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.

The US Food and Drug Administration (FDA) recently expanded the approval of Anktiva (nogapendekin alfa inbakicept-pmln), a bladder cancer treatment, to include adults with high-grade papillary bladder cancer that has not responded to Bacillus Calmette-Guérin (BCG) therapy.

The decision provides a new treatment option for patients whose cancer persists or returns despite standard immunotherapy.

The approval specifically covers BCG-unresponsive, high-grade papillary-only non-muscle-invasive bladder cancer (NMIBC). Anktiva was already approved in April 2024 for certain patients with BCG-unresponsive NMIBC involving carcinoma in situ, with or without papillary tumours.

The latest development is significant because patients with high-grade papillary-only disease previously had fewer approved bladder-preserving treatment options after BCG failed.

The FDA based its decision on evidence supporting Anktiva's earlier approval, alongside scientific similarities between the two forms of bladder cancer.

“We listen to patients, clinicians, and researchers, and we act when the science supports a new approach,” said R. Angelo de Claro, MD, director of the FDA's Oncology Center of Excellence.

“For Anktiva, our review of the similarities between these cancers allowed us to build on the results in patients with CIS and expand treatment options for people with high-grade papillary tumors alone. This approach may also help guide the development of future treatments.”

What Is BCG-Unresponsive Bladder Cancer?

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BCG is a form of immunotherapy used to treat high-risk non-muscle-invasive bladder cancer. Although the name comes from a bacterium originally used in tuberculosis vaccination, BCG is administered directly into the bladder to initiate an immune response against cancer cells.

NMIBC refers to bladder cancer that has not grown into the muscle layer of the bladder wall. Treatment often involves removing visible tumours through a procedure called transurethral resection of bladder tumour (TURBT), followed by BCG therapy to destroy remaining cancer cells and reduce the risk of recurrence.

However, some cancers return despite treatment. These are described as BCG-unresponsive, and patients may need alternative therapies or surgery to remove the bladder.

More About Anktiva

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Anktiva is an interleukin-15 receptor agonist, a type of immunotherapy designed to strengthen the body's immune response against cancer.

It activates and expands immune cells, including natural killer cells and T cells, which help recognise and attack abnormal cells. When administered with BCG, Anktiva provides an additional immune stimulus to help the body fight cancer within the bladder.

The medicine is delivered directly into the bladder through a catheter, a procedure known as intravesical instillation. This allows treatment to act locally rather than being administered through an intravenous infusion.

Treatment begins with weekly doses for six weeks. Depending on the patient's response, additional induction and maintenance treatment may be given, with the overall treatment period extending up to 37 months.

FDA's Approval For Anktiva

The FDA's original approval was supported by the QUILT-3.032 clinical trial, which included 77 adults with BCG-unresponsive, high-risk NMIBC involving CIS, with or without papillary tumours.

The study found a complete response rate of 62%. This means that no high-grade cancer was detected during the relevant assessments. Among patients who achieved a complete response, 58% maintained it for at least 12 months, while 40% maintained it for at least 24 months.

For the expanded approval, the FDA considered these findings alongside laboratory evidence indicating that CIS and high-grade papillary-only tumours share key biological features. Both can recur or progress when BCG treatment fails.

The agency concluded that the earlier evidence of effectiveness could be applied to patients with high-grade papillary-only disease.

The United States shelved the decision to vaccinate poultry as a bird flu prevention measure due to HHS Secretary Robert F. Kennedy Jr.’s skeptical vaccine views

According to a Politico report, the move came as highly pathogenic avian influenza, especially the H5N1 strain, continues to affect poultry farms, threatening bird populations, disrupting egg supplies and raising concerns about transmission to humans.

According to Politico's findings, five people who were involved in the decision-making said that Agriculture Secretary Brooke Rollins pulled back an internal strategy for vaccinating poultry and hens that lay eggs.

The plan was initially intended to be shared with governments of other countries, industry leaders and other stakeholders to help boost bird flu response.

However, it remains unclear whether Kennedy directly asked Rollins to halt the strategy. However, concerns about how poultry vaccination would be received by the health secretary reportedly influenced the decision to keep the document away from wider circulation.

Why Was The Poultry Vaccination Plan Shelved?

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The US Department of Agriculture (USDA) announced a $1 billion bird flu response strategy in February 2025. The plan included $500 million for farm biosecurity, $400 million in financial relief for farmers and $100 million for vaccine research.

Despite the resources, an internal poultry vaccination strategy reportedly failed to be executed as planned. One person familiar with the process told Politico that the technical and communication components were already in place by the summer of 2025, but the final document was circulated among fewer than a dozen people.

Kennedy has publicly opposed vaccinating poultry against bird flu, arguing that vaccines that do not completely prevent infection could allow the virus to continue evolving.

In a March 2025 interview with Fox News host Sean Hannity, Kennedy warned that using vaccines that do not provide complete protection could turn poultry flocks into “mutation factories”.

He argued that allowing the virus to circulate among birds could help identify animals with natural immunity. The proposal attracted criticism from veterinary and vaccine experts, who warned that permitting uncontrolled infections could, in turn, increase viral replication and create opportunities for mutations.

Dr Gail Hansen, a former state veterinarian for Kansas, criticised the idea of allowing bird flu to spread through poultry populations, calling it a “really terrible idea, for any one of a number of reasons”. She warned that a virus circulating through a flock containing millions of birds would have many opportunities to evolve or mutate, which increases the risk to other animals and farm workers.

Also read: US Health Secretary Wants To Expand Vaccine Injury Reporting: Benefits And Risks Explained

Can Vaccinating Poultry Help Control Bird Flu?

Vaccination is one the effective tools for reducing bird flu infections and containing transmission. However, vaccines do not always provide sterilising immunity, meaning vaccinated animals may still become infected even if they are protected against severe disease.

So, if vaccination reduces visible symptoms without fully preventing infection, infected birds may be harder to identify unless monitoring systems are efficient.

However, this does not mean vaccination inevitably creates dangerous mutations. The evolution of viruses occur naturally, and vaccination can reduce the number of opportunities for viral replication. The overall effect depends on the vaccine effectiveness, surveillance, biosecurity and how the nature of the virus.

Countries including France, China, Egypt and Mexico have used poultry vaccination against avian influenza. In the US, the USDA granted conditional approval for an avian influenza vaccine in 2025, but poultry vaccination has not been adopted yet.

H5N1 has infected people following exposure to infected animals, but sustained human-to-human transmission has not been established yet. Hence, preventing infections in poultry remains important for reducing opportunities for the virus to spread and evolve.

The Keralam government has introduced the Keralam Senior Citizens (Care and Protection of Rights) Bill, 2026, to regulate elderly-care facilities and services. It proposes mandatory registration of care centers and caregivers, prescribed standards, caregiver certification, and penalties for violations.

Referred to the Assembly’s subject committee, the Bill would establish a legal framework for elderly care if passed.

Keralam introduced its first elderly-care policy in 2006, updated it in 2013, and released a draft State Policy for Elder Persons in August 2025. The state also enacted the Kerala State Senior Citizens Commission Act, 2025, and has a dedicated department for senior citizens’ welfare.

Why Does Keralam Need The Bill?

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Chief Minister V. D. Satheesan introduced the Bill, expressing confidence that it would make Kerala a model for elderly care.

“Nobody should feel that they are alone or abandoned. The way a society treats its elderly determines how civilized it is,” he said.

Keralam has one of India’s largest elderly populations, partly due to its high life expectancy. Older adults are projected to account for 22.8% of the state’s population over the next decade, up from 18.7%, highlighting the growing need for care services.

What Does The Bill Propose?

• Dignity and care: Promotes ageing in place, home-based care, safety, and social inclusion.
• Access and rights: Seeks better access to healthcare, legal aid, safe public spaces, digital inclusion, and abuse-reporting mechanisms.
• Protection units: Proposes state and district-level bodies to monitor care services and address complaints.
• Care-centre regulation: Requires registration of senior citizen care centres and sets service standards.
• Caregiver certification: Proposes training, phased certification, a Keralam Geriatric Care Certification Framework, and a state register of caregivers.
• Cybercrime safeguards: Proposes a Senior Citizen Cyber Fraud Cell at every cyber police station.
• Welfare funding: Calls for a state reserve fund for care, protection, welfare, and social security.
• Penalties: Provides for punishment for violations of the proposed law and related rules.

Why Elderly Care Needs A Broader Approach

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Speaking to HealthandMe, Dr. Rajeev Jayadevan, Ex-President of IMA Cochin and Convener of the Research Cell, Kerala, said the principles outlined in the Bill could eventually apply across India, particularly as Keralam has a higher proportion of older adults than many other states.

With shrinking nuclear families and urbanization, fewer family members may be available to provide full-time care, increasing reliance on state-supported services, including home care, medical consultations, and palliative care.

He emphasized that older adults have distinct care needs and highlighted patient autonomy in end-of-life decisions. Living wills allow people to document their medical-care preferences in advance, helping families and healthcare professionals understand their wishes and potentially avoid unwanted interventions.

Dr. Rajeev also stressed the need for trained, certified caregivers, effective oversight of care providers, and safeguards against elder abuse.

As older adults increasingly use digital platforms for services such as banking, digital literacy and protection against online scams and financial fraud are also essential, he noted.

What Are The Health Challenges Facing Older Adults?

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India’s senior citizen population is projected to reach around 230 million by 2036, or approximately 15% of the population. Southern states, along with Himachal Pradesh and Punjab, have larger elderly populations, with regional disparities expected to widen.

Moody’s Ratings said in September that India’s population is expected to age significantly as fertility falls below replacement levels.

Older adults often face chronic conditions such as diabetes, high blood pressure, and high cholesterol, alongside complications including diabetic kidney disease, diabetic retinopathy, cataracts, and glaucoma. These health needs underscore the importance of accessible, coordinated long-term care.