Public health measures to tackle alcohol misuse and obesity
This week saw the introduction of two long awaited public health measures. These were: the Public Health (Alcohol) Bill and agreement by Government to introduce legislation to make it mandatory to include calorie counts on menus.
Heralded by the Minister for Health Leo Varadkar as the “most far-reaching” piece of legislation designed to tackle alcohol misuse proposed by “any Irish Government”, the Public Health (Alcohol) Bill contains a range of measures aimed to reduce alcohol consumption in Ireland.
These include the introduction of health warnings and calorie details on alcohol labels and new restrictions on advertising marketing and sponsorship.
Under the new legislation Environmental Health Officers are also to be given stronger powers to police the new legislation.
While for many the Bill does not go far enough as it does not introduce a complete ban on all alcohol sponsorship something that many health campaigners have been calling for, it does however contain proposals to introduce a minimum price for alcohol for the first time in Ireland.
The setting of a minimum price per unit of alcohol will make it illegal to sell or advertise alcohol at a price below a minimum set price which is yet to be set by the Government.
A study carried out by the University of Sheffield recently noted that Minimum Unit Pricing (MUP) would only have a small impact on alcohol consumption for low risk drinkers. Somewhat larger impacts would be experienced by increasing risk drinkers, with the most substantial effects being experienced by high-risk drinkers.
The University of Sheffield study reported that the alcohol products most affected by this policy are those that are currently being sold very cheaply, often below cost prices, in the off-trade, i.e. supermarkets and off-licences. The price will be set when the Bill is published.
The laws in relation to calorie counts on menus will require restaurants, take-aways and all food outlets to post the calorie content of each meal alongside the price.
According to the Department of Health
“drafting of calorie posting legislation will start immediately and should be ready for enactment in 2016. The proposed laws will require all menus, including boards, leaflets, digital menus or other forms, to display the amount of calories alongside the price in the same font size and colour”.
Calorie posting is one of a range of measures on obesity planned for 2015. Others include revised Healthy Eating Guidelines and a new Obesity Policy and Action Plan.
Three parent IVF
The news this week that English MPs have voted in favour of proposals to allow the creation of babies from 3 parents was a massive breakthrough for fertility medicine.
This move, which requires a further vote in the House of Lords, could see the UK being the first country in the world to allow this type of IVF which stops certain types of genetic diseases being passed from mothers to their children and indeed to subsequent generations.
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Developed by scientists at Newcastle University in the UK, the pioneering IVF-based technique aims to reduce the risk of mitochondrial diseases.
Known as ‘mitochondrial donation’ the techniques involve removing faulty mitochondria inherited from the mother and replacing them with the healthy mitochondria of another woman. The nuclear DNA, containing 99.9 per cent of genetic material from the mother and father, remains unchanged.
Professor Doug Turnbull Professor of Neurology and a consultant at Newcastle Hospitals NHS Foundation Trust, Newcastle University, said: “I’m delighted for patients with mitochondrial disease. This is an important hurdle in the development of this new IVF technique but we still have the debate in the House of Lords, and importantly the licensing by the HFEA.
“Finally, I think the quality of the debate today shows what a robust scientific, ethical and legislative procedure we have in the UK for IVF treatments. This is important and something the UK should rightly be proud of.”
Mitochondrial diseases are caused by inherited mutations in the DNA contained in mitochondria – tiny structures present in every cell that generate energy.
Every year, in the UK around one in 6,500 children are born with severe mitochondrial diseases, which can be devastating and particularly affect tissues that have high energy demands – brain, muscle (including heart), liver and kidney and can also lead to death in early infancy.
While controversial for some for others like UK woman Sharon Bernardi, who lost all seven of her children to mitochondrial disease, this decision is simply life changing.
“This is the best thing in the world that could have happened. It is such good news for affected families, like winning the lottery a thousand time over,” she said.
Cost of medicines
The cost of medicines in Ireland once again made the headlines this week with an excellent report by Susan Mitchell in the Sunday Business Post which reported that the Minister for Health Leo Varadkar had drawn up plans to use legislative powers to impose price cuts on big pharmaceutical companies.
As the SBP reports Minister Varadkar has been critical of the high cost of medicines in Ireland in Ireland and has vowed to tackle the problem.
The story was picked up by a number of the national newspapers the next day with reports that the Health (Pricing and Supply of Medical Goods) Act 2013 could be used by the Government to force companies to reduce the cost of drugs.
Ireland’s drugs bill has long been criticized and currently standing at approximately €2 billion, is one of the highest in the EU.
While time will tell what impact this move if it goes ahead will have on the cost of medicines in Ireland, the news this week that the HSE has agreed to provide Eculizumab (solaris) for sufferers of the rare blood diseases: Paroxysmal Nocturnal Hemoglobinuria (PNH) and atypical Haemolytic Uraemic (aHUS), was very welcome indeed for these patients and their families.
Eculizumab is hugely expensive costing approximately €430,000 per patient per year in Ireland and the HSE stated that its provision would be on the basis of clinical need.
The Director General of the HSE, Tony O’Brien said:
“This is an astronomical price to pay for any drug. However, the HSE did not want the patients awaiting access to Eculizumab caught in the crossfire between a drug manufacturer attempting to enhance its corporate profits at all costs, versus the HSE attempting to protect scarce money for delivering health services”
According to the HSE
“Demands on the health services continue to grow year-on-year. The opportunity cost of the inordinate price demanded for this important drug will inevitably, over time, be felt in other parts of the health services and will impact on the ability to fund important other services developments such as home-care packages, medicines and drugs, and the recruitment of badly-needed nurses. Consequently, the HSE urges the manufacturer concerned to reconsider the price that is charges for Eculizumab in this country.”