Like the arms race, the funding of new cancer drugs is an endless upwards spiral. First though, let's have the good news. Yesterday, the Phamac office in Wellington announced that from October 1st, the expensive cancer drug Keytruda will be made available to eligible people with advanced triple-negative breast cancer, head and neck cancer, colorectal cancer, bladder cancer, and Hodgkin lymphoma.

Mid-year, a highly politicised funding boost to Pharmac had made this expansion of treatment possible. Otherwise, and without government subsidy, each Keytruda treatment would cost each patient in the vicinity of $150,000. (The patent for Keytruda doesn’t run out until 2028, when some less expensive generic versions will gradually become available.)

Last year, following another coordinated campaign of pressure from politicians, patients and the pharmaceutical industry, Keytruda had been made available to people with locally advanced and metastatic non-small cell lung cancer (NSCLC), provided they met certain eligibility criteria.

But here’s the thing. Yesterday, just as Pharmac announced the expansion of Keytruda availability, the Fierce Pharma industry news website carried this headline story: “Akeso, Summit’s new bi-specific crushes Merck’s Keytruda in study, signalling potential new standard in lung cancer.”

The Keytruda-beating data from Akeso and Summit’s ivonescimab that oncology industry watchers had been awaiting, are here. The China-only data are impressive, signaling the PD-1/VEGF bispecific antibody’s potential as a new standard of care in non-small cell lung cancer (NSCLC). Ivonescimab slashed the risk of disease progression or death by a whopping 49% compared with Merck’s Keytruda in the phase 3 HARMONi-2 study....

Sure, early days yet. This was a single study funded by the drug companies developing the new medicine for the market. But it's also a useful reminder that as the NZ population ages, and its co-morbidity conditions become more complex, the drug bill for keeping up with the newest, most effective treatments is going to keep rising steeply.

Footnote: How do these new cancer drugs work? Essentially, Keytruda is an antibody that blocks a protein called PD-1 (programmed cell death 1) found on the surface of the immune system T-cells and that stops them from attacking the cancer cells. Keytruda – and evidently, the new drug Ivonescimab – both prevent an activated PD-1 protein from stopping the immune response. It just seems that Ivonescimab may be much better at doing it.

Keeping the (bad) faith

Every incumbent government feels obliged to check in every now and then with the voting public to show they’re staying in touch – even if they’re actually veering off in new policy directions that were never even whispered about on the campaign trail. David Seymour’s reported changes to his Treaty Principles Bill sound like a classic example of this kind of performative listening.

As yet the public hasn’t seen the draft Bill. But adding the words “hapu” and “iwi” – as Seymour has done after a selective exercise in “listening” to feedback – won’t resolve the core problem. Namely, the Bill apparently still refuses to recognise that indigenous land rights are uniquely different from private property ownership rights.

Trying to deny the existence of indigenous rights, and putting the iwi and hapu relationship with the land on the same footing as Woolworths’ ownership of its supermarket sites would not be a useful way forward, or display much willingness to listen to feedback.

Par for the course, though. At this point, nearly a year on from the 2023 election, the National Party campaign trail promises “to reduce the cost of living, restore law and order and improve our schools and healthcare” haven’t worn very well, have they?

Sure, it's been only a year, but even the generously inclined would have to concede that the realities of life under the coalition government have borne precious little resemblance to the prior packaging. Regardless, the Luxon administration keeps repeating that (a) “the government is doing what it said it would do”, and/or (b) “It was in the coalition agreement... ”

Neither claim stacks up. In reality, those coalition agreements were documents of convenience, setting out how the three party leaders would prop each other up in power. They’re not a public mandate. Quite the reverse. ACT got only 8.64 % of the vote, New Zealand First got only 6.08%. Yet so many items on their wish-lists are now being imposed on all of us.

As for the government doing what it said it would do...give me a break. Twelve months ago, the centre-right parties were giving voters barely a hint of what they have since carried out. No one cast a vote last election thinking that, if elected, a National-led government would:

• cancel the ferries contract
• seek to ram through fast track legislation vastly increasing the powers of central government
• scrap the smokefree legislation
• halve the excise tax on tobacco products
• reduce health spending per capita while imposing a hiring freeze on the public health system
• encourage GPs to raise the cost of doctor's visits,
• re-introduce prescription charges,
• raise the speed limit
• reduce the disabled’s funded access to support,
• kick families out of emergency housing and onto the street etc etc.

Also, there is the gap between what was promised and what is being delivered. National’s repeated promise that a foreign buyers tax would help pay for its tax cuts proved to be just as shonky post-election, as the economists had warned. Instead, National has made over 6,000 public servants pay for the tax cuts with their jobs and livelihoods, at a time when unemployment is rising and the economy is in slowdown mode.

That hand on heart promise of a careful “line by line” evaluation has turned into an utterly arbitrary firing squad, based on the weird premise that if a job hadn’t existed in 2017, it isn’t necessary now, in 2024.

Wait, there’s less

Did anyone vote to divert taxpayer money away from the building and repair of state schools, into creating dozens of charter schools run for religious reasons and/or private profit? Maybe the 8.64% who voted for ACT did, but the other 91% of us didn’t. Did any voter expect that training those promised 500 extra Police would be paid for by making such a low government pay offer to existing Police as to make working overseas seem to them like an ever more attractive prospect?

We could go on, but you get the general picture of bad faith in action. On the campaign trail National promised to fund 50 extra medical students but has funded only half that number. It promised to restore law and order but the staff cuts imposed at the Serious Fraud Office have reduced the ability to crack down on white collar corporate crime, on child trafficking and on money laundering by criminals and terrorists.

The false distinction between (essential) “frontline” public servants and (disposable) “back room” staff has broken down, with even frontline workers at Oranga Tamariki being jettisoned.

Buyers Remorse

Despite the coalition government (a) doing stuff the electorate had no inkling it would do and (b) not doing stuff it promised to do... you have to ask – why aren’t there more signs of buyers remorse showing up in the polls? Sure, the polls would normally be relatively benign for a newly elected government – but this government is conducting economic and social experimentation on a scale not seen here in 30 years. Where’s the pushback?

It is certainly not coming from the Labour benches. In effect, Labour has hung a “Back in 2026” sign on the policy door, a decision that suggests Chris Hipkins and the Labour brains trust may have already decided that Election 2026 is unwinnable.

Certainly, waiting until 2026 (!) to unveil your tax policy will all but ensure that the next election is fought not on the government’s manifest failings, but on scaring voters about Labour’s new tax and spend intentions.

Taking the next two years to decide where you stand on a wealth tax – and then unveiling it on the eve of the election – seems to be a stunningly inept tactical move. Whatever else you can say about David Seymour and the ACT Party, if asked where they stand on any issue, they won’t ask you to wait two years for an answer.

Footnote: Weirdly, Labour seems more concerned about policing dissent within its own ranks – David Parker is chided every time he puts his nose over the parapet – than it is in attacking the government. Basically, Opposition parties have two tasks – to oppose (with good reasons and heartfelt passion) what the incumbent government is doing and to propose a better set of alternatives. Under the leadership of Chris Hipkins, Labour has been M.I.A. on both fronts.

The Power of the Illuminati

Sarah Tudzin is one of those Grammy winning over-achievers who seem to fit 48 hours work into each day of her life. A recording engineer/collaborator with boy genius and Weyes Blood and an inveterate performer, she’s also onto her third album as the singer/writer/driving force behind her Illuminati Hotties project.

On the recent album Power, Tudzin is exploring a gentler form of indie pop, without losing any of her ability to write memorable hooks. Oh, and her postings on X- like this retweet of a comment by feminist theorist Marilyn Frye – is worth your time, too.

Here’s the title track from the new album, an appreciative visit to the world that her wife inhabits:

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