Heart attacks and strokes are among the leading causes of death globally, with millions suffering from cardiovascular diseases (CVD) every year. There are more than seven million people in the UK alone, with about 100,000 patients experiencing heart attacks annually. However, a group of researchers at University College London (UCL) estimate that one 'polypill' taken daily day could eliminate a majority of these cases dramatically lowering death tolls.

The proposed polypill, a combination of a statin and three blood pressure-lowering drugs, has been under study for over two decades. Experts argue that introducing this pill universally for individuals aged 50 and above could be more effective than the current NHS Health Check, which assesses risk factors every five years for those aged between 40 and 74.

Studies have repeatedly proven the effectiveness of the polypill in preventing CVD. A groundbreaking 2019 study in The Lancet found that five years' use of the polypill cut the risk of heart attack and stroke by a third. In addition, previous modelling analyses have estimated that if given universally to people over 55, the polypill might be able to prevent 80% of heart attacks and strokes.

Today, the NHS Health Check follows a risk-based model in which patients are tested for CVD risk factors and treated with drugs accordingly. Yet, as per UCL's study, this system has serious flaws:

Low Uptake: Just 40% of those eligible for the NHS Health Check choose to have it, leaving a considerable number of at-risk patients undiagnosed and untreated.

Ineffective Prediction of Risk: The majority of heart attacks and strokes happen to people at average risk levels, thus making it challenging to identify the need for intervention effectively.

Limited Effectiveness: Even at maximum take-up, the NHS Health Check programme is predicted to have fewer health impacts compared to a polypill initiative applied to the whole population.

Simplicity and Affordability of the Polypill Strategy

One of the big benefits of the polypill is that it is so easy. In contrast to the existing screening-based model, the polypill scheme would not involve complicated medical tests or lengthy risk assessments. Instead, people reaching 50 would just have to fill out a few questions to determine possible side effects before they were prescribed.

Professor Aroon Hingorani of the UCL Institute of Cardiovascular Science, one of the strongest proponents of this scheme, says:

"Finally, the time is now to do much better on prevention. A population approach would prevent a lot more heart attacks and strokes than is done today with a strategy of trying to target a smaller group only."

Aside from the possible health implications, the polypill is also an economic solution. The drugs used are off-patent, thus cheap to produce and distribute. With the vast economic cost of managing CVD-related illnesses, a preventive model could result in substantial cost-saving for the NHS in the future.

The polypill has been proven to be effective by numerous international trials. In 2019, a randomised trial in rural Iran discovered that participants who took the polypill for five years had a 34% reduced risk of having a heart attack or stroke compared to non-participants.

Likewise, modelling research has indicated that even if only 8% of people aged over 50 took up the polypill regimen, it would still be more beneficial to their health than the NHS Health Check programme.

Is This a Case of Over-Medicalisation?

One of the main objections to the polypill strategy is the suggestion that it might result in the unnecessary medicalisation of a significant proportion of the population. But, it is argued, it should be considered as a preventative measure, not as mass medication.

Professor Sir Nicholas Wald of UCL's Institute of Health Informatics explains:

"Instead of being a 'medicalisation' of a significant proportion of the population, a polypill programme is a prevention measure to prevent an individual from becoming a patient."

He compares it with public health measures like water fluoridation or compulsory seatbelts—interventions that have been shown to have a significant impact in reducing public health danger at low individual cost.

With the evidence in favour of the polypill's effectiveness and viability overwhelming, experts are calling on the NHS to act now. It is their belief that substituting the NHS Health Check with a polypill-based prevention program could be the UK government's flagship policy under its pledge to put disease prevention ahead of cure.

As Professor Hingorani points out, "The status quo is not a justifiable option." With CVD still a major cause of death globally, taking a population-wide polypill approach could be a turning point for preventative medicine, potentially saving thousands of lives annually. The question now is whether the NHS will take up this call and establish a policy with the potential to transform the prevention of cardiovascular disease on a national level.

In a major milestone in fetal and paediatric neurosurgery in India, doctors at the All India Institute of Medical Sciences (AIIMS), New Delhi, have performed the country's first open fetal surgery to repair myelomeningocele, the most severe form of spina bifida.

The six-hour procedure was carried out at 25 weeks of pregnancy, in which surgeons were able to repair the baby's spinal defect before birth. The surgery, performed on November 12, entailed repairing a cerebrospinal fluid leak in the lower back while the baby was still in the uterus.

According to AIIMS press release, the operation followed more than five weeks of preparation in multiple disciplines, including detailed fetal imaging, counselling, planning anaesthesia and surgical simulations.

The procedure was done by more than 30 clinicians and nurses from neurosurgery, maternal-fetal medicine, obstetrics, anaesthesia, plastic surgery, radiology and neonatology.

Professor PS Chandra, Head of Neurosurgery at AIIMS, who facilitated the entire surgical execution by the neurosurgery team, said that prenatal surgery could help reduce the incidence of hydrocephalus and Chiari malformations linked with spina bifida.

What Is Myelomeningocele?

Myelomeningocele is an open neural tube defect in which the spinal cord and its protective coverings protrude through an opening in the developing spine. It occurs when the neural tube, which eventually develops into the brain and spinal cord, does not close completely during early pregnancy.

The condition can cause permanent nerve damage, muscle weakness or paralysis, loss of bladder and bowel control, and complications involving the brain and spinal cord. Some affected babies also develop hydrocephalus, a condition in which excess cerebrospinal fluid accumulates in the brain.

In many cases, surgery to close the spinal defect is performed after birth. However, exposure of the spinal cord to the surrounding amniotic fluid during pregnancy can contribute to further neurological injury.

India continues to face a burden of neural tube defects. A 2024 review of 27 Indian studies estimated their pooled prevalence at 9.46 per 1,000 births.

Also read: India’s Xenotransplantation Push: Can Pig Organs Help Bridge the Organ Shortage? | Interview

Is Fetal Surgery The Way Forward?

Unlike conventional postnatal surgery, open fetal repair involves operating on the fetus while it is still inside the uterus. The surgeon accesses the uterus, exposes the affected area of the baby's spine and closes the defect, protecting the exposed spinal cord and its coverings. The aim is to limit further damage to the developing nervous system and improve certain neurological outcomes.

Professor Deepak Gupta, who led the neurosurgical part of the procedure, said, “This establishes an important new capability for fetal care and paediatric neurosurgery in India. In rigorously selected cases, prenatal repair seeks to limit ongoing injury to exposed neural tissue, reduce the subsequent need for cerebrospinal-fluid diversion for hydrocephalus, and improve selected neurological outcomes. It is not a cure, and long-term multidisciplinary care remains essential.”

Evidence for prenatal repair comes from the landmark Management of Myelomeningocele Study (MOMS), an international clinical trial. It found that 40% of children who underwent prenatal surgery required a cerebrospinal fluid shunt by 12 months of age, compared to 82% of those who underwent surgery after birth. Prenatal repair also helped with better motor outcomes and a lower incidence of hindbrain herniation linked with Chiari II.

But fetal surgery comes with its risks. It can increase the chances of premature delivery. It also carries risks related to the opening and subsequent healing of the mother's uterus. It is therefore performed only on carefully selected pregnancies at specialised centres equipped with resources.

Milestone In Fetal Surgery

The AIIMS procedure brings a complex fetal intervention, which is already done in other countries, to India's public healthcare system.

Professor Neena Malhotra, who led the maternal-fetal medicine and obstetric part of the surgery alongside Professor K Aparna Sharma, said, “This accomplishment reflects the collective commitment of an exceptional multidisciplinary team.”

Professor Sharma added, “Fetal intervention in this case is a very well-reasoned and planned decision to optimise the outcomes of both the baby and the mother. The safety of both mother and fetus depends on detailed counselling, high-quality anaesthesia, and coordinated surveillance before and after surgery.”

AIIMS said the procedure was performed free of cost under the Government of India's Janani Shishu Suraksha Karyakram (JSSK). The mother and fetus will continue to receive close monitoring throughout the remainder of the pregnancy, delivery and newborn period.

Also read: First Human Spinal Cord Transplant Reported In Russia But Can It Reverse Paralysis?

Can Spina Bifida Be Prevented?

Prevention of spina bifida remains essential even though the option of fetal surgery is available. Neural tube closure takes place within the first 28 days after conception, often before a woman realises she is pregnant.

Adequate folic acid intake before conception and during early pregnancy can significantly reduce the risk of neural tube defects. Preconception counselling, folic acid intake and dietary interventions with folate are therefore important to prevent spina bifida.

The World Health Organization (WHO) has issued its first-ever guidelines for the diagnosis and management of type 1 diabetes in adults. The recommendations aim to improve insulin access and blood glucose monitoring in countries where healthcare resources are limited.

Released on November 14 to mark World Diabetes Day 2026, the guidelines cover insulin treatment, blood glucose monitoring and care in emergency and humanitarian settings. They are meant to help healthcare providers deliver safer treatment, regardless of the resources available.

The guidelines come as the global burden of type 1 diabetes continues to grow. In 2025, 500,000 people were diagnosed with type 1 diabetes, adding to an estimated 9.5 million people living with the condition worldwide in 2025, according to the WHO. Although type 1 diabetes is often diagnosed during childhood, it can develop at any age, including adulthood.

WHO Guidelines On Type 1 Diabetes

Also read: Effect of Diabetes on Different Organs: Why the Damage Is Not the Same Everywhere

A primary recommendation is intensified insulin treatment through multiple daily injections, along with the doses adjusted according to blood glucose levels. People with type 1 diabetes cannot produce enough insulin and therefore need lifelong insulin therapy to survive.

The guidelines recognise insulin as an effective and affordable treatment option. Insulin analogues, which are modified forms of insulin designed to alter how long the medicine works, may also be used when needed. The guidelines also address how treatment and monitoring can be adapted in low-resource settings and during emergencies.

The recommendations also emphasise regular blood glucose monitoring.

• HbA1c testing: A blood test that provides an estimate of average blood glucose levels over the previous two to three months.
• Finger-prick testing: Allows people to check their blood glucose levels at home at different points during the day.
• Continuous glucose monitoring (CGM): Uses a small sensor worn on the skin to track glucose levels throughout the day.
• Urine glucose testing: May be considered when blood glucose testing is not available.

Importance Of WHO Guidelines

Also read: World Diabetes Day 2026: Is India's Toxic Air Adding To Its Diabetes Crisis? What Experts Say

More than a century after insulin was discovered, access to affordable treatment remains a challenge for many people with type 1 diabetes. Interruptions in insulin supply can be life-threatening because the body depends on externally administered insulin to regulate blood glucose.

Without enough insulin, blood glucose can rise dangerously and lead to diabetic ketoacidosis (DKA), a fatal complication.

“Insulin is a lifesaving treatment, discovered more than 100 years ago. Yet many people with type 1 diabetes do not have access to affordable and high-quality insulin,” said Dr Søren Brostrøm, WHO Director of Noncommunicable Diseases and Mental Health.

“The new WHO guidelines provide evidence-based recommendations to help countries deliver the best possible care, including in settings where resources are limited and health services are disrupted.”

The WHO guidelines aim to reduce these gaps by providing recommendations that can be implemented across different healthcare systems, including those with limited resources. They also support the organisation's bigger target of ensuring universal access to affordable insulin treatment and blood glucose self-monitoring by 2030.

The WHO has encouraged countries to involve people living with type 1 diabetes in designing diabetes programmes, so that they reflect practical challenges patients face.

Type 1 diabetes is an autoimmune condition in which the immune system destroys the insulin-producing beta cells in the pancreas. Unlike type 2 diabetes, it is not primarily caused by insulin resistance or lifestyle factors.

People with the condition need lifelong insulin treatment, alongside regular glucose monitoring and medical follow-up. Without appropriate management, diabetes can lead to complications affecting the eyes, kidneys, nerves and cardiovascular system.

Did Robert F Kennedy Jr. lie during his 2025 confirmation hearings to become US health secretary? US senators have opened up an investigation into whether Kennedy misled Congress about his 2019 trip to Samoa, months before a measles outbreak killed 83 people.

Ron Wyden of Oregon, incoming chair of the Senate Finance Committee, has launched an investigation into evidence that Kennedy “unlawfully lied” during his confirmation hearings, The Guardian reported.

Wyden is also expected to seek records from Children's Health Defense (CHD), the anti-vaccine non-profit Kennedy headed at the time, including documents related to his Samoa visit.

“We are beginning an investigation into evidence that Secretary of Health and Human Services Robert F Kennedy, Jr unlawfully lied to Congress on multiple occasions,” Wyden said in a letter to the group sent on Wednesday and obtained by The Guardian. The letter was also signed by Angela Alsobrooks, a Democratic senator from Maryland.

The investigation comes as the US faces its worst measles crisis in decades. More than 5,000 cases and eight deaths have been reported in 2026, the highest annual case count since 1991. The country is also at risk of losing its measles elimination status, achieved through decades of public health and vaccination efforts.

Also read: US Set To Lose Measles-Elimination Status After 26 Years: Prof Devi Sridhar Explains Reasons Behind Resurgence

What Is The Controversy Surrounding RFK Jr's Samoa Trip?

Kennedy allegedly misrepresented the purpose of his 2019 Samoa visit during two congressional hearings last year, telling lawmakers that the trip had “nothing to do with vaccines”.

However, letters obtained by The Guardian and the Associated Press in August reportedly contradicted his testimony.

In a letter to the Samoan prime minister before the visit, Kennedy explicitly said he wanted to study the measles, mumps and rubella (MMR) vaccine. He used the words “vaccine” or “vaccination” eight times.

“I am writing this letter to you in the hope that we might be helpful to the people of your great nation,” he wrote, suggesting that the deaths of two children following MMR vaccination could have resulted from manufacturing issues.

“I would propose my team conduct detailed health informatics assessment in Samoa of what happened with your MMR vaccines,” Kennedy wrote.

How Is Kennedy's Visit Linked To Samoa's Measles Outbreak?

Kennedy visited Samoa just months before a measles outbreak killed 83 people. Critics have argued that his presence emboldened anti-vaccine activists and worsened the country's vaccination crisis.

Children were among those who died in the outbreak, which exposed the consequences of low vaccination coverage.

Kennedy has denied the allegations, saying he never made public statements about vaccines or discouraged Samoans from getting vaccinated.

Read More: EXCLUSIVE: Ex-CDC Vaccine Advisor Says Measles Outbreak Bigger Than Reported, Slams RFK Jr’s ‘No-See Evil’ Approach

Why Is RFK Jr Under Scrutiny?

The letters have raised questions about the purpose of Kennedy's visit and the accuracy of his congressional testimony.

During his confirmation process, Kennedy pledged to maintain existing vaccine policies. However, after taking office, he moved to change several of them.

“We are deeply concerned by the tactics Kennedy has used – both before and during his tenure as secretary – to stand in the way of children receiving life-saving vaccinations,” the two Democratic senators wrote.

“In Samoa and in the United States, unvaccinated children have died tragic and preventable deaths during measles outbreaks. We intend to hold Secretary Kennedy accountable for the grave harm he has caused to vulnerable children. We also intend to hold him accountable for any false statements made to Congress, a crime that undermines the Senate’s ability to fulfill its constitutional duties.”

What Has Kennedy Said About Measles Vaccination?

Long known for his vaccine-skeptic views, Kennedy has spent years amplifying misinformation about vaccines, including the MMR vaccine.

But as measles cases mounted in the US, he urged American parents to vaccinate their children during an August CNN interview, marking a notable shift in his public messaging.

The appeal came as US measles cases surpassed the 2025 annual total.

"I've never questioned the efficacy of the MMR vaccine," the health secretary told CNN. However, the damage had already been done, with cases continuing to rise and eight deaths reported in 2026.