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.

Health officials in Alberta have urged people who received injections, aesthetic procedures or other medical services from a home-based business in Edmonton to get checked for possible exposure to HIV and hepatitis B and C.

The warning was issued on August 21 after authorities said an individual, identified as Max Klein, had allegedly been providing medical and aesthetic services from a home-based, unlicensed business.

According to reports, Klein has not held an active medical practice permit in Alberta since 2015, and his registration was cancelled in 2022.

The College of Physicians and Surgeons of Alberta had previously taken action against him following a 2015 incident involving the administration of an illicit substance to a colleague without consent, according to reporting on the health alert.

Officials have asked anyone who received services from the business to contact Health Link at 811 or a healthcare provider to know if testing, monitoring or follow-up treatment is required.

People Who Received Injections May Need Blood Tests

The alert is meant for people who received a range of services, including injections, aesthetic procedures, medical treatment, and other health services from Klein. It said these individuals “may have been exposed to blood-borne pathogens, including hepatitis B, hepatitis C, and HIV” and could also face risks of injury or other health complications.

People referred through Health Link will receive a Blood and Body Fluid Exposure assessment through Primary Care Alberta. Depending on the circumstances and timing of exposure, healthcare professionals can determine whether testing or post-exposure treatment is appropriate.

Alberta health authorities said that, “Procedures involving injections, needles, or skin penetration should only be performed by a qualified provider who follows appropriate infection prevention and control practices.”

The province warned that receiving such services from “unqualified or unregulated individuals” can increase the risk of infectious disease exposure, injury and other adverse health outcomes.

Also read: From Liver Inflammation to Cancer: When Hepatitis Becomes a Serious Warning Sign

Why Can Unsafe Injections Spread HIV And Hepatitis?

Injections and other procedures involving needles can carry a risk of transmitting blood-borne infections if proper infection-control practices are not followed.

Hepatitis B, hepatitis C, and HIV can all be transmitted through exposure to infected blood. The risk can arise through contaminated needles or other equipment, particularly when sterile equipment is not used correctly or instruments are reused.

The World Medical Association notes that unsafe injection practices, including unsterilised equipment and reuse of syringes, can spread hepatitis B, hepatitis C and HIV.

Also read: England Set To Become One Of The First Countries To Eliminate Hepatitis C; Here's How

HIV And Hepatitis May Not Cause Immediate Symptoms

One reason why testing is important after a potential exposure is that blood-borne infections may not always cause noticeable symptoms soon after infection.

Healthcare professionals can determine which tests are appropriate based on the type of procedure, exposure, and how long ago it occurred.

Delhi’s air pollution may be doing more than triggering respiratory problems and heart disease. A new review by Delhi University researchers suggests prolonged exposure to fine particulate matter could also affect the brain. It said that smog could lead to changes in the brain structure, memory, attention and other cognitive functions.

Researchers examined 129 peer-reviewed studies on the neurological effects of particulate matter and found that long-term exposure to PM2.5 may contribute to cognitive impairment and structural and functional changes in the brain.

The findings are particularly relevant for Delhi, where residents can face prolonged exposure to fine particles during periods of poor air quality.

PM2.5 May Reach The Brain Through Multiple Pathways

According to the review, some of these particles may also reach the central nervous system through the olfactory pathway in the nose.

Researchers also stated that air pollution can affect the blood-brain barrier, which normally helps prevent harmful substances in the bloodstream from reaching brain tissue.

Vandana Mishra, one of the researchers associated with the review, said, “Air pollution is no longer only a lung and heart problem; it is increasingly a brain-health problem.”

She added that research now links long-term particulate-matter exposure with cognitive decline, impaired neurodevelopment and biological processes linked with Alzheimer’s and Parkinson’s diseases.

Also read: Why Everyone Is Talking About 'Inflammaging'? The Silent Cause Of Premature Skin Ageing

Pollution Can Trigger Inflammation And Oxidative Stress

The review identified several biological pathways through which PM2.5 could affect the brain. Fine particles can trigger inflammation and oxidative stress, potentially damaging cells and their connections.

Researchers also noted effects on mitochondria, the structures responsible for producing energy inside cells.

Another concern involves immune cells within the brain. Persistent activation of these cells by pollution-related inflammation may affect neurons and their connections.

The hippocampus and prefrontal cortex could be particularly be affected as they play major roles in memory, learning, attention, planning and decision-making.

Also read: Air Pollution May Increase The Risk Of Painful Rheumatoid Arthritis Flares, Study Finds

Brain Structure May Also Be Affected

The review found evidence from neuroimaging studies suggesting that chronic exposure to air pollution may be associated with reductions in brain volume and cortical thickness, particularly in the frontal and temporal lobes.

Researchers also cited studies reporting changes in the hippocampus and disruptions in connections between different regions of the brain.

These findings do not mean that every person exposed to Delhi's pollution will develop brain disease. Instead, they indicate that long-term exposure may be associated with biological and cognitive changes that need to be investigated further.

Children And Young People Particularly Vulnerable

The review also raises concerns about exposure during childhood, when the brain is still developing. Researchers cited studies reporting differences in grey and white matter volumes among children exposed to air pollution, along with possible associations with attention, behaviour and cognitive development.

Early-life exposure may be particularly important as the brain undergoes rapid development during childhood, including the formation and strengthening of connections between nerve cells.

The researchers have cautioned against interpreting the findings as proof that Delhi's air pollution directly causes Alzheimer's or Parkinson's disease.

The Democratic Republic of the Congo is set to receive 70,000 doses of Ervebo, an Ebola vaccine that was developed for a different strain of the virus that caused an outbreak more than a decade ago. As the country battles its deadliest Ebola outbreak caused by Bundibugyo virus, latest updates suggest that the death toll has topped 2000.

The vaccine was allocated by the International Coordinating Group on Vaccine Provision. Of the 70,000 doses, 20,000 will be used in a Phase 3 clinical trial to determine whether Ervebo can actually protect people against Bundibugyo. The remaining 50,000 doses will be given to frontline and healthcare workers.

Ervebo is licensed for Ebola virus caused by the Zaire strain. There is currently no licensed vaccine specifically approved for Bundibugyo virus disease.

Ervebo Was Designed To Combat Zaire Strain Of Ebola

It has since played an important role in controlling Ebola outbreaks caused by that virus. Additionally, WHO lists Ervebo as the only currently licensed vaccine for Ebola virus disease.

The problem in the current outbreak is that Bundibugyo is a different species of orthoebolavirus. That means it simply cannot be assumed that Ervebo can protect against the Bundibugyo virus.

Also read: Congo's Ebola Outbreak Is Spreading Fast But WHO Says It Can Still Be Contained In 3 Months

Early Studies Suggest Some Cross-Protection May Be Possible

If there is no certainty that Ervebo protects against Bundibugyo, then what is the scientific reason for its testing? To answer that question, WHO says early laboratory and animal studies suggest that the vaccine may provide some protection against Bundibugyo.

Some studies have also detected immune responses that cross-react with Bundibugyo virus after vaccination against Ebola virus.

WHO's guidance concluded that the available evidence was insufficient to determine or reliably estimate Ervebo's effectiveness against Bundibugyo.

Also read: DR Congo Ebola Outbreak Becomes Deadliest In Country's History As Death Toll Hits 2,325

Upcoming Trial Could Help

WHO's Technical Advisory Group updated its recommendation in July and said Ervebo should be prioritised for inclusion in a Phase 3 research study because there is no Bundibugyo-specific vaccine currently ready for evaluation.

The trial could provide the first meaningful human evidence about whether vaccination with Ervebo prevents Bundibugyo infection or reduces severe disease.

WHO has also stressed that Ervebo should not be used as a routine Bundibugyo vaccination programme outside the research settings, because its effectiveness against the current strain remains unproven.

Why A Zaire Vaccine Is Being Used During A Bundibugyo Outbreak?

The decision comes down partly to urgency and the lack of alternatives. According to the CDC, the Bundibugyo outbreak in eastern DRC has spread rapidly, with 5,375 confirmed cases and 2,557 deaths.

The virus is also circulating in areas where conflict, displacement, and population movement have made contact tracing and outbreak control particularly difficult. Waiting for a completely new vaccine to be developed, tested and approved could take much longer.

Ervebo, meanwhile, is already widely used against Ebola virus. Testing whether it provides cross-protection could therefore offer a potentially faster way to contain the outbreak.

WHO Director-General Dr Tedros Adhanom Ghebreyesus welcomed the vaccine allocation, calling it, “An important example of global solidarity in action.”

He said WHO and its partners remain committed to strengthening surveillance, rapid detection, quality care, community engagement and vaccination efforts to bring the outbreak under control.

Also read: Ebola Outbreak Is Claiming 1 Life Every 30 Minutes In DR Congo: UN Humanitarian Official

A Bundibugyo-Specific Vaccine Is Still Needed

Researchers are also working on vaccines specifically designed to target Bundibugyo. WHO says several candidates are under development, including approaches from IAVI and Oxford University, while other research groups are exploring vaccines designed to provide broader protection against multiple Ebola species.

Two vaccines specifically designed against Bundibugyo virus have entered Phase 1 safety trials in humans. CEPI-backed studies are also examining whether existing Ebola vaccines can generate immune responses against Bundibugyo, using blood samples from people who have previously received Zaire-targeting vaccines.