67 episodes

Pomegranate Health presents compelling stories about medicine and society: how doctors make difficult ethical and clinical decisions, how they can communicate with patients and how health delivery can be made more equitable. The podcast is produced by the Royal Australasian College of Physicians (RACP) to inspire excellence in practice.
You’ll hear from clinicians, researchers and advocates. Episodes are developed with the guidance of RACP members and listener input is always welcome. You can leave comments, find story transcripts and further resources for professional development at the website, racp.edu.au/podcast.

Pomegranate Healt‪h‬ RACP

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Pomegranate Health presents compelling stories about medicine and society: how doctors make difficult ethical and clinical decisions, how they can communicate with patients and how health delivery can be made more equitable. The podcast is produced by the Royal Australasian College of Physicians (RACP) to inspire excellence in practice.
You’ll hear from clinicians, researchers and advocates. Episodes are developed with the guidance of RACP members and listener input is always welcome. You can leave comments, find story transcripts and further resources for professional development at the website, racp.edu.au/podcast.

    Ep67: Boosting Public Health in the Indo-Pacific

    Ep67: Boosting Public Health in the Indo-Pacific

    This is the fourth and final part in our series on Global Health Security. Australia’s Indo-Pacific Centre for Health Security was launched in 2017 to provide development assistance to health services as far-flung as Fiji, Cambodia and Timor L’este. Its mission is always tailored to the needs of the partner government. In Indonesia it has provided training to the veterinary sector to foster antimicrobial stewardship. The 2020 COVID-19 pandemic was a sudden shock to the development agenda and has forced a rapid redeployment of resources. Since recording this interview there has been an additional $500 million dollar commitment to fund doses of COVID-19 vaccine and technical assistance to the Pacific and Southeast Asia.

     
    Guests

    Dr Robin Davies AFPHM (Director, Indo-Pacific Centre for Health Security)

    Dr Stephanie Williams AFPHM (Ambassador, Indo-Pacific Centre for Health Security)

    Claim CPD credits and find links to additional resources at www.racp.edu.au/podcast.

    • 44 min
    Ep66: Gendered Medicine 1- Heart Disease

    Ep66: Gendered Medicine 1- Heart Disease

    We traditionally think of cardiovascular disease as a man’s problem, but it’s the leading cause of death for women as well as men in most of the industrialized world. Despite great advances in the management of heart disease in recent years, women are still not getting the same quality of care as men. Readmissions and mortality following an acute myocardial infarction at least two times higher in women as they are in men.

    Put simply, cardiovascular disease is better understood in men, the presentations and diagnosis occur more promptly, and therapies are more consistently delivered to male patients. In this episode we explore the subtle biases at every stage that nudge male and female patients down different health pathways and result in gendered health outcomes.

    Guest

    Associate Professor Sarah Zaman FRACP (Westmead Hospital, University of Sydney)

    Log CPD credits and find links to additional resources at www.racp.edu.au/podcast.

    • 41 min
    Ep65: A New Script for Global Public Health

    Ep65: A New Script for Global Public Health

    In this episode we present some provocative solutions to problems presented in the previous two stories.We heard about pharmaceutical patents, and how embedded intellectual property law is in global trade relations. There’s this fundamental assumption that innovation occurs thanks only to the vigour of the private sector and the plucky entrepreneur. It’s even been said that financialized capitalism is “the greatest engine of progress ever seen.”



    But the reality is that shiny smartphones and targeted drugs wouldn’t exist without massive government spending on research. It’s public money that funds the riskiest stages of development, before private enterprise takes these products to market with the benefit of monopoly pricing. Dr Owain Williams and Associate Professor Peter Hill argue that states can demand more control over the outputs and pricing of drug and vaccine research, and that the current intellectual property regime is not the only way to stimulate innovation.



    In the second part Associate Professor Adam Kamradt-Scott talks about the lessons learned and not learned from pandemic modelling in past years. He also makes the case for establishing an Australian Centre for Disease Control with standalone jurisdiction, to cut through some of the conflict we’ve seen in recent months between state and federal leaders.  

    Guests

    Dr Owain Williams (University of Leeds)

    Associate Professor Peter Hill AFPHM (University of Queensland)

    Associate Professor Adam Kamradt-Scott (University of Sydney, United States Studies Centre)

    Log CPD credits and find links to additional resources at www.racp.edu.au/podcast.

    • 42 min
    Ep64: Big Pharma and the People’s Vaccine

    Ep64: Big Pharma and the People’s Vaccine

    This is part 2 in our series on global public health and focuses on the impact of intellectual property laws on the development and distribution of pharmaceuticals. The COVID-19 pandemic has stimulated a frenzy of vaccine development never seen before, but also examples of hoarding, price hikes and vaccine nationalism. The crisis has brought together scores of governments, manufactures and philanthropic organisations to pool research outcomes and patents, but the response from big pharma has been mixed. We’ll discuss where the IP rules have come from and where exceptions are sometimes made for public health emergencies. We also discuss how pooled procurement mechanisms and advanced market commitments can help get drugs and vaccines to populations in developing countries and whether COVID-19 can prompt a permanent change to the existing IP regime.



    Claim CPD credits and find links to additional resources at www.racp.edu.au/podcast.

    • 44 min
    Ep63: the WHO’s Biggest Test

    Ep63: the WHO’s Biggest Test

    During the COVID-19 crisis there has been some criticism of the World Health Organisation as to whether it declared a pandemic soon enough or covered up for China’s failings. But few commentators have explained the role and responsibilities it shares with its member states in dealing with a pandemic. A prototype of the International Health Regulations were conceived during the cholera epidemics of the mid 1800s, and but the most current version of the IHR was formalised in 2005 in response to SARS. In the book “Disease Diplomacy,” Associate Professor Adam Kamradt-Scott documents the political and social factors that have accompanied the implementation of the IHR. In this podcast we consider how the unprecedented scale of the current pandemic and the mixed response from member states has challenged the viability of the WHO.

    Guests

    Associate Professor Adam Kamradt-Scott (University of Sydney, United States Studies Centre)

    Claim CPD credits and find links to additional resources at www.racp.edu.au/podcast.

    • 40 min
    Ep62: Essential Ethics in Adolescent Health

    Ep62: Essential Ethics in Adolescent Health

    In episode 59 we shared a sampler of the Essential Ethics podcast from the Children's Bioethics Centre, at the Royal Children’s Hospital, Melbourne. A couple of cases studies were presented to help us define “the Zone of Parental Discretion” – a space in which decision-making about a child’s medical care is conceded to parents even if it’s not optimal clinical management.

    Today’s thought experiments come from the oncology department. First, we’re asked to consider when an adolescent should be permitted to make autonomous decisions about their health, even if these would lead to worse clinical outcomes. How does a clinical team decide whether to accept this wish or to override it?  



    In the second case study, the final outcome has already been determined by an incurable brain tumour. A 14 year old girl has been diagnosed with a high grade medulloblastoma. Therapy has little chance of cure but around 30% of patients have their life prolonged by 2 or 3 years but comes with disabling side effects. The parents want to bypass recommended treatment and try prayer and natural therapies instead . Does this terminal prognosis broaden the zone of parental discretion, and how can the clinical team help the family with the terrible choices they have to make? 

    Guests

    Prof John Massie FRACP (Royal Children’s Hospital Melbourne, Murdoch Children’s Research Institute)

    Associate Professor Clare Delany (Children’s Bioethics Centre, University of Melbourne)

    Diane Hanna FRACP (Royal Children’s Hospital, Melbourne, Walter and Eliza Hall Institute of Medical Research)

    Kanika Bhatia FRACP (Royal Children’s Hospital, Melbourne)

    Molly Williams FRACP, FAChPM (Royal Children’s Hospital, Melbourne)



    Claim CPD credits and find links to additional resources at www.racp.edu.au/podcast.

    • 42 min

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