years, he says, heart attacks and strokes have declined 60 percent and 70 percent, respectively. Cancer deaths are down 15 percent in 15 years. An AIDS diagnosis is no longer a death sentence. Researchers are on the trail of a universal flu vaccine, based on new understandings of the influenza virus and the human immune system. Chemotherapy was invented here — and it is being replaced by treatments developed here. Yet the pace of public health advances, Collins says, is being slowed by the sequester.

He entered federal service to oversee decoding of the human genome, which he describes as “reading out the instruction book for human beings.” We are, he says, at the dawn of the era of “precision medicine,” of treatments personalized for patients’ genetic makeups.

This will be, Collins believes, “the century of biology.” Other countries have “read our playbook,” seeing how biomedical research can reduce health costs, produce jobs and enhance competitiveness. Meanwhile, America’s great research universities award advanced degrees to young scientists from abroad, and then irrational immigration policy compels them to leave and add value to other countries. And now the sequester discourages and disperses scientific talent.

In the private sector, where investors expect a quick turnaround, it is difficult to find dollars for a 10-year program. The public sector, however, with its different time horizon, can fund for the long term, thereby drawing young scientists into career trajectories and collaborations impossible elsewhere.

We might note in particular the point that "Other countries have 'read our playbook,' seeing how biomedical research can reduce health costs, produce jobs and enhance competitiveness." 

Sunday, August 11, 2013

3-D Printing: "Robohand" and the Future of Prosthetics

A visit to the Makerbot retail store in Manhattan is an eye-opener, even for those who have been following the rise of 3-D printing over the last few years.  One can see--and touch--the dimensions of new breakthroughs in prosthetics (to say nothing of any other gave of physical object that might be manufactured).

Makerbot, headquartered in Brooklyn, has been around for a while, but it has chosen to create a showcase for itself in the East Village.    That's good, because now more people will see the potential of 3-D printing, including its potential for medical devices. 

Take a look at this "Robohand," or prosthetic hand, for example, pictured below:

The basic design was created by a man who had lost his hand, and, well, wanted another one.  So here it is: all the parts here were made by a 3-D printer, except for the bolts (which could be made by 3-D), and the cords.   It's functional and capable of grasping.   

So how much did it cost?   The machine to make it, from Makerbot, is $2200.  The material, the filament, is about $2.  The CAD/CAM software is free, one of thousands of such free programs from Thingiverse

We might ask: What will this same project look like a year from now?  And how much will it cost?  We all know the answer--if we allow this new technology to advance.

And of course, that advance is vital for many, including our Wounded Warriors, to whom we owe so much.  President Obama recently announced an additional $100 million for medical research and treatment; 3-D printing of prosthetics helps us see how that money could make a difference--not just for the benefit of Wounded Warriors, not just for anyone else in need of prosthetics, but also for the huge new industry now on the horizon.   Doing good and doing well--that's the magical combination of the industrial revolution and mass production.  

Here's another picture of another prosthetic device, alas, not as clear.  

And here, for what it's worth, is a picture of the description of the process by which this "Robohand" was made.   

Much more, of course, to be found on the Makerbot websites. 

The future is, indeed, bright.  

Thursday, August 1, 2013

The Needed Framework for Cures

Gillian Tett's thought-provoking article in the FT points to a looming problem--the public could be losing confidence in "Big Data"-ish strategies, even when they have nothing to do with the National Security Agency.

In particular wide-scale biomedical research will be caught in the downdraft of public anxiety over spying and privacy.

It's an interesting point, and Tett cites two possible solutions: private data centers, in which the data is anonymized, and popular subscription campaigns.

Both are worthy suggestions, but it's clear that nothing will work amidst public cynicism, skepticism, and even hostility.

It's going to take political leadership--backed up by leadership from other sectors across all of society--to reinstill public confidence.

That is, it's going to take a framework, not unlike that which the federal government created around infrastructure projects, such as canals and railroads, in the 19th century.  Or around the telephone, television, and Internet networks of the 20th century. 

"The disaster of the last decade of FDA regulation of antibiotic development..."

From David Shlaes' blog on antibiotics: "We explore the disaster of the last decade of FDA regulation of antibiotic development, the recent record of FDA antibiotic approvals and the state of antibiotic resistance in the US. In short, the FDA now realizes that their oversight of antibiotic development over the last 10-15 years has, in part, led to a dangerously thin pipeline of new antibiotics."

One might think that this would be a big issue in DC. 

Here's an earlier chart illustrating the dire situation: