Caribbean Community (Caricom) leaders met with United States Vice President Mike Pence on the margins of the final day of the Summit of the Americas in Lima, Peru.Caricom Heads of State and delegation meeting with members of the US CongressSecond Vice President and Foreign Affairs Minister Carl Greenidge told the Department of Public Information (DPI), following the meeting, that Caribbean leaders “took advantage” of the opportunity to dialogue with Vice President Pence.“It was a good opportunity to at least exchange ideas at practically the highest level in the United States,” Minister Greenidge said. Greenidge noted Vice President Pence confirmed that the US remained interested in the Caribbean and Latin America.During the meeting, the Caricom Heads of State and delegations also had discussions with the Vice President’s team, including the new Head of the United States Agency for International Development (USAID).“It was a wide-ranging discussion. The Caribbean raised many of the problems they would have raised before, but also looked at an ongoing framework of cooperation with the US and setting a scene for the types of discussions that may arise,” Minister Greenidge explained.The discussions, in relation to Guyanese concerns, were along the lines of migration and crime and security. “We share, of course, some of the other things the Caribbean would normally have,” Minister Greenidge added.These include resilience, the problem of de-risking and the disappearance of correspondent banking. The regional leaders also raised concerns over the rigid formulation and enforcement of rules without reference to the so-called collateral damage that they may pose, especially on small States, Minister Greenidge noted.The Caribbean Region is considered the “third border” for the United States. The US State Department notes that the US’s Caribbean 2020 multi-year strategy seeks to engage the Caribbean Region “in the areas of security, diplomacy, prosperity, energy, education, and health”. This will be coordinated by the State Department and USAID.Following the meeting with Vice President Pence, the Caricom leaders were also engaged by several members of the US Congress.The Caricom Heads of State and delegations were participating in the eight Summit of the Americas, which was hosted by the Organisation of the American States under the theme “Democratic Governance against Corruption”.World leaders from the Caribbean, Latin America, the US and Canada adopted the Lima Commitment in line with the theme and have pledged to do more to eradicate corruption in public office.
Politicians aren’t always as dumb or cynical as they sound, but you wouldn’t know that from Wednesday’s confirmation hearing for Scott Gottlieb. Democrats criticized the nominee to run the Food and Drug Administration for the “conflict of interest” of knowing too much about the industries he’d regulate. (4/5) JAMA: Prime Time For Shared Decision Making Viewpoints: Gottlieb At FDA — A Change Agent Or A ‘Man Who Knows Too Much’?; ‘Prime Time’ For Shared Decision Making A collection of public health opinions on health care from around the country. This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. This doctor was once a student like me. Now she is using vulgar language to describe a patient and flying into a rage because a sub-intern called her. The interaction shook me, mostly because I knew I wasn’t immune to becoming a doctor like her. I started looking for answers about how or why this transformation takes place. An abundance of articles in medical journals made me realize that the health care system can be harmful to doctors’ mental health. Burnout affects all medical specialties, at rates climbing higher than 50 percent. Doctors get worn out by daily battles with insurance companies, cumbersome electronic medical records, and increased patient caseloads. The lack of job control coupled with low reward and high demands increase exhaustion. (Erin Barnes, 4/5) As an investor in early-stage life-science companies, Gottlieb has presumably developed a hard-won, highly valuable understanding of the nuance of product development. This will help him identify opportunities for accelerating the approval process, as well as to head off any nefarious attempts to game the system at the expense of patients. If Gottlieb can leverage his experience as a company builder (along with his experience as a doctor, policy wonk and cancer patient), he might be able to unleash the latent passion within the FDA and inspire its innate creativity. With the right leadership, the FDA — however improbably — might lead us out of our present health-care miasma. (David Shaywitz, 4/5) Last winter, the mayor of Ithaca, New York, Svante Myrick, proposed to provide a safe and legal space in which people could inject heroin. It may sound like a radical and desperate way to reduce the harms of drug use. But its effectiveness — and cost-effectiveness — is well supported by research. Supervised injection facilities (SIFs) such as the one proposed by Mayor Myrick are a close cousin to syringe exchange programs (SEPs). The difference is that SIFs don’t just provide clean injection equipment, as SEPs do, but also medical staff for supervision of injection of preobtained drugs, which can prevent unsafe techniques and drug overdoses. (Austin Frakt, 4/5) The recognition that informed patients often choose more conservative and hence less expensive medical options has made shared decision making a focus of value-based care. In 2007, Washington State passed legislation incentivizing shared decision making as an alternative to traditional informed consent procedures and forms for preference-based treatment decisions that include an elective procedure, such as joint replacement for hip or knee osteoarthritis. (Erica S. Spatz, Harlan M. Krumholz and Benjamin W. Moulton, 4/4) The Washington Post: Trump’s Nominee For The FDA Could Be The Leader The Agency Needs Stat: To Fight Physician Burnout, I’m Making A Binder Of Medical Successes JAMA Forum: Safe Injection Facilities Reduce Individual And Societal Harms St. Louis Post-Dispatch: Children Are The Collateral Damage Of Nation’s Opioid Epidemic The theory is that generic drugs should be less expensive than the original. By the time a generic hits the market, the drug’s patent has expired, allowing competition from companies that didn’t spend millions of dollars to develop it. As more options become available, prices are supposed to drop. But because of quirks in America’s regulatory system, it doesn’t always work out this way. (Mark L. Baum, 4/5) Stat: Why President Trump Needs To Finally Name A Science Advisor Insights from science and technology are relevant to many of the decisions about actions and policies that a president must make — whether they deal with the economy, public health, urban issues, transportation, agriculture, land use, the environment, or national security. What are the potential benefits of new gene-editing technologies, and what are the risks? What effect does hotter weather have on agricultural productivity? Could terrorists make an effective nuclear bomb if they were able to steal or buy plutonium or highly enriched uranium? While scientific insights won’t be the only factors the president considers in any given decision, it would be foolish for him to make policy or take action without having the relevant scientific facts. If access to those facts is to be timely, the president needs people close at hand, in the White House, who can find, vet, and explain them. (John P. Holdren, 4/5) I write prescriptions most days in my work as a family physician. These prescriptions are often for commonly used medications, such as antihypertensives, antibiotics, and antiglycemics. Writing the prescription is a small part of what happens between a physician and a patient. Recently, I have started to write a different type of prescription. In some situations, these unconventional prescriptions may be as important, if not more important, as traditional prescriptions. (Norah Neylon, 4/4) Foster care programs across the country are overwhelmed by an influx of children dubbed by health care officials as “opioid orphans,” collateral damage from the nation’s opioid-addiction epidemic. They are youngsters who have been literally orphaned or left in the care of aging grandparents or other young siblings because of parental drug abuse. Statistics are slim in Missouri, where state Department of Social Services officials have refused to acknowledge or speculate about whether drug abuse has caused the four-year uptick in foster care needs. The department’s latest annual report, with data from 2015, indicates the system is strained. It said more children were entering foster care than leaving, and that social workers need manageable caseloads to help find permanent homes for children. (4/5) The Wall Street Journal: How FDA Rules Made A $15 Drug Cost $400 JAMA: The Prescriptions I Write The Wall Street Journal: The Man Who Knows Too Much