UK egg bank opened

The UK's first 'human egg bank' has opened, according to an article published in the Mail on Sunday. The bank has been set up by Mohammed Taranissi, director of the Assisted Reproduction and Gynaecology Centre in London, and will store more than 1,500 frozen eggs. He has built up the store of eggs over five years, using donations from women attending his clinic for fertility treatments. Twenty-two UK clinics are licensed to freeze eggs, but donated eggs are scarce. The GMC said that not enough was known about the procedure, or about human development, to be assured that 'a potential health time bomb was not being produced'. The success rate with fresh eggs is significantly greater than with frozen. (Mail on Sunday 2004; 28 November)

Threat to AIDS drugs for developing countries

Antiretroviral treatment for AIDS patients in developing countries is set to become more expensive. As from 1 January 2005 members of the World Trade Organisation must grant 20-year patents to new pharmaceuticals. Some existing medicines are to be reviewed for patent protection. Médecins Sans Frontières has expressed concern that supplies of affordable, generic medicines will fall. Generic preparations have succeeded in giving people longer, healthier lives. In addition, where first line treatment is failing the charity has to buy patented medicines at much greater cost. MSF estimates that 5.5 million people in developing countries need antiretroviral treatment now if they are to expect to survive two years, but only 440,000 are receiving it. (BMJ 2004; 329:1308, 4 December)

Cybersuicide

Cybersuicide - suicides or suicide attempts influenced by the Internet - has resulted in the deaths of nine people in two suicide pacts in Japan in October 2004. Unusually, these pacts seem to have been arranged between strangers who met over the Internet and planned the tragedy through suicide websites. An editorial in the BMJ contrasts these with traditional suicide pacts, in which the victims are people with close relationships. The websites describe suicide methods, including details of medication that would be fatal in overdose. Such websites are thought possibly to trigger suicidal behaviour in predisposed individuals, particularly adolescents. Little information exists about the Internet and suicide pacts. (BMJ 2004;329:1298-1299,4 December)

High Court rules that babies should not be resuscitated

The High Court has given permission to doctors in separate cases to withhold life-saving resuscitation from two babies. Luke Winston-Jones, a nine-month old with Edwards' syndrome, has since died. Charlotte Wyatt, born at 26 weeks and suffering from severe lung disease of prematurity, is still alive in neonatal intensive care. Both sets of parents took their cases to the court asking that the babies receive full resuscitation if needed, but the judges ruled that this would not be in their best interests. Margaret Brazier, professor of law at Manchester University, said the question arose as to how much these babies should be treated given that the means to do so is now available. Currently, doctors make decisions regarding newborn resuscitation on the 'viability' of the baby. (bbc.co.uk 2004; 12 November, Times 2004; 8 October, Independent 2004; 8 October)

Genetic slippery slopes

The Human Fertilisation and Embryology Authority (HFEA) has granted a licence to a London clinic to screen embryos for familial adenomatous polyposis (FAP). Four couples have had pre-implantation genetic diagnosis (PGD) for the condition. FAP causes multiple rectal and colonic polyps, leading to malignant tumours in most affected people. Prophylactic colectomy is commonly performed during teenage years. In principle, any condition with a known genetic marker could now be screened for. Up until now screening has only been allowed for conditions such as Huntington's chorea and cystic fibrosis. Meanwhile a press release from the Cystic Fibrosis Trust in November 2004 stated that almost a third of CF patients face problems obtaining life saving drugs and the specialist centres are seriously underfunded. (BMJ 2004;329:1061, Guardian 2004; 2 November)

High Court refuses to stop suicide tourism

A 66-year-old British woman with cerebellar ataxia has died in Zurich following physician-assisted suicide. The local council caring for Mrs Z brought the case to court requesting a ban to prevent her travelling to Switzerland. She was too ill to travel there alone, and needed her husband to accompany her. The High Court ruled that it could not prevent her from travelling there: 'The court should not frustrate indirectly the rights of Mrs Z. The role of Mr Z is now a matter for the criminal justice agencies,' said Justice Mark Hedley in his ruling. Assisting suicide is a criminal offence with a maximum jail term of 14 years. Physician-assisted suicide is legal in Finland, Sweden, The Netherlands, Oregon (USA) and Switzerland. The Swiss authorities are concerned at the number of euthanasia tourists: there were over 90 such visitors in 2003 compared with three in 2000. (bbc.co.uk 2004; 6 December, Guardian 2004; 4 December)

BPAS refer women to Spain for late terminations

The British Pregnancy Advisory Service (BPAS) has been criticised for referring women to Spain for late terminations. Spain's laws on late abortion are actually stricter than the UK: after 22 weeks it is only legal where the mother's health is in grave danger. Staff at the Spanish clinic admitted to a reporter that they 'play with the laws a little bit'. BPAS have defended themselves against the allegations, comparing it with Irish women who travel to England for terminations. BPAS see it as part of their service to provide women with access to abortion whenever they can. Health Secretary John Reid has launched an investigation into the actions of BPAS. (Telegraph 2004; 10 October, Guardian 2004; 25 November)

Malaria vaccine trial

A promising new malaria vaccine has shown encouraging results in a trial on 2,000 children in Mozambique. The research (published in The Lancet on 15 October) showed a reduction in incidence of severe disease of 58% and of new infections of 45%. The vaccine causes the immune system to attack the malaria parasites before they reach the liver. Developed by GlaxoSmithKline Biologicals in collaboration with the Malaria Vaccine Initiative, it is to undergo further trials. The Bill and Melinda Gates Foundation has contributed $150 million (£84 million) to the programme. (Times 2004; 15 October)