Microsoft word - media review 13 aug.doc

13 Augustus / August 2007
In hierdie uitgawe / In this issue:
Fakulteit Gesondheidswetenskappe / Faculty of Health Sciences
Universiteit Stellenbosch / Stellenbosch University
Algemeen / General
Fakulteit Gesondheidswetenskappe /
Faculty of Health Sciences

Die Inetkey moet oop wees om dié lêers te kan oopmaak. / The Inetkey should be open for access to these files.
Lung Abscess

Talkina rural in Beaufort-West
Elektroniese Media / Electronic Media

Weekand AM
SAfm; 4 August 2008
New research conducted in SA has indicated that babies born with HIV have a 96 percent chance of survival if
they start ARV treatment immediately. The study was carried out by Professor Mark Cotton of Stellenbosch
University and Dr Avy Vialari of the University of the Witwatersrand, who comment.

Universiteit Stellenbosch / Stellenbosch University
Universiteite stik aan Pandor-teikens
DIE BURGER; 8 Augustus 2007
Algemeen / General
'Let HIV moms have abortions'
CAPE ARGUS; 9 August 2007
HIV-positive pregnant women should routinely be offered the choice of abortion in the context of the
serious challenge the pandemic presents to maternal health, says the Health Systems Trust. It has
responded with a submission after a Constitutional Court judgment which asked for increased public
participation in the Choice on Termination of Pregnancy Amendment Act. In response to the judgment,
provincial governments are set to hold a series of provincial hearings around the country this month.
The purpose of the act was to help the health system provide better access to high-quality termination
of pregnancy services, and research shows it has been "hugely successful" in achieving the objective.
"There has been a phenomenal 91% decrease in abortion-related maternal mortality and morbidity in
the last three years," according to Health Systems Trust chief executive Dr Lilian Dudley. However,
while the trust recognised the success, Dudley said, it wanted to emphasise the challenge to maternal
health presented by HIV/Aids. "In addition to measures to prevent perinatal transmission, and to offer
HIV-positive women high-quality antenatal and post-natal care, the option of voluntary abortion should
be offered as part of the continuum of care for HIV/Aids," she said.
Presently, these services were not integrated, and HIV-positive pregnant women were not offered the
choice to terminate unwanted pregnancies. "Care must be taken to see that women are afforded an
unreserved choice to terminate or continue their pregnancies," Dudley stressed. The trust's suggestion
is that the health system be transformed to "maintain and increase access" to safe abortion, and that
high-quality abortion services form part of integrated sexual and reproductive health services,
including HIV/Aids services.
It was also critical, Dudley said, that women were properly informed via community-based outreach, so
that they were aware of measures that would increase their access to safe legal abortion. By virtually
eliminating abortion-related death and illness, safe abortion had decreased a particular burden on the
health system in South Africa. "But HIV/Aids presents another challenge in terms of maternal health,"
Dudley warned.

Diabetes drug looks set to get clean bill of health
CAPE ARGUS; 6 August 2007
Di Caelers
Diabetes patients taking the drug Avandia, mired in controversy earlier this year over its alleged
threats to heart health, can rest easy as it looks set to get a clean bill of health from the US Food and
Drug Administration (FDA). The recommendation from the FDA's advisory committee, to support
Avandia's continued availability to patients in the US, was "nearly unanimous", manufacturers
GlaxoSmith-Kline (GSK) have said.
In May the Cape Argus reported that diabetes patients taking the drug had been advised by the
European Medicines Agency not to stop their treatment. At issue was the cardiac safety of
rosiglitazone, sold under the brand names Avandia, Avandamet and Avaglim, after the New England
Journal of Medicine raised concerns about increased risk of heart attack and death in Type 2 diabetes
patients taking the drug. The journal article, based on an analysis of data from 42 clinical studies,
showed a small increased risk for heart attack and death among about 15 500 patients treated with
rosiglitazone. But death from all causes had not increased significantly.
At the time the European Medicines Agency said that when the drug was first authorised in the
European Union, in 2000, it was stipulated not for use in patients with a history of heart disease.
The agency said its committee had already assessed most of the studies in the journal paper and in
September last year had updated product information about the heart health risks. Now GSK has
welcomed the FDA recommendation in favour of rosiglitazone and said it would continue providing
information to the body to help it reach a final decision. On July 30, the FDA Endocrinologic and
Metabolic Drugs Advisory Committee, and the Drug Safety and Risk Management Advisory
Committee, voted to keep the medicine available to US patients. The FDA will make the final decision.

Nurses as competent as doctors in abortions, says study
CAPE ARGUS; 6 August 2007
Di Caelers
New evidence on safe abortions from a University of Cape Town team, which shows nurses to be as
competent as doctors, will give the World Health Organisation (WHO) a tool to influence global policy.
The evidence that trained nurses perform abortions as safely as doctors, but at a much lower cost,
emerged from a WHO-commissioned study by UCT's Women's Health Research Unit and the National
Hospital of Obstetrics and Gynaecology in Vietnam.
Reported this week in the UCT publication Monday Paper, the study is an attempt by the WHO to
assure women greater access to trained healthcare providers. Estimates are that unsafe abortions
account for as many as 68 000 deaths and nearly 5 million permanent or temporary disabilities a year,
the majority in developing countries.
The researchers' paper, published in the British medical journal The Lancet in December, was named
as runner-up for the Society of Medical Writers 2006 Academic Writing Award. The Monday Paper
reported that South Africa and Vietnam were exceptions to the norm in most countries with legalised
abortion, where only doctors were allowed to conduct the procedure. South Africa allows qualified
nurses to perform abortions in the early first trimester of pregnancy and in Vietnam it can be performed
by doctor's assistants.

Victory for cheap generic medicine
CAPE ARGUS; 8 August 2007
Di Caelers
Pharmaceutical giant Novartis has lost its court challenge against the Indian government, a decision
that effectively secures the production of cheap generic treatments for HIV and Aids, used routinely in
South Africa. The case hit the headlines earlier this year with Archbishop Emeritus Desmond Tutu
backing an international call for Novartis to drop its court challenge, an attempt to force India to curtail
the production of cheap generic drugs.
Predictions were that an outcome in favour of Novartis would impact severely on HIV/Aids treatment
across the developing world, where more than half the people on ARVs are taking Indian drugs.
The landmark decision by the High Court in Chennai this week to uphold India's Patents Act in the
face of the Novartis challenge has been hailed as a major victory for access to affordable medicines
by patients in developing countries.
The battle was backed by international medical humanitarian organisation Medecins Sans Frontieres.
The director of the group's Campaign for Access to Essential Medicines, Dr Tido von Schoen-Angerer,
said the outcome was a huge relief for millions of patients and doctors in developing countries "who
depend on affordable medicines from India".
The court's decision, he said, made the possibility of Indian patents "on the medicines that we
desperately need" less likely. "We call upon multinational drug companies and wealthy countries to
leave the Indian Patents Act alone, and stop pushing for ever stricter patent regimes in developing
countries," Von Schoen-Angerer said.
Earlier this year Dr Eric Goemaere, head of MSF in South Africa, said that if Novartis won the case,
"we won't have alternatives to brand drugs coming from India, and drug prices will inevitably go up".
At issue for Novartis was the refusal of permission for a patent for a cancer medicine, Gleevec, on the
grounds that it was a new form of an old medicine, and thus not eligible for patent under Indian law.
Novartis then challenged the actual law, India's 2005 Patents Act.
In other countries where Novartis has a patent for Gleevec, the medication is sold at $2 600 a patient
per month. In India, generic versions are sold for less than $200 per patient per month. India only
began giving patents on medicines to comply with World Trade Organisation rules, but it designed its
law with safeguards so patents could be granted only for real innovations. This means that companies
seeking a patent for modifications to a molecule already invented, in order to extend even further their
monopolies on existing drugs, would be unsuccessful in India.
It is this aspect of the law that Novartis was seeking to have removed, and a ruling in its favour would
have drastically restricted the production of affordable medicines in India crucial to the treatment of
diseases throughout the developing world. Developing country governments and international
agencies like Unicef and the Clinton Foundation rely heavily on importing affordable drugs from India,
and 84% of ARVS that MSF prescribes to its patients worldwide come from Indian generic companies.
MSF said it was crucial that India be allowed to remain "the pharmacy of the developing world".

Action over botched eye implants involving 125 South Africans to be heard in
CAPE TIMES; 7 August 2007
Alex Eliseev
JOHANNESBURG: A British attorney representing 125 South Africans who had faulty lenses
surgically inserted into their eyes is flying to the United States to negotiate a multimillion-rand out-of-
court settlement. If the talks fail, a mega trial is set to begin in the Superior Court of California later
this year on behalf of at least 171 victims from South Africa, Britain and Saudi Arabia. Duncan
Stackhouse was scheduled to fly to California today ahead of tomorrow's negotiation. "There are no
guarantees," he said. "Hopefully the negotiations will be successful."
In 2005, a US company exported batches of lenses which, during shipping, fused chemically with their
silicone packaging. This resulted in defective lenses being inserted into the eyes of patients seeking a
cure for cataracts. The victims suffered great damage to their eyes. Pretoria pensioner Alex Garisch
lost sight in one eye.
Court papers have been filed in California against manufacturers Ophthalmic Innovations International
and packaging company Quadra. The SA victims in the legal action won't have to travel to the US or
pay any legal fees. If the case is successful, the lawyers will claim their stake from the amounts
awarded to individuals. Stackhouse said up to 900 sets of lenses were imported into Britain, 350 into
Saudi Arabia and hundreds more into Brazil and India. South Africa received 400 sets, of which up to
300 may have been faulty. Stackhouse claimed the manufacturers knew the lenses were faulty in
1999 and did not obtain approval to distribute them in the US - instead, they "dumped them on the rest
of the world" in 2000.
The relatively small number of UK citizens involved in the legal action is because they could go for
free corrective surgery whereas their SA counterparts had to fork out thousands of rand for their
corrective procedures. The lenses were used to substitute the eye's natural lenses where cataracts
had clouded them over. Stackhouse explained that a retired appeals judge will preside over
tomorrow's mediation session. If the case lands up in court a jury will hear the case and, if they rule in
favour of the victims, will decide on compensation. Each victim could claim between R1 million and
R3m in damages.
Surgeons in affected countries also had no way of telling the lenses were faulty - in fact many thought
they were an excellent product. Pretoria pensioner Garisch went partially blind after a botched
operation in 2000. He lost sight in one eye and refused further surgery as he was frightened of losing
his second eye. Garisch died last year, Stackhouse said.
Veronica Clark was another victim who could no longer rely on her craft-making for a living after her
eyesight was damaged. In Britain, a public hazard alert was issued in 2004 after about 260 sets of
lenses were surgically removed. Locally, the Medicines Control Council ordered a recall of the

Eye doctors replace faulty lenses across SA
Aquasense was not approved by the FDA
CAPE ARGUS; 11 August 2007
Eye specialists across the country have performed corrective surgery on hundreds of elderly patients
after faulty lenses provided by an American-based company were implanted in their eyes. Last week
British attorney Duncan Stackhouse travelled to the United States to negotiate an out-of-court
settlement on behalf of 171 victims from South Africa, Britain and Saudi Arabia. It is believed that 125
of these victims are South Africans. The lenses were also exported to Brazil and India.
The lenses, called Aquasense, were made by Ophthalmic Innovations, and packaged by Quadra.
Reports indicated that the lenses, used for patients with cataracts, fused chemically with their silicone
packaging during shipment. Court papers have been filed against both companies in California.
Weekend Argus spoke to a Cape Town-based doctor who implanted the Aquasense lenses.
The doctor, who asked not to be named, later performed corrective surgery on 40 patients to remove
the faulty Aquasense lenses. He described the corrective surgery as "technically difficult and
challenging". "In terms of a normal cataract operation, the cloudy content of the lens capsule, which is
behind the pupil, is removed. "An artificial lens, which is very like a soft contact lens, is then implanted
in the lens capsule. You use the same procedure to remove the implanted lens, and implant a different
artificial lens."
Medical journals describe the complication that resulted from the use of faulty lenses as opacification
of the lenses, which meant they can no longer be seen through. The doctor said the US company,
Ophthalmic Innovations International, was not the only one which had manufactured the defective
lenses. "There were four lenses, from different manufacturers, which had complications, including
hazy eye-sight, with a result much like a cataract. But if we do not use new products, medical
technology will not advance.
"One of the companies with these lenses was Bausch and Lomb, and we still use their lenses today."
The Journal of Cataract and Refractive Surgery says Bausch and Lomb's Hydroview lenses, Mentor
Opthalmics' MemoryLens and MDR's SC60B-OUV lenses, also resulted in opacification. The Cape
Town doctor said the class action was under way because the Aquasense lenses had allegedly not
been approved by the Food and Drug Administration in America. The FDA regulates and approves
food and medicines.
"The other companies involved at the time took responsibility for the defective lenses. We as doctors
also rely on the manufacturers to get the lenses approved. "This American company apparently knew
it had not been approved, and then still made it available to other parts of the world." He said many of
his patients were not interested in taking action against the company. "My patients are elderly people.
When there were complications with the lenses, all they wanted to do was get new lenses. They just
wanted to move on with their lives."
Although there were media reports of patients who had lost their eyesight, or whose vision was
permanently impaired, the doctor said none of his patients had had such serious consequences.
He conceded some of his patients could have gone for corrective surgery elsewhere. However,
according to the doctor, a Gauteng-based doctor performed "hundreds of operations" with the
Aquasense lenses. "They were not as commonly used in Cape Town as they were in Johannesburg."

New-generation ARVs could cost 500% more, says health minister
CAPE TIMES; 8 August 2007
DURBAN: New-generation anti-retroviral drugs (ARVs) could cost 500% more than those now being
dispensed by the Health Department, Health Minister Manto Tshabalala-Msimang said yesterday.
Speaking at the opening of the Women in Partnership Against Aids, Tshabalala-Msimang said: "The
reduction of prices of medicines is a critical concern. "Of concern is that new- generation ARVs may
cost 500% more." Tshabalala did not elaborate on the increases, but said 76% of health districts were
now distributing ARVs.
She said the government was promoting research into traditional medicine "and how it can help in the
fight against Aids". "We believe traditional medicines can have an important role." Almost 300 000
people will be on the government's antiretroviral programme by the end of 2007, but the minister
cautioned that the government could not control how people behaved in taking medicines or their
"risky behaviour". "It remains the responsibility of people to modify risky behaviour. Government
cannot do this for people."
She urged parents to be more involved with the attitudes of their children, and welcomed a recent
report that showed the HIV prevalence rate in the 15-to-24-year-old age groups had shown a slight
drop. Citing the recently released Report on National HIV and Syphilis Prevalence Survey, she said
the infection rate had dropped from 15.9% in 2005 to 13.7% in 2006. The 20-to-24-year-old age group
had shown a decrease from 30.6% to 28%.
"This finding suggests a sustained change in attitudes. We still need to strengthen our programmes,"
she said, adding that increases in the 30-to-39-year-old age group was "a cause for concern". She
said the department was discussing with the Treasury an increased budget for the distribution of
condoms. More than 380 million condoms were being distributed annually, including femidoms.
She pointed out that condoms cost 22 cents each while femidoms cost the state R8 each. – Sapa


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