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.

Recent legal developments have highlighted the importance of advance planning for end-of-life care.

A Living Will is something every adult should consider discussing and creating at some point.

Conversations within families about individual preferences in the event of a terminal illness are an important first step, and these discussions should take place while everyone is still in good health.

Individuals may have very different views about how they wish to be treated if they develop a terminal illness or certain severe, irreversible conditions. For instance, some may not want ventilator support, while others may choose to avoid ICU care.

Some might accept ICU care but prefer not to undergo CPR. Others may prefer not to receive artificial feeding through tubes. Yet others may wish for every possible treatment to be attempted. A few may prefer to spend their final days at home.

Creating A Living Will

It should be noted that a Living Will does not impose any limitation on treatment for common medical conditions such as infections, surgery for curable illnesses, or routine hospital care.

These preferences apply only to situations such as terminal illness—for example, advanced cancer—or irreversible conditions such as a persistent vegetative state.

Creating a Living Will is now relatively straightforward. It must be signed in the presence of two witnesses and attested by a notary or a gazetted officer.

The earlier requirement of countersignature by a Judicial Magistrate has been removed to make the process easier. Templates are also available online that individuals can use as a basis for drafting their own. Before preparing one, it is helpful to discuss the pros and cons of their choices with the family doctor.

It is important to again emphasize that a Living Will is NOT about refusing all treatment, hospitalization, or ICU admission for routine medical care. Rather, it addresses only specific situations.

When such preferences are clearly documented in advance, important decisions about withholding or withdrawing treatment in select circumstances become less contentious.

Doctors and hospitals will no longer be hesitant to withhold unnecessary treatment measures in such situations, as it will already be documented in the patient’s own Living Will. Relatives also will not face the difficult decision of withholding or withdrawing futile medical treatment on behalf of their loved one.

Essentially, the Living Will protects the patient’s wishes when they are no longer able to speak for themselves.

What Happens Without A Living Will

In a terminally ill patient who is unable to communicate, the absence of a Living Will often leads to differences of opinion among family members about what the patient might have wanted.

This uncertainty frequently results in a collective decision to “do everything possible,” just to be on the safe side.

Doctors are reluctant to override the wishes of relatives, even when they believe that further treatment measures are unlikely to be beneficial.

As a result, the patient may receive prolonged medical interventions that neither improve the underlying condition nor enhance quality of life. Once started, these treatments may continue indefinitely until the patient dies naturally.

This may take months, years, or even decades, and also incur huge costs. In the absence of a Living Will, complex legal procedures are required to withdraw these treatments — even if all the relatives are convinced that they should be withdrawn.

Bolivia has reported an outbreak of mosquito-borne Chikungunya virus disease, with cases rising to more than 5,000 nationwide.

Chikungunya is transmitted by the Aedes aegypti and Aedes albopictus mosquitoes -- the same species that spread dengue fever and Zika virus disease. As a result, the disease becomes challenging to diagnose.

The South American country's Ministry of Health, in a statement, shared that "5,371 cases of chikungunya have been registered nationwide".

The worst areas in Bolivia include

• Santa Cruz (4,500 cases)
• Cochabamba (303 cases)
• Tarija (332 cases)
• Chuquisaca (81 cases)
• La Paz (68 cases)

The Ministry informed, "joint efforts to control and manage the vector".

It further noted that an investigation is being conducted to share the results and cause of death, as well as ongoing epidemiological surveillance for all vector-borne disease.

To curb the cases, the Health Ministry noted that "it is supporting the provision of biolarvicide and insecticide for departmental and municipal actions to prevent an increase in cases".

This includes the distribution of about 1,300 liters of insecticide and biological larvicides applied with backpack sprayers, Outbreak News Today reported.

The government also urged the general public to clean weeds from yards and gardens to eliminate the vector’s resting places

Global Cases

In January, the surveillance data from the European Centre for Disease Prevention and Control (ECDC) reported 2,881 cases of Chikungunya virus disease and no associated deaths from 11 countries in European Union this year.

The ECDC noted that the Americas have reported 2,879 cases and one associated death, with Brazil reporting the highest number of cases in 2026.

In addition to Bolivia, other countries in South America reporting chikungunya include Costa Rica, El Salvador, Honduras, and Mexico.

French health authorities also reported a significant rise in chikungunya disease in Mayotte, an overseas department in the Indian Ocean. Since the beginning of 2026, more than 270 confirmed cases have been recorded, Vax-Before-Travel reported.

ECDC data shows that the weekly average of cases in the last two weeks of February 2026 was around 65.

Symptoms And Prevention

There is currently no antiviral drug treatment for chikungunya. While two vaccines against chikungunya have received regulatory approval, it still lacks widespread rollout.

Common symptoms of chikungunya include:

• abrupt onset of fever
• joint and muscle pain
• headache
• nausea
• fatigue
• rash

While serious complications are rare, the elderly and children under one year old may be at risk of long-term symptoms and even death.

The ECDC advised people "to take enhanced measures to prevent mosquito bites".

India's drug regulator, the Central Drugs Standard Control Organization (CDSCO), has threatened pharmaceutical firms with action for promoting GLP-1 weight-loss drugs among the general public.

Glucagon-Like Peptide-1 (GLP-1) receptor agonists are a class of medicines that help lower blood sugar, support weight loss, reduce the risk of heart and kidney complications, and can even lower the risk of early death in people with type 2 diabetes.

In an official circular, the CDSCO warned drug makers from indulging in "direct or indirect advertising" for obesity and metabolic disorders.

The regulatory body also cautioned pharma companies against campaigns using influencers, noting that any violation "could attract regulatory action".

Advertisements, which "function as a surrogate advertisement for prescription-only drugs, shall be viewed seriously and may be treated as irrational or misleading marketing practice", read the letter signed by the Drug Controller General of India (DCGI) Rajeev Raghuvanshi.

The order comes as the CDSCO noted that drugmakers have been engaging in surrogate promotional activities, under the garb of disease awareness campaigns, and digital media outreach.

What The CDSCO Mandated

• Weight-loss drugs, specifically GLP-1 medications, must only be sold with a prescription from a registered medical practitioner.

• There should be no ads, whether direct or indirect, in print, electronic, digital, social media, or any other public platform intended, directly or indirectly, to promote the product to the general public.

• No GLP-1 drugs must exaggerate for therapeutic efficacy; suggest for assured or guaranteed weight loss outcome; and induce demand for pharmacological therapy

• awareness campaigns
• influencer engagement
• corporate campaigns

Rush For Generic Weight Loss Drugs

The government's advisory comes patent for semaglutide -- an active ingredient in diabetes and anti-obesity drugs, specifically Wegovy and Ozempic -- expires on March 20.

This will allow Indian pharma companies to launch cheaper generic versions, significantly increasing affordability and access for millions battling Type 2 diabetes and obesity.

Major Indian drugmakers gearing up to launch their generic semglutide injection in the country in March include Sun Pharmaceutical Industries, Zydus Lifesciences, Alkem Laboratories, Dr. Reddy’s Laboratories, Torrent Pharmaceuticals, and MSN Laboratories.

Obesity A Chronic Metabolic Condition

The CDSCO stressed the importance of "lifestyle modification measures (diet, exercise, behavioural interventions)" in treating obesity.

"Obesity is a chronic metabolic condition requiring comprehensive management, including lifestyle interventions," the regulator said.

"Pharmaceutical therapy, where indicated, must not be projected in a manner that undermines public health initiatives promoting diet control, physical activity, and preventive healthcare," it added.

WHO Guidelines On GLP-1 drugs

Amid increasing prevalence of GLP-1 drugs, the World Health Organisation (WHO), late last year, acknowledged its role in treating obesity.

However, it warned that medications like GLP-1 alone will not solve the problem affecting more than one billion people worldwide.

The global health body also issued conditional recommendations for using these therapies as part of a comprehensive approach that includes healthy diets, regular physical activity, and support from health professionals.