Should Patient Advocacy Groups Disclose Ties to Drug Makers?

By Tracy Staton for Fiercepharma.com Here's an unintended consequence: Eli Lilly stepped up to the disclosure plate, becoming the first drugmaker to release its list of grants. Researchers took that new data, analyzed it, and found that only a quarter of the health advocacy groups that received grants actually mentioned Lilly's funding on their websites, and only 18 percent mentioned it in their annual reports. Even those that did mention the financial link didn't disclose the amount. The researchers from Columbia University's public health school looked at 161 organizations and data from the first half of 2007. Lilly gave $3.2 million to advocacy groups during that time frame, targeting groups dealing with psychiatric or neurological problems such as depression or schizophrenia, endocrine illnesses such as diabetes, and cancer. As the Los Angeles Times points out, those three areas were Lilly's three top performers by U.S. sales, together bringing in $10.1 billion. The study has lawmakers promising to consider new disclosure rules for patient organizations, the New York Times reports. Doctor payments now have to be disclosed, so why not these grants? After all, advocacy groups lobby agencies and lawmakers on patients' behalf, and they act as public relations agents for particular diseases and patient groups, the researchers said. "I'm not saying it's wrong, just that it should be disclosed," Professor Sheila Rothman told the NYT. "There is no way at this point that you can follow the money as a citizen, a health care provider or as a legislator or regulator." Read the LA Times article.

Candy Prohibition Creates Black Market Swell

By Hank Cardello, for The Atlantic

 The recently passed Healthy, Hunger-Free Kids Act (PDF) offers some positive steps to improve how our children eat in schools. But in trying to make schools nutritional oases, public health officials have unwittingly unleashed the black market genie ready and able to fill the void left by departing sodas and snacks. Now, budding student entrepreneurs are rushing in to meet the demand for snacks and beverages that are no longer available legitimately.

Once again, well-intended legislation has not considered how market forces might affect the intended outcomes. Here are some examples: 

    • Following the passage of the Texas Public School Nutrition Policy, which banned candy, enterprising students at Austin High began selling bags full of candy at premium prices, with some reportedly making up to $200 per week. 

    • Similarly, young entrepreneurs at one Boca Raton (Florida) middle school make runs to the local Costco and buy candy bars, doughnuts, and other high-calorie snacks in bulk. They then offer these goodies for sale in an environment that has supposedly eradicated such goodies. 

    • An eighth-grade student body vice president in Connecticut was forced to resign after buying Skittles from an underground "dealer." 

    • The U.K. has also seen its share of black market trade in banned foods, snacks, and beverages, with schools in Oxford, Dorset, and Essex reporting healthy underground markets trading in food contraband. The plots ranged from kids selling McDonald's hamburgers in playgrounds to bicycle-riding entrepreneurs hauling bags of soft drinks and milk chocolate for sale. 

    • Even the schools themselves are complicit. Outside that South Florida middle school mentioned earlier, vending machines stocked with high-calorie snacks and sugar-sweetened beverages adorn the waiting line for buses after classes. While biding their time in line, many of the students take advantage and load up. 

Black markets evolve when demand for wildly popular products is not being met by supply. Case in point: Prohibition. 

The Volstead Act, implemented in January 1920, was designed to eradicate the health and societal problems associated with alcohol consumption. The statistics say it failed. While rates initially declined, per capita consumption for the remainder of the decade actuallyincreased by approximately 50 percent over 1919 rates. In addition, government costs to enforce Prohibition against black market activities tripled during the 1920s. And, instead of consumers switching their alcohol dollars to dairy products and other alternatives, spending on alcohol increased, as did spending on substitutes. 

Bottom line: Prohibition did not improve the health of Americans as anticipated. 

The primary reason for the Volstead Act's failure was that it did not focus on the real issue: excessconsumption of alcohol. As evidenced by studies at the Mayo Clinic, banning is not the answer since there are actually positive benefits that accrue from moderate consumption of alcoholic beverages such as red wine, like raising good (HDL) cholesterol, reducing blood clots, and helping to prevent artery damage from bad (LDL) cholesterol. 

If we are to learn anything from the temperance movement, we should turn our efforts to reducing excesscalorie consumption—not applying a Prohibitionist approach in attempting to rid our society of products that consumers like and demand. 

Bans—whether for sodas, candy, or books—ultimately do not serve us well. We are wasting a huge opportunity to teach calorie and portion-control lessons to our children. By prohibiting the most popular food items, one does not remove the demand. Children will find those items available in other outlets outside school guardianship. 

It's time to rethink our tactics.

St. Fiacre? Patron Saint Of Hemorrhoid Sufferers

According to Johns Hopkins, more than half of all Americans develop hemorrhoids by age 50, and men and women are at equal risk. In fact, the condition is so ubiquitous that hemorrhoid sufferers have their own patron saint, St. Fiacre.

During the Middle Ages, an integral part of the therapy for certain ailments included supplication to "patron" saints for possible divine intervention. Through legends surrounding his life, St. Fiacre, a 7th century Irish monk, has become the patron saint for hemorrhoid sufferers (and gardeners). During Medieval times, hemorrhoids were known as St. Fiacre's curse. St. Fiacre is also known as the patron saint of gardeners as he was told he could farm all the land he could manage to cultivate in a single day. He was given a rather small shovel by his bishop. So he could grab as much land as possible, he spent a very long day spading his garden and developed a severe case of prolapsed hemorrhoids, the legend goes. Seeking a solution, he sat on a stone and prayed for help. The legend states he enjoyed a miraculous cure from the stone. 

Today, a number of factors increase the risk of hemorrhoids or can make them worse. For example, they are more common with age, peaking at around age 65. Hemorrhoids are also associated with obesity, pregnancy and childbirth, liver disease, prostate enlargement, chronic cough, and diarrhea -- all of which can increase pressure on veins in the anus and rectum. Contrary to popular belief, heavy lifting, long periods of sitting, and chronic constipation do not lead to hemorrhoids, although these factors can irritate existing hemorrhoids. Excessive rubbing or cleaning of the anal area also can irritate an existing condition. 

Science Magazine Names USAID-Funded HIV Research as Top 10 Breakthrough of the Year

On December 17, Science Magazine named a promising HIV study as one of the top ten achievements of 2010. The groundbreaking research provided the first-ever proof of concept that a microbicide can effectively and safely reduce HIV transmission in women.  Ninety percent of the study was funded by USAID as part of the U.S. President's Emergency Plan for AIDS Relief.

The HIV prevention trials were conducted by the Center for the AIDS Program of Research in South Africa (CAPRISA) with assistance from two USAID-funded implementing partners, Family Health International (FHI) and CONRAD.  Researchers of the study tested the use of a vaginal gel containing 1% of the anti-HIV drug tenofovir. The drug was administered over a 30-month period to 889 South African women and was proven to reduce HIV infections by 39 percent.  

The microbicide trial exemplifies USAID's commitment to supporting game-changing breakthroughs in global health, and also to focus on women and gender equality, both of which will expand under President Obama's Global Health Initiative.  Further, USAID is committed to building a solid foundation of robust science and new technologies, enabling innovation to redefine and strengthen U.S. development assistance globally.

Notably, the microbicide study was one of two breakthroughs in HIV/AIDS prevention recognized in the Top 10 list.  Science Magazine also recognized the Pre-Exposure Prophylaxis Initiative (iPrEx) study, which confirmed that daily oral use of a combination antiretroviral (ARV), Truvada reduced the risk of HIV infection by 44 percent among men who have sex with men. This historic iPrEx trial provides the first proof of concept that oral PrEP of an ARV can prevent HIV transmission.  

USAID is looking to complement the iPrEx results with a similar study for women.  The FemPrEP clinical trial  — led by FHI with support from USAID — is designed to test the safety and effectiveness of a daily dose of Truvada for HIV prevention.  Finding a woman-controlled method of prevention is critical in the fight against HIV/AIDS.

Another Reason To Reconsider That Grande Latte: Firesheep

From Kelly Jackson Higgins, at Darkreading

Average Joes Now Can Be Hackers, Too

The dangers of unprotected WiFi have been well-documented, but that hasn't stopped most customers at Panera and Starbucks from using these connections while they sip their lattes. It used to be that it would take a relatively seasoned hacker across the caf? or in the parking lot to pull off a so-called sidejacking attack against a WiFi user.

But a new tool unleashed in October by Eric Butler, a Seattle-based Web application software developer and researcher, made has now made it possible for the average Joe to hijack a WiFi user's Facebook, Twitter, or other unsecured account session while drinking a cup of Joe.

The controversial Firesheep tool is a Firefox plug-in that lets anyone hijack a WiFi users' cookies by merely pointing and clicking on a nearby WiFi user's Facebook or other account that automatically pops up on the attacker's screen.

Sidejacking attacks are nothing new-- most websites aren't SSL-encrypted today, leaving users open to having their sessions sniffed and hijacked when they log onto sites such as Facebook from the WiFi at Starbucks. Firesheep basically makes this type of attack easy enough for any nontechnical person to do: The tool pops up a window, you click the "Start Capturing" button, and it finds and displays user accounts currently on insecure websites via the WiFi network. "Their name and photo will be displayed: Double-click on someone, and you're instantly logged in as them," Butler explained in his blog post about Firesheep.

Robert Graham, CEO at Errata Security, who developed and released his Hamster sidejacking tool three years ago, says although sidejacking has been a well-known threat for ten years, Firesheep makes the attack more visual and easy to execute. "The way I did it with [my tool], I had to guess where the cookies were going," Graham says, adding that Firesheep grabs that information via the browser and more quickly. "[Butler's] tool works in cases where mine doesn't. It's a better solution."

Firesheep takes advantage of websites that don't SSL-encrypt logins, so when a user visits Facebook, Twitter, Hotmail, or YahooMail, his cookies can be automatically lifted and used by an attacker on the WiFi network to take over his account.

Butler says he hopes Firesheep will force websites to go SSL. "Websites have a responsibility to protect the people who depend on their services. They've been ignoring this responsibility for too long, and it's time for everyone to demand a more secure Web. My hope is that Firesheep will help the users win," he said in his blog post.

Errata's Graham says he'd like to be able to say that sidejacking is old news. "I should be able to say that," he says. "But I can't because I can take this down to Starbucks and hack people, and get to their email and their bank account. That should not work."