Good morning everyone. I took a long break from writing. I was on vacation. So I would like to start off by wishing everyone a Happy New Year. I hope you have a prosperous new year.

The American football season is coming to an end. The playoffs started yesterday. Again, some of you who are not familiar with American football may not be able to understand some things, but none the less, the message is still the same.

Yesterday’s game was between the Seattle Seahawks and Minnesota Vikings. The Vikings had the home field advantage. Both teams had very good defense. The Vikings got the ball to start the game and so after half time, the Seahawks would be getting the ball. As I said, it was a defensive struggle and the only points were scored by the Vikings. Scoring involves getting the ball into the opponents end zone or past their goal line either by passing (throwing) the ball to one of your players or carrying the ball (rushing). This is called a touchdown. You get 6 points for scoring. Then you get an extra point if you kick the ball from about 25-30 yards, through the opponents goal post. The extra point is almost automatic, but kickers do miss sometimes. So you get 7 points. But if you fail to get into the end zone, you can kick the ball from wherever your team is and get a field goal. Usually, teams try a field goal if the distance is 60 yards or less. You get 3 points for a field goal.

At half time, Minnesota was leading 3-0. There was still a minute left in the first half and Minnesota had the ball. The Seahawks were supposed to get the ball after halftime. But instead of trying get a score, Minnesota elected to let the clock run. That was a very conservative approach. If I was the head coach, I would have tried to score something. Seattle is a good team and you cant let a good team stay in the game. You have to put them away by being aggressive. In the second half, Minnesota managed to get 2 more field goals and were leading 9-0. Seattle managed to get a field goal and the score was 9-3 in favor of Minnesota. But at about 1 min 45 seconds left in the game, Seattle scored a touchdown and went up  10-6. Minnesota got the ball and were very close to the Seattle end zone. But instead of trying to score a touchdown by passing the ball, Minnesota elected to be conservative and rush the ball. Unfortunately they could not score a touchdown. So they elected to get a field goal. They let the clock run down to about 25 seconds and then stopped it by calling a timeout. They were at the 27 yard line of Seattle. Minnesota sent their kicker out to get a field goal to win the game. This should have been automatic, but the kicker missed and Minnesota lost the game. 

So the moral of the story is that don’t be conservative. Offense is the best defense. Be aggressive. Go after things instead of trying to settle for something.

Hi everyone, today is World AIDS Day. Just to refresh your memory Human Immunodeficiency Virus (HIV) causes Acquired Immune Deficiency Syndrome or AIDS. The virus was first identified in 1984. It was a virus that crossed over from monkeys/apes to humans. Ebola is another virus that is capable of crossing over from one species to another. If possible, read my book Taming Ebola from Amazon Kindle Publishing. One of the reasons for writing about AIDS today was obviously because it is World AIDS day, but to also draw attention to what has happened since 1984. AIDS is the world’s most important public health issue. There is also an article about it in Metro Philadelphia. Also as you know I work in the pharmaceutical industry and I have been fortunate enough to have worked on two drugs that fight HIV and that are still on the market in the US and rest of the world. The objective of World AIDS day is to unite everyone in the fight against HIV and to remember those that are living with the disease and those that have died.

AIDS first got visibility when actor Rock Hudson was diagnosed with it and then eventually died because of it. The virus weakens our immune system and many people die due to opportunistic infections that the compromised immune system cannot fight. Rock Hudson left $250,000 to start the American Foundation for Aids Research (amfAR). Since then Magic Johnson announced he was HIV positive. Tennis player Arthur Ashe contracted AIDS because of contaminated blood that he received as a transfusion during surgery. Most recently actor Charlie Sheen admitted he was HIV positive.

There is a huge stigma associated with AIDS because it was believed to be caused by promiscuous sex and sharing of drug needles by intravenous drug users. But as seen with Arthur Ashe’s example, not everyone who contracts AIDS, does so because of their lifestyle. Also it has been proved that AIDS cannot be transmitted by casual contact, food, water and surfaces.

The Metro article lists 10 facts about AIDS. One of them is very sobering and it is that the number of new cases is growing in low- and middle- income countries, predominantly in sub-Saharan Africa. Also these new cases are in girls ages 15-19. Because of advances in medicine and education about transmission, the number of new cases in the Western world has stagnated and in some cases gone down. These are AIDS mature populations. But sub-Saharan population is AIDS naïve population. These countries cannot afford the cost of medications and also there is a huge lack of education. Pharmaceutical companies are making these drugs available through compassionate use and by doing clinical trials in these countries. There are some non-profit pharmaceutical companies developing affordable drugs by getting grants from the Gates Foundation and Clinton Foundation. The countries in the United Nations have agreed to eradicate AIDS by 2030. Let us hope they are successful.

Hi friends. I would like to wish you all a very Happy Thanksgiving. For my friends in India, Thanksgiving is a tradition in the US. It was the time when early European settlers first came to the US. The native people welcomed them and then Thanksgiving was started after the first harvest. I will keep this short. For many of us, holidays and festivals are a way to see old friends and family members. Whenever there is a gathering, food is the main focus. The host and hostess are running around trying to get everything ready. Others are playing games or decorating. But take a few minutes to think about what you are thankful for. It will slow everything down and put things in perspective. So I hope you enjoy your company. Eat drink and be merry. Pair up protein and carbs. Get some exercise, so you don’t have too much weight gain. But remember to be thankful for what you have.

Hi everyone. Today I am going to talk about a very sobering subject. Protecting our Mother- Earth. In Indian mythology, Earth is considered the mother of all living things. But one of it’s own creatures, humans, have polluted her and we are the only ones that can prevent further deterioration. In an UN sponsored climate conference in 2010, it was decided that an average increase in temperature of 2°C above pre-industrial levels will be devastating to the environment and the effects could be irreversible. The pre-industrial levels refer to the temperature in 1750 when the industrial revolution began and the use of fossil fuels became more commonplace. On November 10, 2015, we reached the halfway point. According to the World Meteorological Organization (WMO) we are headed towards uncharted territory at frightening speed. The warming in temperature is a direct result of increase in concentration of the three greenhouse gases: carbon dioxide, methane and nitrous oxide. These gases are the creation of human beings. These gases are produced by industrial, agricultural and domestic activities. The amount of carbon dioxide went above 400 parts per million in the spring of 2015.

So what is the big deal about the temperature rising by 1°C. Well to put things in perspective, a million years ago when the Earth came out of the ice age, global temperature rose 4-7°C in 5000 years. In the past century alone, the temperature rose 0.7°C, which is roughly about 10 times the rate of temperature increase during the ice age. In the future, if we continue along this path, the rate will be 20 times faster. If there was no human influence, the Earth’s temperature would still increase, but the increase will be very slow. The increase that we have seen is highly unusual.

What are the consequences of this? It will lead to hotter summers, colder winters, melting of the ice caps and rise in ocean levels. There will be an increase natural disasters like hurricanes, tornadoes and snow storms. Many island nations are actually worried that the rise in water levels can submerge their islands and want the UN to lower the threshold to 1.5°C. This is also going to have a severe economic impact due to money spent in recovering from natural disasters.

I sincerely believe that in our lifetime, we will see disastrous effects. I read somewhere that the Amazon rainforest will be gone by 2050. That is only 35 years from now. I think we need to do something about it. The politicians are not going to do anything about it. They keep having meetings which don’t produce any action items and only compromises. Many prominent billionaires like Bill Gates, Sir Richard Branson are donating significant sums of money to sponsor research into technologies aimed at slowing or reversing climate change. But we need to do something too. Take public transit to work or school. If you can afford it, buy electric or hybrid cars. Sign-up for electronic delivery of bills. Follow the three R’s: Reduce, Reuse, Recycle. Insulate your house, change old windows. Buy organic produce, try to be vegetarian at least once during the week. Simple steps will add up to giant steps and perhaps we can hope to reverse the damage.

Hi everyone. I am resuming my blog after a brief break. Today I would like to talk about being grateful for what you have. I work in the city of Philadelphia. It is America’s sixth largest city. Just like all big cities, Philadelphia has homeless people. A few days ago, I was having lunch with my boss. It was a nice day, so we were sitting outside a restaurant. There were other people also eating outside. A homeless person approached many people who were sitting outside. Everyone ignored him. Bu when he came to our table, he asked us for a couple of dollars. My boss said, that he did not have any small bills, but offered half his uneaten sandwich. I had five dollars which I gave him. He also took my boss’ sandwich and walked away. A couple of days ago, I was getting lunch and another homeless person approached me and asked me if I would buy him a salad. I agreed. Another lady next to me offered to buy him some iced tea. So we both bought him lunch. During both those occasions, I couldn’t help but think about how fortunate I was. It is said that there are three necessities in life: food, water and shelter. So i am grateful that I can eat three meals a day, I have clothes to cover my body and a roof over my head. I am also grateful for waking up everyday. No matter who you are, you got to where you are because of someone. So take a moment to reflect on what you have and be grateful. Be grateful for the people in your life. Call a friend whom you have lost touch with. Nowadays with Linkedin, Facebook, Whatsapp, it is so easy to connect. Call your teachers and thank them. Call your mentor and thank them. Just be grateful.

“But that’s no fair” my kids said in unison. It was one of those days when they were bickering about something and I took their electronic privileges away. I said “Life is not fair, little baby penguins get eaten by killer whales”. My daughter said “What does that mean anyway?” So I proceeded to tell them about predator and prey. It is true that life is not fair. But in the wild it is Nature’s way of ensuring the survival of the fittest. Even in our day to day lives, if you are not better than someone else, you don’t make the team or you don’t get the promotion. Now I agree that in some instances, people who actually deserve to make the team or get a raise don’t. But for the most part, survival of the fittest holds. You know the joke where they say you don’t have to run very fast to get away from a bear, you just have to be faster than the other guy. Years ago, I was in an organization like the ROTC. We were all competing to go to paratrooping camp. Unfortunately, there were 4 slots and I was the fifth. Guess what, I could not go to the camp. I felt bad, but that was how it all went. I tell our kids to develop a thick skin and not to be oversensitive. I also tell them that when someone criticizes you or gives you negative feedback, look at who it is. Is it someone that cares about them like a parent or a teacher or a mentor? In that case, take the criticism seriously. But if it is someone that does not care about them, a stranger or a student in school forget it and move on. Life is too short to dwell over little things. Also in your professional life, your job etc, there are going to be bad reviews, or layoffs. It may be personal or it may be business related. You have to suck it up and move on. The first time I got laid off from a job was at the end of January 1995. At about the same time, my father passed away. I was reeling from one shock and got a second one. But my employers did not feel sorry for me. In fact my supervisor called to convey his condolences, but then said “can you please help me with something before you leave, I am swamped.” I went in to work, helped my supervisor, did my exit interview and caught a plane in the evening to be with my family. Do you think my employer was unfair?

Children get trophies for participation. They don’t keep score in games. Every team makes the playoffs. Are we sheltering our kids to become gutless, spineless adults who expect someone else to fight for them? I always wonder if we are preparing our younger generation for the real world where there is fierce competition, there are no points for second place and life is not fair.

Hi everyone, before I provide additional information, I would like to mention that I have worked in the pharmaceutical industry for 18 years and I have seen the drug development process from up close. So my view may be biased. I will try to be neutral and present the facts. Also it should be noted that my thoughts on this subject do not represent the views of my company. I started writing books and this blog to express my thoughts. The first amendment gives me the right to freedom of speech. I want to be true to you, my readers, true to the topic at hand and finally true to myself. In doing so I am going to choose thought provoking topics that may not sit well with everyone. I am not going to beat around the bush or walk on eggshells on such topics.I am going to choose examples to get my point across. This is not fiction, but real facts about people and issues.

Okay, now that the disclaimer and disclosure is out of the way, let us delve into this issue. Back in mid-September, Turing Pharmaceuticals and it’s CEO came under a lot of fire for raising the price of their drug Daraprim by 5,455% i.e. from $13.50/tablet to $750/tablet. The company cited R&D costs as one of the main reasons for the price increase.

According to many estimates, the cost of bringing a new drug to market is $2.6 billion and it takes 10-15 years. When the drug is discovered, the company applies for patent protection and patents last for 20 years. But given that the company spends so much time and money, it essentially has about 5 years to recoup their cost. Consider the fact that the company is working on more than one drug at a time. It has to go through several stages of development. Actually, I have covered this in my book Taming Ebola. You can find it at http://www.amazon.com/Taming-Ebola-Aniruddha-Railkar-ebook/dp/B00PM1HJMY/ref=sr_1_1?ie=UTF8&qid=1445350572&sr=8-1&keywords=Taming+ebola. So I will not cover it here. But one out of 10 new drug candidates are successful. Sometimes drug candidates fail in later stages and the company cannot recoup their costs at all. For existing drugs that are off patent, cheaper generic versions can be obtained, but even developing a generic drug can take 2-3 years and $10-50 million. So generic drug manufacturers also have to recoup their costs. Unlike an innovator, there may be many generic drug manufacturers for one drug, therefore their margins are very thin.

Drug pricing is also determined by supply and demand, the effectiveness of the drug and other factors as well. For example there are certain diseases that affect a very small number of the population. Obviously, the per unit cost of such drugs is high. Some drugs can cure the disease, while some can slow the progression. For some diseases, there is no cure, but the patients still have to be treated. Another factor is reimbursement by insurance companies. In the US, the private insurance companies as well as government programs cover many drugs and so the out of pocket costs for the patient are less. But in Europe, many drugs are covered by government programs and it is fairly common for them to exclude some drugs off their formulary. But that means some life saving drugs will not be available to everyone. Companies do negotiate prices to make it more attractive for governments to put the drugs on the formulary. This trend is catching up in the US. Pharmacy Benefits Management (PBM) companies like Express Scripts and CVS are negotiating discounts for their members. Recently, Gilead Sciences got approval for a dug that completely cures Hepatitis C. The cost: $84,000/year. The previous treatment was a combination of two drugs: interferon and Ribavarin. The cost: $1,500/year. The cure rate: 50%. CVS made a deal with Gilead. But Express Scripts refused. Instead they made a deal with Gilead’s competitor Abbvie. Lawmakers in the US have challenged the prices and written letters to Gilead management. So far no success. I realize that people who cannot afford medicines or do not have good insurance coverage, should not have to choose between putting food on the table and buying medicines. But I feel we need to look at more than the economics. Given a choice between 100% cure and high cost versus 50% cure and low cost, is that worth a chance? What about costs of hospitalization or an organ transplant? Can you put a price on the amount of time with loved ones and improved quality of life?

Hi everyone. As I said, I will try to post something about health, wealth and wisdom. I also hope to publish on a regular basis (once a day, once a week or once a month) but not sure. Please provide suggestions on the frequency of my posts.

Today’s post is about health. For those in the US, I am sure you heard about a former basketball player, Lamar Odom being hospitalized and is now in critical condition. I hope he makes a recovery. But one of the culprits in Mr. Odom’s medical problems was reportedly a dietary supplement which is like an “herbal Viagra”. I am sure Pfizer is not too happy about that comparison. However, this does put the whole issue of dietary supplements under the spotlight. According to an article on Yahoo (https://www.yahoo.com/health/dietary-supplements-send-23000-to-the-hospital-115936324.html) approximately 150 million Americans take dietary supplements. It is a $14.8 billion, yes billion with a “b”, industry. In the US, dietary supplements are not regulated by the Food and Drug Administration. Every year, 23,000 people are hospitalized due to dietary supplements. But the cause for concern is that 21.6% of those cases are children. Obviously, the supplements were not stored properly and were within reach of children. Some of the most popular dietary supplements? You guessed it- weight loss and sexual enhancement. Out of the 23,000 cases, weight loss supplements resulted in 3,339 cases in women and about a third of that in men. On the other hand 567 cases in males were related to sexual enhancement products and 368 cases were attributed to body building products. Corresponding numbers in women were virtually non-existent.

If you are taking or considering taking dietary supplements, please consult your doctor first. If your doctor is okay with it, don’t exceed the recommended dosage hoping for faster results. If possible, do a search on the ingredients, especially the one that is the “active” ingredient. See if any of those ingredients will interact with existing medications that you may be taking. If possible, buy supplements from manufacturers that have been certified by some organization (I am not trying to endorse a particular manufacturer, but I am sure you have seen the commercials).Finally, most importantly, please keep any and all supplements out of reach of young children.

Hi all, Yesterday I asked you what topics you would like me to address, a good friend suggested writing about stepping out of ones comfort zone. So here goes, Last night I was watching Dancing With The Stars (DWTS), In this show, a male or female professional ballroom dancer is paired up with a female or male actor respectively. This year the youngest star. Bindi Irwin, the daughter of the late Crocodile Hunter. Steve Irwin. is 15, The oldest star is celebrity chef Paula Deen. who is 68, Former contestants have been astronaut Buzz Aldrin, Apple co-founder Steve Wozniack, Also wounded Iraqi war veteran, Noah Galloway. who lost one arm and one leg. Jose Renee “JR” Martinez. who suffered severe burns while serving in Iraq and double amputee Olympic snowboarding champion, Amy Purdy, JR won his season of DWTS, Noah Galloway wanted people to know that he is more than a guy without an arm and a leg; and Amy Purdy thinks that the only disability is the one in your mind, All these dancers have one thing in common, They stepped outside their comfort zone and did something completely different from what they were used to doing. On a trip to Cancun a couple of years ago, I stepped out of my comfort zone. I don’t know how to swim, But I wore a life jacket and jumped into a sink hole 30 feet deep, I was not sure if I could find the courage to do so. I did have a life jacket, but when I jumped, it almost came off, Anyway, after I jumped, I felt free, terrified, but free. So my friends, step out of your comfort zone and do something different that makes you uncomfortable.