The Greatest Experiment in Social Services

The latest podcast is out!

I recently chatted with new contributor, David Evans from Pasadena, California (yes THAT David Evans, the internationally respected treatment and science literacy expert) on how healthcare can be delivered.

We focus on the United States and explore a few of the options for Medicare for All that are, finally, entering the public discourse. Of course, I am a supporter of a National Health Service, free at the point of service, funded by the public purse, and available to all from cradle to grave. And David educates me on how the US might transition to a medicare for all. What the opportunities and opportunities are.


Women Are The Cure!

The latest episode of A Shot In The Arm podcast is out!

We talk with the South African HIV, women’s rights and science activist, Yvette Raphael. I met her nearly twenty years ago, recently diagnosed with HIV and an HIV workplace peer educator. Since then - my word - has she blossomed into one of South Africa’s leading civic leaders! I caught up with her as she participated in an advisory board review of HIV and family planning clinical research on the East Coast of the US. She also visited the Smithsonian’s exhibit Oubreak: Epidemics in a Connected World. She happens to be featured in it, as part of a project on which she collaborating with my partner in crime, NewsDoc Media’s Erik Espera.

We reflect on the - still paltry - state of clinical scientific research into the needs of women in an era of AIDS. So little is understood about HIV and family planning, including contraception and access to safe abortion. I would be in serious hot water with Zeda Rosenberg, if I didnt mention the microbicide ring too. Women account for 52 per cent of all people living with HIV around the world. Can any of our subscribers, listeners and readers direct us to the percentage of global HIV research investment that actually goes towards women and HIV?

Yvette is very interested in Depo-Provera, the injectible birth control drug (and the inspiration for long term injectible PrEP). For so long, there have been suggestions out there that it might increase a woman’s risk of acquiring HIV. Hopefully, we will have a definitive answer later this summer. But it is a crying shame that we have not answered this earlier, and to empower women to make their own decisions about their HIV and reproductive health.

Yyvette talks about the crisis of gender-based violence. A group of young women activists, including Yvette and Vuyiseka Dubula, the head of Stellenbosch University’s Maties HIV centre, has spearheaded a dramatic and highly effective campaign, including a national day of protest, TotalShutdown. The campaign has revolutionized the national debate, reaching even President Cyril Ramaphosa. You can learn more by watching this documentary The People Versus Patriarchy.

We speak about the use of social media - and how the activists have employed it, not only to raise up women, but to engage men through the #menaretrash hashtag. Yvette talks about the U=U movement, and she talks about Bruce - Bruce Richman - one its leaders.

Afterwards (and I know it is a substance heavy episode). I also touch on the breath-taking number of biomedical news reports that came out this last week - CRISPR, stem-cell treatment for Crohns Disease, and of course, the pig heads. We cannot throw up our hands and scream “Brave New World” every time something new is announced. We have to inform ourselves and prepare for the wave of biomedical change that is pouring over us and which will transform our lives. We need to learn from and aspire to be like Yvette Raphael.

You can find A Shot In The Arm Podcast at itunes, google play music , Spotify and Stitcher. Follow us on Twitter, Facebook @shotarmpodcast, and if you like, us - give us 5 stars! Go on, you know you want to….

References You May Find Useful:



International Partnerships for Microbcides

The People Vs Patriarchy

If you are concerned, or want to learn more about HIV testing, prevention and treatment:

and of course…

Pet Shop Boys

All About The Money

The new episode of A Shot In The Arm Podcast is released today on

itunes, google play music , Spotify and Stitcher. Follow us on Twitter, Facebook @shotarmpodcast.

We chat with Chris Collins, President and CEO of Friends of the Global Fight about the essential work he and his team do to protect US funding for the Global Fund and the global response to AIDS, TB and malaria.

It is amazing how Chris and colleagues have sustained, and indeed grown, bipartisan support for the Fund, when this current US administration seeks every opportunity to slash budgets.

Chris talks about the direct impact of development aid on the safety and prosperity of the US, at home and abroad. The late Ambassador Richard Holbrooke (with whom I co-founded the Global Business Coalition on HIV/AIDS with MTV’s Bill Roedy and Georgia Arnold) said that the health of an HIV positive South African miner through access to HIV treatment directly affects the wellness and security of an auto worker in Ohio. Chris calls out particularly the continuing menace of that awful HIV co-traveller, TB.

I am humbled and grateful to everyone for the huge support for A Shot In The Arm’s first episode, 21st Century Prevention. Many of you commented that while it may be nice to see the contents of our HIV prevention shopping bag, they are very unlikely to happen in the current political climate. So why not call that out?

So, I have tried to join the dots between what the US administration actually does and what it would mean for HIV. I make clear my absolute rejection of that kind of evidence-free and isolationist tribal populism. It is shocking, and all too possible. I keep coming back to Congresswoman Lee’s challenging Secretary of State Mike Pompeo over his assertion that AIDS can be ended and significantly cutting funding at the same time.

We all have to watch for the tendency to drift towards the data that supports our narrative. I know I can do that from time to time. But there is something very different happening now in the US, UK, Hungary, Brazil…. It is beyond the bounds of usual political discourse. We have been here before: A pernicious bullying by the entitled that results from the rest of us not caring enough. And we have beaten it before: Tribal populism only wins when we let it.

This is particularly the case in health. Good health, like good education, is a foundation of civilized society. Everyone is entitled to good health. The question ultimately comes down to how we achieve this. Maybe privately or publicly provided, or a blend of the two. Our job is simply to make that a reality. And in the coming weeks, we will explore the science that could help us.

Finally, I am delighted to share some very good news. The Californian Prostitutes Education Project (CALPEP) of which I am a Board member, announced today that it has appointed the amazing community advocate Jamila Shipp as new Executive Director to succeed Gloria Lockett (who is a friend of A Shot In The Arm, regular contributor and co-host). You can find the announcement here.

I hope you enjoy the podcast. You can find us on iTunes, Google Play Music, Spotify and Stitcher. Follow us on Twitter, Facebook @shotarmpodcast. Be sure to subscribe, and if you like us, give us five stars!

A Shot In the Arm Podcast is brought to you by NewsDoc Media and Hunuvat Global.

Links you may find interesting:


If you are concerned, or want to learn more about HIV testing, prevention and treatment:

21st Century Prevention

This week sees the launch of A Shot In The Arm - my new podcast produced by NewsDoc Media and Hunuvat Global. It has the lofty aim of demystifying some of the more complex, and less explored areas of global health and human rights.

I have been asked why I couldn’t come up with anything more catchy. Three reasons, really. Firstly, It’s a reference to the infancy of public health in the aftermath of the second world war.  In the jolly, good old days, everybody was supposed to queue in an orderly fashion, and be injected with this or that (whatever the clever boffins were beavering away at). Then, we would send them merrily on their way, never to bother us again. Oh how wrong we were!

There is something sinister about it too. Healthcare so brings to mind needles. There is nothing pleasant about having a thin metal pipette poked through your skin. It is not surprising that we can be squeamish about. Yet, needles can also be seductive, We can use them to get ourselves high, to bring ourselves down – and in many countries, including some states of the USA, we can end the lives of people we decide should not be living.

And finally, there is something invigorating and uplifting about “A Shot In The Arm”. Like a brisk walk, a strong cup of coffee, or a dram of whisky.

Of course, there are many people who will think that “A Pain In The Arse” is more apt, if they think I should open my mouth at all. I confess it is an odd, and not altogether pleasant experience hearing your own voice for forty minutes. But the two special guests on the first episode, Gloria Lockett of CALPEP and Mary Ann Torres of ICASO, are really, really good , and compelling. They have very different histories in fighting AIDS, but both have a deep commitment to service, a raw dedication the least advantaged in society.

Gloria reflects on 34 years of advocating for and providing HIV testing, prevention and education to minority sex workers in the California Bay Area. Mary Ann gives an update on the horrific ramifications of the political and economic collapse in Venezuela.

The name of the first episode is “21st Century Prevention,” and Gloria and I consider how to incorporate and adapt biomedical advances, like Pre Exposure Prophylaxis (PrEP) and point of care HIV diagnostics into the back-breaking and relentless work of reaching out to communities on the margins of society, people who are not routinely connected to the fabulous world of HIV service organizations and networks.

Of course, the foundation of good HIV prevention is treatment. Treatment been the crowning achievement of the AIDS response to date, and with it, an understanding that if your virus is suppressed fully, you do not pass on the virus. The U=U movement has been a monumental achievement: The community has taken scientific evidence and given it deep personal meaning, enthusing all sorts of different communities from all over the world.

You’ll hear that I am more excited about PrEP than Gloria - although we both agree it is an important tool for any prevention strategy. I am fascinated at how it could encourage people to stay engaged, get regularly tested - not just for HIV, but for all sorts of health questions. She is concerned, rightly and understandably, about how its benefits and risks are not oversimplified and over-pomised. It is not like the AIDS movement has become obsessed with shiny new objects in the past, only to toss them away when we realize they aren’t the magic bullet after all.

We are both thrilled at how point of care HIV testing can bring real-time diagnoses to people, and enable them and their health workers to act promptly. The memory of my three week wait for HIV test results in 1989 still weighs heavily on my memory.

I confess I’m more excited about self-testing too. With everything a swipe of a smart phone away, HIV is just another thing that is easy to manage in the privacy of our own homes. Should we have a place to live. Gloria rightly observes that too many people are disconnected from the internet age. So how do we reach them? We can also reflect on the value of an internet search, if you end up with information that is just plain wrong, like, say AIDS-denialists or purveyors of alternative remedies. Gloria keeps me on my toes, and is going to be playing that role regularly, methinks, through this season.

And what happens to your social media-based health, if the power gets switched off?

That is the kind of ominous “crazy” Mary Ann describes in her analysis of the crisis in Venezuela. I am struck by how quickly things have fallen apart, and now, how little information we have - no details of the number of people with HIV still remaining in the country, how many have died, how rates of new infections have been affected. President Maduro’s forces have still not released the HIV treatment and infant formula they commandeered in mid February…

It is a stark reminder of how vigilant we all must remain. Nothing can be taken for granted, and we must consistently take responsibility for ourselves and each other.

Over the coming weeks, we will explore advances in hepatitis, immunology, and attempt to discern lessons from ebola, zika and (why?) measles. We will try to make sense of the opportunities and risks of data, how to act promptly and sensibly. I surprise myself at how optimistically I think our world can deliver on the promise of everyone being entitled to good health. Part of that enthusiasm is rooted in the exceptional people we will meet and chat with.

Enjoy the shows. Please like and subscribe @shotarmpodcast on twitter, facebook and youtube.

Right. Well, Im off for a dram of whisky.