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Tuesday, 14 May, 2024

FOCUS: MEDICAL SCHEMES

Ministers deliberately ‘demonise’ medical schemes, claims BHF research

Venilla Yoganathan - 0
Research presented at the annual Board of Healthcare Funders conference this week, including allegations that various Health Ministers have deliberately promoted false claims about medical schemes to bolster the case for National Health Insurance (NHI), was slammed by Deputy Health Minister Sibongiseni Dhlomo. The findings highlighted assertions from a succession of Ministers that the medical scheme industry was on the verge of collapse, that beneficiaries routinely run out of benefits midyear and are dumped on the state, and that most...
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NEWS UPDATE

Pharmacy ARV treatment will erode GPs’ income – HPCSA

The Health Professions Council of SA (HPCSA) has warned against pharmacists being allowed to prescribe HIV treatment, saying it could affect the income of medical practitioners, and that it “encroaches on the preserve of doctors.” The controversial policy of pharmacist-initiated management of antiretroviral therapy (Pimart) was approved by the SA Pharmacy Council in 2021 but is on hold after a legal challenge brought by the Independent Practitioners’ Association (IPA), which represents doctors, reports Business Day. “Perhaps it is not politically palatable but it is a reality that I think must be confronted,” chair of the medical and dental board of the HPCSA, Arthur Rantloane, told delegates at the annual Board of Healthcare Funders (BHF) conference on Tuesday. The IPA said the policy “encroaches on the preserve of doctors”. Under Pimart, appropriately trained pharmacists were given the go-ahead to prescribe ARV therapy to people with HIV, to protect people from acquiring the virus, or...

Overtime cuts impact on hospital services

Cutting doctors’ overtime will have a significant impact on service delivery, particularly on weekends and holidays, with one physician saying this could see hospitals struggling to maintain adequate staffing levels, leading to reduced services or even closures of certain departments. This comes after the Gauteng Health Department reduced overtime budgets this year, forcing doctors to sign three-month renewable contracts that left them unpaid for April. Patients were already being turned away, with some dying while waiting in long emergency queues at casualty wards, one frustrated doctor at Chris Hani Baragwanath Hospital told City Press. While working overtime last weekend, she said, “we lost three patients in one shift, because we had no emergency surgeons on duty”. “The cases relied on available doctors who did what they could. We lost a multiple gunshot wound patient, a bottle-stabbed patient and a poison-overdose patient, who all needed urgent surgery. But we had limited hands. We did our best...

AstraZeneca withdraws Covid jab worldwide

London-based AstraZeneca has withdrawn its Covid jab worldwide, but says the discontinuation is unrelated to legal action related to serious side effects. “As multiple, variant Covid-19 vaccines have since been developed, there is a surplus of available updated vaccines,” the Anglo-Swedish company said, which had “led to a decline in demand for Vaxzevria, which is no longer being manufactured or supplied”. The firm’s application to withdraw the vaccine was made on 5 March and came into effect on 7 May, according to The Telegraph. AstraZenevca had previously admitted in court documents that the vaccine causes side effects like blood clots and low blood platelet counts. Legal action In the UK, 51 families are currently pursuing legal action against the company, arguing its “defective” jab – around 50m doses were given in Britain – was to blame for their injuries and deaths of loved ones. However, lawyers argue that the true number of people laid low by...

SA to import costly cystic fibrosis drug, but few can afford it

Although US drug manufacturer Vertex has reached an agreement with Equity Pharmaceuticals to import and distribute its cystic fibrosis treatment Trikafta in SA, the drug will probably be out of reach for many eligible patients, particularly public health patients, because of its cost. Only Discovery Health Medical Scheme (DHMS) now offers a benefit with cover for this class of drug, known as Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulators, and even these patients may face co-payments for Trikafta. The rare genetic disorder cystic fibrosis leads to an overproduction of mucus in patients’ lungs, but the exorbitant cost of the medication has placed Vertex at the centre of an international campaign by activists pushing it to slash the cost of the treatment, which few governments and patients can afford. BusinessLIVE reports that the US list price of Trikafta is more than $300 000 a year. As Vertex has not attempted to register Trikafta with...

SAMA committee member’s hunting selfie backfires

A lay pastor and a member of the South African Medical Association Research & Ethics Committee, who bragged online about getting an erection after shooting a buck in 2019, is continuing his quest to have the man who called him out for his “sick and disrespectful” post found guilty of defamation. The hunter, Mark le Roux, lost his first lawsuit against the Cape of Good Hope SPCA’s chief inspector Jaco Pieterse in the Palm Ridge Magistrate’s Court in September. The Sunday Times reports that he has now filed a late application to appeal the judgment. In September 2019, on Facebook, Le Roux posted a photograph of the bloodied antelope he had shot propped up behind the steering wheel of his bakkie while he lay on the roof with his tongue hanging out, mimicking the fresh kill. The caption, translated from Afrikaans, read: “I killed my first buck on my late uncle’s farm......

Jobless pharmacists demand jobs

Unemployed community service pharmacists staged a sit-in outside the Department of Health offices in KwaZulu-Natal and Gauteng last week, after the national and provincial Health Departments failed to respond to an earlier memorandum in mid-April about jobs. Representatives of the national Unemployed Pharmacists SA, with members in all nine provinces, said that the document had been handed over and emailed to the various stakeholders on 15 April, in which the group had demanded immediate allocation of employment and letters of appointment for more than 150 post-community service pharmacists in each province. They also called for the absorption of all community service pharmacists upon completion of their service, and that vacant positions be adequately filled by the post-community service pharmacists to ensure a continuous cycle of employment. Masego Moepye, a group representative in Gauteng, with an honours degree in pharmacy, said the stakeholders had failed to respond to their memorandum by 24 April,...

DA loses court case against emergency Covid restrictions

The Department of Co-operative Governance & Traditional Affairs (Cogta) has welcomed the Supreme Court of Appeal’s dismissal of the DA’s appeal over the constitutional validity of Section 27 of the Disaster Management Act (DMA) and the Covid-19 emergency regulations. The Cogta Minister at the time was Nkosazana Dlamini-Zuma, who had instituted the restrictions after the President’s declaration of a national lockdown during the pandemic, reports the Cape Times. The DA had argued that given the breadth of the powers conferred on the Minister, it was constitutionally required that the DMA ensures National Assembly has the power, by resolution, to disapprove and undo regulations enacted by the Minister. The respondents, including the President, the Minister, and the Speaker of the National Assembly, argued that the very purpose of a state of emergency was to permit a suspension of the normal constitutional order, which is not the case in a state of disaster. They said...

Health Department weather alert app warns pregnant women

Negative effects of climate change are predicted to intensify as the world continues to warm up, and in efforts to alert pregnant women – and mothers of infants – to dangerously high temperatures, the Department of Health is piloting a scheme which combines data from the SA Weather Service with its MomConnect app. MomConnect is being used by more than 422 500 women who receive targeted SMS and WhatsApp messages based on the developmental stage of their foetus or child, reports Business Day. Adverse health effects caused by climate change are expected to increase as global temperatures rise, according to the Intergovernmental Panel on Climate Change. Consequently, SA would see more frequent floods, heat stress, water stress and wildfires, Elizabeth Leonard of the Clinton Health Access Initiative told delegates at the annual Board of Healthcare Funders (BHF) conference this week. Pregnant women and infants are particularly vulnerable to extreme temperatures, she said,...

Chinese scientist who first leaked Covid sequence back in lab after lockout

The scientist who in 2020 published the first sequence of the virus that causes Covid-19 has been let back into his Shanghai lab after spending days locked outside, where he sat in protest. That publication, by Zhang Yongzhen, PhD, helped lead to the development of tests and vaccines for the virus. His sit-in protest since the weekend came after he and his team were suddenly notified they were being evicted from their lab, the latest in a series of setbacks, demotions, and ousters since the virologist published the sequence in January 2020 without state approval. When Zhang tried to go into the lab over the weekend, guards barred him from entering. He sat outside on flattened cardboard in the rain while members of his team unfurled a banner that read “Resume normal scientific research work”, according to pictures posted online. “I won’t leave, I won’t quit, I am pursuing science and the truth,” he...

MEDICO-LEGAL

Dentist fails to have charges over patient’s death dismissed

Durban dentist Anwar Mohamed Jeewa, charged with the death of a Canadian man at his illegal drug and detoxification centre in Westville in November 2017, has failed in his bid to have the court discharge some of the charges he faces. TimesLIVE reports that Jeewa had wanted the court to strike off the murder charge, among others. He is charged with the murder of Milos Martinovic, who died after being treated at his unregistered facility in November 2017, and also with unlawfully selling a schedule 6 substance; unlawfully manufacturing a schedule 6 substance; exporting a schedule 6 substance and establishing and managing an unregistered treatment centre. Martinovic had gone to Jeewa’s Minds Alive rehabilitation centre seeking a cure for his addiction to Xanax but died as a result of an alprazolam overdose. Martinovic had arrived at the centre – which offered addiction treatment through ibogaine – with several boxes of Xanax that Jeewa...

Legal tussle over R15m payout after Covid death

A Durban woman has accused a Momentum claims investigator of colluding with a prosecutor to deprive her of her share of a R30m life insurance payout after her boyfriend died, apparently from Covid, shortly after he took out life cover worth millions. She also alleges that a doctor signed off the boyfriend's death certificate without seeing his body. But Momentum told News24 it stands by its investigator and has no doubts about his integrity. It also argues that the woman’s claim is fraudulent. The matter dates back to April 2020 when 26-year-old Ha San Kazi was reported to have died from Covid-19 four months after taking out R30m in life cover. A death certificate was issued by Home Affairs after 85-year-old Dr Eric van der Veen reported he had examined the body and confirmed the death. Kazi was allegedly cremated, and the woman, believing she was entitled to at least half of the...

J&J offers new deal in baby powder cancer litigation

The ongoing litigation revolving around J&J’s baby powder’s alleged link to ovarian cancer has taken a new turn, with the company planning to ask thousands of people who are suing it to vote for a settlement that would resolve all litigation for $11bn – $2.1bn more than it offered last year. Last week, J&J urged those who blame the talc-based powder for ovarian cancer to support a third bankruptcy filing aimed at corralling all current and future legal claims. Two earlier attempts to use Chapter 11 to foster such a deal failed when plaintiffs held out for a bigger payout. This time around, according to a Bloomberg report in News24, J&J seeks a so-called “pre-packaged” bankruptcy under rules allowing companies to speed through Chapter 11 cases if they have enough creditor support. In bankruptcy court, plaintiffs are converted into unsecured creditors. Under Chapter 11 rules, J&J will need 75% of talc plaintiffs to back...

SOME RESEARCH HIGHLIGHTS IN THE PAST WEEK

CARDIOLOGY

Rush of anger may trigger heart attack – US study

In efforts to dig deeper into a previously observed link between anger and heart attacks, researchers from Columbia University Irving Medical Centre, Yale School of Medicine, and St John’s University in New York, recruited a group of participants with the intention of making them angry – and confirming the earlier findings. A total of 280 healthy young adults were randomised into four groups: a control group that counted out loud for eight minutes and maintained a neutral emotional state, and groups who recalled events that made them angry, sad or anxious. Before they began, and at intervals for 100 minutes afterward,...

CORONAVIRUS

Scientists find Paxlovid does not shorten Covid symptoms in fully jabbed

Researchers have suggested that for people who are fully vaccinated but have at least one risk factor for severe Covid, the antiviral drug Paxlovid did little to reduce symptom duration – however, experts have cautioned that the findings might not apply to older patients, and that further studies are needed. The phase 2/3 trial of 1 296 participants, led by Pfizer scientists, were randomly assigned in a 1:1 ratio to receive nirmatrelvir–ritonavir (Paxlovid) or placebo every 12 hours for five days within five days of Covid-19 symptom onset. CIDRAP reports that a total of 654 participants took Paxlovid, and 634 participants...

High immunity levels a challenge for Covid trials

Researchers deliberately infected participants with SARS-CoV-2 in ‘challenge’ trials – but high levels of immunity complicated efforts to test vaccines and treatments, frustrating the scientists and raising questions about the usefulness of such trials. When Paul Zimmer-Harwood volunteered to be intentionally infected with SARS-CoV-2, he wasn’t sure what to expect. He was ready for a repeat of his first brush with Covid-19, through a naturally acquired infection that gave him influenza-like symptoms. It turned out that Zimmer-Harwood, a PhD student at University of Oxford, UK, had nothing to worry about. Neither he nor any of the 35 other people who participated...

GASTROENTEROLOGY

How old is too old for colonoscopy?

A large observational study in the US has suggested the risks of surveillance colonoscopy might outweigh the benefits for some older patients, in whom colorectal cancer was rarely detected through this method, regardless of prior adenoma finding. Medpage Today reports that among 9 601 patients aged 70 to 85 with a history of adenoma, 0.3% of surveillance colonoscopies found colorectal cancer, while 11.7% found advanced adenoma, and 12% found advanced neoplasia. The results did not differ significantly by age, said the researchers, led by Jeffrey Lee, MD, MPH, of Kaiser Permanente Northern California. Patients with a history of advanced adenoma versus non-advanced...

GENETICS

Researchers find genetic cause of rare disease after 25 years

After a quarter of a century of uncertainty, US scientists have finally uncovered the cause of a rare progressive neurological disease known as spinocerebellar ataxia 4 (SCA4). For most people, the first sign is difficulty walking and balancing, which gets worse as time progresses. MedicalXpress reports that the symptoms usually start in a person’s 40s or 50s but can begin as early as in the late teens. There is no known cure. And, until now, there was no known cause. Now, a multinational study led by Dr Stefan Pulst, professor and chair of neurology, and Pattie Figueroa, a project manager in neurology,...

HARM REDUCTION

SA linked to global scandal as PMI extends Big Tobacco reach

An ambitious deal between a leading global medical education provider and Philip Morris International (PMI) collapsed this week, with Medscape acknowledging its “misjudgment” and saying it will not accept funding from any organisation affiliated with the tobacco industry in the future. This followed an intensive investigation – by the respected British Medical Journal (BMJ) and The Examination – into the planned collaboration. The probe also linked South Africa to the scandal, finding that the Alliance of South Africa Independent Practitioners Associations (ASAIPA), a coalition of health practitioner associations and a medical education provider, has already hosted seminars sponsored by Philip Morris...

WOMEN’S HEALTH

Hormones safe for menopause – US study dispels old flawed findings

The benefits of hormone therapy for the treatment of menopause symptoms outweigh the risks, and what is available now is very different from two decades ago, said researchers at the conclusion of a recent study. “Among women under 60, we found hormone therapy has low risk of adverse events and is safe for treating bothersome hot flushes, night sweats and other menopausal symptoms,” said study author Dr JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital at Harvard Medical School. This is a departure from the advice many women have been given in the past. The latest analysis, published in JAMA, is...

Depression risk ‘40% higher’ in perimenopause – UK meta-analysis

British researchers have suggested that women who are approaching menopause have a 40% higher risk of suffering from anxiety and depression than those with no menopausal symptoms. The experts from University College London (UCL) said perimenopausal women had more chance of experiencing these symptoms in the run-up to their periods stopping, with the development of new cases or existing symptoms getting worse. Menopause typically affects women aged 49 to 52, the point at which women experience the highest rates of depression, reports The Independent. Common emotional and mental symptoms of menopause and perimenopause include low mood, anxiety, mood swings, low self-esteem and issues with...

ABOUT US

MedicalBrief is Africa’s authoritative weekly digest of medical matters, both on the continent and around the world. It brings you a succinct summary of the latest developments, both in news and research, with links to the original material. Contact us: info@medicalbrief.co.za

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