Day: February 17, 2020

To fight severe coronavirus disease and even ageing, make metformin an OTC drug, now!

This is a post by a Guest Author
Disclaimer: The author’s views are entirely his or her own, and don’t necessarily reflect the opinions of the Consumer Choice Center.

For more than a month now, the COVID-19 epidemic that struck China and risks spreading globally has understandably captured the attention of much of the world. While apparently less fatal than its close relative SARS, COVID-19 is much more easily spread and, like the former, capable of causing severe lung pathology and aberrant immune responses that kill 1–3% of the patients and probably cause serious disability in those with severe illness who recover.

As Zumla et al. note in the recent Lancet piece, much of the response so far has understandably been aimed at arresting the spread of the disease from central China, however, this should not undermine the urgency of developing treatments against it, especially its severe form. While Gilead’s novel anti-Ebola drug remdesivir has shown glimpses of promise against COVID-19 and could even see mass production in China in generic form, according to Zumla et al., there is another, extremely cheap and widely available drug that could potentially help those that need help the most. The drug in question is the wonder-drug against diabetes type II, metformin:

Specific drugs to treat 2019-nCoV will take several years to develop and evaluate. In the meantime, a range of existing host-directed therapies that have proven to be safe could potentially be repurposed to treat 2019-nCoV infection. Several marketed drugs with excellent safety profiles such as metformin, glitazones, fibrates, sartans, and atorvastin, as well as nutrient supplements and biologics could reduce immunopathology, boost immune responses, and prevent or curb ARDS [acute respiratory distress syndrome — D.G.].

Thus, even though metformin is not a direct treatment for the Wuhan coronavirus itself, it is quite possibly a means of preventing severe, potentially fatal complications in the already infected people, which is a significant benefit, in my book.

There is even more to this drug, however, than its role in treating diabetes and potentially helping save people with COVID-19.

Basic facts and history of metformin

Metformin is the most widely used treatment against diabetes type II. As David Sinclair, tells us, “Metformin is a derivative of a natural molecule called a “biguanide,” from a flower called Galega officinalis, also known as “goat’s rue” or “French lilac.” It has been used as a herbal medicine in Europe for centuries. In 1957, Frenchman Jean Sterne published a paper demonstrating the effectiveness of oral dimethyl biguanide to treat type 2 diabetes. Since then, the drug has become one of the most widely taken and effective medicines on the globe.” Metformin’s mechanism of action in diabetes is through decreasing glucose production in the liver.

It is one of the cheapest medicines and is universally considered as highly safe and effective, and only causes the severe complication of lactic acidosis in a small proportion of users, usually those with impaired renal and (or) hepatic function. Some researchers think that it may actually not cause lactic acidosis at all.

Metformin, ageing and diseases of ageing

Even though the exact mechanism of how metformin might slow down ageing is not well-understood, it has been known at least since 2002 that its administration activates the AMPK pathway, at least in the human skeletal muscle cells of type II diabetics.

The most fascinating hint that metformin could have significant anti-ageing benefits in humans has been provided by the recent study conducted by Bannister et al. In it, they compared the mortality of British diabetics who were prescribed metformin to those who were prescribed another drug and that of non-diabetics. Astonishingly, the results suggest that people taking metformin could live longer than even non-diabetics, even though diabetes is supposed to be a systemic, debilitating disease.

Another extremely impressive result that directly relates to humans comes from the study in which metformin was one of the three drugs administered to nine volunteers for a year (the other two were human growth hormone and dehydroepiandrosterone (DHEA)). Astonishingly, the volunteers have shown signs of reversal of their epigenetic age as measured by their epigenetic clocks (by on average 2.5 years).

Finally, metformin is a potential drug candidate against several severe particular pathologies of ageing such as Alzheimer’ssome cancersheart diseasechronic inflammation and leaky gut. Even outside aging, it could help treat debilitating conditions like inflammatory bowel disease.

Metformin’s restricted status is a global disgrace

The fact that metformin could help save people struck by severe Wuhan coronavirus disease, that it could prolong people’s lives and make them better able to benefit from more revolutionary anti-ageing treatments down the road, while being safe for the vast majority of people makes it astonishing, jaw-dropping, if you will, that there is apparently only one country in the world where it is officially available over-the-counter — Thailand.

To say that this situation is outrageous would be a severe understatement. There is no remotely reasonable justification under any possible risk model to continue classifying metformin as a prescription drug. The only plausible result of doing that is massive suffering and premature deaths. Public health authorities all over the world must follow the example of Thailand and release metformin over the counter.

The World Health Organization (WHO) must play its role, too. It lists metformin among the world’s essential medicines but the best possible way of ensuring access to it, if it is so sorely needed and safe, is to make it an OTC drug. It should call upon countries to do just that. The WHO’s position on ageing also needs to be thoroughly revised. Its current approach is to promote something called “healthy ageing.” It should lead in recognizing that ageing is a pathology, and the one that causes the most suffering at that. Ageing cannot be healthy by definition.

Recognizing ageing as the pathology it is would quickly pave the way to making drugs like metformin available to everyone who would like to try to prolong their lives.

Guest post by Daniil Gorbatenko.

The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

La taxe digitale est mauvaise pour les consommateurs

Le Royaume-Uni a annoncé pendant le Forum économique mondial à Davos qu’elle va introduire une taxe digitale. Depuis trois ans, l’Union européenne (UE) discute d’une proposition similaire pour le reste du continent. Les États Unis soulèvent la question de l’équité au niveau des échanges commerciaux, et le Grand-Duché propose de trouver une solution à l’échelle de l’OCDE. Avant tout par contre, la taxe digitale (ou taxe GAFA) est mauvaise pour les consommateurs.

Le concept de la taxe digitale date de moins de cinq ans. Le concept est celui que dans un aspect de justice sociale, il ne serait pas acceptable que les grandes entreprises du net ne paient pas leurs impôts. Une taxe digitale fera en sorte de remédier à cette injustice — et pourra aussi remplir les trésoreries des États avec de nouvelles recettes.

Le ministre des finances français, Bruno Le Maire, avait commencé à l’automne de l’année 2017 à s’orienter vers ce qui était alors connu sous le nom de «taxe numérique». Le Maire avait mené une campagne primaire de centre droit pour le parti républicain français, en tant que conservateur fiscal. Tout de même, il semble avoir trouvé le social-démocrate en lui depuis qu’il a rejoint le gouvernement d’Emmanuel Macron. Qualifiant cette situation de «question de justice», Le Maire a appelé à l’unité européenne sur la matière de cette taxe digitale. Pendant la présidence estonienne de l’Union européenne, il a réuni les ministres des Finances pour obtenir un soutien.

Cependant, les ministres du Danemark, de la Suède, de Malte et de l’Irlande ont rapidement manifesté leur opposition. Certains critiques ont fait valoir que cette mesure pourrait être considérée comme une punition des entreprises américaines, car la plupart des entreprises concernées seraient américaines.

Ces pays n’avaient pas tort : Donald Trump a clairement indiqué qu’une taxe digitale sera considérée comme mesure protectionniste par Washington, et aura des conséquences en matière de politique commerciale. Le débat sur les droits de douane sur le vin français, qui date de l’été de l’année dernière, était une conséquence de l’introduction de la taxe digitale (dite taxe GAFA) en France.

Le Luxembourg a abandonné le camp de ceux qui s’opposent à la poursuite cette taxe, et propose plutôt de négocier au niveau de l’OCDE. Est-ce que le gouvernement oppose toujours la taxe, et la proposition OCDE est en connaissance du fait que les États-Unis ne donneront jamais leur accord, ou estce que le Luxembourg va ultimement soutenir la proposition de la Commission européenne ? Le temps nous le dira.

Il est difficile de donner un sens à ce débat – et aux propositions concrètes. Pour commencer, la Commission européenne ne précise pas ce qui fait qu’une entreprise est numérique, et encore moins où tracer une ligne entre les modèles économiques plus numériques, moins numériques ou non numériques. De plus, elle reste ouverte sur ce qui relève exactement d’une taxe sur les revenus numériques. En effet, le groupe de l’OCDE sur l’économie numérique, qui s’est penché sur cette même question pendant plus de 2 ans, a conclu qu’il était en fait impossible de mettre une clôture autour de l’»économie numérique». L’opposition de l’Allemagne – qui a bloqué l’avance de cette taxe pendant les trois dernières années – n’est ainsi pas seulement une réaction de peur face à Donald Trump, mais aussi une réaction informée.

Les données financières passées et récentes révèlent que les niveaux de rentabilité sont très divers pour les entreprises numériques, moins numériques et non numériques. Les données du monde réel montrent également que les secteurs traditionnels comptent un grand nombre d’entreprises traditionnelles très rentables. Dans le même temps, ce sont les entreprises numériques qui affichent les taux d’imposition effectifs les plus élevés – et non les entreprises traditionnelles. En outre, les données concernant les taux effectifs d’imposition des sociétés suggèrent qu’il n’y a pas de différence systématique entre les impôts sur le revenu payés par les sociétés numériques et ceux payés par leurs homologues traditionnelles.

Comme d’autres taxes, l’impact d’une «taxe numérique» sur les revenus des entreprises numériques se répercuterait sur les activités commerciales moins numériques dans l’UE et ailleurs, affectant ainsi l’emploi et les recettes fiscales des entreprises numériques comme les PME ainsi que les taxes sur les revenus personnels générés dans les industries numériques et moins numériques de l’UE. Avant tout, une taxe numérique est aussi une taxe sur la consommation de leurs produits.

Très souvent, l’augmentation des impôts indirects implique inévitablement une augmentation des prix pour les consommateurs sur le continent européen. La TVA a longtemps été reconnue comme la taxe qui affecte le plus durement les plus pauvres. Il semble cruel de restreindre leur pouvoir d’achat à un moment où les personnes à faible revenu en particulier peuvent avoir un accès plus simple à de nombreux produits grâce à l’Internet.

The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

Level the cannabis ingesting field by legalizing consumption in commercial spaces

Basements and garages were once the only places you could consume cannabis in peace. But now, if the provincial consultation process advances the interests of consumers, millions of Ontario residents will be able to try some forms of the newly legal substance in licensed commercial settings, including bars, lounges and outdoor festivals. One caveat to this development is that the province will not revise the Smoke Free Ontario Act, so only ingesting cannabis products, not smoking them, will be considered for enclosed public spaces.

By significantly increasing consumer choice, moving forward with commercial consumption would be a big win for cannabis consumers in Ontario. This move would bring cannabis regulation closer to alcohol regulation, a big improvement over current “lock-and-key” cannabis rules. More importantly, this would elevate the legal market over the illegal market by giving consumers something the black market never could: a legal and controlled place to consume.

That said, the specifics of how Ontario regulates consumption are key. Edibles and beverages should be available in any restaurant, bar, or clubs currently licensed to sell alcohol, as well as in stand-alone establishments dedicated solely to cannabis consumption. Ready access to legal consuming space is what can ultimately make the legal market more attractive than the alternative. The black market has always had various forms of edible cannabis available for sale but it has never offered a controlled and legal place for users to ingest or consume it. By liberalizing where it allows cannabis consumption the Ontario government can empower the legal and regulated market at the expense of illicit trade.

There are those who say cannabis and alcohol shouldn’t be mixed, and such behaviour shouldn’t be encouraged by allowing their sale in the same places. It’s true: people shouldn’t mix cannabis and alcohol. But that doesn’t mean these products shouldn’t be made available alongside each other, subject to appropriate regulation. Provincial certification programs could train servers both in the risks of combining alcohol and cannabis and in how to avoid abuse where possible. We already trust certified servers to understand the harms of alcohol intoxication and to cut customers off when they are intoxicated. It is not unreasonable to believe they can help enforce responsible consumption of cannabis.

In addition to commercial consumption, the province is also considering a special occasions permit (SOP) to accommodate cannabis consumption at concerts and outdoor festivals, to be used either separately or alongside an alcohol SOP. This should be reasonably simple to implement. Festivals would be able to offer their adult attendees a wider range of products, thus benefiting both vendors and future customers. As to smoking or vaping cannabis, festivals would be well within their rights to allow this in roped-off or age-restricted areas or wherever they currently allow tobacco use. Edibles and beverages could be sold alongside alcohol so long as the servers have the proper certification.

How do municipalities fit in? Ontario made the huge mistake of giving local city councillors veto rights on cannabis retail within their city limits. A city or town that opts out of cannabis retail obviously doesn’t mean consumers in those cities and towns can’t buy cannabis. It just pushes them back into the illegal market, which is precisely what we want to avoid.

Ontario should not make the same mistake with consumption. If a restaurant, bar, club or lounge can meet the provincial licensing required to sell edibles and beverages, it should be free to do so without busybody city councillors intruding into their business.

Green-lighting commercial cannabis consumption is the right thing to do. But the province must get it right. Competitive and consumer-friendly policies for commercial consumption would give consumers greater choice and convenience and help put a dent in the still-prevalent black market.

Originally published here.

The Consumer Choice Center is the consumer advocacy group supporting lifestyle freedom, innovation, privacy, science, and consumer choice. The main policy areas we focus on are digital, mobility, lifestyle & consumer goods, and health & science.

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org

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