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            21 / 11 / 16

            Cultural understanding can help science turn fatal diseases into chronic conditions

            • When Frederick Banting (pictured) became the first person to use insulin in humans he started the process of turning diabetes from a terminal condition into a chronic one. Unbeknownst to him at the time, he would changes the lives of billions of patients in the future.

              Prior to the 20th century, a diagnosis of diabetes was pretty much a death sentence. Symptoms such as excessive thirst and weakness were a precursor to a slow and painful death. The discovery of insulin – originally made from frozen, ground and filtered dog pancreas – changed that forever. There were many more developments over the years that improved the treatment of diabetes but the discovery of insulin was key.

              Reading of Banting’s birthday on November 14, I pondered how medicine has turned other terminal conditions into chronic diseases, conditions that can now be managed effectively thanks to improvements in science and medicine.

              A recent BBC video introduces two HIV patients: one is 22 and newly diagnosed, and the other has been living with the condition for 30 years. The programme gives a fascinating account of how the lives of HIV patients have changed over the years. Soon after we first heard the acronyms HIV and AIDS back in the mid ’80s, there followed a state of hysteria over a new disease that was killing thousands of people indiscriminately. In the words of George, the 54 year old patient, “when I was diagnosed, you weren’t expected to live more than a few years. [E]very month there was a funeral. Friends just disappeared.”

              There was no cure, and it affected people rich and poor, young and old. Many of us remember the hyperbolic, offensive headlines that followed the epidemic. Imagine what it would be like now with the unstoppable beast of social media helping to stoke the flames. You can almost hear Trump’s rhetoric.

              But fast-forward 30 years and the picture is very different. Yes, HIV is still a very dangerous, potentially fatal condition, but incredible advancements in medical science mean that the vast majority of HIV patients who are able to get treatment can live life to the full, treating the virus like a chronic condition which can be managed with an effective drug regime. Gone are the days when the patient would spend 10 minutes swallowing a colourful cocktail of medicines. Some patients can now be treated with a single tablet. George was taking eight tablets, five times a day. Now its one pill three times a day. According to George, the biggest challenge is remembering to take them.

              Even some cancers are beginning to be seen more and more as manageable, chronic conditions. Blood disorders such as leukaemia can be controlled with a daily medication, letting patients live an almost normal life with a normal life expectancy. Other cancers, such as testicular cancer now have an almost 100 per cent cure rate if caught early enough. As recently as 1985, the diagnosis of testicular cancer was a death sentence.

              Yet, there are many cancer types that have an incredibly poor prognosis. Lung cancer and pancreatic cancer still have incredibly low survival rates and there is little available in terms of medical treatments that can help. Sure, there are some drugs that will prolong survival for a few months, maybe years in some cases, but in general the news is rarely positive.

              The reasons for this lack of progress are varied – lack of funding or interest, or the difficulty in treating the type of cancer. But very often the main reason is the cancer is discovered too late to treat effectively. For almost all cancers, the earlier the diagnosis the better the chance of successful treatment. So we need to get better at raising awareness. For all cancers. Not just the ones where there is the most funding, the highest levels of PR or powerful campaigning groups supporting the cause. But for those where there is less noise and support.

              Take the examples of breast and lung cancer. One is perceived very much as a “blame free’ disease, has huge reserves of funding and an incredible PR machine behind it. The other is still perceived as a cancer that is brought on by the lifestyle of the patient, has far less funding and far less PR backing. The result? One has one of the most improved diagnosis and survival rates in the world. The other is still the common cancer with the lowest survival rate after Pancreatic cancer.

              Despite the regular and varied PR nightmares that the pharma industry suffers – such as pricing and access controversies or accusations of inappropriate marketing – there are far more instances where the people who work in the industry have genuinely improved the lives of millions of patients. The problem is they’re not always very good at talking about it. That’s where we come in. As brand and communication experts, it’s our job to make sure these stories are heard and told around the world.

              Health through the Culture Lens is a weekly series exploring important cultural currents in health and pharma

              • Article by Lee Gazey