30 Nisan 2014 Çarşamba

The superbugs the WHO warns we need to worry


WHO officials have warned of a crisis that is threatening to turn these widespread infections, which are at present very easily taken care of with a brief program of medicines, into significant killers yet again.




Staphyococcus aureus (MRSA) – skin infections, wound infections, bloodstream infections, arthritis


Streptococcus pneumoniae – skin infections, sore throats, pneumonia, meningitis, bronchitis, conjunctivitis


Nontyphoidal Salmonella - diarrhoea


Shigella species - diarrhoea and dysentry


Neisseria gonorrhoeae – gonorrhoea




The superbugs the WHO warns we need to worry

The superbugs we must all dread


WHO officials have warned of a crisis that is threatening to flip these typical infections, which are at the moment effortlessly handled with a quick program of drugs, into key killers once more.




Staphyococcus aureus (MRSA) – skin infections, wound infections, bloodstream infections, arthritis


Streptococcus pneumoniae – skin infections, sore throats, pneumonia, meningitis, bronchitis, conjunctivitis


Nontyphoidal Salmonella - diarrhoea


Shigella species - diarrhoea and dysentry


Neisseria gonorrhoeae – gonorrhoea




The superbugs we must all dread

Stem cell remedy repairs broken hearts in monkeys

Stem cell heart repair trials

Cardiac cells derived from human stem cells (green) and monkey heart cells (red) in a photo issued by the University of Washington. Photograph: Murry Lab/University of Washington/PA




Scientists have efficiently repaired damaged monkey hearts by injecting new heart cells created from human stem cells, paving the way for a trial in people just before the finish of the decade.


Researchers now hope that the remedy could give individuals a new lease of lifestyle following huge heart attacks that trigger scarring and in the long run heart failure.


“When human embryonic stem cells had been 1st discovered, this is just the type of treatment individuals hoped they would lead to. We are optimistic, but we are also cautious,” stated Charles Murry, who led the crew at the University of Washington in Seattle.


The heart is 1 of the poorest organs in the body at repairing itself when it sustains injury. Right after a heart attack, muscle tissue in the heart dies off, and is replaced a month or so later on with scar tissue. This does not contract like regular heart tissue, so the heart is weakened and struggles to pump blood around the body.


Much more than 100,000 people have heart attacks in Britain every single year, and one particular in three dies prior to reaching hospital. Significant heart attacks are accountable for 750,000 individuals residing with heart failure in the United kingdom. But the productive trial heralds the chance of a new approach: “We believe we can do our first patient in around 4 years in a phase-1 trial,” Murry mentioned. The study is reported in the journal Nature.


Studies in mice and rats have previously proven that injections of stem cells can help to repair damaged heart muscle, but those animals have considerably various physiology and heart rates to people.


Sian Harding, director of the British Heart Basis cardiovascular regenerative medication centre at Imperial School London, called the operate a big phase forward.


“This is as close as you can get to placing these cells into humans. It truly is actually essential, simply because this is searching at a big volume of muscle, and that has not been accomplished prior to. It truly is what you are going to need in humans,” Harding stated. “It shows us you can make the muscle, hold it there, get the blood vessels in, and have it perform even at higher heart rates.”


Murry’s crew examined the process in four pig-tailed macaques and located that the cells assisted to restore heart tissue injury. The researchers induced small heart attacks in the monkeys by blocking a heart blood vessel for 90 minutes.


For the duration of the subsequent two weeks – ahead of scar tissue had time to kind – they injected one billion younger heart cells developed from human embryonic stem cells into and around the damaged heart muscle. The animals have been offered drugs to stop their immune techniques rejecting the cells.


Most of the injected cells – all around 90% – died off. But the remainder grew into fresh heart muscle that commenced to perform with the animals’ remaining healthful heart tissue. The cells formed connections with neighbours for passing electrical signals across, and blood vessels grew into the new tissue to provide it with oxygen and nutrients.


But the procedure did not go fully smoothly. All of the monkeys that acquired human heart cells developed irregular heartbeats, or arrhythmias, which lasted for two to 3 weeks. Though none of the animals died from the arrhythmias, the dilemma will make researchers wary of transplanting the cells into humans.


The cells most likely caused irregular heartbeats simply because they were immature when they had been injected. As the cells matured in the animals, the arrhythmias subsided, Murry advised the Guardian.


“If we did this in individuals there would be a vulnerable period of a handful of weeks and they would stabilise following that, but we would favor to solve the problem prior to we treated individuals,” Murry mentioned.


Murry explained that close to a quarter of the heart muscle groups was damaged in the monkeys his group treated. Had they triggered significantly much more harm the monkeys might have died prior to the scientists had had a chance to inject them with fresh heart cells.


Harding added that rather of injecting the heart cells, one more choice might be to make grafts of heart cells in the lab and transplant them as a sheet of tissue. These could sit in excess of scarred heart tissue, and aid the heart to pump more strongly.


John Martin, professor of cardiovascular medicine at UCL, was cautious about the examine since it failed to present no matter whether the transplanted cells improved the perform of the monkeys’ hearts. The occurrence of arrhythmias was worrying as well, he extra.


Anthony Mathur, director of cardiology at Barts Well being NHS trust, is working with Martin on a trial that will see three,000 heart attack individuals across Europe infused with stem cells taken from their own bone marrow. Whilst the cells do not gather in the heart and make fresh muscle tissue, they do release chemical compounds that lessen damage and possibly assist the heart to recover. A single benefit of the procedure is that individuals do not need to have to get anti-rejection medication, simply because the cells are their own.


Peter Weissberg, health care director at the British Heart Basis, explained: “This analysis brings us 1 step closer to repairing a damaged human heart, but we nevertheless have some way to go until finally we reach our aim.”




Stem cell remedy repairs broken hearts in monkeys

Top quality of life in retirement a lot more critical than typical pension revenue, minister suggests

Mr Webb induced controversy the day soon after the Spending budget when he explained that he was “relaxed” about the thought of pensioners paying their savings on a Lamborghini.


Appearing yesterday before MPs on the Commons Function and Pensions Committee, Mr Webb said that in potential pensions will be ready to have a “mixture” of capital and earnings to enable them to get pleasure from their retirement.


Mr Webb mentioned: “The significance here is that in the previous we’ve thought about what we want in retirement [is] a normal cash flow but actually what you want in retirement is good quality of lifestyle and that may possibly be a mixture of capital and cash flow and it may be different at different factors in retirement.”


He also explained that the changes to pensions will allow elderly individuals to shell out off debts that have been “getting them down”.


Mr Webb explained: “One of the excellent factors about these new freedoms is some folks will spend off debts that have been hanging more than them, that have been obtaining them down, that they wouldn’t have been capable to pay out off. They’ll be capable to do that and they’ll come to feel excellent about it.”


The minister also insisted that his reforms have not dealt a “death blow” to the annuities industry.


He stated that around a hundred,000 to 200,000 annuity revenue could still get area every single yr and explained these goods are likely to become competitive as companies will know that retirees have a better option of choices accessible to them.


Controversy in excess of annuities has been developing amid tumbling costs in current many years and issues that folks are not acquiring the best deal they could by purchasing close to. Up till now, about 400,000 folks a 12 months have bought an annuity.


Mr Webb stated: “I never believe it is a death blow to annuities. Plainly there is a set of men and women, and we can argue and discuss how big that will be, who will not buy annuities now, and estimates, and they are only guesstimates truly, differ significantly.


“But obviously an awful great deal of people even now require an earnings in retirement.”


Mr Webb explained: “It depends who you pay attention to, but it really is still considered a hundred,000, 200,000 annuities a year will be offered… I will not believe that the approach is irredeemable.”



Top quality of life in retirement a lot more critical than typical pension revenue, minister suggests

No Longer King Of The North, Pfizer Seems to be To Recapture Crown

Company is war and practically nothing is much more illustrative of that level than a healthful cycle of M&ampA activity.  Amid a wave of healthcare transactions, Pfizer Pfizer, one of the world’s biggest pharmaceutical companies, announced a $ one hundred billion bid for the British pharmaceutical company AstraZeneca AstraZeneca.


What if this have been the least negative selection for Pfizer in an increasingly challenging organization atmosphere?  Pfizer, like other big pharmaceutical businesses, is struggling. The blockbuster patent cliff has left the firm with greatly diminished income and has endangered earnings per share. In 2010, Pfizer revenue was much more than $ 65 billion while in 2013 income declined to $ 51.6 billion, a lower of far more than 20% in 3 years.


Rather of tactically obtaining vibrant biotech firms with actually mission-oriented cultures or even innovating through good old-fashioned lab function, Pfizer is trying to turn into the world’s greatest pharmaceutical enterprise by means of a complex financial initiative.



So why is Pfizer performing this?  As a $ 200 billion healthcare business, Pfizer can show its relevance in a way that only a key deal can command. This deal also allows Pfizer to compensate for lost income and merchandise exclusivity by acquiring AstraZeneca’s merchandise lines and investigation abilities. Lastly, as most great CPAs will inform you, keeping away from taxes is the subsequent ideal issue to rising income and this acquisition could considerably reduce the company’s tax liability.


But this wouldn’t be the 1st time Pfizer has executed this sort of financial maneuvering.  If background repeats itself, the following precedents must be noted. On January one, 2010, after acquiring Wyeth for $ 68 billion, Pfizer had 116,500 workers. By the finish of 2013, the firm had 77,700 employees, a reduction of more than 38,000 men and women. Also, in 2013 the organization initiated a $ ten billion stock repurchase prepare. In the course of the exact same time period Pfizer increased its earnings per share from $ one.94 to $ three.19.  The result of this kind of tactics had been quick lived, nevertheless, as Pfizer was weakened by a violent downturn in the economy and the realities of the great patent cliff.



AstraZeneca’s R&ampD Web site in Mölndal, Sweden: primary gate (Photo credit: Wikipedia)




By acquiring AstraZeneca, Pfizer could increase its earnings by turning into a British-based mostly corporation with a significantly reduce tax burden than a U.S. firm. Furthermore, for the income portion of any deal, considerably of the income Pfizer would use to acquire AstraZeneca would come from Pfizer’s huge offshore accounts. So Pfizer could obtain a significant asset by making use of money that would have been taxed at a increased fee if they had been ever brought back to the U.S., and Pfizer would conserve substantial taxes on product product sales going forward by getting to be a British-based business and enjoying a significantly reduced tax charge.


All this tends to make ample economic sense for Pfizer, a firm that has lost large amounts of income on its most profitable goods – drugs like Lipitor, Norvasc, Celebrex and Lyrica that now face competition from minimal-value generic brands.  But the proposed acquisition of AstraZeneca would not bolster the combined company’s blockbuster holdings for long. AstraZeneca has and will continue to lose exclusivity of many of its own blockbusters. In 2013, AstraZeneca misplaced exclusivity of Seroquel IR. It will lose exclusivity of Nexium in 2014 and Crestor in 2016. At the exact same time, income of Brilinta/Brilique, which had been anticipated to compensate for losses from other drugs have been disappointing.


As the previous blockbuster cohort declines, there is a new generation of blockbuster medicines, but a lot of have not come from classic huge pharmaceutical businesses. They are now the legacy of the big gamers in biotechnology like Amgen Amgen, Celgene Celgene and Gilead Sciences Gilead Sciences. The irony is that these had been all tiny biotechnology organizations not also long ago. That they are market common-bearers these days demonstrates that mission-oriented R&ampD organizations driven by dynamic cultures can make scientific breakthroughs and accomplish development.


For now the stakes are higher for all the gamers in the healthcare kingdom as an “acquire or be acquired” frenzy reigns.  After this round of mergers and acquisitions comes to an finish, which invariably it have to, it is very likely big pharma will return to business as normal, even though the subsequent logical move ought to be to obtain greater biotechnology organizations ahead of the biotechs grow to be the rulers of the land.



No Longer King Of The North, Pfizer Seems to be To Recapture Crown

The international battle for clean air podcast transcript

HM: Hugh Muir


SB: Simon Birkett


JV: John Vidal


DP: David Pasadas


SB: Sarah Boseley


KLK: Katie Leach-Kemon


AC: Aaron Cohen


SJ: Sam Jones


AP Ana Peñalosa


HM Simon Birkett is on a mission.


SB It’s an extraordinary feeling, whenever I ask people to sign up to the campaign or help – everyone did.


HM He wants to rid his city from air pollution.


SB I wrote a letter to the European commission, and the next thing I was getting calls from Brussels.


HM And there’s quite a few pollutants out there.


SB So we get diesel exhaust, for example, tyre and brake wear; we get construction dust, coal particles, benzene.


HM His campaign group is called Clean Air in London. He says there’s a hidden epidemic.


SB Well it is. I would argue that we are with invisible air pollution where we were 30 years ago with smoking. And I know, actually, that quite a lot of scientists and also media commentators, particularly those who have been following this story for many years, have actually moved their families outside London and now commute in.


HM He’s one of many around the world trying to do something about the air we breathe. With all the fantastic advances we hear about carbon capture, renewable energy, electric cars … why are we still pumping so much pollution into our atmosphere. Today on the Global development podcast we’ll take you to the Philippines, to one of the top three polluted cities in the world. Then to Mexico to hear how their government is tackling the crisis. And we’ll hear from the Guardian’s health editor, Sarah Boseley – she’ll tell us how pollution is affecting all of our lives. This is the Guardian Global development podcast. I’m Hugh Muir, that’s all to come.


First then, to Manila where the Guardian’s environment editor, John Vidal, sent us this report.


JV This is metro Manila, a 12 million strong megalopolis in the Philippines. It’s no different from any number of other major cities in Asia. The smell is awful and the noise makes it almost impossible to talk. In the end, I’ve had to record this back in the studio so that you can hear me properly – that’s how bad it can be. The hospitals here are full of people with respiratory and heart diseases. The latest figures suggest 2 million people in Asia will die prematurely of air pollution this year. The WHO, that’s the World Health Organisation, now thinks that one in eight people in the world dies from air pollution.


Jeepneys are the most popular form of transport for Manila’s poor. But these brightly coloured buses also leave vast plumes of diesel smoke in their wake. David Pasadas has lived in the city for years and is a consultant on urban and green issues.


DP In the Philippines, normally, right now, the law says that all vehicles have to be Euro 2 compliant, new vehicles. But old vehicles, they have a hard time meeting even Euro 1 standards because a lot of the public vehicles are using these rebuilt engines. And so you see a lot of vehicles, when they’re accelerating, like these Jeepneys and these tricycles, you see visible plumes of black smoke or white smoke.


JV Is that also because the fuel they use has been adulterated, has been smuggled in – what’s going on with the fuel?


DP Because we are an archipelago of 7,100 islands, it’s very easy to smuggle in fuel – and there have been reports of that. Aside from that, there’s a lot of contaminants in the fuel, unless you get it from a reputable gas station. And I guess it’s not just in the Philippines but it’s a common pattern in Asia.


JV But you’re a refugee, you now live in a suburb 20km outside the main city. What happened to your health when you moved outside, did it improve?


DP Actually it’s not as bad. It improved, but I was getting a lot of respiratory allergies in the city because you could literally see the pollution coming from the vehicles. You would feel it on your skin and your face after a long day of work taking the public transport. A lot of that is really because a lot of these public transport drivers have a hand-to-mouth existence, meaning the probably earn maybe £15 in a day, after a hard day of work. They don’t religiously maintain their engines. So you see a lot of engines here that are actually already starting to burn oil.


JV You’re young, and many of the people in the Philippines are very young. We get the impression that there’s building up a sort of public health crisis which will show itself in 20-30 years’ time as these respiratory diseases become worse and worse. Is that understood in the Philippines, that air pollution really is a serious problem now?


DP Originally, I thought only the middle class and the upper middle class understood these things because there were paying for like inhalers … and expectorants. But lately I’ve also tried to talk to some of these, for example, these Jeepney drivers. And I was surprised to learn that they are aware of the risks, and it’s like they’re caught in a situation where they want to change but they don’t know how.


JV And because it costs a lot of money to change.


DP It costs money if you’re running a dilapidated surplus engine. Because these public transport conveyances they don’t really get to taste a new engine per se. What they mean by new engine in their case is really a surplus rebuilt engine. So the life of the engine has a limited expectancy. And what they do is to save money they try to prolong it. And that’s where the problem occurs.


JV But you could also say that the life of the human who’s driving some of these cars is pretty limited as well.


DP Is greatly shortened yes, yes. I think they are aware of that. But if you’re living a hand to mouth existence I think some of them have this fatalistic view on life; meaning if you talk to them about climate change and other issues about the world what they’ll tell you is I have to feed my family and that’s what’s paramount to them.


JV And it’s not going to get any better. Within 20 years the Philippines is expected to be using an extra 10m or 15m cars – that’s per year! And there’s no sense that the industry, the fuel companies or the city are able to do anything about it. And that’s not even counting the air pollution that comes from factories or homes. The problem is it’s shortening the lives of everyone. Pollution here follows the poor. It’s a world problem but they’re breathing most of it.


HM Earlier this year, in March, some unseasonably warm weather affected countries in northern Europe. Not a bad thing in itself. But when combined with sand blown in from the Sahara desert, and the fumes from cars and power stations, well, it caused panic in the newsrooms. So what really happened? Sarah Boseley, the health editor here at the Guardian explains.


SB There really was a bit of a panic about the air pollution levels in the UK and in parts of Europe as well. I think that’s maybe partly because we’re increasingly aware that air pollution is very problematic. So the Saharan sand is a very minor issue actually by comparison with what we’re getting from diesel cars and, more to the point, diesel lorries and taxis and the like.


At the end of March, we had the release of a really important report from the Institute for Health Metrics and Evaluation, based at the University of Washington in Seattle. They have been responsible for a whole series of papers, really good papers, looking at what they call the global burden on disease. So they’ve been calculating what diseases the world suffers from, how many lives are lost and how many years people live with disabilities because of those diseases. Now they’ve looked at transport as well, which is a bit of a departure from the usual infectious diseases, chronic diseases, including cancers and such like.


What was really interesting in this was that they put together both the air pollution factors and also road injuries. And when you do that you actually come up with some quite stunning and worrying figures about the damage that our road transport is doing to us.


KLK Hello everyone. Thank you all for coming today and for your interest in this research.


SB Katie Leach-Kemon from the Institute of Health Metrics and Evaluation at the University of Washington in Seattle, who produced the paper, had some interesting things to say about the way they collected the data, which is not always easy because countries put it together in different ways.


KLK You can also use the tools to look at risk-factor rankings across countries; so this shows in Nigeria and China what the risk factors are for premature death and disability. You can see in China air pollution, ambient air pollution from all sources not just vehicles, actually ranks fourth and in Nigeria it ranks eighth.


SB They say, in fact, that deaths from road transport are higher. They have a greater burden on the population of the planet than deaths from the things that we all think of as being the big killers: HIV, tuberculosis and malaria. And that injuries and pollution from vehicles jointly contribute to six of the top 10 causes of deaths every year.


AC: As more people are living next to busy roads, the population exposure to traffic related air pollution is increasing.


SB And also we had Aaron Cohen, who is principal scientist at the Health Effects Institute in Boston, which is a non-profit … And their interest is air pollution. He was talking about the ultra-fine particles that emanate from diesel school buses.


AC The geographer Michael Jarrett at University of California at Berkeley in a recent HGI report estimated the proportion of the population living near busy roads in several major world cities. This slide shows residential proximity to the burgeoning road network in Beijing, where he estimates that 76% of residents currently live within 500 metres of major highways; and 50 metres of busy streets where levels of traffic-related air pollution emissions are the highest.


SB It’s increasingly worrying that there are such high levels of pollution in developing countries. Very likely developing countries haven’t taken this on board yet because most people think of transport as being a really fundamental important thing for developing countries because you have to get your goods from A to B in order to be able to sell them. People have to be able to get to the jobs. Obviously having good transport, having a car, all helps development. But unfortunately the downside for health is very much something that people think of as an afterthought.


HM Sarah Boseley in London. And I don’t know about you but now I’m trying to work out how far I live from a major road. Of course air respects no borders. Different countries deal with the problems of pollution in different ways. So what are governments doing to make our cities more liveable? We sent Global development reporter Sam Jones to Mexico City to find out.


SJ I’m standing on a roof garden in Mexico City with Ana Peñalosa, who works for the environmental secretariat of Mexico City. We’re surrounded by grey, lots of traffic noises and some aeroplanes but there’s a sudden stretch of green here, Ana, can you tell us a little bit about it?


AP We’re at the top of one of the buildings, the offices of the environment department secretary of Mexico City, and we have a green roof here. It’s open to all the people who work here. In this building we have the air quality direction. So they are doing all the analyses about the air quality and monitoring of the whole city. We’re actually in downtown, and it’s a lot of cars passing around all the time.


SJ I think we can hear those.


AP So this space, it’s like being away from that.


SJ What’s the public reaction been? You say it serves a very useful purpose, it helps purify the air because it drags down some of the nasty gases which are there because there’s a lot of motor vehicles in Mexico City, as we can hear loud and clear. And it’s good for children, and if you work in this bit of the environment department you can come and have exercise classes on the roof. But what has the public reaction been, what of the people who live in Mexico City, what have they told you about what the project means to them having these green roofs.


AP Well, I think that in general people are very keen. There are a lot of people growing plants and even vegetables in their available spaces at home, like some balconies or even in their rooftop. And the environmental Education department has a lot of these kind of projects and workshops teaching people to grow their own food. Even though there are some big parks like Chapultepec, we’re trying to bring closer to people these green spaces. Like, for example, in hospitals it’s really important because it helps to heal people as well. And in public schools, to teach children to grow plants and vegetables and have green spaces where it’s available, where it’s possible.


SJ And the government, this is one of the measures that they’ve put in place to try and improve the air quality. And there’s a bicycle scheme, similar to the Boris bikes in London or the bicycle scheme in Paris, what other steps has the government taken to try and reduce the problems of very polluted air in the city?


AP Well having implemented things … but of course we believe that transportation modes are directly related to air quality in the city. And of course we’re working really hard on that. For example, the public bike scheme started four years ago and it’s been a tremendous success. And of course people are realising that the alternatives, like transportation alternatives, that are actually more convenient … It’s important that citizens realise that every action they take it’s important, and it counts for having air quality and quality of life in general.


SJ You’re from Mexico City. Can you describe what the pollution was like 10 years ago or 20 years ago?


AP Yeah, it has changed, it has improved – but it’s always more and more people living here, and the city is growing, and you have to monitor and control it continuously.


SJ And as a native of Mexico City, how would you rate the air quality today, this afternoon. If you look around and you take a big, deep breath, how would you describe the air this afternoon?


AP It could be better. I’m from here as you said, you know, it’s fair enough, it’s all right.


SJ There’s noticeable smog, I think, and some of the buildings as we get towards the sides of the valley fade away into blues and greys – but it doesn’t feel quite as bad as it was when I was last here 11 years ago. I mean you think there’s definitely been an improvement?


AP Yeah, when I was a child, yeah, it’s definitely a really noticeable difference. All I can say is that we have to keep working on this and of course changing habits; choosing bicycles instead of your car.


SJ So progress.


AP Yes, definitely. And I really think that Mexico should be a global example of policies to improve air quality in one of the largest cities of the world.


HM Sam Jones speaking to Ana Peñalosa. Well I’m pleased to say we’ve gathered all the correspondents you’ve just heard in our studio: that’s John Vidal, Sam Jones and Sarah Boseley – welcome to all of you. Sam, let me start with you; tell me a bit about what it’s like because you left London you went to Mexico City was it obvious that the air was different, was it obvious that the atmosphere was different to you?


SJ It’s a very noticeable difference. There’s a constant haze, a kind of pall that hangs in the sky. If you try and climb up a few flights of stairs you’ll find your lungs are working a little bit harder than they would in London.


HM Of course we heard about the green roofs and cycle schemes, do those sort of things really make a difference?


SJ I think they have made a difference. The Mexico City I saw last week was very different to the Mexico City I saw 11 years ago. Going back 11 years, there was much more pollution, it was denser, the streets were still full of the kind of iconic green-and-white Volkswagen Beetle taxis, they’ve disappeared now. You’re seeing liquid gas-powered buses; and perhaps the most noticeable difference is seeing people cycling in Mexico City, which I wouldn’t have imagined a little over a decade ago. Brave people take to their bikes in Mexico City – about 27,000 journeys a day so far and that’s rising.


In terms of the green roofs, it seems to have captured the public’s imagination to a certain extent. I mean putting green roofs on top of buildings is not going to cure problems in a city of 21 million people with a massive, massive pollution problem. But it does seem to be serving an educational purpose and people are starting to think about the way they travel. But, clearly, you’re going to need rather more than that to sort out the effects of millions and millions of highly polluting cars.


HM John Vidal, we’ve recently seen Paris halving the amount of traffic that it’s allowing into its city centre to reduce smog, and Beijing tried that too – does that work?


JV No.


HM Why not?


JV There’s still far too much of it. The scale of what’s going on at the moment is so enormous, and I’m a bit of a pessimist. If you can see pollution that’s only the very top bit. What really gets people is what you can’t see, they’re so small, we’re talking about the 2.5 microns; this is the stuff that goes right down in your lungs, you can’t see that. We think that if we can smell pollution, that it’s bad. It’s not. The worst stuff is the stuff you can’t smell, you can’t see it, it’s invisible, it gets right down in there – that’s the really dangerous stuff. That’s the stuff the WHO is now realising is leading to the heart attacks and so many respiratory problems. We’ve just swapped one kind of pollution, which was factories burning coal, for another kind of pollution, which is really largely from gases like NO2 and the particulate pollution, and that’s the dangerous stuff. So just getting rid of a few cars is not going to be enough. You have to do it on a very large scale to make any difference at all.


HM And, Sarah Boseley, it’s not just about a shorter life expectancy is it there are implications for children as well; tell us about those.


SB Well it’s interesting. Once upon a time we used to think that pollution perhaps made things lot worse for people, and particularly for kids. And as time has gone on, we’ve realised that actually you’re talking about an awful lot of diseases and cancers. And the latest thing, I mean I was quite stunned to see a study in October last year that said that air pollution could actually cause low birth rate in babies. And that is really quite an incredible link. In fact it’s a European study so you’re not even looking at the developing world. I’ve been to Kathmandu and seen horrible, horrible pollution … Again, as John is saying, it’s often the stuff we’re not seeing. You’re seeing low birth weight babies and they think that air pollution may have been a cause for that.


JV In east London I was talking to respiratory doctors at King’s College, and they’re measuring, by the age of five they can see that the birth weight of babies has gone down and you can already see the neurological effects on children that age.


HM And why east London? What do we know about east London?


JV Because there’s very, very heavy traffic going through those main roads. If you’re living within a 100 yards of those roads, you are effectively being polluted – and seriously polluted.


SB It does stand to reason, actually, because we know that smoking causes low birth weight so why shouldn’t air pollution.


HM Sam Jones, do you feel that people you met in Mexico City actually felt that this was a priority; obviously the politicians go to international gatherings and they know that globally people think it’s important, but do the people on the ground really feel we must do something about the air?


SJ I don’t think it’s reached critical mass by any means. It’s a gigantic city and most people have more pressing concerns. Many people are living a hand-to-mouth existence, and I think it’s fair to say that improving air quality is not even on their list of priorities at the moment. Politicians are doing what they can, and the environmental secretary of Mexico City is very keen to stress that it’s actually advising Tehran on its air quality at the moment. I was told while I was there that some of the C40 cities have shown an interest in some of the smartphone applications that the Mexico City government is using. But in terms of on the ground take up and involvement in any kind of push to improve air quality – no evidence of that.


JV Hugh, can I just say I think that a major problem is that we thought this was one of the environment problems which had gone away … It hasn’t. And so there’s a big perception gap with the politicians – they haven’t realised; one in 12 people dying of diseases linked directly to air pollution is extraordinary.


HM But I explained that though because it did seem logical that once you’d got rid of all the dirty fuel that this problem would be better.


JV It hasn’t gone away. We, the media, I think have been very bad at it, we haven’t realised. What has also happened is that the medics are beginning to appreciate much, much more the links. So there are a lot of advances which have been done in the field of medicine which are making people understand this is much more serious than we thought.


SB Yes, but I would say actually that pollution is a complicating factor in other diseases. So, actually, you can’t blame just the pollution for the deaths, it’s just not like that. People have a genetic propensity and there will be other things in their lives that are causing the problem. So that’s one of the reasons why it’s been overlooked.


HM So does that mean that we are underestimating the amount of it because some people will die. And, as you say, their deaths won’t be attributed to pollution – there will be other things. But in fact pollution will have been the crucial factor.


SB No, I think we are starting to appreciate it and that’s what these studies are about. The WHO has attributed far more lung cancer and bladder cancer now to air pollution, for instance. And they can do some very clever stuff with studies where they factor out everything else. So we are seeing it, as John says, for the first time. But I think in the past that perception that it had gone away was perhaps because it was mixed up with other stuff too.


HM Sam, in Mexico City, what did you feel was driving their initiative there; was it an altruism that we should think more about people’s health or was it a political imperative; what do you think was behind it?


SJ I think some of it is altruism and some of it is a kind of firefighting. When you’ve got a city that big and it’s ever growing, if you’ve ever flown into Mexico City you look past the wing and it stretches on and on and on, there’s more people arriving every day, it’s a genuine megacity, something has to be done because it won’t be habitable if things get much worse. Twenty years ago they had the bright idea of moving the refineries out of the city, which has made a massive difference, clearly.


The other factor in all this is Mexico is an emerging country, an emerging economy, it recently hosted a huge high-level meeting on global development and how to work better, and it’s projecting itself as a forward-looking country, as the kind of country that will take seriously developed country concerns such as environments, such as air quality. So it’s two pronged: yes they’re trying to make things better for the people who live there because they have to because it’s giant and it’s very polluted, and also they’re trying to show that they are capable of being this world player.


HM But, John Vidal, it’s difficult isn’t it because you have this phenomenon of countries emerging and becoming more industrially developed, but a lot of things come with that. And it’s difficult for the developed world to say to those countries that are emerging, “Don’t do this” because they say, “Well hang on, that’s what you did to become as powerful and as rich as you are.”


JV Yes but there are lessons to be learned from everyone’s progress, if you like. I think what’s happening in China is very, very interesting because there you have pollution on a very, very great scale now. And that’s mainly industrial pollution mixed with the traffic. And there, I think, the authorities are realising that unless they do get it under control then they stand a real risk of civil unrest, of civil problems and all kinds of other things attached to it. So if you live in a polluted city, and I’ve been to these places, people get really hacked off and they really don’t like it. And that’s a trigger for political dissent. And I think that will be one of the reasons why China gets its act together much quicker than some other countries.


HM So to what extent to you think the international bodies, the international health bodies, are really gripping this? They may not have solved it but they’re on top of the scale of the problem.


SB I don’t think, actually, they’re focusing on it as perhaps a lot of people would like them to. And that’s simply because there’s so much else happening all the time. We’re now into a situation where we have to worry about the spread of chronic diseases. So we’ve got heart disease and cancers caused by other things such as lack of exercise and eating the wrong foods – that’s the up-and-coming thing now, what they call the non-communicable diseases. So what happens is that there are fashions in health in the things that people turn their attentions to, and this isn’t as high a priority as a lot of people would like.


HM What are ordinary people doing; I suppose I’d just like to get some sense of what the ordinary listener can do because all of this is being solved at a very macro level, at a governmental level but ordinary people have to go out and walk in polluted air. What sort of things were they doing in Mexico, Sam, quickly?


SJ The people who are concerned about this are trying to use carpooling to cut down on the amount of pollution, or rationalise it a little bit more. Mexico City is rather too big to walk round. Those who care and who can get on the bike scheme and pedal their way round, that’s rising. But if you’re poor and you’ve got a long distance to travel in Mexico City, you’re not left with very many options, it’s basically the bus.


HM John, I thought technology was supposed to save us from all of this. Why isn’t it or will it?


JV Face masks, that’s what we need.


HM That’s very old technology, isn’t it?


JV It is. In a funny way you’ve got to stop breathing in the worst bits. Unfortunately, most of the masks are really not much use at all, frankly.


SB I was just going to say, actually it doesn’t stop the particulates.


JV Exactly. But every time you see somebody with a mask you think this area’s polluted so you do actually take more care, so in a way it is quite good. No, the only way anyone has ever found to reduce air pollution is to either cut down, get the factories burning much less fuel and get the cars to burn electric or something completely different, or get rid of the cars. That’s the only way you’re going to do it, otherwise it will build up and build up.


HM And, Sarah, what’s the health advice? Is there any credible, sensible health advice being given to people who live in areas that have this serious problem?


SB Well, the distressing thing is how little you can do about it, and pregnant women are a case in point; what do you do? You can give up smoking, you can give up alcohol, you can’t stop yourself in Bradford breathing in the diesel fumes from the buses and the lorries, and it’s not just cars of course. But you can try to help the community as a whole by walking, by cycling, by those sort of things, but you can’t actually protect yourself – you have to make a fuss about it.


JV Hugh, there was one thing which I noticed … which was rather beautiful; the most polluted place in the whole of Britain happens to be Kensington and Chelsea – the richest borough in the whole of London. And this was quite extraordinary. Why? Because of the cars. They all drive very large diesels around there and also because they’ve got some big railway engines which burn a lot of diesel. But it is funny that the pollution does actually follow the rich as well.


HM Well it does show, doesn’t it, how things change because not so long ago diesel was supposed to be the thing that was going to save us from all of this.


JV Exactly.


HM And that thinking has all been turned on its head.


But that’s it for this edition of the Guardian Global development podcast. My thanks to John Vidal, Sam Jones and Sarah Boseley, to all our contributors, and of course to you for listening. If you have any comments about the programme or want to add your voice to the discussion, head to theguardian.com/global-development and please subscribe to hear future podcasts via iTunes or another pod catching service. My name’s Hugh Muir, the producer was Matt Hill. Until next time, goodbye.



The international battle for clean air podcast transcript

Wellpoint Boosts Profit Forecast On Younger, Greater ACA Enrollment

Wellpoint (WLP), one particular of the nation’s greatest overall health insurance coverage businesses, extra 1.3 million more subscribers across its government and industrial firms thanks in massive part to the Reasonably priced Care Act.


Wellpoint now explained it expects its healthcare enrollment to increase for the full year by 1.three million to one.4 million members, like more than 400,000 that came from government-run exchanges in the very first quarter, in accordance to the company’s earning report today. Wellpoint also raised its earnings per share forecast to “greater than $ 8.forty per share.”


“Our membership is developing across our platforms and we are pleased with the progress we have seen in the exchanges,” Wellpoint chief executive officer Joe Swedish said.


Wellpoint’s revenue outlook is enhanced in portion since the combine of company is monitoring how the firm projected from the exchanges.Wellpoint is a significant operator of Blue Cross and Blue Shield strategies, which includes these operated beneath the Anthem brand.


Even though some observers of enrollment anxious that the population signing up for coverage would be older and sicker and value health programs far more income, Wellpoint executives mentioned subscribers trended younger every day of the signup period in the last weeks as more and much more Americans took to the exchanges in the waning days of the open enrollment time period, which ended last month.


Insurance coverage businesses for significantly of this quarter possessing been telling Wall Street that they are going to be able to deal with the 1st year of chance from newly insured buyers acquiring subsidized personal wellness plans by way of government-run exchanges. Beneath the law, hundreds of thousands of Americans can get subsidies to buy an array of overall health prepare alternatives.


In the first quarter, Wellpoint said net income was $ 701 million or $ two.forty per share. Revenues rose 1.two percent to $ 17.six billion.


The enhanced forecast is the most recent in a parade of rosy monetary projections from health insurance businesses benefitting from the overall health law. Other insurers performing well consist of UnitedHealth Group UnitedHealth Group (UNH), Humana Humana (HUM), Cigna Cigna (CI) and Aetna Aetna (AET).


Just final month, Swedish raised the company’s earnings outlook from “greater than $ eight.00 per share to higher than $ eight.20 per share” and noticed growth of “1 to one.three million net new health-related members.”


When a company raises its earnings forecast, that implies it will make more cash than it originally believed.


In addition to promoting overall health benefits to employers and people, Wellpoint is a significant contractor to states and the federal government by supplying coverage underneath Medicaid packages for the bad and the Medicare overall health insurance coverage system for the elderly. In the initial quarter, Wellpoint said it additional 75,000 new enrollees in its government organizations and that was largely Medicaid.


Wellpoint CEO Joe Swedish



Wellpoint Boosts Profit Forecast On Younger, Greater ACA Enrollment