The Detail

The volume of people taking new and effective weight loss drugs has grown so big that it's shrinking food portions in the US The impact of weight loss drugs around the world is so huge that big food companies are jumping in on the bonanza, targeting people on the medication with special food lines.The self-injecting drugs like Ozempic, made famous by celebrities including Oprah Winfrey, are forecast to be worth $165 billion by the 2030s.They're so popular the pharmaceutical giants can't keep up with the demand from millions of people around the world, which means New Zealand is missing out."New Zealand tends to be at the bottom of the list for pharmaceutical companies when it comes to supplying them," says Niki Bezzant, who writes about the boom in the Listener.Even access to the Pharmac-funded drug Sexanda for people with type 2 diabetes is limited because of the squeeze on supply. And while drugs similar to Ozempic are available here they're not as effective in reducing weight and they cost $500 a month.That's out of reach for most New Zealanders when they're expected to stay on them for the rest of their lives."If you start taking this for obesity then you're going to have to keep taking it to have the effect. You can't just go on it and then go off it," says Bezzant."It's the same as any other thing you might do for weight loss except for gastric surgery which is more permanent but even then can still fail."The medical director of the New Zealand College of General Practitioners, Dr Luke Bradford, says more New Zealanders will be able to afford them as more versions of Ozempic and cheaper generics come on the market.He says it is likely that within 10 to 20 years half of New Zealanders will be taking the drugs."We're going to see a real shift in their use and outcomes for patients over the next decade or so."I can see that down the line, and if we can improve the safety and the efficacy, that people will be on them if they need them and if their weight is high," Bradford tells The Detail. He notes however there is a significant proportion of people who can't take the meds because of side effects.They include nausea, constipation, diarrhoea; gastroparesis and pancreatic cancer in rare cases, and possibly depression. But the drugs are also credited with preventing obesity-related cancers and heart disease.Bezzant says the implications of the weight loss drugs boom go beyond the pharmaceutical industry. Already big food companies are responding as the appetites of millions of people shrink and US takeaway chains are also adjusting their offerings…Go to this episode on rnz.co.nz for more details

The case of 'Jay', held indefinitely without charge for 18 years, is raising questions of how we treat our intellectually disabled communityIn 2016, the case of an autistic and intellectually disabled man kept in an institution for nearly 20 years horrified the country.Ashley Peacock was detained as a compulsory patient under the Mental Health Act.Deemed to be 'high risk', his parents spent years battling to have him released.Eventually he was freed from the cell-like room he was kept in for at least 23 hours a day, and now he's living in his own house by a river on the Kapiti Coast.It turns out that Ashley's case was not an isolated one.Last week, the Supreme Court reserved its decision on the fate of a man known as "Jay", whose mother says he is being arbitrarily detained, and his human rights breached.Jay's situation has spooky similarities to that one eight years ago; with issues including the weighing up between the risk to the public and the human rights of the intellectually disabled; and the law that allows us to detain someone who's been charged with no crime, indefinitely.RNZ investigative journalist Anusha Bradley has been covering Jay's case.She tells The Detail that when she got a call tipping her off about the case she really couldn't believe it."I thought 'what?' This guy's been locked up for 20 years ... and the first thing I thought of was, that's what happened to Ashley Peacock, and I thought he was the last one. How is that still possible?"She tracked down Jay's mother (J is just his initial, his name is suppressed) whose lawyer Tony Ellis has for the last eight years been asking courts to overturn an order to detain him under the Intellectual Disability Compulsory Care and Rehabilitation Act.There are about 100 people held under this Act at any one time, roughly 30 of them in secure hospital level care. About 10 percent of people held under the Act have been held for longer than 10 years. Jay is one of those."But because it's such a small population, it's hard to get the actual figures because of privacy issues," Bradley says. "So yes, there are people who this is their everyday experience."In the podcast she talks about how Jay got into this situation, and the factors keeping him there.But this case "poses so many questions," she says…Go to this episode on rnz.co.nz for more details

A more deadly strain of Mpox has ventured beyond African borders, but even though it will arrive here some time, there's no need to panic.A new strain of Mpox has been found outside its country of origin but a health expert here says there's no need for Kiwis to panic.The World Health Organisation (WHO) has declared the outbreak of Mpox Clade 1 in Central Africa a public health emergency of international concern.Health experts believe it's more transmissible and more severe than the Clade 2 strain that's already spread globally.So far 96 percent of the cases are in the Democratic Republic of Congo, but infection is spreading rapidly in neighbouring countries. Two cases have been detected in Pakistan, and one in the Philippines. On Thursday Sweden reported its first case, and its health agency confirmed the person contracted the virus during a recent stay in Africa and is now isolating.It sounds alarming but an infectious disease expert from the University of Auckland says we don't need to be stockpiling toilet paper just yet.New Zealanders should be keeping an eye on how the outbreak develops but Associate Professor Mark Thomas thinks it will be some time before it gets here."It won't be an overwhelming number of cases to begin with and likely public health efforts assisted by vaccination will bring it under control relatively quickly. By that, I would think within a month or two," he says.The main point of concern is the severity of Clade 1, and its higher death rate which is 10 percent. The other variant is found in West Africa and has a lower death rate of about one percent.But those death rates are based on case and death figures from the African countries where the virus originates.Thomas says during the last global spread of Mpox Clade 2 a couple of years ago, other countries didn't record the same mortality rates.And that could be for several reasons. One is that some countries may be less rigorous with reporting, which makes the mortality rate skew higher.In Africa, "people with mild cases don't bother going to a health professional and don't get recognised as having Mpox. Whereas New Zealand, Sweden, UK, the States, it might be that a much higher proportion of people go, including those ones with very mild illness," he says.What is Mpox?Mpox is a viral infection that's closely related to smallpox. It used to be referred to as Monkeypox because initially scientists thought it was a virus that particularly affected monkeys…Go to this episode on rnz.co.nz for more details

Is New Zealand going through a bout of austerity ... or are we just in a funk after being battered by a parade of bad economic numbers?The banks' rush to drop mortgage rates has given homeowners and businesses a pinprick of light at the end of the economic tunnel. But daily headlines of job losses and a stressed public service show the pain is far from over.Critics of the public service cuts say the government is making it worse not better - but is it austerity?Definitely, says Bernard Hickey of The Kākā newsletter. He says government cost cutting measures have been too harsh."When the government is cutting public spending when clearly public services are needed then that's austerity," he says. "And when you're doing it and it reduces the size of the government relative to the size of the economy, effectively putting a sinking lid on the size of the government, that's austerity and that's what this government's doing."Politicians in charge avoid the word with its negative connotations, arguing instead for the need for fiscal responsibility, the New Zealand Herald's deputy political editor Thomas Coughlan tells The Detail.He says the effect of the public service cuts along with years of interest rate hikes have been cruel."New Zealanders feel like they're in a funk and the data supports that, we are in a funk."An important indicator of economic performance, GDP per capita, has gone backwards in recent years; the economy is not growing at the speed its needs to, to keep up with the growing population. Unemployment is rising as a result of interest rates being hiked, and jobless figures are expected to rise further."If it feels like you're worse off, you probably are worse off," he says.The triple-dip recession that has resulted from the Reserve Bank raising the official cash rate has been "quite uniquely bad," says Coughlan.He explains that the monetary system is built on the fact that high inflation is bad and has destroyed many economies, with rapidly rising prices caused by inflation hurting poor people the most."We've designed this whole system which allows the Reserve Bank to put the economy through an enormous amount of pain because we collectively have decided as a society that that pain is worth it because inflation is worse."Coughlan says people are starting to question if this is the best way to cure the economy of inflation.Hickey says the government has failed in its promise to cut spending without cutting frontline services…Go to this episode on rnz.co.nz for more details

Internationally ground-breaking research from inside the police force has quantified the difference between how Māori and Pakeha are treated when it comes to lawGround-breaking work on fairness and equity within New Zealand's police force has quantified for the first time the gap between Māori and Pakeha when it comes to how they're treated.It comes from the world-leading project Understanding Policing Delivery, which granted a research team unrestricted access to police staff and data.Controlling for all other relevant factors, including previous criminal history, youth and gang affiliation, Māori are still 11 percent more likely to be charged with an offence than a Pakeha person in the same situation.The project's Independent Panel chairperson, Professor Khylee Quince, who is the Dean of Law at AUT, says that's really concerning."Probably not surprising; but we've got hard evidence now that there is that form of systemic discrimination that needs to be accounted for and addressed."The three-year exercise was prompted by the global spotlight on the legitimacy of policing in the wake of Black Lives Matter protests and other events, including the British investigation of problems within the Metropolitan Police, as well as a couple of instances here that have shaken confidence in policing.It looked at systems and procedures - rather than individuals - through a lens of fairness and equity.The project pitted frequent critics of the police with front line officers - a situation that was initially uncomfortable for both sides."Me, and most of the other members of the Independent Panel, we are 15 people from academia, different community advocacy spaces and it's quite a risk to get involved with it," says Quince."We are all people who've been quite critical of the police in the past so a bit of reputational risk ... you know, you lose a bit of street cred to be seen to be 'patched over' if you like," she laughs."We haven't been captured by the police!"It's been quite an eye-opener for me to take off the necessarily critical lens and be a critical friend to the police."Police on the Operational Advisory Group of 30 front line officers spread all through the country were also wary to start with."It was like a river between us," says OAG chair Superintendent Scott Gemmell."On the one side was the Independent Panel and the research teams; on the other side was a whole lot of police officers. The scepticism by both sides as to whether we were actually going to be able to pull this off - or even come together - was palpable. But it changed. It was really quite cool to see…Go to this episode on rnz.co.nz for more details

After almost three decades, legislation around gene modification and editing technology is getting an overhaul. After exhausting all the available options for treating his rare blood cancer in New Zealand, David Downs was told by his doctor to go home and make the most of the time he had left.Then, assisted by a stroke of luck and a lot of fundraising, he took part in a gene-editing trial in the USA. Three weeks after the treatment, there was no sign of cancer in his body.Last week, the government confirmed plans to end the country's nearly 30-year ban on genetically engineered and modified organisms outside the lab.The reformed legislation will use Australian laws as a blueprint and include the establishment of a gene technology regulatory body, to ensure any developments won't impact human health or the environment.In the wake of this announcement, Downs spoke to The Detail about his experience receiving life-saving gene editing treatment."The CAR-T cell therapy, from a patient's perspective, is very straight forward compared to the normal treatments. Chemotherapy is the normal treatment for blood cancer, that is essentially poison, you're putting poison in the human to try and kill the cancer cells. When you go to CAR-T cell therapy it's quite different because instead of trying to kill the cancer, it basically assists the immune system to do its job."Downs says the idea behind the therapy is that while the immune system can fight infection naturally, it doesn't recognise cancer cells as dangerous, so CAR-T cell therapy essentially teaches the immune system to recognise and kill the cancer."My experience was going to get my blood taken out, which takes a few hours but it's not particularly difficult. Then they send that blood off to a laboratory, I wait about three weeks while those T-cells get genetically engineered and that's very precise. Then they send it back to me and I basically get one injection of my own blood," he says.Downs says that once those genetically engineered cells are in his body, they recognise the cancer as a danger and destroy them."The little, tiny PAC-MEN are going around chomping away at the cancer cells," he says."When I went back, three or four weeks after the shot, they said that's it, there's no sign of cancer left in your body."…Go to this episode on rnz.co.nz for more details

The new wave of open banking takes a step forward this week with the release of two Commerce Commission decisionsThe Commerce Commission is set to make two big announcements this week, which are expected to result in a big leap forward for open banking.There's also a piece of legislation going through parliamentary processes at the moment that will lay the foundation for open banking to take off in New Zealand.Today on The Detail we try to cut through the jargon to explain what it is, how it will work, and who will benefit most.To some, it is a new and scary concept - allowing third parties to have access to your banking details - but internationally it's been around for nearly a decade, and we're actually already doing it. The problem is, the way we're currently doing it is not completely secure, and banks hate it.BusinessDesk technology editor Ben Moore says historically our open banking has been done via a process called 'screen scraping'. If you've ever used POLi payments, for example to pay a road toll on the NZTA website, you've done that."You give a company your credentials to your bank account, they log into your bank account with some software, it goes in, sees what it needs to, does what it needs to, and then logs out."It's not the most secure way of doing things," [because you are giving them your banking password], "and banks don't really like it very much. They say it's a breach of their terms and services."It's about giving consumers back the right to share their own data that's held within organisations like banks."At the moment that power is in the hands of those banks, so it's a fundamental change in the concept of who holds your data.So how does it work?The big banks have had to spend a great deal of money to upgrade their legacy security systems so that they can create what Moore calls a "bolt-on tunnel connector", or bridge, which is called an Application Programming Interface (API) - an interface between computer programmes.That's so data can be shared.New legislation has been designed to ensure the API is highly secure and standardised across all the banks.That enables third parties, usually fintec companies, to offer their services, whether they be mortgage broking or budgeting services, or online payment services. They can't just reach in and grab your information - you have to give them permission…Go to this episode on rnz.co.nz for more details

What was in the infamous Hobson's Pledge advertisement in the Herlad that has sparked outrage and boycotts?The New Zealand Herald and its publisher NZME hit a nerve last week, publishing an advertisement from Hobson's Pledge that critics have called 'misleading', factually incorrect, and racist.The full front-page wrap urged readers to sign a petition to 'Restore the Foreshore and Seabed to Public Ownership'.It prompted a call out from the Māori Journalist's association, Kawea Te Rongo, a boycott from Te Pāti Māori, Iwi Radio severing its ties and an open letter signed by 170 lawyers refuting the ad's claims.Plans for a second ad were scrapped by NZME, which promised a review into its advertising policies - sparking more fury from Hobson's Pledge spokesman Don Brash, and the Free Speech Union.But was the outcry against the ad justified?Today The Detail speaks to a former editor-in-chief of The Herald, and Tumuaki Wāhine - vice-president - of the Māori Law Society to find out.At the centre of the debate is a claim that there are applications from iwi, hapu and whanau for customary marine titles of nearly all the New Zealand coast under MACA - the Marine and Coastal Area Act.That part is true.But what's not true is that these would limit public access to the beaches.Natalie Coates is the Tumuaki Wāhine for Te Hunga Rōia Māori o Aotearoa - the Māori Law Society - and one of 170 lawyers who penned an open letter laying out why the ad was wrong and racist."I think it's helpful to go through line by line, but also overall it's important to make sure you look at the ad in its whole and how it creates an impression," she says.The front paged was titled 'restore the foreshore and seabed to public ownership'. Public ownership was highlighted in red.This is the first falsehood, because as Coates explains, the majority of the foreshore and seabed hasn't historically been publicly owned."It's not owned by anybody currently, except for the areas of foreshore that are currently in mainly non-Māori private ownership actually … so, the idea of restoration is false," she explains.Coates adds that the impression given by lines like 'restore public ownership' and 'iwi are going to get title' is that Māori will come to own this area, and that simplistic message misses the nuances of the true meaning…Go to this episode on rnz.co.nz for more details

Capturing the health of a piece of bush, and figuring out what predator pests are around, often comes down to the state of its smallest inhabitants On a cold, dark Saturday night two self-named "nature nuts" are deep in native bush near Whakatāne getting very, very close to some of our tiniest creatures.So miniscule are the bugs that they look like specks of dirt.But they are enough to light up the eyes of Russell Ingram-Seal and Wayne O'Keefe whose close-up camera captures even the hairs on their legs.On this trip Russell's mission is to find the rare icing sugar wolf spider, so called because of the white hairs all over it. If we locate it.We're on the Brettkelly family farm which is a mix of native bush, exotic forest and flat pasture.Tonight, we want to get an idea of the state of the health of our 35-hectares of native bush in the hope that one day, like many landowners around the country, we can bring kiwi here and be part of Whakatāne's claim as the kiwi capital of the world.Russell calls himself a nut for invertebrates and kiwi. He started the night walks with Whakatāne Kiwi Trust, and is also involved in a new book about beetles. He's armed with a plastic beating stick and tray to catch the bugs; a high-end torch which lights up the bugs like a disco ball; a jar with a magnifying glass lid; and a pencil with a brush at the other end.Wayne's hefty high-end camera can capture the tiniest hairs on the tiniest creatures. Nature photography is his passion and is part of his work with the Bay Conservation Alliance, a charitable trust that supports community conservation groups.He leads the ground breaking Project Keep, the Kōkako Ecosystem Expansion Programme that aims to connect two isolated groups of the bird in the Bay of Plenty."Not in my lifetime, but ultimately all the kōkako populations in the Bay of Plenty are connected," he says.Tonight, it is the flora that impresses Wayne."I've been blown away by the mosses, and the little warts and the filmy ferns. It's special for that," he says.Check out how to listen to and follow The Detail here.You can also stay up-to-date by liking us on Facebook or following us on Twitter.Go to this episode on rnz.co.nz for more details

Researchers into poverty are asking the government where the evidence is that its new benefit sanction regime will work…Go to this episode on rnz.co.nz for more details