antibiotics

South Africa needs to urgently look to countries such as Rwanda, Thailand and Brazil, where they have employed community health workers (CHWs) to deliver a range of primary health care services that dramatically reduced mortality, public health expert Professor David Sanders told the National Health Assembly (NHA).

 

Speaking during yesterday’s (THURS) plenary session, Sanders said by extending the scope of what CHWs could do and by supporting properly selected and trained individuals, the country could make a very real impact on maternal and child mortality.

ANTIBIOTIC resistant "superbugs" in SA’s hospitals are likely to make headlines in the coming years as the world faces the threat of an end to potent and cost-effective treatments for many infectious diseases.

In recent weeks, 10 patients have tested positive for a "superbug" called New Delhi metallo-beta-lactamase (NDM-1) at Life Glynnwood Hospital in Benoni. NDM-1 ultimately contributed to four deaths.

NDM-1 is an antibiotic-resistant enzyme produced by a bacterium. It causes those being treated with underlying conditions to become ill.

Health Minister Aaron Motsoaledi has announced several new measures aimed at the improving health services in the country.

Addressing the media on the sidelines of a National Health Council (NHC) meeting on Thursday, the minister announced an 18% aggregate reduction in the cost of anti-TB medication and antibiotics, which translated to a saving of R242 million.

This was part of government's continued efforts to reduce the cost of healthcare, he said.

Motsoaledi announced the appointment of District Clinical Specialist Teams as part of the department's efforts to "re-engineer the primary health care system."

Scientists have sounded the alarm over Tuberculosis superbugs stalking communities across the Western Cape that could wreak health havoc throughout South Africa. One variant, called DRF150, is resistant to almost all the front-line antibiotics used to treat drug-resistant TB, which means hundreds of thousands of rands may be needed to bring the mini-epidemic under control. The new strain has its epicentre in George, where 60 patients are affected, but another 20 cases or so have also been found in Worcester, Villiersdorp and the northern areas of Cape Town. A few cases have been isolated in Mpumalanga and in Nairobi, Kenya. It poses a serious threat for both local and national health authorities, according to Professor Tommie Victor, the specialist who identified it. The Victor team's findings have been published in the European International Journal of Tubercle and Lung Disease, and have been accepted for publication in the Journal of Clinical Microbiology in the United States. According to the study findings, which analysed data from 72 clinics in the Boland, Overberg and Karoo regions, more than 60 percent of drug-resistant TB is being transmitted from person to person. Until now, usually drug-resistant TB occurred in people who did not take their TB medication regularly. Pointing to the astronomical expense of treating drug-resistant TB, Victor said treating ordinary TB cost about R200 per patient for a six-month course. In the case of drug-resistant TB, that spiralled to between R25 000 and R30 000, and the treatment period required was tripled to 18 months. The Stellenbosch group has come up with a new method of identifying drug-resistant TB in 12 days, much shorter than the usual two months of testing required - a delay which Victor said could be partly to blame for its spread.(Source: Di Caelers, Cape Argus, November 12 2003) Links\//\ 'Super' tuberculosis strain discovered in SA http://www.mg.co.za/Content/l3.asp?ao=23661 Global Plan to Stop TB http://www.stoptb.org/GPSTB/default.asp This document describes the action and resources needed over the next five years to expand, adapt, and improve DOTS - meeting the 2005 global targets and setting the world on the road to the elimination of TB. Prepared over the last two years by a team from Partners in Health and the Stop TB Partnership secretariat, with funding from the Open Society Institute, the Global Plan incorporates contributions from over 150 experts in TB control, public health and development around the world, and has the backing of WHO, the World Bank and many other agencies involved in the Global Partnership to Stop TB.

Africa's AIDS drugs trapped in the laboratory -Kenya has the pills. Now the fight is on to get them to the people. There is no lock on the door, no phalanx of guards, no visible impediment to the drugs leaving the glass chamber that the laboratory technicians call a stability room. The pills come in little white boxes with labels such as lamivudine, zidovudine and efavirenz, technical names disguising the fact that these tablets are the stuff of life. Take them together and if you have HIV you can stave off death for years. Millions in Africa have the virus but not the pills. A stone's throw from the laboratory AIDS is wiping out communities, yet these pills cannot leave the stability room. This is Nairobi, the factory is Kenyan, and a web of influence spun by the world's pharmaceutical giants encloses its labs, ensuring the AIDS drugs stay inside. For Africa, getting them out would be a milestone in controlling the pandemic. Two things are happening which could untangle the web. Activists are preparing a legal challenge to allow Kenya to make and import generic AIDS drugs. And Nairobi's factories are boosting their capacity to make their own cheap drugs in expectation of that court victory. For decades, African companies have produced generic copies of antibiotics and other drugs, paying royalties to those western companies which developed and patented the formulas. Prices tumbled, making them affordable to the poor. But that has not happened with AIDS. The western companies, fearing for profits and market share, have refused permission for generic copies of drugs known as anti-retrovirals (ARVs). But in the labs of Nairobi manufacturers such as Cosmos they sense change coming. Following World Health Organisation guidelines, they have successfully copied branded AIDS drugs, registered them with health authorities, printed labels for the boxes and stored them in the stability room. Under international patent law, there they must stay unless the makers obtain a licence. There is nothing preventing mass producing. We have the expertise, access to raw materials, the registration, said Prakash Patel, Cosmos's chairman and managing director. By the end of the year we will be producing. I think we will be the first to produce ARVs in Africa. Dr Patel's boast reflects swelling confidence that the multinationals will not block African generics. Another Nairobi firm, Laboratory & Allied, also said it could switch to ARVs within weeks. That optimism stems from a series of victories in recent years which asserted the right of countries facing public health emergencies in the developing world to override intellectual property rights by issuing what is called a compulsory licence to make or import generic drugs. Countries such as Britain issue compulsory licences occasionally, giving> the NHS cheaper drugs, but African states have hesitated: the drug giants have friends in Washington and other capitals who can withdraw investment and trade concessions from uppity African states. But such a threat has now receded. The World Trade Organisation's Doha declaration said that developing-world countries could make or import generics. Even President Bush wants cheaper drugs for Africa. Yet the drugs industry is fighting back, by cutting prices of branded drugs, warning health ministers that national treatment programmes would bankrupt their budgets, and depicting generics as unsafe. John Musunga, commercial director of GlaxoSmithKline's Nairobi office said , the firm had no plan to stop generics, yet pinned on his wall was a strategy apparently advocating the promotion of doubt of generics. Mr Musunga also rejected claims that the industry exerted improper influence over the Kenyan government. Two years ago, an amendment protecting patents was slipped into Kenyan legislation. After an outcry it was removed. The Guardian has obtained a letter from Kaplan & Stratton, a Nairobi legal firm, to the Kenya industrial property office, requesting an amendment for an unnamed client. But the momentum towards African generics is growing. The Consumer Project on Technology (CPTech), a not-for-profit group started by the radical American campaigner Ralph Nader, is coaching groups in South Africa, Ghana, Uganda and Kenya to mount legal bids for compulsory licences. The plan is to reassure African governments that the international climate has changed. The prize is not just lower prices, but more sustainable supplies suited to Africa, such as all-in-one pills. Kenya seems to be moving fastest, with some government officials enthusiastically backing the initiative. The first case you get in Africa is going to have a huge effect on other African countries. If it's a positive decision they'll look to that, it'll have a domino effect, said James Love, of CPTech. We should succeed in Kenya. It would be a crime against patients if we don't succeed. In Nairobi's biggest slum, Kibera, they are waiting. Médecins Sans Frontières has identified candidates for ARVs, people such as Kevin Wanjala, 11, who was born with HIV and has been chronically sick. Shy and small for his age, he was at the top of his class in his favourite subject, English, before dropping out due to illness. When I grow up I'd like to be a car mechanic, he says. Kevin is nearing AIDS, said Florence Olanya, an MSF nurse. Without drugs he is unlikely to last two years. ( Source: The Guardian 21 May 2003). Source:http://www.guardian.co.uk/international/story/0,3604,960106,00.html