Obesity R&D, Climate reports, healthcare spend
Obesity drugs: Latest R&D data. Climate disclosure standards. UK Healthcare spend, 50 year underspend. A day in the life of a home schooler. UK Climate Change Committee Report.
Obesity drugs: Latest R&D data
Climate disclosure standards
UK Healthcare spend, 50 year underspend
A day in the life of a home schooler
UK Climate Change Committee Report
I’ve been somewhat dissatisfied with the way UK healthcare has been examined over the long term. There are relatively few reports* (that I’ve found) so I thought I would slowly do my own assessment. Unsurprisingly, it’s taking a long time fitting this in my night hours. But, I have a couple of conclusions worth sharing already. I will try and drip these out over the year. The first conclusion is compared to France and Germany (and most of UK’s G7 peers where we have OK data). The UK has significantly underspent on healthcare.
The overall summary is that the UK underspent on healthcare for the 50 year period of 1970 to 2020. The underspend vs Germany and France is between 2 to 4 percent points of GDP.
But what does this mean in dollar or pound terms?
The approx. gap in USD is 46,000 per person less spend cumulatively per person or in absolute terms this is GBP989,719m (based on UK ONS GDP figures). So in the order of GBP1,000bn or GBP1 trillion.
To give you scale of this underspend vs Germany. If all this money was spent on hospitals, given an average hospital is about GBP500m, then this would have been >1900 more hospitals. Today the UK has 1200 – 1300 hospitals (900 in England).
So we would have over double the number of hospitals if this had been spent on capital!
(No investment advice, yadda yadda) I thought I’d give you a glimpse into a slice of the healthcare week. You may have been reading a lot about newly launched obesity drugs and I covered some of this in my podcast last year with Stephan Guyenet in anticipation.
But, the R&D does not stop with current obesity research. A US biopharma company has revealed data on what is dubbed “Triple G” - so called because it is a triple combination of a GIP, a GLP-1 and a glucagon.
Sorry all those who gave up university science or never even went there but, in sum:
This approach is the concurrent activation of the glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and glucagon (Gcg) receptors (i.e. triagonism). The idea is that this combines the anorectic and insulinotropic activities of GLP-1 and GIP with the energy expenditure effect of glucagon.
There is about 50 years or more of science within that statement so don’t feel bad about not knowing. If you really want to understand more check out this journal paper in Cell. The bottom line is that the phase II results were very striking (although need to replicated in phase 3)
The date showed that patients on the highest dose lost 22% of their bodyweight on a placebo-adjusted basis at the 48-week point.
As reported by Elizabeth Cairns of Evaluate Pharma:
“....prompted one delegate to ask whether future obesity trials might look at getting patients out of the obese or even overweight categories altogether, bringing their body mass index down to 25 or less. The average weight loss of 58lb (26kg) seen in the trial could take a patient from a BMI of 35 to “a skinny 28”, Dr Julio Rosenstock of Velocity Clinical Research, another presenter at the symposium, said.
Dr Jastreboff had earlier pointed out that the weight reduction curve was still continuing at 48 weeks, suggesting that even greater weight loss could be produced after longer treatment. Maybe obesity resolution is not such a crazy thing to aim for.” [My emphasis, but it’s not out of reach, maybe??]
There are potential side effects though, so it’s not a complete home run yet. A little more on side effects in blog.
Latest report from UK climate change committee: “A lack of urgency. While the policy framework has continued to develop over the past year, this is not happening at the required pace for future targets.
Stay firm on existing commitments and move to delivery. The Government has made a number of strong commitments, these must be restated and moved as swiftly as possible towards delivery.
Retake a clear leadership role internationally. The UK will need to regain its international climate leadership.
Immediate priority actions and policies. Action is needed in a range of areas to deliver on the Government’s emissions pathway.
Develop demand-side and land use policies. The Government’s current strategy has considerable delivery risks due to its over-reliance on specific technological solutions, some of which have not yet been deployed at scale.
Empower and inform households and communities to make low-carbon choices. Despite some positive steps to provide households with advice on reducing energy use in the last year, a coherent public engagement strategy on climate action is long overdue.
Planning policy needs radical reform to support Net Zero. The planning system must have an overarching requirement that all planning decisions must be taken giving full regard to the imperative of Net Zero.
Expansion of fossil fuel production is not in line with Net Zero. As well as pushing forward strongly with new low-carbon industries, Net Zero also makes it necessary to move away from high-carbon developments.
The need for a framework to manage airport capacity. There has been continued airport expansion in recent years, counter to our assessment that there should be no net airport expansion across the UK.
Report here. And Chris Stark tweet thread here.
This is what AI has to say about the pros/cons of sustainability standards in honour of the new IFRS S2. “The objective of IFRS S2 Climate-related Disclosures is to require an entity to disclose information about its climate-related risks and opportunities that is useful to primary users of general purpose financial reports in making decisions relating to providing resources to the entity.”
Pros:
1. **Standardization:** ISSB accounting standards provide a uniform global framework for sustainability reporting. This means that companies, regardless of where they operate, use the same guidelines, making it easier for investors to compare sustainability efforts across businesses.
2. **Transparency:** These standards increase transparency, as companies are obligated to disclose their sustainability efforts and impacts. This enables investors to make more informed decisions by evaluating a company's environmental, social, and governance (ESG) performance.
3. **Risk Evaluation:** ISSB standards help investors identify potential environmental and social risks associated with investments. It provides a clear framework for risk analysis related to sustainability challenges, which can materially impact a company's performance.
Cons:
1. **Implementation Challenges:** The adoption of ISSB standards can be resource-intensive, especially for smaller companies that may not have the capacity to undertake comprehensive sustainability reporting. This could potentially distort the investment landscape, favoring larger, well-resourced companies.
2. **Ambiguity:** While ISSB provides guidelines, the interpretation of these standards can still be subjective, potentially leading to inconsistent reporting. This might cause some confusion or misinterpretation among investors.
3. **Focus on Short-Term Impact:** Although the standards focus on sustainability, they may inadvertently cause companies to prioritize short-term ESG metrics over long-term sustainability strategy. This could lead to a situation where companies are more focused on appearing sustainable rather than being truly sustainable.
As an investor, it is crucial to look beyond the numbers and also consider the qualitative aspects of a company's performance. Link to ISSB standards via my Linkedin post.
Regular readers will know, I’ve tilted much in favour of home education ideas where appropriate. See my podcast with Naomi Fisher for discussion (although Naomi is probably more extreme than me, there is a range of ways and views of doing this).
If you’d like a glimpse of what it might be like feel free to follow Catherine Oliver at her substack here. I don’t think I’d be brave enough to give you a day in our lives regularly, but maybe one day!
Ten years too late, I read Rachel Cusk's "A Life's Work: On Becoming a Mother". Reflecting on my reading at the time, I described it as "A deep incision, revealing the otherworldly gore beneath the veil of muslins and cot sheets". It was the first book I had read which captured anything of significance about my experience of motherhood. "What to Expect When You're Expecting" was useless. By the time I became pregnant, I had babysat many babies, changed many nappies and I had a degree in Biomedical Sciences. I did not need to be prepared to "have a baby". I needed to know what it might *feel* like to be a mother. All of which is a roundabout way of letting you know that I have been waiting for Lucy Jones' "Matrescence" for some time. People should trade in their positive pregnancy test for this book.
“Matrescence” is part lyrical memoir and part sturdy journalism. Using her own motherhood experience as a framework and reaching to the natural world for vivid exemplars (the black lace-weaver spider mothers who feed their living bodies to their spiderlings), Jones draws on research from a wide range of fields to develop the concept of “matrescence” - the process of becoming a mother. She emphasises its importance both as an identity and in a broader, relational sense. Reading "Matrescence" was a deeply affirming experience for me. At last, there is mothering on the page in a way that I recognise.
Like Jones, I had the startling experience of reading Adrienne Rich's work from the 1970s and realising that very little had changed fifty years on. The prevailing motherhood culture still makes it difficult for mothers to admit to the deep ambivalences, the wild love and secret fury at the heart of mothering. Women are still oppressed and men are still being called on step up to caregiving roles. Obstetrics and midwifery continue to be driven by ideologies that centre the baby and not the mother.
In “Matrescence", Jones follows her deep curiosity, looking into the physical, psychological and emotional changes that occur in matrescence. Her hope is that the book starts a new conversation around the transition to motherhood and I couldn't agree more that it is needed.
Podcasts:
I’m podcasting with @_F_B_G_ Fergus Butler-Gallie soon. What questions do you have for a a young priest ?
Listening: Reid Hoffman on AI w/ TylerCowen.
Thanks for reading.
Thank you Ben! Adding Matrescence to my reading list now.