Tag Archives: NHS

Good Things From Bad Infections

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Covid-19 inspires dread and may bring about the deepest economic recession of the twenty-first century. But it also inspires creativity, kindness and a true sense of community. Oh, and criminality and cruel hoaxes too, but let’s leave them aside for now. Let me mention two examples of what I mean…

Today is ANZAC Day in Australia and New Zealand, when we recognise the heroism of our armed forces and mourn the fallen. The day starts with a Dawn Service in every city, every town and everywhere worldwide where there are more than a handful of Aussies and Kiwis. These are always well attended.

Because of Covid-19 the normal gatherings were not allowed today, so our local RSL (Returned and Services League) delivered invitations to surrounding houses inviting us to stand in our driveways at 0615 holding candles, to at least hear the sounding of Last Post and the reading of “They shall grow not old…”; and then walk to the RSL Club for tea and an Anzac biscuit and a chat with club members – observing the obligatory 1.5m social distancing rule of course.

We accepted the invitation and it was a moving experience. We also got to meet neighbours whom I usually see only when I’m collecting for the Salvation Army. I’m expecting a repeat, without the social distancing, in future years.

My second example is the astounding success of an old soldier’s fund-raising on behalf of the NHS (the UK’s National Health Service). 99-year-old Captain Tom Moore resolved to walk 100 laps of his garden, with online sponsorship to raise a targeted GBP1,000 before his 100th birthday. He has actually raised close to GBP30 million. And to top it off, he now holds the record as the oldest person to have a single at No.1 in the British charts. If you haven’t seen and heard the video-clip already, click here now.

This is not the same record as ‘Ground Control to Captain Tom’. Click here if you haven’t seen that one.

Tom Moore’s effort is not directly related to Covid-19, but I have no doubt that the stupendous scale of the public response has everything to do with it.

PrEP

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PrEP stands for Pre-Exposure Prophylaxis – a combination of two medicines (tenovir and emtricitabine, sold under the trade name Truvada) that greatly reduces the risk of HIV infection. It is a prescription drug taken daily by people who are at high risk of infection. According to the US Centers for Disease Control (CDC) the risk reduction is at least 90% for sexual transmission of HIV and at least 70% for injected drug use.

I’m in the UK at the moment and a big news story has been the dispute over who should pay for PrEP. The disputants were the National Health Service (NHS) and the local authorities. The NHS argued that it was a public health issue, so the local authorities should pay. The local authorities argued that they couldn’t afford it. The judgement came down against the NHS.

So what is there to get stroppy about? Well, it seems to me blindingly obvious that the cost of PrEP should be born by the individuals who need its protection. The pills cost GBP13 (USD17) per day. This is as much as five café-bought cups of coffee every day. That’s a lot of money, but I’d hazard a guess that a drug habit costs more. And for people at risk of sexual transmission, good old-fashioned condoms are a very affordable alternative.

This point was made in a Radio 4 interview with a lobbyist. She seemed affronted and said that it was not always practicable to use a condom every time one has sex. By way of elaboration she said that people were often too drunk to remember to use a condom. Finally, in words that could have been crafted to create maximum stroppiness, she said that if taxpayers declined to pay for PrEP they would be up for much higher expense to treat HIV-positive people. “That sounds like blackmail,” said the interviewer. The lobbyist disagreed.

Sometimes public policy should not be based simply on cash flow projections. Principles should come into the picture too. Every time a principle – the principle of personal responsibility, for example – is violated in favour of financial pragmatism it becomes harder to invoke that principle the next time.