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Anand Chaturvedi, an executive for Korean Company Doosan Infracore- which acquired Bobcat from Ingersoll Rand- and his wife Garima, a doctor in internal medicine, both in their mid 30's, and their lives between two continents. Chaturvedi works for Doosan in Atlanta and Garima set up the diabetes clinic in Udaipur, Rajasthan. A couple's unique way of working to provide help to deal with diabetes in India, as a way of honoring a brother who died of cancer.

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This essay from the Yale-Griffin Prevention Research Center which puts focus on preventive medicine looks at the food we eat in a different way. In order to have a real conversation on food it says ignore the latest fads on nutrition on keto, paleo or other diets, and think about how our ancestors ate in a healthy way that both prevented disease and provided the right nutrition. It was mostly plants as meat was not freely and easily available. So much so that the consumption of meat and animal protein may have gone up by as much as 90% today. Processed foods did not exist, and unprocessed plant foods were there in abundance. They were not called low fat low carb or vegan then. It is during the beginning of the 19th and in the 20th century that the production and marketing of shelf stable, nutrient poor, high calorie, high sugar and salt processed foods replaced the normal way our ancestors had their food leading to the public health crisis of today, both in health quality, outcomes and cost.  It says replace meat and where appropriate dairy healthier plant based beans, lentils, whole grains, and vegetables, fruits so that animal protein gets back to the levels of the centuries before the 20th century shift to processed foods. It says use common sense beans including soyabeans and lentil beans replace meat wherever possible and oats with berries and nuts replace eggs. Vegetable and garbanzo beans salad replaces cheese and yogurt reducing the cheese or yogurt to very moderate levels. Focus on wholesome food and eat like our ancestors did and exercize then everything else will fall into place. ...

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Britain's National Health Service has setup a medical review of gender treatment of young people. It's conclusion after 4 years of research- "The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.” This NHS review found no clear proof that  gender dysphoria in children or teenagers was resolved or alleviated by what is called gender-affirming care, where a child's declared “gender identity” is affirmed and supported with social transition, puberty blockers and/or cross-sex hormones. After Cass the British government issued an emergency ban on puberty blockers for children under age 18. A similar approach is being taken in the Scandinavian countries, and in Netherlands, France, Germany, Belgium, Switzerland, the move is away from medical treatment of gender issues. American medicine, Cass says is “out of date,” and has put politics ahead of science.Not one American medical association or governmental official has reached out to discuss Britian's Cass report. Says Cass- “I think that’s where you’re misleading the public. You need to be honest about the strength of the evidence and say what you’re going to do to improve it.”   ...

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There is no treatment for nonalcoholic fatty liver disease linked to obesity. It is twice as prevalent in Hispanics compared to other whites and African Americans. The fatty liver is a result of bad eating habits and lifestyle with little exercize. It is expected to be the leading cause of liver transplants in the U.S. by 2020. At the current rate about 25 millon Americans are expected to have the disease by 2025, according to the chief of liver transplant division at UCLA School of Medicine.

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In a sign of the changes roiling the pharmaceutical industry the off patent business of American maker Pfizer is based in Shanghai. The generics business of Mylan Pharmaceutical is incorporated in Netherlands and run from Pittsburgh. Pressure is increasing in the generics industry from manufacturers in India and China. Pfizer announced the merger of its Upjohn off patent pharmaceuticals business with Mylan to fight pricing pressures. Pharmaceutical prices in the U.S. are the  highest in the world and generics offer only small relief compared to the government mandated pricing of the same pharma products in India. Generics drugs are also offered at lower prices by distributors who buy in bulk adding to pricing pressures in the U.S. The government rarely intervenes in the negotiated prices as it does in India or in other countries in Europe including Britain.  In fact many asthma patients young and old alike are forced to do without inhalers because of the exorbitant prices set by American manufacturers with scant help from government under Democratic or Republican administrations in the U.S. In this respect middle class customers in India have better access to asthma inhalers as well as hundreds of other medicines basic to healthy living. This has created a greater level of basic equity/fairness in India as well as in Europe in this regard than in the U.S.  In this sense the pricing of basic care medicines in the U.S. adds to the sense of a lack of fairness. To that is added the manner in which the banking and financial industry operated resulting in the financial crisis of 2009 and damage to the bank savings accounts of ordinary Americans hit by unemployment, underemployment, and lower savings accumulation with interest rates kept low to offset the damage done by the banks through bad lending. This is also why an astonishing percentage of Americans like never before in the last 50 years do not have basic funds for spending to manage a health crisis in the family. Just as in times of the Depression in the U.S. industry operates in a way that is oblivious to what ordinary Americans are experiencing only to be excoriated by FDR. ...

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The need for a global response to a global problems not a lot of local solutions is the subject of this article by Dr. Larry Brilliant, who for 7 years 1973-80 worked with the World Health Organization to eradicate smallpox globally. 1. Action for a global response-The WHO can act as the vehicle for action globally-  restructure it and empower it to do the job. Put the right people in place who have the confidence globally. Set a new pandemic treaty and put it in place. 2.  Get a more advanced version of the mRNA vaccine which does not need a cold chain. India is reportedly working on one. Put funds and people in place for vaccine drives in poor countries.  Other action needed is learning from the situation in South Africa where the HIV patients are reported by Stephanie Nolan in NYT to have been more susceptible to mutations of the new variant. How can resources be put in place in poor countries so that patients in vulnerable populations get their medicines regularly, and are vaccinated. Overall how can these populations have the vaccine supplies needed- including ones without cold chain suggested by Larry Brilliant, potentially through vaccine work in India. Can international teams be developed with developed countries in Europe and US financing the effort and India offering its manpower and knowhow?   ...

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Glaxo's 2008 earnings take a hit of $400 million from a settlement of a five year investigation by the US attorney's office in Colorado and the US Attorney's office in Massachusetts. The investigation was about the manner in which Glaxo marketed its antidepressant drug Paxil and the drug Wellbutrin SR. Glaxo is said to have promoted the depressants for off-label uses. This follows settlements of $2.3 billion by Pfizer for off-label promotion of painkiller Bextra. Eli Lilly settled with $1.4 billon for similiar charges on antipsychotic medicine Zyprexa.

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Astra Zeneca faces over 9000 lawsuits from people who developed diabetes after taking it. Its a drug for bipolar disorder and schizophrenia that has sales of $20 billion over the years, with $4 billion in 2008. Now it is revealed that Astra Zeneca conducted studies on the effectiveness of Seroquel from 2000, and these studies show that Seroquel was less effective than a generic medicine haloperidol, that has been around for 50 years. Seroquel was only more effective than a placebo,the analysis says from hundreds of pages of unsealed documents.

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Mr. Newsom's win by a large margin in California's Governor recall election suggests a new approach might work for Democrats in pushing back on Republican challenges. This is to focus on the Covid 19 efforts of government and make Mr. Trump the issue to generate enthusiasm among Democrats. US president Biden says the Newsom victory is a result of voters supporting the approach taken by Democrats for response to the pandemic: "strong vaccine requirements, strong steps to reopen schools safely, and strong plans to distribute real medicines." The California governor recall election results are that 64% voted for Mr. Newsom, more than the 62% who first elected him governor, and close to the 63% who voted for Mr. Biden in 2020 US presidential election. Democrats outnumber Republicans two to one in California yet the results showed this new approach might work for Democrats- working at the grassroots level to build support and energize its voter base, and to follow its own action based approach to Covid 19. ...

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A comprehensive study on immigration's impact on the U.S. by the National Academies of Sciences, Engineering and Medicine in 2016, looks at the broad fiscal and economic impacts of immigration. On the drawbacks the new immigrants can lead to lower wages for earlier waves of immigrants and high school dropouts. It can also burden government finances, education budgets at local and state levels. On the plus side it leads to more innovation, entrepreneurship and technological change in the economy. Other facts that are new in the report and run against the popular narrative are that 53% of immigrants had at least some college, including 16% with graduate education, as of 2012- which explains the technological impact of being open to immigrants. It is this that helps lift overall growth says the report- "the prospects for long run economic growth in the United States would be considerably dimmed without the contributions of high-skilled immigrants." About 42.3 million immigrants live in the U.S. in 2014, 13% of the population, increasing from 24.5 million or 9% in 1995. Unauthorized immigrants doubled in this period to 11 million.  A surprising result considering the popular idea of anti-immigrant sentiment in the U.S. is that a WSJ/NBC poll shows 54% of respondents saying immigration helps more than it hurts. In 2006 only 45% to 42%, considered immigration as beneficial to the country. Immigration is an issue today even though in recent years the large scale deportations under the Obama administration and difficulty finding jobs have reduced the flow of immigrants - since 2009 about 300,000-400,000 new unauthorized immigrants arriving and similar number leaving.   ...

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The cooperation announced between India and Britain on the experiment to look at one grid between countries in different time zones could be a game changer in the way new technologies have already achieved in making solar less costly than fossil fuel. Embrace of new technologies is essential for achieving net zero emissions. India first proposed connecting solar energy across countries and time zones at the International Solar Alliance in 2018. If a way can be found to integrate the grid across time zones the problems of solar energy could be tackled effectively. Storage would not be needed in the way it is now as the solar energy can be sent to other areas with the demand. And the equally vexing problem of supply can be solved as the regions such as Spain could be generating solar energy when the sun had set in India. It is ambitious but it also brings in scientists and engineers from Europe, America, India and Japan to tackle the problem. There is also the opportunity to build on one discovery to make another scientific discovery in the way advances have happened in medicine and science.  And nothing about net zero is not ambitious. One of the lessons Modi learned early in Gujarat is that experiments are needed and to never rule out new ideas. In some of his speeches he describes the early experiments with electricity and solar energy in Gujarat that led to more ambitious efforts over time, and eventually to where solar targets like the one made at COP26 Glasgow of 500 gigawatts by 2030 are now within reach. ...

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Nancy Koehn reviews Marc Freedman's "The Big Shift: Navigating the New Stage Beyond Midlife." Freedman says baby boomers need a new "map of life " to approach the extended years of life that modern medicine and longevity provides. Some way to redefine their lives with purposefulness and commitment. He calls this the encore stage of life, and sees this as a new opportunity if handled in the right way. Accumulated experience and struggles through prior years can be helpful evolving in new ways to find one's passion, for purposeful activity that contributes to the life of future generations.

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A bill passed in the House and now going to the Senate in the US will put a tax on remittances of 3.5% for people who are not US citizens or nationals. It was at 5% but lowered to 3.5% just before the vote. 

Total remittances from the US in 2023 are  $656 billion, according to the World Bank. Total remittances to Africa from US $12 billion of $92 billion total. DW.com shows a family outside Accra, Ghana depending on these remittances for food, medicine and education.

An out of control migrant problem with tens of millions of migrants flooding the US and Europe became a major issue in the 2024 US election. Voters clearly supported strong action to control migration and human smuggling across borders.

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Joe Biden was about 78 when he entered the presidency. Reagan ended his presidency at age 79 in 1989. It is about 35 years since Reagan, and advances of medicine are making it possible for people to work longer with retirement ages extended to age 65 in many countries. Mr. Biden looks healthy and brings much experience from his decades in the Senate of the US. His 36 years in the Senate are the longest for any president. Turning 80 should not be a hurdle in that sense if one is healthy and the country needs this experience. During a foreign affairs crisis with China and Russia this experience of 12 years as ranking member of the Senate Foreign Relations Committee is invaluable. More so as Biden reflects America's values. During his 36 years in the Senate he put forward the Violence Against Women's legislation in Congress. As Vice President he continued to advocate for working class and middle class and for families. One has to go back to Harry Truman to sense this kind of fervent and resolute action for workers and families, and for the American people. As president he passed the $1 trillion legislation for Workers and Families and to fight Climate Change. Building America Back Better is one of its goals and further investment in America and its people is being pushed forward.  Mr. Biden is living at a time when there is a struggle for the soul of the nation and he believes in his role in this struggle which gives him the energy he needs for his role in 2024 for continuing the work he has begun. ...

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The purpose of the National Education Policy was to prepare India's young people for India as a developed modernized country and to meet the educational needs of such an economy. The idea was to break the idea of silos based education that separate the science, engineering, medicine, law, arts, humanities, languages based education into separate non mixable parts. It is based on the idea that in modernized economies one needs critical thinking abilities, creative thinking, that mixes the humanities and arts with sciences, with engineering, and other scientific fields.  Because of India's diveristy, history of disadvantaged populations, to build an inclusive economy is also a goal to tap into the widest pool of human potential and talent in a country with 1.2 billion people. For this to happen the goals are set for inclusivity for gender and disadvantaged populations.  What is not in NEP is the investment part, and the governance part, both critical for it to be effective. Investment at 4-6% of GDP is inadequate, as this Brookings report point out. For healthcare and education, India has to expand its share of GDP dedicated to these two areas to make it comparable to other advanced nations. This will pay off in infrastructure development and exports led growth as inputs of education are key to get productivity up in manufacturing and in R&D. Governance is essential part of this overall plan as the public school system in India as in Brazil, Mexico and other countries suffers badly from a lack of attention- with discipline, transparency, good government, increasing incomes and rewarding teachers at every level. ...

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Silbersweig of the Brigham and Women's Hospital makes a convincing case for the importance of liberal arts and philosophy studies for pursuing a career in medicine. His studies extend from philosophy at Dartmouth to interdisciplinary studies in psychiatry, neurosciences, at Cornell Medical College, to work in these fields and the physical sciences at Brigham. He says the study of philosophy helped him to ask questions, to work and think in unique ways. Interdisciplinary studies are important combined with interdisciplinary work between people from different but related fields, says Silbersweig. Students have to be willing to be explorers and have the broad and rigorous education to make this possible.

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A Commission in Britain has raised serious concerns about transgender medicine and its impact on the health of young people. Parents across the US and in European countries are very seriously worried about the impact on their children creating a great deal of stress, coming so soon after the pandemic when elder care caused much distress.

Cass Commission's 4 year research for Britain's National Health Service concludes that gender affirming approach is mistaken. The American Medical Association, the American Academy of Pediatrics and the Department of Health and Human Services, are not a taking a science based approach to this important issue for parents of children, and the serious unease this is causing across the Nation in 2024, is shown in a report in the NYT by Pamela Paul.

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Emily Baumgaertner of NYT does a wonderful report on how RFK Jr. is right on the dot when it comes to obesity and health, chemicals in food supply and health, affordability of medicine and Pharma. There are so many points most Americans can agree on if only they listened carefully and looked for ways to tackle serious problems such as health and obesity, by avoiding getting tangled up in propaganda lines or controversial headlines. As this report shows Senator Booker and other Democratic senators, share a common concern with RFK Jr., the rest of the American people and most Republicans in Congress about the fight to get Americans good health practices- removing chemicals from the food supply, putting healthy foods in school lunches and creating a culture of eating healthy foods, and fighting bad practices. Do this without getting tangled up in controversies about vaccines or spreading misinformation or exaggerating vaccine positions of political opponents. ...

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British Journal of Sports Medicine confirms what other studies have shown. 150 minutes of walking - any kind of walking including up the stairs at home and in the home and outdoors, can reduce health risks including aging by 73% compared to only 49 minutes daily.

Other studies have shown the need in a desk bound work culture to move around and not be statinary or sedentary. That alone lowers health risks and bad backs, bad necks. All types of exercize are important, one does not need a marathon or hard exercise, even the incidental movement throughout the day say medical experts is vastly underestimated. Walking to the bus or subway, tram stop, moving about the house frequently, just stop the sedentary situation plays a big part in remaining healthy.

Veerman, a health expert says find something you enjoy and do it, something you like that is your thing. That includes going up and down the stairs at home.

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Preparations and strategies for the final assault on Tripoli, Libya. The move up the Mediterranean coast to seize an oil refinery in Zawiyah 30 miles from Tripoli, after moving through through the Nafusah mountains in the west. All the time cutting off supplies to the capital and pushing the Gaddafi forces back into the open towards Tripoli, where NATO airstrikes were effective. The rebel army was resupplied with weapons from Qatari special forces and many received military training in Qatar. British and French military advisers provided assistance and aerial/satellite photographs. British, French and Qatari troops provided weapons, fuel, medicine and food. NATO airplanes and predator drones attacked targets as the rebels advanced.

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Pfizer's aggressive promotion of Chantix an antismoking drug. Article by Steinberg and Foulds in the Annals of Internal Medicine, suggesting treating smoking not like alcoholism but like diabetes with lifelong taking of medication like Chantix to curb craving for nicotine after cessation of smoking. The article may have been intended to promote Chantix to insurance companies to cover its use as a drug for treatment of diabetes type lifelong disease. It costs $100 a month for Chantix. The drug can cause depression and psychological disorders so the FDA is considering putting a black box warning on the drug for patients to take due care in using it. Chantix had USA sales of $680 million in 2007.

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What is behind Pew Research Report finding showing an unacceptable concentration of wealth that endangers democracy. Higher income groups making $244,000 a year in 2024 gained 19 percentage points of the total US Household Income moving from 29% in 1970 to 48% in 2024. About 50% of the nation's income going to 20% of its people and most of that to 2%-5% of the people of the US. The gains meant loss of 17 of these percentage points for middle income households making $106,000 a year that went from 62% in 1970 to 43% in 2024. Another 2 percentage points was suffered by vulnerable Lower Income groups making $35,000 a year who owned 10% of US wealth in 1970 went down to 8%.  The problems of divisiveness in the Nation come from three distinct areas. First money for state financed education for all being put into wars in the Middle East from Reagan through Obama and Trump and some wasted through capital misallocation to low priority investment by faulty capital market allocation. Second the high cost of pharmaceuticals and healthcare putting a heavy burden on low income and middle income households making $35,000 or 106,000 a year. Third the neglect of manufacturing that cutoff the opportunities for middle and lower income households and their one chance to move up the ladder. And the parallel shift of resources to technology and financial sectors that created opportunities for a smaller group of immigrant and higher middle income households with these skills.  These are the sources of America's distress and each problem is being attacked at its source by president Biden- exit from Afghanistan, canceling student loans that are egregious and prevent the investment in education America needs, large sustained investment in manufacturing and new supply chains, antitrust action on tech monopolistic behaviour, redrawing the shape of America's pharmaceutical sector to provide access to medicine to all parts of the population.    ...

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The Biden vaccination target of 70% of American adults at least partially vaccinated with one dose by July 4, 2021 remains elusive as vaccination rates have dropped. From a high of 2 million a day vaccinations have dropped to 400,000 a day during the first week of June 2021. Vaccination skepticism particularly in the south and western part of the US is making it harder to vaccinate the rest of the US population. This poses increasing risks as the new variants of the virus such as the Delta variant found in India, and now the most widely prevalent strain of virus in the UK, remain a serious problem. The unvaccinated population in the US is too large for any degree of safety in numbers vaccinated. Consider that at the press briefing given by the White House on June 3, 2021, only 28 states out of 51 states have fully vaccinated 50% or more of their population. There is a large variation between different states with states in the south such as Mississippi as low as 34% at least one dose and a similar situation in Alabama. In Arkansas, Georgia, Carolinas, and Louisiana  it is higher at about 50% with at least one dose. Even these figures are deceiving as in some parishes in Louisiana only 20% have even one dose. Studies show that only after the second dose are enough antibodies released to protect well against coronavirus. This is why vaccine experts at Baylor College of Medicine cited in NYT foresee a second wave in the southern US because of the South so underachieving in the case of vaccination.  ...

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Ursula Von der Leyen is actually a nickname of the new European Commission president from Germany. Her father was Ernst Albrecht, a top CDU politician and state premier for Lower Saxony. She adopted the name when she switched studies from the University of Gottingen in the late 1970's to study at the London School of Economics and changed her name to avoid the attention of the Red Army faction, a terrorist group at that time. Ursula studied at the European School in Uccle, during a time when her father was atop European civil servant in Brussels. Of her time in London she says: "I lived more than I studied...In 1978 I immersed myself for one year in this seething, international, colorful city. For me coming from the rather monotonousm white Germany, that was fascinating. For me London was the epitome of modernity: freedom, the joy of life, trying everything. This gae me an inner freedom that I have kept till today. And another thing I have kept the realisation that different cultures can get along together very well." She switched to medicine, and married a physician. In 1990 she joined the CDU like her father. She held posts related to the family and work ministries, and Merkel promoted her to defense where she did not do as well as at family related ministries, and then to the head of the European Commission, knowing full well the value of an internationalist with outlook broader than Germany's in the European Union of today. ...

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The World Bank's Jim Yong Kim leads an effort to bring infrastructure development to war torn regions, including $1 billion in investment in the war torn Democratic Republic of the Congo. This would help build hydroelectric power plants, roads and agricultural infrastructure, especially along the border with Uganda and Rwanda. This is where Kim sees the World Bank making the greatest difference. Kim is unique because he brings a background in anthropology and medicine, compared to the background in politics and finance of previous World Bank presidents. He increased committments to sub-Saharan Africa to about $14 billion in the current fiscal year ending June 2013, from $12.2 billion in 2012. This is his first year at the World Bank.