UK government tries to control MMR panic

POLICY AND PEOPLE

UK government tries to control MMR panic Last year, the government he UK government’s drive to launched a £3 million campaign to persuade parents that the comincrease take-up of the vaccine, which bined measles, mumps, and rubella included production of information (MMR) vaccine is safe gained new packs for parents and health profesmomentum last week after the airing sionals. The government is now said of a television programme about to be considering a television adverAndrew Wakefield. In 1998, tisement in which Wakefield argued the Chief Medical that the MMR vacRights were not granted Officer, Liam cine should be withDonaldson, could drawn. Wakefield to include this image in appeal to parents. and colleagues had electronic media. A Department of found an association Please refer to the Health spokesperbetween autism and printed journal. son confirmed to intestinal abnormalThe Lancet that the ities in 12 children government is lookand a possible relaing at new ways of tion with MMR conveying accurate vaccination (Lancet Donaldson—appealing for calm information to par1998; 351: 637–41). ents. The spokesperson noted, howCriticisms of the study and ever, that there is no plan to change Wakefield’s interpretation of the data the emphasis of the campaign to conhave followed. But public fears have vey the community responsibilities of remained, and private clinics offering vaccination to parents; the message the single shots have been besieged will remain one of individual choice. with requests from anxious parents. The spokesperson said that the health Prime Minister Tony Blair has department’s research had indicated been widely criticised for refusing to that parents are already confused and confirm that his youngest child has anxious and “you don’t want to add had the MMR vaccine, but has reinto the guilt. We want to act on what’s forced the government’s message. “I best rather than in response to a deplore scaremongering, whether in media frenzy”, she said. politics or the media. Our children’s health is too important for that”, a statement read. Sarah Ramsay PA Photos

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News in brief UN plea on Chernobyl aftermath On Feb 6, the United Nations called for renewed efforts to help millions of people affected by the Chernobyl nuclear accident, saying that 16 years after the incident those affected remain in a state of “chronic dependency”. The UN warned that populations in Belarus, the Russian Federation, and Ukraine would continue to decline unless significant new measures are adopted to address health, the environment, and unemployment. The report proposes 20 projects that address development needs to stimulate cooperation between international organisations, donors, and the voluntary sector. Medical help for UK prisoners overseas Medical experts will be offering their services free to seriously ill British prisoners overseas as part of a scheme launched on Feb 11 by the UK Foreign and Commonwealth Office (FCO). The Pro Bono Medical Panel will provide advice and help implement the FCO’s new clemency policy by considering the medical evidence in support of a plea on compassionate grounds.

Dutch investigators recommend prescription of heroin to addicts

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hronic, treatment-resistent heroin addicts should be given the drug on prescription and the narcotic should be registered as a treatment for addiction. These are the recommendations of Dutch researchers who studied 549 heroin addicts—smokers and injectors—in six cities during 1998–2001. Their report was presented to Health Secretary Els Borst on Feb 4. Wim van den Brink (Academic Medical Centre, Amsterdam) and colleagues compared the effects of 6 or 12 months treatment with methadone plus heroin with 6 or 12 months use of methadone alone. About 50% of the heroin/methadone group and 25% of the methadone group showed physical and mental health improvements and a decrease in criminal behaviour. The retention rate of the programme was about 70%. The findings are similar to a Swiss study on the effects of heroin prescription, published last year (Lancet 2001;

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358: 1417–20). The main difference was the absence of a control group in the Swiss study. Van den Brink said the 25% improvement is a remarkable result. “For the treatment of infections or fractures that wouldn’t be impressive, but for the treatment of chronic illnesses it’s high. If you could score such a percentage with a new treatment of chronic depressed or schizophrenic patients it would be spectacular.” He pointed out that, 2 months after the free heroin prescription was stopped, the health of more then 80% of the participants had deteriorated severely. “That’s why we think the Netherlands should introduce a permanent treatment programme for patients that don’t benefit from methadone treatment. We must get rid of the idea that heroin is just a narcotic and realise that under stringent medical conditions it can be used as medication. The great advantage of registration

of heroin as a medicinal product is that we can guarantee the quality of production and distribution and we can monitor the safety.” Borst, who commissioned the research, was positive about the results. “I am a fervent advocate of evidence-based medicine”, she said. “I only sponsor research like this because I think every patient deserves the best possible treatment in his specific situation. And this treatment should always be effective and safe. It would be great if we could offer these problematic addicts the prospect of a normal life.” Borst will discuss the ’ recommendations with the cabinet and parliament later this year. This month, a controlled largescale trial of heroin on prescription started in seven large cities in Germany. Half of 1120 addicts will receive heroin, the remainder will be prescribed methadone. Frank van Kolfschooten

THE LANCET • Vol 359 • February 16, 2002 • www.thelancet.com

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