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Medicine 2019: Physicians of the world

On Day 2 of the RCP Medicine 2019 conference, Professor Cheng-Hok Toh chaired a session on physicians for the world.

Professor Beverley Hunt, professor of thrombosis and haemostasis at King’s College London, discussed the global impact of thrombosis. Her goal was convey how the size of the thrombosis problem is under-appreciated and what can be done to reduce the burden. Globally, 12 million deaths per year were ‘cardiovascular’ and 10 million were due to stroke, but venous thromboembolism (VTE) was not indicated as a separate category. VTE deaths are estimated at 3 million a year globally and 60% of VTE are directly related to hospital admission. One in four deaths are as a result from blood clots, but thromboprophylaxis is cost effective and greater awareness and education can be used to save a significant number of lives.

Dr Keith Ridge, chief pharmaceutical officer at NHS England, gave a presentation about the global risk of antimicrobial resistance. It is estimated that 700,000 deaths are due to drug-resistant infections, and this is rising. The ‘One-health’ approach has been used to help reduce the spread of antibiotic resistance across policy-makers, general public, health workers, pharma industry and farming and agriculture. The UK is taking the lead to help and support around 30 countries with the optimal use of antimicrobials and stewardship across all sectors. The UK is making progress in antimicrobial prescribing and usage, but is still about 10 years behind countries like Sweden and the Netherlands, there is still more to do in primary care and even more to do in secondary care.

Dr Luke Kane, GP and volunteer with Doctors of the World, talked about his experience of humanity and kindness in an Ebola treatment centre and what doctors can do to help vulnerable patients to access quality healthcare. There was a difficulty with working with the different motivations and driving forces behind the other teams working in the clinic. Ebola will always break out due to the reservoir in bats and other animals, and in 2014 Médecins Sans Frontières described the global response to the Ebola outbreak as ‘a global coalition of inaction’. Norway’s doctors sent to treat the Ebola outbreak were provided ‘danger money’ leading to their motivation to go out to be financial rather than medical or empathetic, in contrast, the NHS did not supplement the UK doctors’ income so their motives were less mercenary. Dr Kane emphasised the work of charities like Doctors of the World helping vulnerable people all across the globe that need the support, help and advocacy to protect them from illness, abuse, callousness and neglect.