Clay is unique especially from the perspective of medical geology, that is, the impacts of geologic materials and geologic processes on animal and human health. Clay is the only natural material that can impact human health through all routes of exposure: ingestion, inhalation, and dermal contact. Moreover, these impacts can be harmful as well as beneficial. Ingestion of clay, a form of geophagy, has been practiced for millennia and is still widely practiced today. Humanoids have been ingesting clay for at least two million years to ease indigestion and counteract poisons. Some additional benefits may accrue from eating clays such as providing some nutrients but these benefits are far outweighed by the likely negative consequences such as tissue abrasion, intestinal blockage, anemia, exposure to pathogens and toxic trace elements, and potassium overdose. Inhalation of airborne minerals including clays has impacted the heath of millions. In the 1930s thousands of people living in the Dust Bowl in the U.S. southwest inhaled copious amounts of clay contributing to deadly ‘dust pneumonia.’ Using clay as a poultice to stem bleeding and cure certain skin ailments is an age-old practice that still has many adherents. A classic recent example of the antibacterial properties of clay is the use of certain clays to cure Buruli ulcer, a flesh eating disease. However, walking barefoot on clays in certain volcanic soils can result in non-filarial podoconiosis or elephantiasis. The absence of clays in soils can have serious health consequences. In South Africa, clay-poor soils yield crops lacking in essential nutrients and may be the principal cause of Msileni joint disease. Clearly, a detailed knowledge of the clays in the environment can have significant benefits to human health and wellbeing.

The increased detection of pharmaceuticals in finished drinking water has become a growing cause of concern in recent years. The removal of atenolol, ranitidine, and carbamazepine by sepiolite, following functionalization of its surface by organosilane grafting, constituted the subject of this investigation. Silylated surfaces include octyl, γ-aminopropyl, 3-chloropropyl, and triphenyl moieties. The sorption of atenolol and ranitidine was higher on sepiolite functionalized with 3-chloropropyl, while carbamazepine showed a higher sorption on sepiolite with triphenyl groups. Filtration experiments of both ranitidine and carbamazepine on octyl- and triphenyl-sepiolite, respectively, showed a higher retention of ranitidine in comparison to carbamazepine, in spite of the fact that the number of sorption sites was lower due to its higher binding rate.

Kesselheim proposes doubling the NIH’s budget to promote clinically meaningful pharmaceutical innovation. Since the effects of a previous doubling (from 1998-2003) were mixed, I argue that policymakers should couple future budget growth with investments in experimentation and evaluation.

In contrast to the well-known stories of the embryotoxic drug, thalidomide, in countries where it was responsible for large numbers of birth defects, there is limited information on its history in India. Its presence before 2002, when the country issued the first marketing licence for a thalidomide-containing preparation, is assumed to be negligible. This article challenges this view by showing that the drug entered the Indian subcontinent through the former Portuguese territory of Goa around 1960. We examine the subsequent development of its distribution, use and regulation in India from the mid-1960s up to the present situation. Colonial legacies are a crucial explanation for the early appearance of thalidomide on the Indian subcontinent. They also influenced its re-emergence as drug for treating leprosy reactions in India after 1965. We identify key actors in this process: the original German producer that delivered thalidomide free of charge, European doctors who worked for international non-governmental organizations, the World Health Organization (WHO), which supported clinical trials and later discouraged the use of the drug, and finally the Indian state institutions that limited its distribution and later quickly opened the way for the private sector to produce and market thalidomide and its analogues. Finally, we discuss the risk of thalidomide-induced birth defects by casting a critical look on the present state of regulatory provisions and the monitoring of birth defects in India.

A free world is one in which human beings can live free, self-directed lives. A great obstacle to such a world is severe poverty, still blighting the lives of half of humankind. We have the resources, technologies, and administrative capacities to eradicate severe poverty, but doing so requires some restructuring of existing social arrangements. We might begin with the current regime governing innovation, which has monopoly markups as its key funding source. Such monopoly rents encourage the quest for innovations, but also greatly impede their diffusion. This headwind harms the poor, who cannot afford monopoly prices and whose specific needs innovators thus tend to ignore. It also works against potential innovations whose benefits would mostly go to third parties whom buyers care little about. Both problems can be much alleviated through a supplementary alternative reward mechanism that would enable innovators to exchange their monopoly privileges on any patentable technology for impact rewards based on the social benefits achieved with it. By promoting innovations and their diffusion together, international impact funds would bring substantial gains in justice and cost-effectiveness, especially in the pharmaceutical and green-technology sectors.

The paper surveys the intellectual property (IP) laws of seven Southern African Development Community countries to better understand the nature, scope, and depth of their patent laws with particular focus on their utilisation of TRIPS flexibilities to facilitate pharmaceutical access. The selected countries – Botswana, Malawi, Namibia, South Africa, Tanzania, Zambia, and Zimbabwe – represent a mix of both major and modest economies. While the current literature contains widespread assertions on the impact and effect of TRIPS on access to medicines in these countries and less-developed countries in general, this paper finds that the countries lack explicit and workable provisions implementing key TRIPS flexibilities. Hence, available TRIPS flexibilities have not been well utilised and it is often the complicated and unworkable domestic framework – rather than TRIPS – which becomes the stumbling block to pharmaceutical access. Another major finding is that patents may not be a major impediment in the region given that few patents and even fewer pharmaceutical patents are filed. The paper argues that since the surveyed countries are mainly net IP importers with similar developmental contexts and aspirations, the best approach would be to fully take advantage of existing flexibilities and more aggressively leverage policy space to engender access to cheaper medicines.

The inclusion of antimicrobial resistance (AMR) and increased research and development (R&D) capabilities in the most recent outline of the World Health Organization’s (WHO’s) international pandemic instrument signals an opportunity to reshape pharmaceutical R&D system in favour of antimicrobial product development. This article explains why the current innovation ecosystem has disadvantaged the creation of antimicrobial products for human use. It also highlights how the COVID-19 pandemic experience can inform and stimulate international cooperation to implement innovative R&D incentives to bring new, life-saving antimicrobial products to the market.

Scanning electron microscopes (SEMs) are a popular analytical tool due to their high spatial resolution, large depth of field, and analytical capabilities. However, in many cases, the large-scale installation and cost of SEMs can be a barrier to entry for smaller laboratories or facilities. The introduction of a more compact benchtop SEM has changed the landscape, enabling scientists in many fields to adopt the technology and revolutionize research. Benchtop SEMs can be used in a variety of industries including materials science, pharmaceutical research, energy exploration, science education, and academia. These industries require analysis at the nanoscale for quality control, failure analysis, and R&D, for all of which the benchtop SEM is perfectly positioned to provide necessary detail. These advantages and new developments in the technology have made the benchtop SEM a widely available and well-accepted tool.

Every year, over 250,000 public authorities in the European Union (EU) spend about 14% of GDP on the purchase of services, works and supplies. Many are in the health sector, a sector in which public authorities are the main buyers in many countries. When these purchases exceed threshold values, EU public procurement rules apply. Public procurement is increasingly being promoted as a tool for improving efficiency and contributing to better health outcomes, and as a policy lever for achieving other government goals, such as innovation, the development of small and medium-sized enterprises, sustainable green growth and social objectives like public health and greater inclusiveness. In this paper, we describe the challenges that arise within health care systems with public procurement and identify potential solutions to them. We examined the tendering of pharmaceuticals, health technology, and e-health. In each case we identify a series of challenges relating to the complexity of the procurement process, imbalances in power on either side of transactions and the role of procurement in promoting broader public policy objectives. Finally, we recommend several actions that could stimulate better procurement, and suggest a few areas where further EU cooperation can be pursued.

The complexity and inefficiency of the U.S. health care system complicates the distribution of life-saving medical technologies. When the public health is at stake, however, there are alternatives. The proposal for a national PrEP program published in this issue of the Journal applies some of the lessons of the national COVID vaccine campaign to HIV prevention. In doing so, it draws on other examples of public health approaches to the financing of medical technology, from vaccines for children to hepatitis C treatment.

A substantial portion of biomedical R&D is publicly funded. But resulting medicines are typically covered by patents held by private firms, and priced without regard to the public’s investment. The Bayh-Dole Act provides a possible remedy, but its scope is limited.