Public Health in the News

This year, the National Institute for Communicable Diseases (NICD) has issued reports on three outbreaks of vaccine-preventable diseases — measles, mumps and diphtheria. The current measles outbreak started late in 2022. On 19 June 2023, the total number of measles cases detected was 1,067 across the eight provinces.

People living with HIV can safely use immune checkpoint inhibitors to treat cancer, and they appear to benefit as much as HIV-negative people, according to a study published in the Journal of Clinical Oncology. In this retrospective analysis, which included 390 people with HIV, about 20% experienced immune-related adverse events, similar to the rate for people without HIV. In a matched cohort of people with non-small-cell lung cancer – the most common malignancy – overall survival was similar for HIV-positive and HIV-negative people. “This study should give some level of confidence to clinicians who are treating patients living with HIV and cancer,” lead study author Dr Abdul Rafeh Naqash of the University of Oklahoma’s Stephenson Cancer Center said in a press release. “This study is also important because it represents the real-world population that we would see in the clinic. It provides a level of assurance that immune checkpoint inhibitors are broadly safe for people with HIV and have the potential to effectively treat several types of solid tumour cancers.”

South Africa is sharpening up its HIV prevention efforts by focusing on pregnant and breastfeeding women, children and adolescents as part of the Global Alliance to End AIDS in Children by 2030. This is according to the Health Minister, Dr Joe Phaahla, who delivered a keynote address on behalf of Deputy President Paul Mashatile at the 11th South African AIDS Conference in Durban. The new Global Alliance for Ending AIDS in Children by 2030, made up of United Nations (UN) agencies, civil society groups, governments and international partners, was announced at the International AIDS Conference, in Canada, last year.

Amid the festivities during the opening ceremony of the 11th SA Aids Conference in Durban on Tuesday, there were also several sobering moments. Chief among these was when co-chair of the South African National Aids Council and chair of the Civil Society Forum, Steve Letsike – flanked by several representatives of civil society – told a fully packed plenary hall at the Durban International Convention Centre about a visit earlier on Tuesday to the Hillcrest Aids Trust Centre – a hospice where 80% of the admitted people (living with HIV) are in their end stage of life.

Human papillomavirus (HPV) is a common sexually transmitted infection that can cause various types of cancer in both men and women. HPV is transmitted through skin-to-skin contact during sexual activity, and most people who contract the virus do not experience any symptoms. However, in some cases, HPV can lead to the development of genital warts and cancer.

The World Health Organization and UNFPA, the United Nations sexual and reproductive health agency, today warned that the continuing attacks on healthcare facilities, equipment and workers  in Sudan are depriving women and girls of life-saving healthcare, with pregnant women hardest hit. Some 67% of hospitals in areas affected by fighting are closed, and several maternity hospitals are out of action, including Omdurman Hospital, the largest referral hospital in Sudan. Among the 11 million people in Sudan who need urgent health assistance are 2.64 million women and girls of reproductive age. Some 262 880 of them are pregnant and over 90 000 will give birth in the next three months. All of them need access to critical reproductive health services.

South African National Aids Council (Sanac) civil society forum spokesperson Nelson Dlamini has called for youth friendly health care services at a march in Durban, ahead of the South African Aids Conference. Dlamini says the highest number of new HIV infections are among girls and young women between the ages of 15 and 24. He says KwaZulu-Natal records over 1300 new HIV infections per week in this age group, with young people from underprivileged communities being the hardest hit.

It is estimated that around 4.6 million adults in South Africa have diabetes, which accounts for approximately 8.5% of the adult population, while one in three (13 million) adults in South Africa are classed as being at high risk of developing type 2 diabetes.

The Ministry of Health has launched the use of vaginal rings among women in an effort to stop the spread of new HIV infections. Speaking at the launch of the Catalyst Study Program in Kisumu on Monday, Health Director General Patrick Amoth said teenage girls and young women account for almost a third of all new infections and Kenya needs to adapt local technologies to aid in HIV prevention. The Catalyst Study Program, titled "Catalyzing access to new prevention products to stop HIV," focuses primarily on adolescent girls and young women in order to limit the spread of the HIV/AIDS epidemic.

The winter months are synonymous with the flu in South Africa. Similar to other countries in the southern hemisphere, South Africa has an annual influenza season stretching from April to August. Influenza (flu) is an acute respiratory illness caused by an infection of the respiratory tract with the influenza virus. Influenza is spread through respiratory droplets which you breathe in or can pick up from contaminated surfaces. People infected with the influenza virus show a wide range of symptoms such as sudden onset of fever, muscle pains and body aches, cough, sore throat, blocked or runny nose and headache.

Opening address by Health Minister, Dr Joe Phaahla on behalf of H.E. Shipokosa Paulus Mashatile, Deputy President of the Republic of South Africa and Chairperson of the South African National AIDS Council, during the opening ceremony of the 11th South African AIDS Conference, Inkosi Albert Luthuli International Convention Centre, Durban; 20 June 2023.

The SA Medical Association (SAMA) says fake doctors prey on members of the public who can’t afford healthcare. The HPCSA Inspectorate recently revealed 124 bogus doctors were arrested in the past three years. Established in 2014, the inspectorate started working closely with police to arrest fake doctors in 2020.

The Limpopo health department has advised its residents to take precautions amid a malaria outbreak that has claimed the lives of two people in the province. In a statement, the department said there were 1,423 cases over the past two weeks. This, the department said, was relatively high. In the 2022/2023 financial year, there were 1,745 cases.

The mumps outbreak is affecting schooling in Botshabelo in the Free State, with at least 100 children testing positive. The Limpopo Health Department is urging parents to monitor symptoms. “Symptoms include headache, fever, malaise and loss of appetite. The glands near the ears swell resulting in puffy cheeks and swollen jaw. It causes severe pain. Such swelling usually lasts 2-3 days. We call on parents to seek medical attention if they notice these symptoms,” says department spokesperson Mondli Mvambi.

Scientists have found that a plastic sheet with a funnel-like pouch attached to the bottom edge can, along with a few other steps, cut life-threatening bleeding after vaginal births in hospitals by 60%. This is according to a study presented at the International Maternal Newborn Health Conference held in Cape Town last week. The research was also published in the New England Medical Journal. The piece of plastic, which researchers call a “drape”, is slid in underneath the patient and tied around her waist after she’s given birth. It collects blood in a pouch that hangs off the bottom end of the hospital bed — and it costs less than R30.

US regulators have approved a first-of-its-kind drug to treat hot flushes — a symptom that affects as many as 80% of people going through menopause — by targeting the neural pathways that give rise to them. The approval of fezolinetant (Veozah), announced on 12 May by the US Food and Drug Administration (FDA), provides a way to treat hot flushes without relying on hormone therapy. “A lot of us who work in women’s health are really excited,” says JoAnn Pinkerton, a gynaecologist at the University of Virginia Health System in Charlottesville. “Breakthroughs in women’s health are so uncommon.”

About one in 20 new type, 1 and type 2 diabetes cases could be linked to a previous or an ongoing Covid infection, according to a new study. Overall, people who had tested positive for Covid-19 were 17 per cent more likely to develop diabetes within 12 months of a coronavirus infection.

Ghana has taken a remarkable step in the fight against malaria by becoming the first country in the world to approve the R21/Matrix-M vaccine. It’s poised to be highly effective in young children from 5 months to 36 months, the age group with the highest risk. The approval highlights the continued urgency required to combat this disease, which remains a significant threat to human health and a considerable social and economic burden. Low- and middle-income countries like Ghana record hundreds of thousands of malaria deaths each year. According to the World Health Organization, roughly 619,000 people globally died from malaria in 2021, 96% of them from vulnerable populations in Africa, where the disease is both endemic and perennial.

The nursing profession has taken centre stage as the world commemorates International Nurses Day. The day is commemorated on the birthday of Florence Nightingale who is the founder of modern-day nursing. Health Systems Trust CEO, Dr Themba Moeti joins us for more.

Mumps is an acute viral infection caused by the rubulavirus, also known as mumps virus. It is sometimes called ‘infectious parotitis’, as it causes painful swelling of the parotid and or salivary glands. Mumps is generally a mild childhood disease, mostly affecting children between 5-9 years of age. However, younger and older children as well as adults, can become infected with mumps. People who have had mumps are usually protected for life against another mumps infection. However, second occurrences of mumps do rarely occur.

Popular and academic literature is replete with examples of how to cope with daily stresses. Mental health professions have also long researched and implemented strategies to deal with burnout from workplace stressors.

Researchers have found that digital breast tomosynthesis (DBT) has improved breast cancer screening performance in community practice and identifies more invasive cancers, compared to digital mammography. In addition, radiologists' interpretive performance improved with DBT. The results of the study were published today in Radiology, a journal of the Radiological Society of North America (RSNA). "Our study demonstrated that more radiologists in U.S. community practice are meeting recommended performance standards with digital breast tomosynthesis than they did with digital mammography," said lead author Christoph I. Lee, M.D., professor of radiology at the University of Washington (UW) School of Medicine in Seattle, director of the Northwest Screening and Cancer Outcomes Research Enterprise at UW, and adjunct professor of health systems and population health at the UW School of Public Health. "This is good news for women and breast cancer screening, as digital breast tomosynthesis has quickly become the most popular breast cancer screening modality in the U.S."

A recent clinical study suggests that a "morning after" antibiotic could diminish the risk of common STIs for high-risk individuals. Taking the antibiotic, called doxycycline, within 72 hours of having unprotected intercourse could lower the risk of three common STIs — gonorrhea, chlamydia, and syphilis — by two-thirds among high-risk people, including gay and bisexual men and transgender women who were diagnosed with HIV or are on medication to prevent HIV.

In 2020 the World Health Organization introduced a plan to eliminate cervical cancer as a public health threat by 2030. The first step towards this goal is to have 90% of girls fully vaccinated against human papillomavirus (HPV) by the age of 15 years. Gynaecological oncologist Lynette Denny spells out how much progress still needs to be made, and what hurdles need to be overcome. Cervical cancer is one of the most common cancers in women. Sub-Saharan Africa has the highest cervical cancer diagnoses worldwide. Cervical cancer mortality rates in the region are three times higher than the global average. The burden of HIV in sub-Saharan Africa contributes to the disparity. In 2021, in southern Africa, 63.8% of women with cervical cancer were living with HIV, as were 27.4% of women in eastern Africa.

Adolescent girls and teenage mothers residing in Kampala's Katwe slum have been empowered with knowledge on sexual reproductive health and rights and how to prevent themselves from contracting sexually transmitted infections (STIs)

A new article in the Journal of the International AIDS Society highlights the urgent need for a clear strategy to prevent and treat advanced HIV disease in children and teens. Many children and teens living with HIV still present with severe immunosuppression. They do not start antiretroviral therapy (ART) until they are hospitalized—when it is often too late. The major causes of morbidity and mortality in children living with advanced HIV are pneumonia, tuberculosis, bloodstream infections, diarrhea, and severe acute malnutrition. This article discusses the common clinical presentations of children and teens with advanced HIV disease with a focus on diagnosis, prevention, and treatment. The article also highlights some of the challenges implementing the existing package of care and emphasizes the the need for further research to provide quality care for these groups.

Hundreds of HIV prevention advocates nationwide convened on Tuesday to discuss the implications of Judge Reed O’Connor’s ruling in the Texas Braidwood v. Becerra case that could impact access to PrEP and other preventive health interventions for millions of Americans. The ruling states private insurers are no longer required to cover certain preventive care services under the Affordable Care Act, including PrEP. Advocates called on public and private insurers to maintain coverage to prevent HIV and other conditions no matter the ultimate outcome of the case. Experts from Lambda Legal, the Center for HIV Law and Policy, and the Center for Health Law and Policy Innovation provided preliminary analyses and shared their thoughts on strategies moving forward, including steps in the appeal process. Attendees vowed to take action to raise awareness of this threat to PrEP access, connect with other affected healthcare communities, and get organized for what will likely be a prolonged process to try and undermine preventive health services.

The South African Health Products Regulatory Authority (SAHPRA) has made the decision to withdraw pholcodine-containing medicines from the South African (SA) market due to the increased risk of sudden, severe, and life-threatening allergic reactions occurring during surgery. There is a link between the use of pholcodine-containing medicines and the risk of a sudden, severe, and life-threatening allergic (anaphylactic) reaction when neuromuscular blocking agents (NMBAs) are administered during general anaesthesia. NMBAs are used as muscle relaxants during surgery. The use of pholcodine-containing medicines, up to 12 months prior to surgery, increases the risk of anaphylactic reaction in patients who receive NMBAs.

Three cases of HIV being cured have been reported to date. All three involved men with HIV and either leukemia or lymphoma. The men received transplants of stem cells from adult donors to treat their cancers. The stem cell donors all carried two copies of a mutation, CCR5-delta32, that confers resistance to HIV. CCR5 is a receptor that HIV uses to infect cells. But very few people carry two copies of CCR5-delta32, limiting the chances of finding a compatible donor, particularly for non-White patients. A team led by Drs. Jingmei Hsu at Weill Cornell Medicine, Yvonne Bryson of the University of California, Los Angeles, and Deborah Persaud of the Johns Hopkins University School of Medicine used a modified approach to try to cure HIV.

Deputy President Paul Mashatile, in his capacity as Chairperson of the South African National AIDS Council (SANAC), will on Friday, 24 March 2023, lead the official commemoration of World TB Day and Launch of the National Strategic Plan for HIV, TB and STIs for 2023-2028 in Rustenburg, Tlhabane Stadium, in the North West Province. Given that TB remains one of the leading causes of ill health and death in South Africa, and the challenges of TB patients not completing their treatment as well as the Missing TB Patients, the World TB Day commemoration was designated for March 24 every year to create awareness about the health, social and economic impact of TB locally and around the globe. South Africa remains among the nations hardest hit by TB. This year’s theme for World TB Day is ‘Yes! You and I Can End TB’, and it is clarion call to encourage all South Africans to contribute to the national effort against TB.

Nontsikelelo Zwedala, an activist at the forefront of the Treatment Action Campaign (TAC) protests in the early 2000s, died this month at the age of 52. We asked Zackie Achmat, TAC leader at the time that Nontsikelelo was active in the organisation, to write an obituary for her. Our soft Ntsiki, with a will of steel, is no more. I started writing these words last year as a historical tribute to Nontsikelelo Zwedala and Christopher Moraka as part of a paper on TAC’s campaign for the antifungal medicine fluconazole. Nontsikelelo was still alive.

While there are currently a dozen approved AI systems for breast cancer screening, it has been difficult to evaluate their clinical performance objectively. Now, however, there is a Swedish validation platform ready to compare how well AI systems detect signs of breast cancer—and its development has been led by researchers at Karolinska Institutet. The pilot project started in 2021 and the platform was ready for trial last year. So far it has been used to start the evaluation of three different companies' algorithms based on about 40,000 mammograms from three Swedish regions.

Ladies, let’s talk about sex – specifically, how to make it safe and fun with the help of internal condoms! If you’re looking for a reliable and exciting form of contraception, look no further than the trustworthy female condom. It’s high time we ditch the stereotype that only men buy or wear condoms. Women should take charge of ensuring that they are safe from unwanted pregnancy or STDs during sexual activity. In this article, you will find ways to use internal condoms like a pro, so you can focus on pleasure without any worries.

As public health facilities were rocked by a violent strike over the past two weeks, patients were in crisis. With only skeleton staff attending, there were not enough hands to look after the country’s most vulnerable. But then South Africans stepped up.

Generally, deaths generate more news, but wellness a little. Ditto same with HIV/AIDS, that has changed its status from a ghastly deadly disease during the 1990s to a chronic manageable condition now that can be considered better than diabetes. This journey wasn’t easy for India that had topped globally in HIV/AIDS cases in 1996.Since then we have come a long way. Though the research in finding anti-retroviral therapy (ART) was done elsewhere, India realised the dreams of millions of people living with HIV (PLHIV) globally by making the fruits of such developments affordable and assessable. Today we are poised to set another dream and that is #endAIDS. That isn’t an easy goal either with the challenges around, fortified with collateral damages due to the protracted Covid pandemic.

Anal cancer diagnoses in men in the United States aged 50 and over rose over a decade and states with a higher frequency of AIDS diagnoses tended to have a higher frequency of anal cancer diagnoses too, a national study of anal cancer mortality published in the Journal of Clinical Oncology reports. The study authors suggest that structural inequalities leading to late HIV diagnosis, poor access to care and a diagnosis of AIDS contribute to a higher risk of anal cancer in some parts of the United States for men. In women, anal cancer rates were strongly correlated with smoking prevalence but not with AIDS. Alarmingly, anal cancer in women aged 50 and over had become almost as common as cervical cancer in some states in the midwest and south-east of the United States by 2014-2018.

Four days into the wage strike by health workers has resulted in four lives being lost according to Phaahla. A number of protesting workers have been shot with rubber bullets and the devastation has no end in sight as the National Education, Health and Allied Workers Union has vowed to intensify industrial action.

The theme for International Women’s Day 2023 is DigitALL: Innovation and technology for gender equality. Multiple and intersecting forms of discrimination against women and girls, rooted in gender inequality, harm their health and well-being. Women and girls in many parts of the world face the risks of unintended pregnancies, sexually transmitted infections including HIV and cervical cancer, malnutrition, depression, and respiratory infections, amongst other risks.  

• Morphine was first introduced to Uganda 30 years ago, but as the burden of cancer increases, thousands of people still lack access to even basic treatment or pain relief.
• The Ugandan government cannot fulfil its responsibility to provide end-of-life care for its people. Now, a hospice organisation that has been picking up the slack is running out of money too.
• Meet the health workers doing what they can to provide a good death for cancer patients at the end of their lives.

The total cost of cancer to the global economy will reach 25.2 trillion international dollars between 2020 and 2050, according to an analysis of 29 cancers across 204 countries. Of that, five types of cancer will account for roughly half of that cost. The study, published in JAMA Oncology last month, finds that tracheal, bronchial and lung cancer will be the most expensive, followed by colon and rectal cancer, breast cancer, liver cancer and leukaemia1 (see ‘Which cancers cost the most’). Together, those cancers will cost roughly Int$12 trillion over the next 30 years. International dollars are an artificial currency often used in economic analyses and comparisons across countries.

Ms. Bahous noted that although several historic firsts for gender equality occurred during the first two decades of the resolution, “we have neither significantly changed the composition of peace tables, nor the impunity enjoyed by those who commit atrocities against women and girls.” She said the 20th anniversary "was not a celebration, but a wake-up call," pointing to situations from across the globe that have emerged since then. They include the regression of women’s and girls’ rights in Afghanistan in the wake of the Taliban takeover, sexual violence committed in the war in the Tigray region in Ethiopia, and online abuse targeting women opposing military rule in Myanmar. Women and children also comprise a staggering 90 per cent of the nearly eight million people forced to flee the conflict in Ukraine, and nearly 70 per cent of those displaced within the country.

The introduction of antiretroviral therapy (ART) to human immunodeficiency virus (HIV) patients in the 1980s was a turning point in the treatment of the disease. Once considered a terminal diagnosis, HIV could now be recognised as a manageable chronic health condition. Today, the World Health Organization (WHO) classifies HIV as a global epidemic and reports that ART was used to treat 75% of HIV patients in 2021. ART is a daily treatment method that works by reducing the replication of HIV in the blood, resulting in undetectable and non-transmissible viral levels. Lifelong treatment is recommended to ensure the virus does not continue to replicate and spread.

Following this final stage of approval, the plan will be launched to the public by the new deputy president, Paul Mashatile in his capacity as the chairperson of the South African National Aids Council (Sanac), during the official commemoration of World TB Day on 24 March in Rustenburg, North West. The NSP provides a strategic framework for a multi-sectoral approach that is people-centred to eliminate HIV, TB and STIs as public health threats by 2030.

For businesses and households that can afford it, solar panels and batteries offer a way to keep the lights on during South Africa’s ongoing bouts of loadshedding. Such technologies may also offer a solution for healthcare facilities, where a reliable energy supply can be a matter of life and death.

It is that time of the year when civil society organizations (CSOs), governments, the United States government’s President’s Emergency Plan for AIDS Relief (PEPFAR), and other partners convene in Johannesburg, South Africa, to plan for funding for the year 2023 and beyond. PEPFAR is the largest donor to over 50 countries in the global HIV response. This was the first in-person meeting since the pronunciation of COVID-19 as a global pandemic.

It is reported that women tend to be hesitant to seek healthcare associated with taboo subjects such as sex, HIV, and reproductive health. This lack of awareness becomes a challenge to be tackled for preventative women's healthcare. Experts say promoting women’s reproductive and overall health should be a top priority for community development. According to Sister Thandi Mgcina, healthcare manager at NPO, Rhiza Babuyile, there are still many adolescent girls and women who need to be encouraged to seek healthcare at their closest available facility.

Every two minutes, a woman dies during pregnancy or childbirth, according to the latest estimates released in a report by United Nations agencies today. This report, Trends in maternal mortality, reveals alarming setbacks for women’s health over recent years, as maternal deaths either increased or stagnated in nearly all regions of the world. “While pregnancy should be a time of immense hope and a positive experience for all women, it is tragically still a shockingly dangerous experience for millions around the world who lack access to high quality, respectful health care,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO). “These new statistics reveal the urgent need to ensure every woman and girl has access to critical health services before, during and after childbirth, and that they can fully exercise their reproductive rights.”

The news today is awash with stories about the Düsseldorf Patient, one of five people considered likely cured of HIV after receipt of a stem cell transplant to treat a life-threatening cancer diagnosis. As with all five reported cases to date, the stem cell donor was homozygous for the CCR5Δ32 mutation, which renders immune cells resistant to most HIV variants. The media coverage has been prompted by the publication of a detailed report in the journal Nature Medicine by Björn-Erik Ole Jensen and colleagues. The individual, who identified himself as Marc in an interview with a Dutch news outlet in 2021, has now been off antiretroviral therapy (ART) for four years with no sign of HIV viral load rebound. His current health is reported to be good, although the paper makes clear his journey has been difficult having experienced two relapses of acute myeloid leukemia and reactivation of multiple chronic viral infections (cytomegalovirus, herpes simplex virus 2, human herpesvirus 8 and Epstein–Barr virus). Mild chronic graft-versus-host disease of the eyes with bilateral keratoconjunctivitis sicca (dry eye syndrome) developed after the stem cell transplant and is still present.

Despite being one of the most common non-communicable diseases globally and there being highly effective treatments for it, asthma is often not well controlled in many low-resource settings, according to a cross-sectional study recently published in the Lancet medical journal.

There are people who had a house on Friday and on Sunday morning they only had a foundation. Their entire house was washed away.” This is according to Storm Zurcher, the community policing forum chairperson of the Loch Vaal neighbourhood watch area, who was referring to the widespread destruction of homes, roads and bridges in Loch Vaal, Vanderbijlpark and other parts of the Vaal after devastating flooding at the weekend. On Saturday, the department of water and sanitation announced that a further two floodgates had been opened at the Vaal Dam to ease pressure after heavy rains, which unleashed flooding in the region. The total number of floodgates that have been opened stands at 12.