The helplessness of modern medicine in the face of a deadly virus was the over-riding image of the year. It was a forceful reminder that we don’t have all the answers – especially not in countries where the medical service is degraded by years of civil war and poverty. At home, non-communicable diseases of lifestyle and ageing made the headlines.
Ebola: The WHO first warned of its concerns about the outbreak back in March. By the autumn the disease had rampaged through three West African states, with no sign of being brought under control. The international response was ramped up in October, although Medecins Sans Frontieres warn that facilities are still inadequate. Trials of new drugs started in December. While they come too late for the more than 6000 people who have died in this outbreak, they may prevent the disease from becoming endemic.
Fat and heart disease: Researchers writing in the Annals of Internal Medicine wrote that dietary guidelines urging people to eat less saturated fat to lower their risk of heart disease were not based on sound evidence. Their systematic review and meta-analysis looked at data from 18 countries. They found no clear link between saturated fat consumption and heart disease risk. But the battle isn’t over. Nutritionists claim the research was flawed and current dietary guidelines should not be abandoned.
Statin wars: NICE, the government’s health watchdog, recommended that people with a 10% or greater risk of getting heart disease in the next 10 years should be offered statins – a jump from its previous recommendations that statins should be offered to those with a 20% or greater risk. A group of influential doctors protested that this could mean 5 million more people taking the cholesterol-modifying drugs, with their potential side effects. In tandem, research published in the BMJ (and highly-publicised complaints about it) made it clear that no-one can say for sure how common these side effects actually are.
Diagnosing dementia: NHS England offered GPs a cash bonus for diagnosing elderly patients with dementia. The move raised plenty of eyebrows, not least because services for people diagnosed with signs of early cognitive decline are lacking and existing treatments are limited in effect. But the potentially deleterious effect on trust between GPs and their patients caused the greatest unease among the doctors who called for the payment to be withdrawn.
Spinal cord re-growth: In a year when good news was hard to find, the story of how Polish surgeons used a British-pioneered technique to regrow nerve cells from a paralysed man’s olfactory bulb to ‘re-grow’ his severed spinal cord was heartening. If the team-work, technical know-how and resources brought to bear in this case could be replicated around the world, who knows what triumphs 2015 might bring?