JUNE 02 NEWS ARCHIVES
(Last update was: 19 July 2002 )

ARCHIVED HEADLINE

Aids stats questioned: Cape Town - Government's latest Aids statistics were described as "confusing" and "unreliable" in several circles on Tuesday. According to researchers it is "very naïve of government to say the Aids pandemic is levelling out".

Possible MS breakthrough: Sydney - The discovery of a protein that may lead to a new treatment for multiple sclerosis by protecting nerve cells from attack by the immune system has been announced by an Australian research team.

Grow-your-own transplants: Washington - Researchers say they have shown cloning can work as a source of grow-your-own transplants, by implanting into cattle cloned cells which formed functioning kidney-like organs and working heart tissue.

'Condoms for kids' sparks row: Pietermaritzburg - Proposed legislation to make condoms available for children has been strongly criticised.

Millions for Aids education unspent: Johannesburg - Provincial education departments, which are expected to be at the forefront of Aids education at schools, have failed to spend millions of rands allocated to them by the national department to fight the disease.

Possible MS breakthrough: Sydney - The discovery of a protein that may lead to a new treatment for multiple sclerosis by protecting nerve cells from attack by the immune system has been announced by an Australian research team.

Grow-your-own transplants: Washington - Researchers say they have shown cloning can work as a source of grow-your-own transplants, by implanting into cattle cloned cells which formed functioning kidney-like organs and working heart tissue.

'Condoms for kids' sparks row: Pietermaritzburg - Proposed legislation to make condoms available for children has been strongly criticised.

Millions for Aids education unspent: Johannesburg - Provincial education departments, which are expected to be at the forefront of Aids education at schools, have failed to spend millions of rands allocated to them by the national department to fight the disease.

Mobile thumbs up: London - Young people growing up using mobile phones to send text messages are developing thumbs that are stronger and more versatile than their other digits, Britain's Observer newspaper reported on Sunday.

SA to treat UK patients? London - The British department of health may soon send state patients to South Africa for treatment in an attempt to shorten the long waiting lists in Britain.

2002/03/17

Value for Money Medicines - Consumers will benefit as a result of Medscheme’s latest initiative to bring more affordable medicines to the members of the schemes they administer.

Aids drugs from Brazil: Johannesburg - South African activists on Tuesday said they had imported generic anti-Aids drugs from Brazil, risking the wrath of pharmaceutical firms, which hold the patents.

Vitamin A levels need to be re-evaluated: Chicago - Too much vitamin A may increase the risk of hip fractures in older women, according to a new study that researchers say suggests the need to re-evaluate the levels in supplements and fortified food.

Progestin protects against ovarian cancer: WASHINGTON (AP) -- Progestin is the ingredient in oral contraceptive pills that provides the highest level of protection against ovarian cancer, researchers have found.

Scientists: Liars betrayed by their faces: (AP) -- A heat-sensing camera trained on people's faces was able to detect liars in a study that hints at a way of spotting terrorists at airports.

Uganda issues Ebola alert: KAMPALA, Uganda -- Uganda has issued an Ebola virus alert after the deaths of 28 people from haemorrhaging near the border with the Democratic Republic of Congo.

Tamoxifen preventive for some women: CHICAGO, Illinois (AP) -- The drug tamoxifen may help prevent breast cancer in healthy women with BRCA2 genetic mutations but not in women with BRCA1 defects, new research suggests.

Legs hold clues to health: London - Leg length may determine more than a man's stature but could also be an indicator of his chances of developing diabetes and heart disease, British researchers said on Tuesday.

Aids underspending 'critical': Cape Town - Although they are already halfway through the financial year, provinces have spent only a fraction of the money they were allocated for HIV/Aids programmes, according to a report released on Tuesday.

In a media statement released immediately after the programme last night, Minister Tshabalala-Msimang said:

"I am appalled by the suffering inflicted by some health workers at Philadelphia Hospital on young women admitted for termination of pregnancy. The treatment exposed by the Carte Blanche team represents a grotesque miscarriage of the law that we enacted five years ago to facilitate access to safe and legally sanctioned termination of pregnancy, with respect for the dignity of all women who exercised this option.

"I will leave no stone unturned - and will tolerate no delay - in having the alleged practices at this particular hospital fully investigated and ensuring that appropriate corrective and disciplinary measures are taken. I trust that the Nursing Council will also take up the matter with due seriousness.

"In the light of allegations that similar abuses are occurring at other state hospitals, I would like to invite anybody in possession of evidence or any woman who has experience of such malpractice, to contact my legal advisor, Advocate Patricia Lambert (cell - 082 566 3608) or the head of our women's health section, Dr Eddie Mhlanga (cell - 083 459 6112).

Your communication will be treated as confidential."

Article Source & Reference: Department of Health - http://www.doh.co.za/docs/pr/pr0624-f.html, 2002/07/02

The research conducted early this year by the World Health Organisation's diabetes team found that diabetes was on the increase in the African community in South Africa, where the prevalence rate was estimated to be between 4% and 5%.

Dr Mak Omar, a member of the World Health Organisation's panel on diabetes, who also heads the diabetics unit at the Nelson R Mandela School of Medicine in Durban, told the Sunday Times newspaper that South Africa's figures compare poorly to the rest of Africa. "In Tanzania, for example, the prevalence rate is less than 2%," he told the newspaper.

Changing lifestyles
Omar believes that the main reason for the high rates of diabetes is the change in lifestyle as rural people move to the cities. "We drew the conclusion that African people no longer subsist on a truly African diet," Omar said.

Dr Mac Robertson, a patron and executive member of the Diabetes Association, agreed that a marked change in diet and lifestyle was contributing to the increase in cases of diabetes.

"Urbanisation is a major factor. African people have moved from rural to urban areas in search of jobs. They tend to consume refined food. In the days before Kader Asmal and Ronnie Kasrils, rural Africans used to walk kilometres to fetch a bucket of water. Now many people have moved into the urban areas and have become less active," he told the Sunday Times.

Return to traditional diet
The South African Diabetes Association and diabetes experts have called on the African community to return to their traditional rural diet in an effort to reduce the incidence of the potentially deadly disease.

A rural diet of unrefined carbohydrates is ideal for preventing diabetes, according to Robertson. "Unrefined beans, maize and legumes must be incorporated into the diet," he said.

Diabetes Association spokesperson Noy Pullen told the newspaper that diabetics should avoid white sugar, flour and mealie meal.

"Africans used to eat millet. Most Africans tend to use salt on everything and enjoy between four to six teaspoons of sugar in their tea and coffee," Pullen said in the report.

Article Source & Reference:  Health24 - http://www.health24.co.za/Default.asp?action=article&ContentID=17781, 2002/07/03

Deductions, like that the prevalence of HIV/Aids has decreased among young pregnant women because teenagers allegedly listen to government's Aids message, are "totally unscientific", researchers say.

In the latest study on the prevalence of HIV/Aids among pregnant women, conducted at 421 pre-natal clinics last year, it was found that 24.8% of the women were HIV positive, compared to 24.5% the year before. Government concluded from this that the rate of infection has possibly levelled out, after this figure had increased from 0.7% to 22.4% between 1990 and 1999.

Leigh Johnson from the Centre for Actuarial Research at the University of Cape Town, who was involved in the controversial report on Aids deaths, said he and his colleagues had several problems with this point of view.

Several stages

"There are several stages in the Aids pandemic. The number of new infections peaked in 1998, but the number of people infected with the virus will only reach a high in 2005. The number of Aids deaths will peak in 2010 and the number of Aids orphans in 2015.

"The biggest impact of the Aids pandemic will therefore only truly become apparent over the next decade."

Johnson also said data collected at pre-natal clinics did not always sketch a realistic picture.

"We have known for quite some time that HIV has a negative influence on women's fertility. As the epidemic rages ahead and more women become infertile, the consequence is that less HIV positive women visit the clinics."

Johnson also expressed his concern regarding the fact that government had compared Aids statistics of 1998 with those of last year. Government alleges, among other things, that a decrease of 5.6% can be seen in Aids figures for pregnant women younger than 20.

"The problem with this assumption is that the test group of women who were used for the research, has changed drastically over the past few years. In the past, government included, for example, considerably less rural pre-natal clinics in its sample - something which could have made the figures seem higher than they are in reality."

Johnson said the prevalence of HIV was usually considerably lower in rural areas than in urban areas.

He said government's figures on the number of people in South Africa living with HIV (about 4.7 million) were also inaccurate. The figures only represented people between the ages of 15 and 49, and not the entire population. Willemien Brümmer

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Aids_Focus/0,1113,2-14-659_1198404,00.html, 2002/06/12

Possible MS breakthrough: Sydney - The discovery of a protein that may lead to a new treatment for multiple sclerosis by protecting nerve cells from attack by the immune system has been announced by an Australian research team.

The discovery, published in the international medical journal Nature Medicine at the weekend, offers a new approach to managing the crippling auto-immune disease.

MS, which affects one in 1 000 people worldwide, is more common in women and typically begins between the ages of 20 and 40. Its most famous victims include the British cellist Jacqueline Du Pre, who died in 1987 aged only 42 and the 19th century German poet Heinrich Heine.

It causes the covering that insulates nerve fibres in the central nervous system to deteriorate and results in a slowing down or blockage of messages from the nerves to the brain.

It is characterised by recurrent and destructive inflammation of nerves in the brain and spinal cord, which worsens over time.

A research team from the University of Melbourne, led by MS expert Doctor Trevor Kilpatrick, found the administration of a naturally occurring protein, or cytokine, reversed the loss of nerve cells in mice with the animal form of MS.

The cytokine involved is Leukaemia Inhibitory Factor (LIF), which was first purified by Australian researchers in 1987.

"We were able to show that LIF reduced the severity of the clinical disease in animals," Kilpatrick said.

"It became clear that the LIF wasn't acting on the immune cells, it was actually keeping cells within the brain alive - and they're cells which normally die off in MS."

Kilpatrick's research complements that of Austrian researchers, published simultaneously with his in the latest edition of Nature Medicine, published in New York and London.

Scientists in the University of Wurtzberg in Austria discovered a sister component to LIF, known as CNTF, which also appeared to play a role in protecting nerve cells.

Kilpatrick said as well as providing an insight into the mechanism by which neurones were destroyed in MS, the combined research showed that agents like LIF and CNTF could be used to prevent progressive disability in MS.

"I don't think we're talking about a cure but one component of a complex disease," he said.

"We would see that the therapies that we're advocating would be potentially given in combination with immune therapy.

"That would be the sensitive approach in the future to thinking how an agent such as LIF might fit in treatment protocols for MS."

Human trials were ready to go ahead but timing depended on Amrad, a Melbourne biotech company that holds the commercial rights to the research, he said. - Sapa-AFP

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1193678,00.html, 2002/06/03

Grow-your-own transplants: Washington - Researchers say they have shown cloning can work as a source of grow-your-own transplants, by implanting into cattle cloned cells which formed functioning kidney-like organs and working heart tissue.

The cattle's immune systems showed no sign of rejecting the transplanted cloned tissue, said the team from Children's Hospital in Boston and Advanced Cell Technology in nearby Worcester, Massachusetts.

The researchers said their experiment, published in the June issue of the journal Nature Biotechnology, should put to rest criticism that therapeutic cloning will not work.

"It was pretty spectacular results," Dr Robert Lanza, medical director at Advanced Cell Technology, said. "Until now therapeutic cloning was theoretical."

The researchers cloned steers, using tissue from their ears to grow tiny embryos. Tissue from these embryos was used to make small, kidney-like organs that functioned normally.

"They were making strong yellow urine," Lanza said. "They were removing toxic waste products from the blood at up to 80 percent of what is considered normal for urine."

The whole issue of cloning is hugely controversial around the world. In the United States, Congress is considering either restricting or banning it. President George W. Bush would like to prohibit all cloning involving humans.

Most scientists say they do not want to try to clone a human baby, but doctors, patients' groups and many scientists would like to see cloning technology used in medical research.

One idea behind this therapeutic cloning approach would be to take a person's cells, and use cloning to grow genetically matched tissues or organs.

Possible uses would be in treating diseases in which cells or tissues are destroyed, such as Parkinson's, juvenile diabetes, and stroke. Such cells, it has been postulated, might even be used to grow entire organs.

If this could be done, it might take 80 000 Americans off the waiting list for donated organs. An estimated 3 000 die every year waiting for a kidney, heart, liver or other organ.

No animal is a true clone

Critics have said cloning will not work because the somatic cell nuclear transplant technique used to make Dolly the sheep and other cloned animals does not make an exact genetic duplicate.

What the cloning scientists do is get an egg cell, remove its nucleus, and replace it with the nucleus from a cell taken from the animal to be cloned. Various methods are used to start the egg dividing as if it had been fertilised by a sperm cell.

But the resulting animal does not have 100 percent of the DNA from one animal. Virtually all the DNA is in a cell's nucleus, but some is found in the form of mitochondrial DNA, which is in the body of the egg.

All cloned animals have the mitochondrial DNA of the egg donor, not of the animal that was cloned. "It's the presence of this foreign DNA that raises the question of whether cloned cells would be rejected," Lanza said.

Opponents of cloning research use this argument to say that no scientific advances will be thwarted if all cloning is banned. "We believe we have shown that this is not the case," said Dr Anthony Atala of Harvard University and Children's Hospital, who worked on the study.

The team removed some of the tissue from their tiny cloned embryos. They seeded kidney tissue onto artificial structures that they hoped would grow into kidneys when transplanted back into the steer they were cloned from.

It worked even better than expected.

"They self-assembled in the animal," Lanza said. By themselves, the kidney cells formed a small, kidney-like organ. As a comparison the researchers used cells from an unrelated steer to make a similar artificial kidney, and, as expected, the steer's immune system attacked and killed those cells.

They transplanted cloned heart and muscle tissue under the haunch of a second steer, and that tissue also thrived, the researchers said.

No one has cloned a human embryo, but Atala said the experiment may be even easier to do in people. The promise of cloning lies in the embryonic stem cells, cells that have the power to become any kind tissue in the body at all.

Experiments on embryos left over from test-tube fertility attempts have shown these stem cells are readily found in a human embryo that is smaller than the head of a pin.

If cloning can be shown to work in humans, and if it remains legal, then theoretically a plug of skin could be taken from a patient and used to grow a new heart, brain cells or other tissue for transplant.
Maggie Fox

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1194059,00.html, 2002/06/03

By Lynne Altenroxel

Article Source & Reference: IOL (Independent Online) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020530215128438M320217&set_id=1, 2002/06/03

Marais rushed to hospital after anthrax scare: Western Cape premier Peter Marais and 27 employees of the Western Cape provincial legislature were taken to the Chris Barnard Memorial Hospital on Thursday after fears they had been exposed to anthrax.

Marais's spokesperson Riana Geldenhuys, who was also taken to hospital, said a clerk in the premier's office opened a letter containing white powder.

"The clerk informed senior personnel and they called the police, who in turn called out the police reaction unit," Geldenhuys said.

Jacobs said the reaction unit, wearing protective white outfits, sprayed several desks and placed everyone on the floor, including the premier, under quarantine.

"We were all taken to hospital where nasal swabs were taken," Geldenhuys said.

"Then each of us had to take a shower and were given antibiotics. It's a normal procedure taken as a precaution."

Jacobs said staff at the hospital were very professional.

Hospital spokesperson Elaine Gerber said everyone, including Marais, had left the hospital by early afternoon.

Gerber said the nasal swabs would be sent to pathologists for examination and results should be known within the next 48 to 72 hours.

"In the interim there is medication they must take, but they all seem fine," Gerber said. - Sapa

Article Source & Reference: IOL (Independent Online) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=qw1022761980202B253&set_id=1, 2002/06/03

Aids 'protocols' agreed for rape survivors: The health department said on Thursday that it had reached agreement on protocols for the provision of anti-retroviral drugs to rape survivors.

This follows Health Minister Manto Tshabalala Msimang's announcement on April 17 that rape victims would be provided with anti-Aids drugs at public hospitals as soon as possible.

When the announcement was made, she said government needed time to discuss the provision of a comprehensive package of care for sexual assault victims.

The package was to include counselling as well as testing for HIV, pregnancy and sexually transmitted infections.

Tshabalala-Msimang said various drug combinations and procedures had been reviewed since April 17 to decide on the best package.

"As a result, the public health service will offer a combination of the same two drugs we use in the occupational setting - that is, AZT and 3TC," she said. - Sapa

Article Source & Reference: IOL (Independent Online) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct2002053010513078_430202&set_id=1 2002/06/03

'Condoms for kids' sparks row: Pietermaritzburg - Proposed legislation to make condoms available for children has been strongly criticised.

According to the South African Law Commission, a substantial number of people have rejected the commission's recommendation that confidential access to contraceptives should be provided to all sexually active persons, regardless of age.

The respondents argued that, from a biblical point of view, no child under 18 should be provided with access to contraceptives, and that children should be taught to abstain from sex before marriage.

Those in favour of confidential access to contraceptives approved, provided the condoms were supplied only to children over 12.

Although the commission said it would look at the recommendations again, it seems as if it is determined to make them a final recommendation in the draft, which will be sent to Social and Welfare Minister Zola Skweyiya in June.

Side effects a problem

The commission says: "Given the increase of HIV/Aids, especially among teenagers, all children should be provided with confidential access to condoms."

However the commission takes cognisance that oral contraceptives and injectable contraceptives can have side effects, some of a severe nature, and that the only benefit of taking these contraceptives is that they may prevent pregnancy.

"They do not protect the user from sexually transmitted diseases such as HIV/Aids. Perhaps the answer lies in restricting confidential access to oral/injectable contraceptives to children over the age of 12 years, after a proper medical examination and counselling."

Free access to contraceptives in European schools has been debated for the last two years in Europe. In the United Kingdom, which has the highest teenage birth rate in Europe, a plan to instal condom-vending machines in schools to tackle teenage pregnancies caused outrage. A liberal attitude towards sex education appears to be paying off in the Netherlands, which has the lowest rate of teenage pregnancy in Europe. Dutch children are taught about sex from a young age, but opt to have sex at a later age than their European counterparts.

Christi Naude

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Aids_Focus/0,1113,2-14-659_1187342,00.html , 2002/05/21

Millions for Aids education unspent: Johannesburg - Provincial education departments, which are expected to be at the forefront of Aids education at schools, have failed to spend millions of rands allocated to them by the national department to fight the disease.

This information is contained in a tri-monthly report which was recently handed to President Thabo Mbeki by Education Minister Kader Asmal, showing that provincial departments have done little to spend millions which had been allocated to them to fight the Aids pandemic.

The report on the state of education in the provinces shows that out of the R74 292 million HIV/Aids grants to provinces for the 2001/2002 financial year, only 39.45 percent or R25 049 million was spent.

Should the figures remain unchanged when the National Treasury reconciles its statements, it will mean the level of under expenditure has become worse by close to R14 million from the previous financial year.

During the 2000/2001 financial year provinces failed to spend a total of R10 792 million aimed at curbing the spread of HIV/Aids.

The funds were rolled over to the 2001/2002 financial year to make up the R74 292 million, of which R49 243 million remains unspent as per the latest reports from the provinces.

The statistics show the Eastern Cape, which spent a paltry 6.39 percent and still has R10 996 million unspent, is the worst culprit.

It is followed by Limpopo, which spent only 15.89 percent and still has R8 385 million in its coffers.

The Western Cape spent 23.72 percent and still has R5 301 million. KwaZulu-Natal, which was allocated the highest grant and is one of the hardest hit by HIV/Aids infections, spent 47.8 percent and still has R11 607 million in its coffers.

Gauteng has utilised 38.89 percent, remaining with R4 773 million, while the Free State spent 51.16 percent.

The latter retained R4 251 million.

Only three provinces are reported to have done better in their spending. Mpumalanga, Northern Cape and North West have spent more than 75 percent of their HIV/Aids grants.

The report also notes the pathetic spending of the R21 million funds allocated for early childhood development grants to provinces for the implementation of the compulsory reception year programme for pre-school learners.

At least three provinces spent more than 30 percent of their respective allocations. These were KwaZulu-Natal (53 percent), Northern Cape (53.6 percent) and the Western Cape (30.3 percent).

The Eastern Cape, which is one of the poorest provinces in the country, has spent a paltry 0.28 percent, while the Free State hopelessly registered a 0.9 percent expenditure.

Both provinces have retained R3 874 million and R1 311 million respectively.

The report states that Gauteng, Mpumalanga, Limpopo and the North West have "either not submitted their reports or, worse still, have not spent their funds at all".

A whopping total of R17 761 million remains unspent for the grade reception programme.

The report states that the Department of Education will "review" the current mechanisms used in spending the grants with the aim of improving its utilisation.

In what the report describes as "surprising observation", all the provincial education authorities, except Western Cape, have underspent during the 2001/2002 financial year in their total budget allocations.

The other eight provinces have underspent by at least three percent.

Mpumelelo Mkhabela

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Aids_Focus/0,1113,2-14-659_1187015,00.html, 2002/05/21

Abuse of health workers is rife, study finds: Verbal abuse, ranging from insults to threats of violence, is a major concern for health-care workers in hospitals across Cape Town.

This was one of the findings of a study by the University of Cape Town's Institute of Criminology and the Medical Research Council in which 178 health-care workers were interviewed about their stress at work.

The results of the study were published in the May edition of the South African Medical Journal.

Staff at the Gugulethu and Mitchell's Plain day hospitals and the emergency units at Groote Schuur and GF Jooste were interviewed.

The researchers found that 61 percent of those interviewed "frequently" had to deal with criminal violence, which includes verbal insults and threats, and that this was their main concern at work.

Budget constraints, leading to insufficient staff and equipment, were also a major problem, 63 percent said.

The same numbers said their working conditions had deteriorated over the past few years.

The study consisted of staff observation during busy times and a 12-page questionnaire filled in by 178 nurses, doctors, pharmacists, radiographers and administrative staff.

Very few people said they had been physically attacked, contrary to the impression created by media reports of isolated incidents of violence in hospitals across the country, said field worker Ricky Rontsch.

"We thought we would be confronted with murder, mayhem, terror and fear, because that was what journalistic accounts had portrayed. That is not what we found. In the few incidents where health workers were assaulted, they were hit, bitten or scratched by mentally ill patients, and you can't classify that as crime. Hardly anybody had experienced anything other than verbal assault."

The verbal abuse ranged from staff being told they were useless, to patients saying they would call in gang members if they did not receive instant service or staff being told someone knew where they lived and would attack them at home.

Some health workers were able to laugh the threats off, Rontsch said. Others were often absent as a way of coping.

Although the study was undertaken last year, senior health managers said intimidation of staff had not decreased. By Jo-Anne Smetherham

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020520211917108G123629&set_id=1, 2002/05/21

The surgery took place at the No 2 Zhengzhou university hospital in central Henan province, the Xinhua news agency reported.

The patient, a 28-year-old woman surnamed Feng, had been diagnosed with menopause syndrome due to premature senile ovaries, the agency said.

The woman showed symptoms such as severe mood swings and insomnia, and her skin had become unnaturally coarse over the past two years.

Since the surgery, "Feng's skin has resumed its natural softness and she has enjoyed a good night's sleep," the agency said. - Sapa-AFP

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1187005,00.html, 2002/05/21

The drug, called Iressa, can be taken as a pill - a huge boon to patients used to being hooked up to intravenous infusions for chemotherapy. And it has very few side-effects - none of the nausea and hair loss that often makes chemotherapy patients so miserable.

It takes a new approach, targeting proteins that are produced only by cancer cells, so it does not attack hair follicles and intestinal cells the way other cancer drugs do.

"Giving a drug that blocks an enzyme actually makes patients feel better," Dr Mark Kris of the Memorial Sloan-Kettering Cancer Centre in New York, who presented his findings to a meeting in Orlando of the American Society of Clinical Oncology, told a news conference.

"That is nothing short of amazing."

Iressa, being developed by Europe's second largest drugmaker, AstraZeneca Plc, is not on the market yet but is being tested in clinical trials pending approval by the US Food and Drug Administration.

Kris and colleagues tested Iressa, once known by the experimental name of ZD1839, in 216 patients with advanced non-small cell lung cancer.

All had cancer that worsened despite two or more rounds of chemotherapy. "All these patients had cancer that couldn't be helped by either radiation or surgery," Kris said.

They weren't cured, but 43 percent felt better, the researchers told ASCO's annual conference in Florida. They had less shortness of breath, weight loss, cough, loss of appetite and confusion - all symptoms of lung cancer.

Improvement came fast

"What is quite amazing is that the patients who had that improvement had it within two weeks," Kris told a news conference.

And in 12 percent, the tumours shrank 50 percent or more. Average survival was about six months, so Iressa is no wonder drug, experts said. But it is the first hope to patients with what has been a very hopeless stage of cancer, they say.

"The major side-effect, it turns out, is a minor skin rash that looks like acne," Dr Paul Bunn, president-elect of the American Society of Clinical Oncology and a cancer specialist at the University of Colorado, told reporters.

A second study done in Japan and Europe in patients who had failed one round of treatment showed that 19 percent had their tumours shrink 50 percent or more, and 40 percent felt better.

Lung cancer is the biggest cancer killed in the world, claiming 125 000 lives a year in the United States alone.

Iressa targets the epidermal growth factor receptor (EGFR), a key biochemical switch used by tumours, and only by tumours, to survive and grow.

"By giving a drug that blocks a specific enzyme vital to the growth of cancer cells, we can actually shrink lung cancer," Kris said. "It is the first targeted therapy for lung cancer."

Iressa is expected to reach the market later this year. It is one of several drugs targeting the EGFR, including a rival drug made by biotechnology firm Imclone called Erbitux.

The FDA rejected Erbitux late last year and the drug, which ImClone is co-developing with Bristol-Myers Squibb Co and Germany's Merck KGaA, is now only expected to go on sale in 2003.

Tarceva, made by OSI Pharmaceuticals Inc, Genentech Inc and Roche Holding AG, has won fast track approval status from the FDA.

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1186984,00.html, 2002/05/21

Possible MS breakthrough: Sydney - The discovery of a protein that may lead to a new treatment for multiple sclerosis by protecting nerve cells from attack by the immune system has been announced by an Australian research team.

The discovery, published in the international medical journal Nature Medicine at the weekend, offers a new approach to managing the crippling auto-immune disease.

MS, which affects one in 1 000 people worldwide, is more common in women and typically begins between the ages of 20 and 40. Its most famous victims include the British cellist Jacqueline Du Pre, who died in 1987 aged only 42 and the 19th century German poet Heinrich Heine.

It causes the covering that insulates nerve fibres in the central nervous system to deteriorate and results in a slowing down or blockage of messages from the nerves to the brain.

It is characterised by recurrent and destructive inflammation of nerves in the brain and spinal cord, which worsens over time.

A research team from the University of Melbourne, led by MS expert Doctor Trevor Kilpatrick, found the administration of a naturally occurring protein, or cytokine, reversed the loss of nerve cells in mice with the animal form of MS.

The cytokine involved is Leukaemia Inhibitory Factor (LIF), which was first purified by Australian researchers in 1987.

"We were able to show that LIF reduced the severity of the clinical disease in animals," Kilpatrick said.

"It became clear that the LIF wasn't acting on the immune cells, it was actually keeping cells within the brain alive - and they're cells which normally die off in MS."

Kilpatrick's research complements that of Austrian researchers, published simultaneously with his in the latest edition of Nature Medicine, published in New York and London.

Scientists in the University of Wurtzberg in Austria discovered a sister component to LIF, known as CNTF, which also appeared to play a role in protecting nerve cells.

Kilpatrick said as well as providing an insight into the mechanism by which neurones were destroyed in MS, the combined research showed that agents like LIF and CNTF could be used to prevent progressive disability in MS.

"I don't think we're talking about a cure but one component of a complex disease," he said.

"We would see that the therapies that we're advocating would be potentially given in combination with immune therapy.

"That would be the sensitive approach in the future to thinking how an agent such as LIF might fit in treatment protocols for MS."

Human trials were ready to go ahead but timing depended on Amrad, a Melbourne biotech company that holds the commercial rights to the research, he said. - Sapa-AFP

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1193678,00.html, 2002/06/03

Grow-your-own transplants: Washington - Researchers say they have shown cloning can work as a source of grow-your-own transplants, by implanting into cattle cloned cells which formed functioning kidney-like organs and working heart tissue.

The cattle's immune systems showed no sign of rejecting the transplanted cloned tissue, said the team from Children's Hospital in Boston and Advanced Cell Technology in nearby Worcester, Massachusetts.

The researchers said their experiment, published in the June issue of the journal Nature Biotechnology, should put to rest criticism that therapeutic cloning will not work.

"It was pretty spectacular results," Dr Robert Lanza, medical director at Advanced Cell Technology, said. "Until now therapeutic cloning was theoretical."

The researchers cloned steers, using tissue from their ears to grow tiny embryos. Tissue from these embryos was used to make small, kidney-like organs that functioned normally.

"They were making strong yellow urine," Lanza said. "They were removing toxic waste products from the blood at up to 80 percent of what is considered normal for urine."

The whole issue of cloning is hugely controversial around the world. In the United States, Congress is considering either restricting or banning it. President George W. Bush would like to prohibit all cloning involving humans.

Most scientists say they do not want to try to clone a human baby, but doctors, patients' groups and many scientists would like to see cloning technology used in medical research.

One idea behind this therapeutic cloning approach would be to take a person's cells, and use cloning to grow genetically matched tissues or organs.

Possible uses would be in treating diseases in which cells or tissues are destroyed, such as Parkinson's, juvenile diabetes, and stroke. Such cells, it has been postulated, might even be used to grow entire organs.

If this could be done, it might take 80 000 Americans off the waiting list for donated organs. An estimated 3 000 die every year waiting for a kidney, heart, liver or other organ.

No animal is a true clone

Critics have said cloning will not work because the somatic cell nuclear transplant technique used to make Dolly the sheep and other cloned animals does not make an exact genetic duplicate.

What the cloning scientists do is get an egg cell, remove its nucleus, and replace it with the nucleus from a cell taken from the animal to be cloned. Various methods are used to start the egg dividing as if it had been fertilised by a sperm cell.

But the resulting animal does not have 100 percent of the DNA from one animal. Virtually all the DNA is in a cell's nucleus, but some is found in the form of mitochondrial DNA, which is in the body of the egg.

All cloned animals have the mitochondrial DNA of the egg donor, not of the animal that was cloned. "It's the presence of this foreign DNA that raises the question of whether cloned cells would be rejected," Lanza said.

Opponents of cloning research use this argument to say that no scientific advances will be thwarted if all cloning is banned. "We believe we have shown that this is not the case," said Dr Anthony Atala of Harvard University and Children's Hospital, who worked on the study.

The team removed some of the tissue from their tiny cloned embryos. They seeded kidney tissue onto artificial structures that they hoped would grow into kidneys when transplanted back into the steer they were cloned from.

It worked even better than expected.

"They self-assembled in the animal," Lanza said. By themselves, the kidney cells formed a small, kidney-like organ. As a comparison the researchers used cells from an unrelated steer to make a similar artificial kidney, and, as expected, the steer's immune system attacked and killed those cells.

They transplanted cloned heart and muscle tissue under the haunch of a second steer, and that tissue also thrived, the researchers said.

No one has cloned a human embryo, but Atala said the experiment may be even easier to do in people. The promise of cloning lies in the embryonic stem cells, cells that have the power to become any kind tissue in the body at all.

Experiments on embryos left over from test-tube fertility attempts have shown these stem cells are readily found in a human embryo that is smaller than the head of a pin.

If cloning can be shown to work in humans, and if it remains legal, then theoretically a plug of skin could be taken from a patient and used to grow a new heart, brain cells or other tissue for transplant.

Maggie Fox

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1194059,00.html, 2002/06/03

By Lynne Altenroxel

Article Source & Reference: IOL (Independent Online) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020530215128438M320217&set_id=1, 2002/06/03

Marais rushed to hospital after anthrax scare: Western Cape premier Peter Marais and 27 employees of the Western Cape provincial legislature were taken to the Chris Barnard Memorial Hospital on Thursday after fears they had been exposed to anthrax.

Marais's spokesperson Riana Geldenhuys, who was also taken to hospital, said a clerk in the premier's office opened a letter containing white powder.

"The clerk informed senior personnel and they called the police, who in turn called out the police reaction unit," Geldenhuys said.

Jacobs said the reaction unit, wearing protective white outfits, sprayed several desks and placed everyone on the floor, including the premier, under quarantine.

"We were all taken to hospital where nasal swabs were taken," Geldenhuys said.

"Then each of us had to take a shower and were given antibiotics. It's a normal procedure taken as a precaution."

Jacobs said staff at the hospital were very professional.

Hospital spokesperson Elaine Gerber said everyone, including Marais, had left the hospital by early afternoon.

Gerber said the nasal swabs would be sent to pathologists for examination and results should be known within the next 48 to 72 hours.

"In the interim there is medication they must take, but they all seem fine," Gerber said. - Sapa

Article Source & Reference: IOL (Independent Online) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=qw1022761980202B253&set_id=1, 2002/06/03

Aids 'protocols' agreed for rape survivors: The health department said on Thursday that it had reached agreement on protocols for the provision of anti-retroviral drugs to rape survivors.

This follows Health Minister Manto Tshabalala Msimang's announcement on April 17 that rape victims would be provided with anti-Aids drugs at public hospitals as soon as possible.

When the announcement was made, she said government needed time to discuss the provision of a comprehensive package of care for sexual assault victims.

The package was to include counselling as well as testing for HIV, pregnancy and sexually transmitted infections.

Tshabalala-Msimang said various drug combinations and procedures had been reviewed since April 17 to decide on the best package.

"As a result, the public health service will offer a combination of the same two drugs we use in the occupational setting - that is, AZT and 3TC," she said. - Sapa

Article Source & Reference: IOL (Independent Online) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct2002053010513078_430202&set_id=1 2002/06/03

'Condoms for kids' sparks row: Pietermaritzburg - Proposed legislation to make condoms available for children has been strongly criticised.

According to the South African Law Commission, a substantial number of people have rejected the commission's recommendation that confidential access to contraceptives should be provided to all sexually active persons, regardless of age.

The respondents argued that, from a biblical point of view, no child under 18 should be provided with access to contraceptives, and that children should be taught to abstain from sex before marriage.

Those in favour of confidential access to contraceptives approved, provided the condoms were supplied only to children over 12.

Although the commission said it would look at the recommendations again, it seems as if it is determined to make them a final recommendation in the draft, which will be sent to Social and Welfare Minister Zola Skweyiya in June.

Side effects a problem

The commission says: "Given the increase of HIV/Aids, especially among teenagers, all children should be provided with confidential access to condoms."

However the commission takes cognisance that oral contraceptives and injectable contraceptives can have side effects, some of a severe nature, and that the only benefit of taking these contraceptives is that they may prevent pregnancy.

"They do not protect the user from sexually transmitted diseases such as HIV/Aids. Perhaps the answer lies in restricting confidential access to oral/injectable contraceptives to children over the age of 12 years, after a proper medical examination and counselling."

Free access to contraceptives in European schools has been debated for the last two years in Europe. In the United Kingdom, which has the highest teenage birth rate in Europe, a plan to instal condom-vending machines in schools to tackle teenage pregnancies caused outrage. A liberal attitude towards sex education appears to be paying off in the Netherlands, which has the lowest rate of teenage pregnancy in Europe. Dutch children are taught about sex from a young age, but opt to have sex at a later age than their European counterparts.

Christi Naude

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Aids_Focus/0,1113,2-14-659_1187342,00.html , 2002/05/21

Millions for Aids education unspent: Johannesburg - Provincial education departments, which are expected to be at the forefront of Aids education at schools, have failed to spend millions of rands allocated to them by the national department to fight the disease.

This information is contained in a tri-monthly report which was recently handed to President Thabo Mbeki by Education Minister Kader Asmal, showing that provincial departments have done little to spend millions which had been allocated to them to fight the Aids pandemic.

The report on the state of education in the provinces shows that out of the R74 292 million HIV/Aids grants to provinces for the 2001/2002 financial year, only 39.45 percent or R25 049 million was spent.

Should the figures remain unchanged when the National Treasury reconciles its statements, it will mean the level of under expenditure has become worse by close to R14 million from the previous financial year.

During the 2000/2001 financial year provinces failed to spend a total of R10 792 million aimed at curbing the spread of HIV/Aids.

The funds were rolled over to the 2001/2002 financial year to make up the R74 292 million, of which R49 243 million remains unspent as per the latest reports from the provinces.

The statistics show the Eastern Cape, which spent a paltry 6.39 percent and still has R10 996 million unspent, is the worst culprit.

It is followed by Limpopo, which spent only 15.89 percent and still has R8 385 million in its coffers.

The Western Cape spent 23.72 percent and still has R5 301 million. KwaZulu-Natal, which was allocated the highest grant and is one of the hardest hit by HIV/Aids infections, spent 47.8 percent and still has R11 607 million in its coffers.

Gauteng has utilised 38.89 percent, remaining with R4 773 million, while the Free State spent 51.16 percent.

The latter retained R4 251 million.

Only three provinces are reported to have done better in their spending. Mpumalanga, Northern Cape and North West have spent more than 75 percent of their HIV/Aids grants.

The report also notes the pathetic spending of the R21 million funds allocated for early childhood development grants to provinces for the implementation of the compulsory reception year programme for pre-school learners.

At least three provinces spent more than 30 percent of their respective allocations. These were KwaZulu-Natal (53 percent), Northern Cape (53.6 percent) and the Western Cape (30.3 percent).

The Eastern Cape, which is one of the poorest provinces in the country, has spent a paltry 0.28 percent, while the Free State hopelessly registered a 0.9 percent expenditure.

Both provinces have retained R3 874 million and R1 311 million respectively.

The report states that Gauteng, Mpumalanga, Limpopo and the North West have "either not submitted their reports or, worse still, have not spent their funds at all".

A whopping total of R17 761 million remains unspent for the grade reception programme.

The report states that the Department of Education will "review" the current mechanisms used in spending the grants with the aim of improving its utilisation.

In what the report describes as "surprising observation", all the provincial education authorities, except Western Cape, have underspent during the 2001/2002 financial year in their total budget allocations.

The other eight provinces have underspent by at least three percent.

Mpumelelo Mkhabela

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Aids_Focus/0,1113,2-14-659_1187015,00.html, 2002/05/21

Abuse of health workers is rife, study finds: Verbal abuse, ranging from insults to threats of violence, is a major concern for health-care workers in hospitals across Cape Town.

This was one of the findings of a study by the University of Cape Town's Institute of Criminology and the Medical Research Council in which 178 health-care workers were interviewed about their stress at work.

The results of the study were published in the May edition of the South African Medical Journal.

Staff at the Gugulethu and Mitchell's Plain day hospitals and the emergency units at Groote Schuur and GF Jooste were interviewed.

The researchers found that 61 percent of those interviewed "frequently" had to deal with criminal violence, which includes verbal insults and threats, and that this was their main concern at work.

Budget constraints, leading to insufficient staff and equipment, were also a major problem, 63 percent said.

The same numbers said their working conditions had deteriorated over the past few years.

The study consisted of staff observation during busy times and a 12-page questionnaire filled in by 178 nurses, doctors, pharmacists, radiographers and administrative staff.

Very few people said they had been physically attacked, contrary to the impression created by media reports of isolated incidents of violence in hospitals across the country, said field worker Ricky Rontsch.

"We thought we would be confronted with murder, mayhem, terror and fear, because that was what journalistic accounts had portrayed. That is not what we found. In the few incidents where health workers were assaulted, they were hit, bitten or scratched by mentally ill patients, and you can't classify that as crime. Hardly anybody had experienced anything other than verbal assault."

The verbal abuse ranged from staff being told they were useless, to patients saying they would call in gang members if they did not receive instant service or staff being told someone knew where they lived and would attack them at home.

Some health workers were able to laugh the threats off, Rontsch said. Others were often absent as a way of coping.

Although the study was undertaken last year, senior health managers said intimidation of staff had not decreased. By Jo-Anne Smetherham

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020520211917108G123629&set_id=1, 2002/05/21

The surgery took place at the No 2 Zhengzhou university hospital in central Henan province, the Xinhua news agency reported.

The patient, a 28-year-old woman surnamed Feng, had been diagnosed with menopause syndrome due to premature senile ovaries, the agency said.

The woman showed symptoms such as severe mood swings and insomnia, and her skin had become unnaturally coarse over the past two years.

Since the surgery, "Feng's skin has resumed its natural softness and she has enjoyed a good night's sleep," the agency said. - Sapa-AFP

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1187005,00.html, 2002/05/21

The drug, called Iressa, can be taken as a pill - a huge boon to patients used to being hooked up to intravenous infusions for chemotherapy. And it has very few side-effects - none of the nausea and hair loss that often makes chemotherapy patients so miserable.

It takes a new approach, targeting proteins that are produced only by cancer cells, so it does not attack hair follicles and intestinal cells the way other cancer drugs do.

"Giving a drug that blocks an enzyme actually makes patients feel better," Dr Mark Kris of the Memorial Sloan-Kettering Cancer Centre in New York, who presented his findings to a meeting in Orlando of the American Society of Clinical Oncology, told a news conference.

"That is nothing short of amazing."

Iressa, being developed by Europe's second largest drugmaker, AstraZeneca Plc, is not on the market yet but is being tested in clinical trials pending approval by the US Food and Drug Administration.

Kris and colleagues tested Iressa, once known by the experimental name of ZD1839, in 216 patients with advanced non-small cell lung cancer.

All had cancer that worsened despite two or more rounds of chemotherapy. "All these patients had cancer that couldn't be helped by either radiation or surgery," Kris said.

They weren't cured, but 43 percent felt better, the researchers told ASCO's annual conference in Florida. They had less shortness of breath, weight loss, cough, loss of appetite and confusion - all symptoms of lung cancer.

Improvement came fast

"What is quite amazing is that the patients who had that improvement had it within two weeks," Kris told a news conference.

And in 12 percent, the tumours shrank 50 percent or more. Average survival was about six months, so Iressa is no wonder drug, experts said. But it is the first hope to patients with what has been a very hopeless stage of cancer, they say.

"The major side-effect, it turns out, is a minor skin rash that looks like acne," Dr Paul Bunn, president-elect of the American Society of Clinical Oncology and a cancer specialist at the University of Colorado, told reporters.

A second study done in Japan and Europe in patients who had failed one round of treatment showed that 19 percent had their tumours shrink 50 percent or more, and 40 percent felt better.

Lung cancer is the biggest cancer killed in the world, claiming 125 000 lives a year in the United States alone.

Iressa targets the epidermal growth factor receptor (EGFR), a key biochemical switch used by tumours, and only by tumours, to survive and grow.

"By giving a drug that blocks a specific enzyme vital to the growth of cancer cells, we can actually shrink lung cancer," Kris said. "It is the first targeted therapy for lung cancer."

Iressa is expected to reach the market later this year. It is one of several drugs targeting the EGFR, including a rival drug made by biotechnology firm Imclone called Erbitux.

The FDA rejected Erbitux late last year and the drug, which ImClone is co-developing with Bristol-Myers Squibb Co and Germany's Merck KGaA, is now only expected to go on sale in 2003.

Tarceva, made by OSI Pharmaceuticals Inc, Genentech Inc and Roche Holding AG, has won fast track approval status from the FDA.

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1186984,00.html, 2002/05/21

Stop that kissing and pass the brandy! Winter is officially with us, but a daily dose of vitamin C and a tot of brandy every other night should help to keep colds at bay.

Another health tip is to stop kissing people and shaking the hands of strangers, because that helps to spread disease.

Autumn is officially on its way out, and Tuesday was expected to be the coldest day of the year so far, weather forecaster Evert Scholtz said. He added that the mercury was expected to drop to 3°C in Johannesburg and, later in the day, rise to a paltry 16°C.

"There will be a fresh south-westerly wind blowing and no rain. The rains are over already and the cloud cover we see now will start moving away," Scholtz said.

He said a cold front that hit the Western Cape at the weekend had already passed over Gauteng, causing thunderstorms on Sunday night.

Johannesburg physician Dr Michael Setzer said a daily 500mg dose of vitamin C should help to keep flu at bay, and that while it was a myth that brandy kept you warm, it wouldn't hurt to try it - in moderation.

"Yes, it's an excuse to drink, but it's a good excuse," he laughed.

Setzer said cutting back on dairy products could also help to keep flu at bay.

"People must also be sure to take jerseys with them, to wear when they leave the office, because of temperature variations.

"They must also increase their intake of products containing (the plant) echinacea," Setzer said.

Health-conscious people should also refrain from using gas heaters or making fires inside their homes, as fin-heaters and humidifiers were healthier options.

Scholtz said a cold front was lying over Limpopo and Mpumalanga and moving towards KwaZulu Natal.

"It's moving faster than we anticipated," he said, advising that Gautengers could expect clear blue skies from now on - but these would be accompanied by very chilly weather.

"It's certainly not going to get warm again like it was last week, but it might warm up briefly again next week," he said.

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020506204619408S30054&set_id=1 , 2002/05/07

Now, a new study published in the May issue of the Journal of Marriage and Family shows that co-habitating couples also experience a decrease in health after splitting up.

"Leaving a co-habitation, like a marriage, tends to have a detrimental effect on health," said lead author Dr Zheng Wu of the University of Victoria in British Columbia, Canada.

Wu and his co-author Randy Hart obtained their results from nationwide surveys on physical and mental health and relationship status, conducted by Statistics Canada at 2-year intervals starting in the 1990s. There were 9 775 participants, aged 20 to 64 years when the surveys began.

Looking at this data, the researchers found that both men and women tend to report a decrease in physical or mental health after ending either a co-habitation or a marriage.

Researchers have proposed two theories to explain why married people report better health than non-married people. One supposes that healthier people are more likely to get married, while the other, called the "marriage protection hypothesis", suggests that married couples improve their health by providing each other with social and financial support, and by monitoring each other's health behaviours.

Wu said he tried to understand if either of these hypotheses might explain the health benefits of marriage and co-habitation by analysing the results in different ways.

The authors conclude that "protection effects" may explain much of why married or co-habitating couples experience health gains. The findings also suggest that living together and being married are similar in terms of health benefits gained.

"Although there are some differences between marital and non-marital unions, our research suggests that in terms of health outcomes, the two are quite similar," they write. "The finding that co-habitation and marriage share similar health consequences lends credence to the notion that co-habitation has become a viable form of family living."

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1177778,00.html, 2002/05/07

Here's some good news about Aids: Health Minister Manto Tshabalala-Msimang said on Monday South Africa was beginning to win the fight against HIV/Aids and she would soon release a survey showing infection rates among the youth stabilising.

About 4,7 million of South Africa's 43 million people are living with HIV/Aids, the government says. The United Nations says this is more than any other country in the world.

South Africa has provoked worldwide criticism by blocking widespread access to anti-Aids drugs it deems costly and toxic.

But last month the government announced a dramatic shift in its Aids policy, offering state-funded anti-retroviral treatment to rape victims for the first time.

"I think we are beginning to turn a corner in our country," Tshabalala-Msimang told reporters, saying the stigma attached to people with the deadly disease was waning.

She was speaking on the last day of the government's appeal against a lower court ruling that it must widely offer a drug that cuts the risk of mothers passing HIV-Aids to their babies. The Constitutional Court may take a month to decide the appeal.

"Particularly among youths, we're seeing stabilisation of the infection rate," the minister said, adding the survey would indicate that the "young will outlive the old".

But she said the report, which would be made public after it is reviewed by cabinet, would not be all good news.

"A worrying factor is that we are not seeing HIV stabilisation among women between 25 and 45 coming to public ante-natal clinics."

Tshabalala-Msimang would not comment on the court case which centres on whether a court can dictate government policy and whether the government has a constitutional duty to provide Nevirapine to thousands of HIV-positive pregnant women.

She also declined to say when the government would be ready to roll-out Nevirapine - said to cut HIV transmission from mothers to their babies by up to half - or what it would cost.

She said a key issue was infant feeding options. Breastfeeding is not advised during Nevirapine use, but women who do not breastfeed could be shunned by their communities, she added.

If the government opted to promote formula milk feeding, that would make up some 69 percent of all costs of rolling out Nevirapine access beyond the government's pilot sites where the efficacy and side-effects of the drug are being researched.

Government lawyers have argued it was vital to respect the separation of powers between the judiciary and the executive, but some judges from the 11-bench Constitutional Court have said the case was also about saving babies from death.

Tshabalala-Msimang's briefing was called to announce the health department's plans for the worldwide "Candlelight Memorial" on May 19 to mourn those who have died of Aids.

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=qw1020690000566B232&set_id=1, 2002/05/07

Article Source & Reference: South African Medical Association - News - http://www.samedical.org, 2002/05/07

Article Source & Reference: South African Medical Association - News - http://www.samedical.org, 2002/05/07

Nobel honour for AIDS activist Nkosi Johnson: Nkosi Johnson has done what not even Nelson Mandela and Desmond Tutu could do - win two Nobel prizes in one night. The late young AIDS activist was honoured twice, when he was awarded posthumously the Global Friends Award and shared the World Children's Prize with Nepalese group, Maiti Nepal.

Recalling the brave activist's short life at the awards ceremony, Sweden's Queen Silvia, praised Nkosi for his enormous commitment to AIDS awareness and his courage even in the face of death. His foster mother, Gail Johnson received the prize on his behalf, with his longtime friend Eric Nicholls (12) and two AIDS orphans from Nkosi 's Haven .

Weakened by the ravages of AIDS, yet confident and clear, Nkosi moved scientists, government officials and doctors to tears at the AIDS 2000 Conference, when he told them, ' I don't want babies to die'. He then implored the government to listen to the words of children like him.

The winner of the World Chidren's Prize is chosen by a jury which comprises children who are fighting for the rights of children who have had their rights violated in some way. The second prize, the Global Friends Award, is voted by the children all over the world. More than 125 000 school children participated.

The other winner is Nepalese organisation Maiti Nepal, nominated for its fight against the slave trade in girls from Nepal who are being sold to brothels in India.

(Source: Star, Sowetan,Citizen 16 April 2002)

Article Source & Reference: South African Medical Association - News -  http://www.samedical.org/, 2002/04/17

In a statement published in the latest edition of the South African Medical Journal, they say doctors have a moral duty to prescribe the drugs.

The government is challenging a High Court order won by Aids activists that will force it to give the drugs to HIV-positive women who want to minimise the chances of their infants being infected during birth.

The six doctors who put their names to the SAMJ statement include Professor Louis-Jacques van Bogaert, chief gynaecologist at Mpumalanga's Philadelphia Hospital.

Eighty doctors, nurses and support staff at Philadelphia earlier this month announced they would provide nevirapine to pregnant women regardless of the province's policy on the issue.

The superintendent of another Mpumalanga hospital was earlier axed for allowing an anti-rape NGO to supply anti-retroviral drugs to rape survivors at the hospital.

Cowardice or complicity?

The six said in the statement that doctors should not keep silent while their colleagues were disciplined by the authorities for placing the best interests of their patients above those of others.

It was a fact that many health-care workers who spoke out against the grave injustices in the apartheid system were abused.

"We will not accept history repeating itself," they said.

"More than a decade after the official end of apartheid, we wonder how some of our colleagues became involved in atrocities.

"Was it cowardice or complicity? Over and over, we say 'never again'."

If the state was allowed to dictate particular policies, as in the antiretroviral debate, it shackled the "fundamental principles of medical ethics" and opened the door to possible greater human rights abuses.

The other five signatories of the SAMJ statement were Dr Donna Knapp van Bogaert, bioethics lecturer at Medunsa; Dr Ames Dhai, senior consultant in obstetrics at the Nelson Mandela School of Medicine in Durban; Professor Graham Howarth of the departments of obstestrics, gynaecology and bioethics at the University of Pretoria; David Hanekom, assistant professor of medicine at the University of North Dakota; and Professor Ghoyga Ogunbanjo, of Medunsa's department of family medicine.

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Aids_Focus/0,1113,2-14-659_1169023,00.html, 2002/04/17

Because high levels of HDLs may reduce a person's risk for heart attack and stroke, researchers have been interested in finding drugs to boost HDL levels.

Researchers from the Netherlands evaluated an experimental drug that blocks the action of a protein called CETP, which is known to regulate levels of HDL in the body.

"CETP represents an important target because this protein plays a key role in HDL metabolism," lead author Dr John Kastelein of the Academic Medical Centre in Amsterdam said in a prepared statement. "In fact, a genetic deficiency of CETP is the main reason for high HDL (levels) in Asian populations."

In the study, 198 healthy men and women with a mildly elevated blood fat levels were divided into four groups. Three groups took various doses of the CETP inhibitor while those in the fourth group took an inactive placebo. The investigators measured levels of LDL, or "bad" cholesterol, and HDL cholesterol at various points throughout the 12-week study.

After 4 weeks, those taking the highest dose of the drug saw their HDL levels increase by 34% and their LDL levels decrease by 7%, the authors report.

According to the study, the experimental drug, referred to as JTT-705, appeared to have mild gastrointestinal side effects including diarrhoea, flatulence, nausea and constipation.

"Although these results hold promise, further studies are needed to investigate whether the increase in HDL cholesterol translates into a reduction in coronary artery disease risk," said Kastelein.

The study was sponsored by Japan Tobacco Inc in Tokyo and managed by Orion Clinical Services Ltd, located in Slough, UK.

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1168760,00.html, 2002/04/17

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=qw1018987924746S363&set_id=1, 2002/04/17

Variations in eight genes are implicated in Hirschsprung disease, a condition that affects about one new-born in 5 000, they report in research published online by the specialist journal Nature Genetics.

Individuals with Hirschsprung lack nerve cells in bowel muscles that push faecal material along the intestine and often suffer from a bloated abdomen, constipation, vomiting and bowel inflammation as a result.

A team led by Aravinda Chakravarti of Johns Hopkins University School of Medicine, Baltimore, Maryland, and Stanislas Lyonnet of the Necker Hospital for Sick Children in Paris trawled through the genetic profile of families where Hirschsprung was common.

In addition to mutations in five genes that cause "long-segment" Hirschsprung, which affects a long portion of the intestine, they found mutations in three genes that are to blame for "short segment" Hirschsprung which affects the rectum and a small portion of the colon.

Hirschsprung - named after a Copenhagen doctor, Harald Hirschsprung, who first identified the condition in 1888 - is usually treated by surgical removal of the affected bowel section.

"Short segment" Hirschsprung, in which usually only a few centimetres (inches) of bowel are affected, is by far the commonest form of the disease, accounting for up to 85 percent of all cases.

The research is important because finding the hereditary causes of a disease is a crucial first step towards warning people who are at risk of developing the condition or of passing it on to their children.

The goal is that, eventually, a cure can be found that can block or even reverse the malfunctioning genes.

Scientists have already identified several diseases that are caused by a single gene, such as the fatal brain disorder Huntingdon's disease, but this is the first time that a multiple-gene condition has been unravelled.

"The approach... should serve as a model for dissecting other complex diseases," said Eberhard Passarge of Essen University Clinic in Germany, who has been investigating Hirschsprung disease for more than three decades.

"However, a prerequisite for such an analysis is the careful clinical characterisation of the disease to be studied." - Sapa-AFP

Article Source & Reference: M-Web Health News - http://www.news24.com/News24/Health/Health_News/0,1113,2-14-660_1168470,00.html, 2002/04/17

The British Medical Journal said on Friday a poll of its readers had identified almost 200 conditions that are not real sicknesses - ranging from allergies to jet lag - as more and more ordinary life conditions are redefined as medical problems.

The findings are controversial, with a number of doctors questioning whether debilitating conditions such as obesity and chronic fatigue syndrome - also known as ME (myalgic encephalomyelitis) - are true illnesses.

British and Australian medics writing in the influential journal said some drug companies were "disease-mongering" by widening the boundaries of treatable diseases in order to boost their markets.

BMJ editor Richard Smith said it was easy to create new diseases out of many of life's normal processes, such as ageing and sexuality. The challenge was to get the balance right between the under-treatment of some conditions and the over-treatment of others.

"Global pharmaceutical companies have a clear interest in medicalising life's problems, and there is now an ill for every pill," he wrote in an edition of the influential journal devoted to the subject.

"The concept of what is and what is not a disease is extremely slippery."

In the past 10 years, lifestyle drugs - which improve the quality of life or alleviate the symptoms of old age - have grown into a multibillion dollar business for pharmaceutical companies.

Pfizer Inc's Viagra for male impotence is a prime example. But the industry has also pushed back the boundaries by developing anti-depressants for social phobia, promoting treatments for baldness and pushing new disease categories such as attention deficit disorder.

Advances in genetics may aggravate matters, according to David Meltzer and Ron Zimmern of Cambridge University, since genomic science may soon define us all as patients, in need of correction for genetic "defects," which predispose us to certain diseases.

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1167280,00.html, 2002/04/12

Article Source & Reference: Independent Online (IOL) - Health News -http://www.iol.co.za/index.php?click_id=125&art_id=ct200204121126283V252148&set_id=1, 2002/04/12

She expressed the hope while announcing that the first Polio Eradication Countdown in the Southern African Development Community (SADC) would be launched at a stadium in Northern Province on Thursday.

"Starting with the very first National Day for the Polio Eradication Countdown on April 11, we believe that our country will soon be declared free of this crippling condition, which left thousands of people paralysed in the last five decades," she said.

The World Health Organisation (WHO) estimates that there are up to 20 million polio survivors, 12 million of whom have some degree of disability caused by the disease. Thousands of South Africans have been left paralysed by polio.

A National Certification Committee (NCC) was appointed last July to monitor the polio eradication. The NCC consists of technical experts, including a community health specialist, and epidemiologist, a paediatric neurologist and a virologist.

"We are also establishing a Laboratory Containment Committee (LCC), which will consist of experts in the field of virology," Tshabalala-Msimang said.

South Africa adopted the strategies for polio eradication based on three principles.

Firstly, routine immunisation of children under one year of age against polio should reach at least 90 percent of this age group, in all provinces. This was to ensure that South African communities were protected against a "wild" polio virus, which may be imported into the country by refugees fleeing war-torn countries or people from countries where polio immunisation coverage was below the national and global goals of 90 percent.

• Secondly, mass immunisation campaigns were conducted from time to time, to interrupt transmission of polio in the target age group rapidly.
• The third principle was to actively detect, report and investigate suspected cases of polio, also called acute flaccid paralysis (AFP).

  Healthcare Portfolio spokesperson Slawek Justyniarski said South Africa followed the WHO's recommended immunisation schedule through which infants were routinely vaccinated against nine major childhood diseases: tuberculosis, diphtheria, tetanus, pertussis, poliomyelitis, measles, haemophilus influenza type b and hepatitis b.

  He said all of the nine diseases could cause serious complications and sometimes even death.

  Symptoms of polio include fever, fatigue, headache, vomiting, neck stiffness and pain in the limbs.

  Dr Eddie Mhlanga, the Health department's official tasked with finding ways to eradicate the disease, said the only way to make sure that a child under the age of 15 who had sudden weakness or lameness did not have polio was by testing two stools at the National Institute for Virology [NIV] in Johannesburg which is the only laboratory in the country that can do polio virus isolation.

  He warned that a child with polio could spread the disease rapidly to at least 200 children within a few days. Five doses of oral polio vaccine given to a child would provide lifelong immunity from a disease that could cause permanent lameness and death.

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1166850,00.html, 2002/04/12

Article Source & Reference: South African Medical Association - Health News - http://www.samedical.org, 2002/04/12

The elderly could put a strain on the world's health: For the first time in history the world will contain more people over 60 than under 15 years. 'The world is undergoing an unprecedented demographic transformation' says Kofi Annan, UN Secretary –General at the Summit being held in Madrid, Spain this week.

Ageing populations risk straining the world's health, social security and pension systems as the proportion of working aged people shrinks. The old are commonly thought to pose a problem mainly for rich European countries, which are seeing elderly populations balloon as a result of increased life expectancy and falling birth rates. 'Ageing is definitely no longer just a first world issue. What was a footnote in the 20th century is on its way to becoming a dominant theme in the 21st, highlighted Annan.

The international report 'State of the world's older people' produced by HelpAge International, a British advocacy group, revealed that discrimination, lack of legislation, poor economy and AIDS mean older Africans are deprived of basic rights and services and live in extreme poverty.

The Summit aims to arrange basic strategies of ensuring sufficient income and access to social services for the elderly and mechanisms of including the elderly actively within society.

(Source: Natal Witness 10 April, 2002)

Article Source & Reference: South African Medical Association - Health News - http://www.samedical.org, 2002/04/12

Article Source & Reference: South African Medical Association - News - http://www.samedical.org/, 2002/04/10

The latest in a series of experiments using Onyx-015, a cold virus altered so that it infects and kills only cancer cells and leaves healthy cells alone, produced positive results on liver cancer, the researchers said.

Richmond, California-based Onyx Pharmaceuticals Inc has been testing the virus for several years, using a variety of novel approaches such as putting it into a mouthwash to treat oral cancer and injecting it into tumours.

In the latest experiment they infused the virus into the livers of patients whose cancers had spread there.

"Rather than injecting it directly into the tumour using a syringe and needle, where it might not get distributed evenly, we injected it into the artery, so that the flow of blood carries it throughout the liver," Dr Daniel Sze of Stanford University Medical Centre in California, who helped lead the study, said.

The phase I study was meant only to test the safety of the approach, and Sze told a meeting in Baltimore of the Society of Cardiovascular and Interventional Radiology it seemed safe.

They tested 35 patients whose gastrointestinal cancer, mostly colon cancer, had spread into the liver. None could be cured by surgery and chemotherapy had stopped working for them, so they were dying of their cancer.

Not only was the treatment safe, Sze told the meeting, but it seemed to help fight the tumours. Such patients usually live only six to eight months but the median survival time of this group was just over a year.

CT scans showed the livers swelled at first, perhaps a sign of inflammation from the treatment.

Tumours shrank after treatment

"The tumours shrank somewhat, but more impressive was that blood tests showed that abnormal proteins being secreted by the tumours either decreased significantly, or became completely undetectable," Sze said. "That suggests the tumours, although still visible on the CT scan, are dying or dead."

The researchers were also scheduled to report on their findings to a meeting in San Francisco of the American Association for Cancer Research.

Colon cancer kills 50 000 people every year in the United States, making it one of the deadliest cancers after lung, breast and prostate cancer. It often spreads to the liver, and is very difficult to treat at that stage.

Sze said Onyx-015 might offer an effective way to treat the cancer without the side-effects of chemotherapy. "Standard chemotherapy kills some healthy cells along with the cancer. This engineered adenovirus is designed to kill only the cancer and not to harm healthy cells," he said.

The adenovirus his team used is a relative of the common cold virus. When it attacks cells it uses a protein called p53, which happens to help repair the kind of damage that leads to cancer.

About 60 percent of cancer cells have mutated p53 genes. Researchers changed the adenovirus so that it could not make use of p53 and therefore should not be able to invade healthy cells, but could attack cancer cells with faulty p53.

Sze said his team realised that infusing a virus into the liver could be dangerous. Such a treatment killed 18-year-old Jesse Gelsinger in 1999 in a gene therapy experiment.

Sze said the cancer experiment took this into account. "The maximum dose (used in the Gelsinger case) was something like 25 times as high as our maximum dose," he said.

"That is the Jesse Gelsinger legacy - you can't indiscriminately keep going up. Also, even though our patients had tumours, their liver function was normal. We were certainly aware that if we gave too much stress on the livers they could go into liver failure."

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1165998,00.html, 2002/04/10

To investigate the effect of insomnia on health-related quality of life, Dr David A. Katz of the University of Wisconsin in Madison and Dr Colleen A. McHorney of Indiana University in Indianapolis analysed questionnaires completed by 3 445 patients with chronic illness. Fifty percent of the patients reported insomnia. Sixteen percent of them characterised their inability to sleep as "severe".

After controlling for the effects of depression, anxiety and medical problems, which prior studies failed to do, the investigators discovered that insomnia was "independently associated with worsened health-related quality of life to almost the same extent as chronic conditions such as congestive heart failure and clinical depression."

In particular, patients reported that insomnia had a negative impact on their mental health, vitality and general health perceptions, the researchers report in the March issue of The Journal of Family Practice.

"Clinicians should not ignore insomnia," the authors write. But as they point out, many do, according to the National Commission on Sleep Disorders Research, which recently reviewed 10 000 medical records from nine family practices and found only 123 notations on sleep. And not one suggested an effective response to a sleep complaint.

"By identifying and treating chronic insomnia, including any predisposing conditions that may perpetuate insomnia, clinicians can significantly improve the quality of life of patients with chronic illness," Katz said.

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1166037,00.html,  2002/04/10

Cholera is spread through contaminated food and water. It is an acute intestinal infection that causes copious, watery diarrhoea and can rapidly cause severe dehydration and death if not treated promptly.

Dr Mitchell B. Cohen of Children's Hospital Medical Centre in Cincinnati, Ohio, tested the new vaccine, called Peru-15, in 59 healthy volunteers. The vaccine is made from live, weakened Vibrio cholerae bacteria. Volunteers received either the cholera vaccine or an inactive placebo shot. About 3 months after vaccination, 36 of the volunteers were exposed to live V. cholerae bacteria.

The researchers report their findings in the April issue of Infection and Immunity.

The existing vaccine available for preventing cholera is given by injection, and protects about half of people who receive it, Cohen and colleagues note. This vaccine also produces adverse reactions at the injection site and throughout the body, they add.

In the current study, the only reactions reported more often with the Peru-15 vaccine than with a placebo were headache and abdominal cramps, the investigators report, and only headaches reached statistical significance.

All but one person who received the vaccine (97%) showed at least a fourfold increase in the amount of anti-cholera antibodies in their blood, Cohen's team found.

When exposed to the cholera germ, 5 of the 12 placebo recipients (42%) and none of the 24 vaccine recipients developed moderate or severe cholera, the report indicates. Seven placebo recipients (58%) and one person who received the vaccine (4%) reported any diarrhoea.

"This study demonstrates that a single dose of Peru-15 is a well-tolerated and immunogenic oral cholera vaccine that affords protective efficacy against life-threatening cholera diarrhoea in a North American human volunteer challenge model," the authors conclude. "We believe that this vaccine could be a safe and effective tool to prevent cholera in travellers."

"We plan to conduct a larger scale multicentre challenge study to replicate the results obtained using a production lot of the vaccine," Cohen said.

The researchers don't know how long the protection offered by the Peru-15 vaccine lasts. "This is an important unanswered question," Cohen added. "We hope to look at immunogenicity beyond 6 months after vaccination to give some idea of this answer."

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1166000,00.html, 2002/04/10

Article Source & Reference: IOL (Independent Online) Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020408000845618M125890&set_id=1, 2002/04/10

"As we rise up to the challenge posed by major communicable diseases like tuberculosis, HIV/Aids, the tendency has been to neglect some of the major non-communicable (diseases) that are major causes of death in our society.

"Non-communicable diseases are acquired over a period of time due to what people eat and how they live," she said at World Health Day celebrations in Sebokeng near Vereeniging.

The minister was attending the commemoration of the day along with Gauteng health MEC Gwen Ramokgopa and the World Health Organisation's (WHO) national representative, Dr Welile Shasha.

According to WHO, non-communicable diseases contributed to almost 60 percent (31.7 million) of deaths and 43 percent of diseases in the world in 1998, the minister said.

"Based on the current trends, these diseases are expected to account for 73 percent of deaths and 60 percent of the disease burden in the year 2020."

She said low and middle-income countries such as South Africa suffered the most.

The most prominent non-communicable diseases were cardiovascular illnesses, cancer, chronic obstructive pulmonary disease and diabetes.

They are linked to risk factors such as tobacco use, an unhealthy diet and physical inactivity.

"The theme for this year's World Health Day is 'Move for Health' and it is aimed at promoting healthy, active and tobacco-free lifestyles and preventing diseases and disabilities caused by unhealthy and inactive living," Tshabalala-Msimang said.

Ramokgopa told community members that a small amount of daily exercise made a difference to a person's health and how he felt about himself.

"I ask that you volunteer, and encourage all those with whom you have contact to volunteer, to form small groups, and contribute to the health of your community through organised exercise programmes and other health related activities."

"We will be able to see the effects of your endeavours by the drop in attendance rates at our clinics, for illnesses that are preventable, or can be relieved to a great extent, through exercise," she said.

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Aids_Focus/0,1113,2-14-659_1165488,00.html, 2002/04/09

"Organic produce is consistently better," Gold said.

"Theoretically the food is free of pesticides, and you are generally supporting family farms instead of agora-business. And more often than not it is locally grown and seasonal, so it is more tasty."

Gold is one of a growing number of shoppers buying into the organic trend, and supermarkets across Britain are counting on more like him as they expand their organic offerings.

But how many shoppers really know what they are getting, and why are they willing to pay the price for organic produce?

A straw poll at two central London supermarkets showed that Gold and others who buy organic can generally give clear reasons for their preferences - but what they believe about the organic ideal is not always strictly accurate.

For instance, some trace amounts of approved pesticides can be used on organic products. And about three-quarters of organic food in Britain is not local but imported to meet growing demand.

"The demand for organic food is increasing by about one third every year, so it is still a very buoyant market," said Sue Flock, spokeswoman for the Soil Association, Britain's largest certifying body for organic produce.

A growing market

The big supermarket chains agree.

"(The market for organic) has gone up dramatically," said Jonathan Church, spokesperson for the Tesac supermarket chain.

"We launched our range back in 1997 with just a couple of hundred products, and now we have 1 100, and that is all in response to customers."

So what does organic mean? In Britain, the Department for Environment, Food and Rural Affairs sets the rules.

Anyone involved in producing organic food must register with an approved certification organisation, which will inspect the grower at least once a year.

"(Buying organic) means you are supporting a system of farming that respects the environment, and you are buying food with proven health benefits," Flook said.

"So organic farming aims to avoid the use of artificial pesticides and fertilisers, and no herbicides are permitted."

Instead, organic farmers rotate crops to maintain soil fertility and seek to keep their animals healthy without routinely using antibiotics.

"There are some instances when we do allow certain sprays to be used on crops, but we do not encourage routine use, and there are only about seven artificial inputs that we do allow under organic standards," Flook said.

To ensure the purity of organic farming, the organic lobby has been fighting to keep genetically modified crops well away from their fields.

And according to a European Union report obtained by Reuters last month, there is a risk to farms certified as GM-free. Some GM crops are highly likely to crossbreed with organic or wild plants, the report said.

For some consumers, all the effort of keeping organic food distinct is worth it for the flavour.

But not all shoppers think organic food tastes better, and for many, the organic label is just too expensive.

"I think it is incredibly overpriced and a consumer rip-off," said London shopper Steven Castledine.

But is it good for you?

Church said Tesco was working to bring organic prices down, but admitted the food did tend to cost more.

"Customers recognise that organic products are more expensive to produce, more labour-intensive, and therefore they do expect to pay a higher price," he said.

And the organic lobby says there is evidence that such practices give organic food health benefits over conventionally farmed produce.

For instance, in March the New Scientist magazine reported that researchers had found organic soup had almost six times as much salicylic acid - which helps to prevent hardening of the arteries and bowel cancer - as regular soup.

People who buy organic food tend to think it is the healthier option.

"I feel it is supposed to be better and good for me," said Maureen Roberts of London, who buys organic food occasionally, if the price is right.

But official organisations have held back from endorsing such beliefs.

The food department does not make any claims for organic nutritional superiority. "However, there is evidence for the environmental benefits from organic production," a department spokesman said.

The Foods Standards Agency said it thought people should have the organic option, but there was not enough evidence to say that organic foods were significantly safer or more nutritious than conventional farm products.

"As far as we are concerned, a vegetable is a vegetable and a fruit is a fruit," an agency spokeswoman said.

"There might be different growing methods using different things in the growing process, but the end result is the same."

And many shoppers remain sceptical.

"I never buy organic because I think the (price) mark-up is ridiculous, and I do not think it is that much better for the environment," said Freya Koepping, visiting London from Germany.

"I think it is a marketing ploy and just a craze. We have been eating the same food for thousands of years."

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1165680,00.html, 2002/04/09

The project, dubbed the largest ever international medical research and due for take off on Monday, was jointly launched by Wits University and the National Health Laboratory Services in Johannesburg on Friday.

South African and British scientists will be conducting tests on 1 000 passengers - 500 on Economy Class and Business Class each on a voluntary basis - flying Heathrow Airport to the Johannesburg International Airport between Mondays and Fridays over the test period.

DVT, a condition commonly referred to as Economy Class Syndrome, is the clotting of blood due to damaged blood vessels and is caused by among others, lack of movement, dehydration (partly caused by alcohol - one of beverages offered on board), and time zones, which most travellers experience during lengthy flights.

According to the research study's head, Professor Barry Jacobson of Wits University, the study would examine all factors relating to the formation of clots in the body while flying.

A particular emphasis would be put on factors such as weight, gender, height, age, in-flight activity, genetic profile and seating position.

Volunteers would be asked before boarding the flight at Heathrow, to complete a short confidential questionnaire, have one of their ankles measured and undergo a painless blood sample test.

During the flight each volunteer would be asked to fill a form about their fluid intake and movement on board, while on arrival at the Johannesburg International Airport they will hand it to the medical team.

Spin-offs for volunteers would include 5 000 free voyager miles, a beneficial self knowledge as well as being of service to the world societies.

Addressing the launch on Friday, Jacobson said there had been very little research conducted into how one of the major problems in the health care field could be defeated.

The problem had meanwhile led to numerous media reports about DTV sufferers threatening class action lawsuits against certain airlines for accommodating them in cramped conditions in economy class sections, and for failing to warn them of risks associated with flying in such conditions.

Jacobson said the currently available medications, which include aspirin, had no effect at all.

SAA has expressed its full support of the project as it was bound to provide answers to questions - such as whether there was medical evidence directly linking DVT to air travel, or whether being on board a flight was any different from travelling by car.

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1164939,00.html, 2002/04/09

Article Source & Reference: IOL (Independent Online) http://www.iol.co.za/index.php?click_id=125&art_id=qw1018186381946B262&set_id=1, 2002/04/09

The order of the court specifically points out that government is not required to undertake "the wholesale extension" of the Nevirapine programme. What we are expected to do is to enable the drug to be prescribed to HIV-positive pregnant women and their babies:

• At health facilities where necessary preconditions already exist for this intervention to be effective. These would at least include voluntary counselling and testing services.
• In cases where the attending doctor and medical superintendent consider it medically advisable.

In consultation with provinces, we are developing a circular that will be sent to all public health facilities. Our intention is to ensure that facility managers and health professionals in antenatal clinics are in a position to respond appropriately to this latest development.

The Task Team that is currently being constituted to guide the further development of the programme on mother-to-child transmission will now take on the additional role of communicating and monitoring actions taken as a consequence of today's order.

Government is striving for a comprehensive approach to ensure that women receive appropriate advice on breastfeeding, in line with our national protocols. We have an over-riding concern to ensure that affected women are in a position to make an informed choice abut this programme.

Dr Manto Tshabalala-Msimang
Minister of Health

Article Source & Reference: South African Department of Health, http://www.doh.gov.za/docs/pr/pr0404-f.html, 2002/04/09

This follows requests from individuals in the tourism sector for this recommendation to be dropped as it "scares off" tourists.

But Dr Andrew Jamieson, medical director of Netcare Travel Clinics said: "Advising against malaria prophylaxis is not responsible and may be dangerous. The best way to scare off tourists is to let them find out the hard way about malaria."

He said many travellers who contracted malaria in southern African nature and game reserves only fell ill on return to their home countries and their deaths were not reflected in official South African figures.

"Netcare Travel Clinics have documented evidence of this occurring, and it is senseless to pretend otherwise."

Jamieson added that official malaria statistics in all countries understated the true incidence and risk of the disease.

Definite risk

He said the majority of tour operators and lodge owners were responsible about alerting their guests to the risks of malaria, and that it was only a small minority within the industry who deliberately disregarded the risks.

"As malaria definitely occurs, and is definitely a risk, the official Netcare Travel Clinics policy will remain to recommend prophylaxis with anti-malaria tablets for travellers staying overnight in the Kruger National Park and similar areas, despite pressure from certain airlines and public officials to the contrary."

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1161471,00.html, 2002/03/26

Interviewer: Now, a big day in court tomorrow. Government is fighting against the roll-out of nevirapine in the way the TAC wants. Given the fact that there are now new concerns about nevirapine, let's say that the court rules tomorrow that you have to go ahead as the TAC wants, will you be prepared to follow what the court says, given these new concerns around the drug?

Tshabalala-Msimang: My own view is that the judiciary cannot prescribe from the bench - and that we have a regulatory authority in this country that is interacting with the regulatory authority FDA of the USA and I think we must allow them to assist us in reaching conclusions.

Interviewer: Mmm, so you think it's inappropriate that this is in court, but nevertheless it's there. Will you stand by whatever the court decides?

Tshabalala-Msimang: No, I think the court and judiciary must also listen to the regulatory authority, both of this country and the regulatory authority of the US.

Interviewer: So you're saying no?

Tshabalala-Msimang: I say no. I am saying no.

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct2002032521510845M320375&set_id=1, 2002/03/26

The ruling, by Judge Chris Botha, means that the state is obliged to supply Nevirapine to any public hospital where doctors and medical superintendents believe they have the capacity to provide the counselling and HIV testing needed to give Nevirapine to pregnant women.

It comes into effect immediately - ahead of a government appeal in the Constitutional Court to contest a court order forcing it to implement a national programme to provide the drug.

The government would be in contempt of court if it refused a request for the drug, said Geoff Budlender of the Legal Resources Centre.

Anyone involved - doctors, hospital superintendents or patients - could lay charges against the state if they were denied access to Nevirapine in a public hospital which had the capacity to supply it.

And it is up to doctors to decide if their hospitals have the capacity.

Dr Sajira Lakhana, medical superintendent of Elim Hospital, is one of the people who believes her hospital could supply the treatment.

Lakhana said Nevirapine could cut by one-third the number of HIV-positive babies dying there. About 11 HIV-positive children are admitted every month; every month, two or three HIV-positive children die there.

The young woman who was denied Nevirapine at Elim Hospital six months ago still does not know whether her baby contracted the virus, and will eventually be admitted to this paediatric ward.

Because babies gets HIV antibodies from their mothers, blood tests can give false HIV-positive results for a year after they are born.

This means the young woman has another six, long months of waiting.

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020325212109266M320699&set_id=1 , 2002/03/26

Nurse in hot water after burning boy, 4: A nurse faces charges of assault after she allegedly forced a 4-year-old boy into a tub of extremely hot water. He suffered first and second-degree burns to his feet.

The boy's granny, Hilda Jonas, said the child had been at Kimberley Hospital for intestinal-related ill health for the past four months.

Jonas said the nurse forced her grandchild into a bath after he had defecated in his bed.

"She did not feel the water temperature. The boy screamed because he was burning from the hot water."

The nurse has been suspended pending internal investigations. - By Dineo Khechane

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020325232101739N620190&set_id=1, 2002/03/26

New research presented at the Third European Breast Cancer Conference confirms the results of earlier, smaller studies which have shown the chance of getting the disease rises by about 26 percent in women who have used oral contraceptives compared to those who have not.

For women aged 45 and over the risk is doubled.

"It is a doubling in risk," Dr Merethe Kumle, of Community Medicine in Tromso, Norway told the conference.

"It is clear that oral contraceptives increase a woman's risk of developing breast cancer, particularly when they are used in the later period of reproductive life," she added.

Using data from a large lifestyle and health study, Kumle and her team studied information on 103 027 women who were questioned about their lifestyle, health and use of the pill in 1991/1992.

They followed the medical history of the women to December 1999 and found 1,008 cases of the disease. Most of the women had taken newer versions of the pill which contain lower doses of hormones.

"I think the results from this study of Norwegian and Swedish women are very interesting and confirm results from earlier studies of oral contraceptive use," Kumle said.

Early pregnancy, late menopause, postponing childbirth or not having children are risk factors for breast cancer which affects about one million women worldwide each year.

Studies have also shown that using the pill and hormone replacement therapy (HRT) can increase the risk of the disease, although the risk decreases after women stop taking the drugs.

Kumle stressed that the risk for younger women, under the age of 40, is very low. Most breast cancer is diagnosed in women 50 years and older.

"We found a slightly increased risk of breast cancer among users of the pill, but it is important to underline that young women using the pill are not playing hazard with their health. As contraception, the pill should still be the drug of choice for young women," she added.

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1161166,00.html, 2002/03/26

Article Source & Reference: South African Medical Association (SAMA) - http://www.samedical.org/ , 2002/03/25

He was referring to a statement by the minister who, when asked in an interview on SABC television whether government would heed the court order, said the "judiciary cannot prescribe from the bench".

"We need a clear statement from the highest level of government (on) whether the court and court orders will be respected," TAC secretary Mark Heywood said outside the Pretoria High Court.

Judge Chris Botha on Monday upheld an application by the TAC, the Children's Rights Centre and paediatrician Haroon Saloojee of the Save Our Babies organisation, confirming his earlier order that government should provide nevirapine to HIV-positive pregnant women at state hospitals with the capacity to do so, and where it was medically indicated.

Botha initially granted an order in December last year. In March, he granted the government a positive certificate allowing it to ask the Constitutional Court to hear its appeal against the December order. At the same time, Botha issued an execution order, compelling the government to make nevirapine available outside the existing pilot sites where the drug is being tested, pending the outcome of the Constitutional Court bid.

Tshabalala-Msimang and seven health MECs (of all provinces except the Western Cape and KwaZulu-Natal, where nevirapine programmes have already been expanded past the pilot sites) on Friday applied to Botha to grant a positive certificate to take their appeal against the execution order to the Constitutional Court.

However, Botha issued a negative certificate on Monday. He said the matter of the execution order, unlike the original order, was not a constitutional matter. "I must add I am also not convinced that another court will find that I have exercised my discretion incorrectly. In essence I had to balance the loss of lives against prejudice that could never amount to more than inconvenience."

According to figures before court, the execution order could save at least 10 lives a day.

"In the end the choice was between tolerating the loss of life and tolerating inconvenience, no matter how many lives were at stake," Botha said.

De-registration a crucial issue

In the hearing, Marumo Moerane, SC, for the government, argued that the possible de-registration of nevirapine by the Medicines Control Council (MCC) was a crucial issue in the matter.

In a letter last week, the MCC alerted Tshabalala-Msimang to serious concerns which the United States' Food and Drug Administration (FDA) had expressed about a nevirapine test conducted by a US institution in Uganda.

According to the letter, dated Wednesday, questions had been raised about the reporting and documentation of the study on the use of Viramune (of which nevirapine is the active ingredient) for the prevention of mother-to-child-transmission of HIV.

The MCC said it would review nevirapine in the light of those developments. Botha said in his judgment: "In my view the fact that there may be a revision of the registration of nevirapine is irrelevant."

Such a possibility had existed throughout the case. "Until that happens, there is no reason to review the order or to discontinue the work at the pilot sites.

"What is conspicuous, is that the respondents have not produced any evidence, after almost a year of dispensing nevirapine to approximately one tenth of the affected population, of any deleterious effects encountered in its programme," Botha said.

'Yes and no'

In the SABC television interview, Tshabalala-Msimang was asked if government would be prepared to follow a court order to roll out its nevirapine programme in light of concerns about the drug.

"My own view is that the judiciary cannot prescribe from the bench and that we have a regulatory authority in this country that is interacting with the regulatory authority FDA of the United States and I think we must allow them to assist us in reaching conclusions."

Asked whether the government would stand by the court's decision, the minister said: "No, I think the courts and the judiciary must also listen to the authorities - regulatory authorities - both from this country and the United States."

Asked if she was saying no, Tshabalala-Msimang said: "Yes and no. I'm saying no."

Reacting to this, Positive Women's Network director Prudence Mabele, who has lived with HIV for 10 years, on Monday said: "I get so frustrated by our own government depriving us the right to live."

Heywood said all major health bodies in the world supported the drug. These included the Centres for Disease Control, the World Health Organisation, the United Nations Aids programme and the American National Institute for Health.

"There is no question about its safety and efficacy," Mabele said. "I know many HIV-positive women who have HIV-negative children because of this drug." Heywood said the judge's statements made for a strong case for patients and doctors to sue the government for failure to provide the medication and to prevent enormous suffering.

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Aids_Focus/0,1113,2-14-659_1161116,00.html, 2002/03/25

Groote Schuur opens its heart to UK patients:Cape Town's medical fraternity is agog with the news that British authorities want to send hundreds of patients to Groote Schuur Hospital for heart operations.

The scheme, which is a move to cut the hefty hospital waiting lists in Britain, could see between 500 and 1 000 British patients sent to Groote Schuur annually for cardiac bypasses alone.

The National Health Service in Britain already sends patients, all expenses paid, to countries in the European Union for operations. If British legislation is passed to allow South Africa to be included, the patients could be sent to South Africa within weeks.

"We're very chuffed," Norman Maharaj, the chief director of Groote Schuur Hospital, said of the scheme. "It shows faith in Groote Schuur's capability and its surgeons. But our first priority would be our own patients.

"We have our own waiting lists. We have the surgeons and the capacity here to perform more operations, but we need more money. For every one person from the United Kingdom who is given an operation, we would be able to afford to operate on two of our own people."

It has been reported on BBC radio that the Labour government has already made about R1,6-billion available to address the UK's waiting lists.

There are hundreds of people waiting to have heart valve replacement operations at Groote Schuur, and a large proportion of these are poor or indigent people. A heart valve alone costs between R20 000 and R30 000.

The operations on patients from the UK would be performed in Groote Schuur's private wards. Groote Schuur would draw up a business plan for the scheme, but fees charged would need to be approved by the Department of Finance and the Treasury, Maharaj said.

Ivan Toms, Cape Town's director of health, said it was "quite scary" that the National Health Service could afford to fly patients to South Africa from Britain for operations while "we can't afford to do them for our own patients".

"But cross-subsidisation could make it possible for us to do more of these operations. We are in a unique situation. We have the experts and the infrastructure, just not the money," said Toms.

A proposal would probably need to be drawn up by British and South African health authorities to determine selection criteria; how patients should be cared for before and after the operations; and how their families could be accommodated in Cape Town, Maharaj said.

Article Source & Reference: IOL (Independent Online) - Health News -http://www.iol.co.za/index.php?click_id=125&art_id=ct20020324200555684U2532928&set_id=1, 2002/03/25

Nevirapine hitch is academic, not medical: The government is threatening to close down its pilot sites on maternal transmission if the registration of Nevirapine is withdrawn.

The anti-retroviral, which offers the cheapest way to reduce HIV transmission from mother to child, could be deregistered by the Medicines Control Council after an administrative hiccup at a Ugandan research site led to its manufacturer withdrawing an application for its registration in the US.

International medical organisations, including the World Health Organisation, UNAids and US-based National Institute of Allergy and Infectious Diseases (NIAID), have leapt to Nevirapine's defence, arguing that the problem is purely administrative and that the drug has proved to be effective and safe.

An NIAID statement read: "The reduction in perinatal transmission by the use of Nevirapine, an accessible, inexpensive regimen, represents a major public health advance in resource-poor settings, and NIAID believes there is no reason for programmes implementing this life-saving regimen to change their practices."

On Sunday, Archbishop emeritus Desmond Tutu joined the fray over anti-retrovirals, calling on South Africa to use all accumulated knowledge on HIV and Aids to fight the pandemic with "the same commitment... as we had when we were fighting the scourge of apartheid".

A Pretoria High Court judgment which could force the government to make the drug more widely available is expected on Monday.

The government's advocate in the case, Marumo Moerane SC, told the court on Friday that the state would shut down the pilot sites if Nevirapine's registration was withdrawn.

What is the problem?

Boehringer Ingelheim, the company which manufactures Nevirapine, the drug used to save babies from contracting HIV from their mothers, has withdrawn an application to have it registered in the US for use in preventing maternal transmission because of administrative problems with documentation from a Ugandan research site. When it withdrew its application, the company notified South Africa's Medicines Control Council (MCC) of its decision to do so. The MCC, in turn, notified Health Minister Dr Manto Tshabalala-Msimang. The MCC is also reviewing its decision to register Nevirapine. (The drug is already registered in the US for adult use.)

What caused the problem?

The Ugandan study into Nevirapine was used as a basis for Nevirapine's registration in South Africa. When Boehringer Ingelheim applied for US registration, an audit was conducted into the Ugandan documents - and investigators discovered that it did not meet the requirements of the Federal Drug Administration for approval to be granted. The FDA requires that the entire medical history of each patient be kept. But at the Ugandan hospital where the research site was based, such records are not kept.

What does it mean?

The world's leading medical institutions including the World Health Organisation, say Nevirapine should still be used to prevent maternal transmission of HIV. They point out that Nevirapine's safety and efficacy are not being questioned, and that Boehringer Ingelheim's decision to withdraw its application relates to an administrative matter.

By Lynne Altenroxel and Sapa

Article Source & Reference: IOL (Independent Online) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020324215055795N161104&set_id=1 , 2002/03/25

Mobile thumbs up: London - Young people growing up using mobile phones to send text messages are developing thumbs that are stronger and more versatile than their other digits, Britain's Observer newspaper reported on Sunday.

Mobiles, gameboys and hand-held computers were leading to the kind of physiological development that normally took generations, Sadie Plant of Warwick University told the newspaper.

"The relationship between technology and the users of technology is mutual: we are changing each other," she said.

"The fact that our thumbs operate differently from our fingers is one of the main things that defines us as humans.

"Discovering that the younger generation has taken to using thumbs in a completely different way and is instinctively using them where the rest of us use our index fingers is particularly interesting," the researcher into cybernetic culture said.

Plant studied technology users in cities across the world, including London, Beijing Chicago and Tokyo, noticing that younger people use both thumbs equally well and that they barely looked at the keys.

"They use the absolute minimal movement," she said. "Thumbs are the new fingers," she added. - Sapa/DPA

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1160836,00.html, 2002/03/25

New clinic will offer 24-hour service to the community: Former President Nelson Mandela opened Qaukeni Community Clinic in Lusikisiki, Eastern Cape, over the weekend, the clinic will dispense the drug Nevirapine. The move comes amid sharp debate within the ANC over whether or not the drug should be rolled out beyond official test sites.

In his speech Mandela said, 'Many young people and babies are dying in large numbers every day. The people who are well must give them support and love and we must make sure we give them the proper treatment.' The clinic was born in 2000 when King Sigcau told Mandela that the informal clinic was inadequate for the area's population of over 20 000. Mandela challenged John Kearney, CEO of GlaxoSmithKine to build and equip a new clinic. GlaxoSmithKline donated R2 million toward the Quakeni Clinic. The new 24-hour clinic with modern toilets and running water will service communities from 22 villages, with four professional nurses and a nursing assistant.

Meanwhile on Monday, the Business Day reported that the department of health says there was no way the clinic could make the drug available at present. 'The report in the Sunday Times is saying what we are not going to do. We are not moving an inch on the issue of Nevirapine. We are not going to roll out the provision of these drugs'.

Provincial health department spokesperson, Mahlubandile Mageda, stressed that, 'The national policy says no roll out programme can be made until the results from our pilot sites have been received and processed. That will guide us on whether to expand the programme or not. Until then we are not going to do anything.' Mageda said that not even a recent court ruling ordering the provision of the drug could force the government to change its policy.

(Source: Sunday Times 17 March & Sowetan, Business Day 18 March 2002)

Article Source & Reference: South African Medical Association - News - http://www.samedical.org, 2002/03/19

SA to treat UK patients? London - The British department of health may soon send state patients to South Africa for treatment in an attempt to shorten the long waiting lists in Britain.

A spokesperson on Monday confirmed that the pilot project, launched earlier this year to transfer National Health Services (NHS) patients to Europe, might be extended to South Africa.

The weak rand and excellent quality of medical care in private hospitals, make South Africa an obvious choice. South Africa is already popular among British cancer patients who fly here at their own cost instead of waiting for months for the NHS to administer the critical treatment.

A study done last week showed that at least 10 000 British cancer patients die every year because of the long waiting period and poor quality of treatment. Britons suffering from lung cancer have a 50% lower chance of survival than their counterparts on the European mainland.

In an attempt to ease the load on the system, Britain sends a quota of state patients to Germany and France every year for routine operations at the taxpayers' expense. A research team in York will evaluate this project next week. A decision on possible expansions will be taken then.

A project spokesperson says patients seem to be satisfied to travel in order to receive treatment. Although studies have shown that people prefer to be treated closer to home, South Africa has unique advantages - treatment is at least half the price, the quality is good and it can take place immediately.

Should South Africa be selected, it would be the first time the British NHS sends patients to a destination outside Europe.

The director of a private company in London, who arranges operation packages for patients to the Southern Cape, says he believes patients will jump at the opportunity. According to Rob Gee, director of Garden Route Medicare, who mainly arranges hip, knee and cosmetic operations, dozens of Britons are already treated in South African hospitals every week.

Panorama Medi-Clinic in Cape Town sees an average of five British patients every week and hopes to see at least 300 by the end of the year. The hospital is negotiating a special package for patients and their families with airlines and the hospitality industry.

An NHS nurse recently paid $700 from her own pocket to have a lump removed from her breast in South Africa. The day after her arrival, she was operated on in Cape Town. She would have had to wait more than a month for a specialist appointment in Britain.

According to Gee, more and more Britons are enquiring about treatment in South Africa. "There are people who are not willing to wait any longer. They know they can get good treatment at half the price in South Africa. Many combine it with a holiday - and they still pay less."

Igna Schneider

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1158573,00.html, 2002/03/19

Researchers at Dumfries and Galloway Royal Infirmary in Scotland have found organic vegetable soup contains six times as much of a natural acid which helps combat bowel cancer and hardening arteries as non-organic soups.

Biochemist John Paterson said "the higher levels of salicylic acid in organic food means eating organic may be good for you", New Scientist magazine reported.

He added: "I'm not an evangelist for the organic food movement, but there was a fairly substantial difference." Salicylic acid occurs naturally in plants, which could explain why levels are higher in organic vegetables grown without protection from pesticides, the magazine suggested."

Earlier research by the team discovered significantly higher concentrations of the acid in the blood of vegetarian Buddhist monks compared with that of meat-eaters. 
Sapa-DPA

Article Source & Reference: M-Web Heatlh News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1158267,00.html, 2002/03/19

"Hayfever season is really depressing," said Chieko Onuki, a 58-year-old housewife from Tokyo. "The other day when I went to Narita-san (park), I felt really sick and couldn't even stand up. I've lost my sense of taste, my appetite and some weight."

Onuki has invested in a pack of 50 surgical-style white facemasks and silk tissues because her allergy pills, eye drops and nasal sprays were not keeping her symptoms in check.

"I used to love and enjoy this time of year, I used to go to the mountains, and went skiing a lot," said Yoko Adachi, a 45-year-old paper-manufacturing company worker.

"Nowadays, just seeing a sugi tree is enough to fill my eyes with tears."

The problems of Onuki, Adachi and millions of fellow sufferers would not be so acute if it had not been for the government's policy of encouraging the planting of "sugi" and "hinoki" (Japanese cypress) for timber to rebuild the country's housing stock devastated by World War II.

Widely perceived as an overpopulated concrete jungle, roughly 65 percent of Japan's landmass is forested, but only 17 to 18 percent of Japan's naturally occurring forest area is covered by needle-leaved, pollen-spraying trees.

Yet once you add plantation sugi, hinoki and other coniferous species once promoted by the government, the figure surges to 53 percent of the total 23.5 million hectares (58 million acres), according to the Forestry Agency.

But with 81.8 percent of Japan's 2000 timber needs - 99.3 million cubic metres (3.476 billion cubic feet) - supplied from imports, and the cost of felling prohibitively high, it looks like Japan's pollen-producing forests are here to stay.

While the agency has been developing low-pollen sugi strains and promotes the selective harvest of pollen-laden trees, experts say the problem does not appear likely to blow over - in fact, it will probably get worse.

"The number of patients who show spontaneous remission is very, very rare, so the total number is increasing," said Professor Akiyoshi Konno, director of the Department of Otorhinolaryngology at Chiba University School of Medicine.

"The number of patients who attend our allergy clinic is increasing every year, while 40 years ago it (hayfever) was very, very rare," Konno said.

In Tokyo alone - which is bordered on the west by mountains planted with sugi - the metropolitan government calculates the number of sufferers rose steadily from some 7.0 percent of those surveyed in 1983 to nearly 20 percent in 1997.

Konno believes, however, that while the increase in pollen spores contributes to the rise in cases, "it's not the only reason".

He said clinical tests have shown that inhaling diesel exhaust particulates increases the production of IgE antibodies, which, when they overcompensate to fight pollen inhalation, produce hayfever symptoms.

He also said the gradual increase of Western foods, high in protein and calories compared to Japanese cuisine, contributed to a sturdier immune response system and possibly an overactive production of antibodies.

Even Prime Minister Junichiro Koizumi has been afflicted. As he was to meet representatives of a group of 48 ruling Liberal Democratic Party members who make up the Hakushon (Atchoo!) Alliance earlier this month, he experienced a sudden runny nose and sneezing.

"Something's strange," Koizumi muttered to reporters. "Lately I've been sneezing and had a runny nose."

Shinya Ono, an LDP co-founder of the group and "veteran sufferer", said the group had boosted the amount of funds earmarked to study the disease to 7.3 billion yen ($57 million) in the 2002 fiscal budget, up from 268 million yen when the group started seven years ago.

"Something has to be done to eliminate this disease," a congested-sounding Ono said. He was forced to miss one day of work this spring because of "really terrible" hayfever, a rarity in workaholic Japan.

According to a 2000 study produced by the government's Science and Technology Agency, cedar allergies alone caused Japanese sufferers to spend 286 billion yen a year in medical expenses, in addition to the billions more hayfever costs the country in terms of lost earnings or productivity.

Ono said he hopes researchers can find a cure not only for pollinosis, but for a rash of illnesses related to it.

"Asthma and atopic dermatitis, these are all related because these symptoms are caused by an overreaction of our immune systems," Ono said. 
- Sapa-AFP

Article Source & Reference: M-Web Heatlh News - http://www.news24.co.za/News24/Health/0,1113,2-14_1157891,00.html, 2002/03/19

Hospital to beef up security after execution: Johannesburg Hospital will this week enforce tighter security on its premises, following the execution of a patient in his bed.

On Thursday, a 28-year-old man, who cannot yet be identified, was shot 13 times in the chest and lower body by three gunmen in ward 369.

None of the men, who were seen leaving the hospital in a white Honda and a cream Nissan 4x4, have been apprehended.

The victim was admitted for a gunshot wound to his leg.

By Sunday night no arrests had been made in connection with the shooting, said police spokesperson Superintendent Lungelo Dlamini. He could not provide any further details.

Hospital chief executive officer Sagie Pillay said on Sunday the hospital was investigating ways to beef up its security, especially where gunshot victims were being treated.

"We are looking to increase security in the wards. The thing we are going to do immediately is to install access-control gates in the trauma areas where people with gunshot wounds are admitted."

He also said a chief of security would be appointed from April to review security at the hospital.

"We are treating this as an isolated incident, and already have measures in place where cars and individuals are searched. It is difficult to pick these things up, and this is an issue of concern to us."

Pillay explained that there were 37 access points to the hospital and this made it difficult to control everyone who entered and left.

However, in an attempt to control the number of people entering the hospital, Pillay said, visiting hours would be enforced.

"We are going to stick to visiting hours very strictly. Up to now we have been relaxed about this. If families want to visit patients outside visiting hours, they will have to make special arrangements," he said.

Patients and their families would be notified of the new rule about visiting hours before the end of March.

"It is not designed to frustrate people. It's just that, the fewer people walking around after hours, the easier it will be to control security," Pillay added.

A nurse at the hospital, who did not wish to be named, said she had heard about the incident when she went to work on Friday morning.

She said that although this was the first such incident she had heard of, she wasn't surprised that it could happen.

"You can get inside the basement and get into the wards without anyone checking," she said.

Two patients, who also declined to be named, said they felt afraid after hearing about the shooting at the hospital.

"There is security here, but this is a big hospital and they must put in more security," said one.

By Nalisha Kalideen

Article Source & Reference: Independent Online (IOL) - Health News - http://www.iol.co.za/index.php?click_id=125&art_id=ct20020317213431230N420756&set_id=1, 2002/03/19

Value for Money Medicines - Consumers will benefit as a result of Medscheme’s latest initiative to bring more affordable medicines to the members of the schemes they administer.

All stakeholders in the healthcare industry are concerned about the fact that healthcare inflation is increasing at twice the rate of consumer inflation. It is making quality care unaffordable to the average family, and hurting employers who subsidise their employee’s medical aid premiums.

Blaming others does nothing to provide solutions, and it is unsatisfactory just to make medical aid members pay more as the money runs out.

It is a known fact that South Africans spend above 30% of their medical aid money on medicines, while the rest of the world spends around 12% to 15%. The cause of this is:

· Volume - some people may use unnecessary medication

· Price - we do not always use cost-effective (the best value for money) medicines.

The Medicine Control Council approves medicines based on scientific evidence of efficacy and safety. Pharmaceutical companies compete with each other to make many different medicines, often with the same chemical ingredients, which can be used to treat a particular illness.

However, there is no system in South Africa which currently ensures that the most cost-effective medicines are prescribed. Generic medicines comprise over 50% of all prescriptions in the USA, Canada & Europe, but only a quarter in SA.

So how do we get our cost of medicines down to international norms without compromising on quality?

· Reduce Volume - by cutting down on medical aids paying for medicines which are used inappropriately. This is being done throughUtilisation Review programmes, such as Medi-Serve, which authorize extended benefits for patients with ongoing illnesses.

· Reduce Price - by medical aids and consumers paying only the price at which value-for money medicines can be bought. 

How will the value-for-money system work?

1. On 1 April 2002, Medscheme will introduce a Medscheme Price List which will establish a cost-effective benchmark price for medicines offers the best value-for-money in that particular medicine class. This list will be transparently determined by a team of experts with no vested interest or profit motive, and updated regularly. This list will be available from the Medscheme web-site , www.medscheme.co.za , the middle of March 2002.

2. Where doctors prescribe the cost-effective medicines or one even cheaper, Medscheme-administered schemes will pay the full amount, and the cost will be covered in full, in accordance with scheme rules.

3. If the doctor chooses to prescribe a less cost-effective medicine, he should explain this to his patient, who will then pay the difference between the value-for-money price and the higher cost medicine.

4. An Exclusion list will also be published which will contain the names of those medicines that are considered not to add scientific and financial value to patients’ treatment options and that should thus not warrant any reimbursement from the medical aid.

It is important to note that no medical practitioner will be forced to prescribe in a different way. Should he wish to prescribe a medicine which is on the Exclusion list or not on the value-for-money list, he is entirely free to do so, but should just inform his patient of the cost implications. In the same way, Medscheme members will also no longer be forced to pay unnecessarily high prices, when a more cost-effective medicine exists, which does the same job. 

Our parliament has passed the Medicines Act (No. 90) which seeks to end the old system of non-transparent bonuses and kick-backs which everyone knew was wrong. Medical aids administered by Medscheme believe that the value-for-money concept is a concrete step towards implementing the spirit of this legislation. We now call on stakeholders to support this very practical step which is intended to make cost-effective quality medicines affordable for the majority of South Africans. 

· Patients can be assured of getting the most cost-effective medicines available, which will make their benefits stretch further, and help to keep premium increases down. Their support of value-for-money medicines will make the system work.

 · Doctors will be able to make input into updating the value-for-money lists. Where doctors help us reduce costs, the Medscheme Performance Based Reimbursement programme will reward them for cost-effective care.

 · Pharmaceutical Companies will be incentivised to price their medicines to fall within the Value-for-Money list. Their contribution towards making medical aid more affordable will result in greater support for those who market cost-effective medicines.

 · Medical Aids could expect to see medicine costs coming closer to international norms, and will be able to pass this benefit on to both high and low-claiming members through lower than average premium increases.

 · Brokers have been urging medical aids to do something concrete about bringing down medicine costs (and therefore premiums) for their members, while still delivering real benefits. 

At the end of the day, all stakeholders know that this system will benefit the consumer. It will mean a change in the way things might have been done in the past, but we all know that change is needed. It is no longer acceptable to medical aid members for them to bear the brunt of avoidable increases, and we call upon all parties to support this initiative and to provide input into improving things further as the year progresses.

Article Source & Reference: Board of Health Funders Website -Industry Links (Administrators) - Medscheme -  http://www.bhfglobal.com/benchmarket/links/index.html, 2002/03/18

The seminar, sponsored by provincial Health MEC Gwen Ramokgopa and attended by youths from 250 organisations, was held to discuss health problems facing the province's youth.

In a statement on Sunday, Ramokgopa's spokesperson Simon Zwane said the gathering followed the MEC's concern that despite the government's attempts to assist them, young people continued to be at a high risk of health problems, including sexual abuse, gender-based violence, accidents, unwanted pregnancies and sexually transmitted diseases such as Aids.

Zwane said that about four million South Africans, half that number adolescents and young adults, contract sexually transmitted diseases each year.

"Information from Gauteng clinics in 2000/01 indicates that men with urethral discharge (or drop) constitute 24.7 percent of people who consult clinics for the first time with a sexually transmitted disease," he said.

Teenage pregnancies also remained unacceptably high, with 35 percent of teenagers having been pregnant or given birth by the age of 19.

"The spread of HIV infection among the country's youth has also been daunting. The October 2000 national antenatal sero-prevalence survey showed that HIV prevalence among women in their twenties had increased significantly between 1991 and 2000."

Young people at the seminar identified dysfunctional families, lack of communication between parents and child, as well as peer pressure as factors fuelling problems such as gender-based violence and drug abuse.

Zwane said the findings would be discussed at a workshop to be held later this year to formulate appropriate youth-friendly policies.

Article Source & Reference: M-Web Health News - http://www.news24.co.za/News24/Health/Health_News/0,1113,2-14-660_1157967,00.html, 2002/03/18