Louise Delany, Senior Lecturer, Assoc Prof George Thomson*
In this blog we ask what the tobacco ‘carve out’ from the Trans Pacific Partnership (TPP) Treaty means for public health. Despite the partial exemption of investor-state dispute settlement (ISDS), the TPP agreement as a whole applies to tobacco, and breaches of the TPP might, in principle, be alleged in relation to tobacco. The TPP provides mechanisms to pursue complaints for breaches of its obligations in addition to ISDS. These other mechanisms remain unaffected by the partial, and optional, exclusion of ISDS. While the partial investor-state dispute settlement exclusion is a small step in the right direction, the fundamental inconsistencies between agreements such as the TPP and public health in general are left untouched.
Prof Michael Baker & Prof Nick Wilson
NZ has a long-running Campylobacter infection epidemic with contaminated fresh poultry the major source. Added to this problem is the recent rapid emergence of antibiotic resistance in these Campylobacter infections acquired from locally produced poultry. In this blog we briefly detail these problems and explore potential solutions: (i) build on the past NZ success of regulating lower contamination levels in poultry; (ii) publicise contamination levels by poultry brand; (iii) label fresh poultry with information about Campylobacter contamination and how to reduce the risk; and (iv) encourage consumers to switch to frozen or cooked poultry – or switch completely to other protein foods.
Associate Professor George Thomson, Professor Richard Edwards
There is growing frustration with lack of robust action and progress at the national level with the Smokefree 2025 goal. However, it is not all bad news. A major avenue of hope for a smokefree Aotearoa comes from the enthusiastic efforts by local coalitions of local government, NGOs and iwi. Here we detail some of the progress since 2013 in eight city and district council areas. Highlights include significant downtown smokefree areas in Whanganui, Palmerston North and Whangarei, an innovative smokefree pavement dining bylaw in Palmerston North, smokefree pavements in front of Horowhenua early childhood centres and schools, and smokefree bus stops in a number of places. The race to become the first place to be smokefree in Aotearoa is on!
Ngati Kahungunu: A leader in smokefree/tobacco free events
Professor Tony Blakely
Keytruda, or pembrolizumab, is a new immune inhibitor drug that appears to have pronounced effectiveness in slowing – even reversing – disease progression in patients with advanced melanoma. It has received much media attention in recent months, and even calls from politicians to over-rule the PHARMAC process (currently PHARMAC do not recommend funding). In this blog I apply our BODE3 rapid cost-effectiveness calculator, and find that Keytruda may well be (just) cost-effective – but with huge uncertainty, and variably by age. This blog closely reflects a Radio New Zealand interview with Wallace Chapman last Sunday.
Prof Tony Blakely, Prof Nick Wilson
In this blog we comment for a second time this week on the consultation draft of the NZ Health Strategy, focusing this time on preventive interventions that actually would make a meaningful difference to health in Aotearoa NZ. The draft Strategy has many strong aspects, but by having a ‘people centred’ approach it gravitates to IT systems and individual-level actions, and drifts away from population-level prevention activities that would have the biggest health impact (a goal of the strategy), reduce health inequalities (another goal of the strategy) and be best value for money (yet another goal of the strategy). We recommend that the word ‘prevention’ needs to be more than a garnish sprinkled through the document, but rather an actual substantive item on the menu of offerings. We conclude by offering up some interventions for comparison, and note that the population-wide interventions not highlighted in the Strategy can have an impact on health gain and costs (savings) far in excess of those implicitly in the Strategy’s focus.