Ottawa discusses a national drug plan and a large HIV vaccine trial gets underway: CBC's Health Newsletter

Second Opinion is a vital dose of the week's news in health and medicine, from reporter Kelly Crowe and CBC Health.

Plus why astronauts experience vision problems back on Earth, in this week's Second Opinion

A parliamentary committee is exploring the idea of a national publicly-funded drug plan in Canada. (CBC)

"It's not sexy, it's not sensational." 

But the idea of a national drug plan is being explored by a parliamentary committee, something Dalhousie professor Mathew Herder believes could be a first step in moving toward a national pharmacare program. This week we have a peek inside the committee room where the contentious idea is being examined.

We've also got stories about a new trial in the search for an HIV vaccine and a look at why going into space can mess with your vision back on Earth.

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Testing the water on a national publicly-funded drug plan

Far from the media scrums, in the political safe-zone of a parliamentary committee, a radical idea in public health is being examined. There's been almost no media coverage. But many of the major stakeholders in Canada's health care system — the pharmaceutical industry, doctors' and nurses' associations, patient advocacy groups — have been invited to testify.

The House of Commons standing committee on health is on a fact-finding mission, testing the water on a national drug plan, even though it's not officially on the federal government's agenda. The committee has no legislative authority, but it can ask questions and report on its findings.

NDP health critic and Vancouver Kingsway MP Don Davies (centre) launched a parliamentary study into a national prescription drug plan last April. (Christer Waara/CBC)

"This is a clever way of having ideas put out there without it coming from the health minister or the prime minister," said Steve Morgan, a UBC health policy researcher, who showed that a national plan could cover every drug for every Canadian and still save billions of dollars in public and private drug costs.

Canadians pay some of the highest drug prices in the world. Studies have shown that one in 10 Canadians say they can't afford to take their medications as prescribed. "Every shift, every night or day, we see the impact on patients who are not taking their prescribed medications," the president of the Canadian Federation of Nurses Unions, Linda Silas, told the committee on Tuesday.

As part of this blue-sky thinking, randomly selected Canadians have been given a crash course in the health-care system and then assigned to imagine their ideal version of a drug plan. The Citizens' Reference Panel on Pharmacare report will be unveiled to the committee on Tuesday.

"I'm not surprised it's off the radar. It's not sexy, it's not sensational," said Mathew Herder, Dalhousie associate professor of law and medicine. He thinks the committee hearings are the beginning of "the hard work of implementing a good idea."

Q&A: Dr. Glenda Gray on an HIV vaccine

The first trial to test the effectiveness of an HIV vaccine since 2009 is getting underway in South Africa, where more than 1,000 people are infected by the virus every day.

Scientists are testing a new version of the only HIV vaccine ever shown to provide some protection from the virus. That vaccine was tested in Thailand, and showed about 30 per cent effectiveness in preventing HIV infection for participants during the trial. Dr. Glenda Gray is the head of South Africa's Medical Research Council and is leading the new vaccine trial. This interview has been edited for length and clarity.

Dr. Glenda Gray is leading the first HIV vaccine efficacy study to take place since 2009. (Fred Hutchinson Cancer Research Center)

Why has it been so difficult to find an effective HIV vaccine?
HIV replicates all the time, and it is hard to find parts of the virus that are non-variable and that stay constant so you can develop immunogens that could target those areas. Also no one has ever recovered naturally from HIV, so we can't learn about what protects against infection. The lack of reliable animal models also has not helped our cause.

What is significant about the South African clinical trial?
This is the most advanced vaccine trial, it is the first in many years, will only be conducted in South Africa, and is focused on the [HIV subtype found in southern Africa].

And here are some photos of how World AIDS Day was marked around the globe earlier this week.

Sciencing the hell* out of cancer

Cancer is complicated. Every single patient has a unique disease. This week, a leading cancer researcher explained how that genetic and mutational complexity might be the secret to future treatments. Dr. Pier Paolo Pandolfi even dares to use the "cure" word. But getting there means they'll have to "science the hell out of it."* Listen to the conversation with Kelly Crowe on CBC Radio's The Current.

*courtesy Matt Damon in The Martian

In search of naloxone

​It's a life-saving antidote for an opioid overdose — but can you get it when you need it? That's the question Kas Roussy and Melanie Glanz asked this week. They spoke with advocates who say naloxone should be much more readily available, and one Winnipeg mother who's determined to make that happen.

Do-it-yourself dialysis

Travelling hundreds of kilometres for life-saving treatment is just a way of life for people living in remote Indigenous communities. But in northwest Ontario, there's a man who's saving himself the trip. Steven Chapman has kidney disease, and needs weekly treatments to stay alive. So they've shipped in a home dialysis unit and trained him to use it. Jody Porter looked at the risks involved, and whether it could work elsewhere.

'Miami, we have a problem'

That's how NASA approached him in 2010, jokes University of Miami biomedical engineer Noam Alperin. The space agency was alarmed that many of its astronauts were experiencing blurry vision after returning from space. Further testing revealed a flattening in the back of eyeballs, as well as inflammation in the head of the astronaut's optic nerves.

Many astronauts experience blurry vision when they return to Earth. New research suggests it could be caused by a build-up of cerebrospinal fluid in the cranium and the eye globe. (NASA via Reuters)

Scientists originally blamed the changes on the build-up of blood in the head that happens in the low-gravity conditions of space. But NASA wanted Alperin and his team to look at another possible culprit: the cerebrospinal fluid, or CSF, that protects the brain and optic nerve. The researchers had already developed a way to measure changes in CSF using MRI technology, so they applied the technique to astronauts on both short and long-duration flights.

What Alperin found is that astronauts who spent longer in space experienced increased CSF in the cranium and the eye globe, as well as more severe deformation of the eye. "When you are upright, some of the CSF from the cranium goes down to your spine, but this doesn't happen in space," he explains.

Alperin is now off to Germany, where he will put people into a head down tilt to try to simulate the phenomenon on Earth, and then test some possible solutions.

We recommend...

Here are some other stories we found interesting this week:

  • Why science news embargoes are bad for the public | VOX
  • 'I'm going to die anyway': Should terminally ill patients in Canada get 'the right to try'? | Ottawa Citizen
  • The real plague affecting science? It isn't fraud | STAT

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