Saturday, June 30, 2007

Globespan follow-up, attack on Glasgow airport


Well, (see posting below) Globespan wasn't as bad for me as it could have been. We did not crash. Our plane departed only an hour late, because too few stewards and stewardesses bothered showing up for work (no kidding, we were waiting for replacements to drop in so we could finally leave Glasgow). The food in Globespan's business class and the service provided by its staff were immaculate (mind you, not up to Virgin standards, but then, their prices were several light years below Virgin's, too). The plane was an ageing (ex Iceland Air) 757-200. The business class consisted of a few leather seats with minimal recline that probably have seen better times during their long life-span. There were no individual inflight entertainment units, not even in business class (in other words, worse than Virgin's economy).

On arrival in Hamilton we were greeted by a cheerful ground staff member who said that we were lucky to be only an hour late, as the day before the airline managed to organise a 22 hour delay... so, in balance, you're probably better off not to consider this airline for your travel purposes.

On a more cheerful note, let me assure you that I am entirely innocent and was not involved in this!

I guess I was also lucky for another reason. Had I arrived just one day later, I would not have been able to leave Toronto to go to Kingston, because militant indigenous people decided to block train tracks (possibly for good reasons). So, all trains were canceled.

Wednesday, June 27, 2007

Scared of flying? - Well, here's a reasonable reason

Wish I was kidding, but I shall be flying (trying anyway) on this airline and this plane to Canada tonight... - Thank goodness I am not scared of flying, even though quite possibly I should

Another emergency landing at Munro
Jun, 13 2007 - 8:00 AM



HAMILTON (AM900 CHML) - For the second time in two weeks, a
Flyglobespan jet has had to make an emergency landing at Hamilton's
Munro International Airport.
Reports indicate the Boeing 757 had an engine malfunction about 20
minutes after taking off.

The pilot then declared a mechanical emergency and turned the plane around.

It landed safely shortly after 12:30 this morning.

Two weeks ago, a Flyglobespan Boeing 757 returned to Hamilton airport
after the pilot reported an emergency involving a surging engine.

That plane landed safely, with passengers reporting bangs and flames
coming from an engine.

Tuesday, June 26, 2007

Tony Blair brokering peace in the Middle East


How amusing. Tony Blair, Uk Prime Minister for another day, is seriously proposed as an international envoy to broker peace in the Middle East. The BBC reports that there's currently a special meeting discussing his future role, involving the UK, US, Russia, EU, and UN. Ominously absent are those whose trust he would need to broker anything, namely the folks fighting each other. No doubt it will help a great deal that he's likely to convert to Catholicism after he leaves office, seeing that the people continuing the carnage in the Middle East are Muslim and Jews.

Saturday, June 23, 2007

Good success to the Council of Ex-Muslims of Britain

I like this! There's a newish organisation in the UK called the Council of Ex-Muslims of Britain. Basically they're people who were (as the name suggests) Muslims, and frankly they've had enough of the reactionary near-fascist organisations claiming to represent them. One wonders how long it will take for effigies of them to be burned in some odd place or other.

I am kind of tempted to set up my own little grouping of ex-catholics or ex-christians (but then, i never really believed that kind of fairtytale anyway - I mean, helloooo... a good, omniscient, all-powerful God who kinda doesn't think it's worthwhile interfering with his/her creation's activities like the holocaust in Germany, the genozide in Rwanda and the list goes on and on and on). Surely we are left either with a Leibnizian option of the kind that this is the best of all possible worlds, and things could only be worse if God hadn't created this paradise (Voltaire made rightfully a mockery of this view in his Candide), or we better accept that God (if he/she/it exists at all) is not omniscient and all-powerful, or we concede that may be, just may be God isn't 'good' after all. Either way, secularism seems the most sensible response to it all.

Here's the ex-Muslims' press release:

Manifesto of the Council of Ex-Muslims of Britain


We, non-believers, atheists, and ex-Muslims, are establishing or joining the
Council of Ex-Muslims of Britain to insist that no one be pigeonholed as
Muslims with culturally relative rights nor deemed to be represented by
regressive Islamic organisations and 'Muslim community leaders'.

Those of us who have come forward with our names and photographs represent
countless others who are unable or unwilling to do so because of the threats
faced by those considered 'apostates' - punishable by death in countries
under Islamic law. By doing so, we are breaking the taboo that comes with
renouncing Islam but also taking a stand for reason, universal rights and
values, and secularism.

Whilst religion or the lack thereof is a private affair, the increasing
intervention of and devastation caused by religion, and particularly Islam,
in contemporary society has necessitated our public renunciation and
declaration. We represent a majority in Europe and a vast secular and
humanist protest movement in countries like Iran.

Taking the lead from the Central Council of Ex-Muslims in Germany, we
demand:

1. Universal rights and equal citizenship for all. We are opposed to
cultural relativism and the tolerance of inhuman beliefs, discrimination and
abuse in the name of respecting religion or culture.

2. Freedom to criticise religion. Prohibition of restrictions on
unconditional freedom of criticism and expression using so-called religious
'sanctities'.

3. Freedom of religion and atheism.

4. Separation of religion from the state and legal and educational system.

5. Prohibition of religious customs, rules, ceremonies or activities that
are incompatible with or infringe people's rights and freedoms.

6. Abolition of all restrictive and repressive cultural and religious
customs which hinder and contradict woman's independence, free will and
equality. Prohibition of segregation of sexes.

7. Prohibition of interference by any authority, family members or
relatives, or official authorities, in the private lives of women and men
and their personal, emotional and sexual relationships and sexuality.

8. Protection of children from manipulation and abuse by religion and
religious institutions.

9. Prohibition of any kind of financial, material or moral support by the
state or state institutions to religion and religious activities and
institutions.

10. Prohibition of all forms of religious intimidation and threats.

Here
's a report from the event and a link to a speech given by one of the group's founders.

Friday, June 22, 2007

Novartis versus the cancer patients of India

In our continuing coverage of pharmaceutical companies' misdeeds, for a change it isn't Pfizer that is on today's menu but Novartis.

By Rasha (Saudi Arabia)
Saturday, June 16th, 2007
Swiss “Novartis” is one of the largest pharmaceutical companies in the world. Novartis has launched two law suits against India’s government after the country refused to grant a patent for (Glivec) a new form of the original compound of an anti-cancer medicine. Novartis is challenging not just the Glivec decision, but also a section of India’s patent law designed to promote cheaper generic medicines for poor patients who cannot afford patented medicines.

The law allows India to refuse a patent for an existing medicine that has been slightly modified. In countries such as the US, companies have modified medicines then re-patented them to extend their monopoly and keep generic competition off the market. India’s law ensures that this practice – called “ever-greening” – would not block access to affordable generics.

India changed its Patents Act in early 2005 to meet its obligations as a member of the World Trade Organization, India adopted a new patent law that lets drug companies seek patents on medicines invented after 1995 or for new and more efficacious versions of older drugs. The government tried to ensure that medicines that were not innovative, were not granted patents. Novartis is pressuring India to eliminate a perfectly legal public health safeguard.

If Novartis succeeds, additional patents are likely to happen, resulting in further restrictions on the production of generic drugs in India and causing high prices for newer medicines. India’s generic medicine industry is often called “the pharmacy to the developing world” because it produces quality drugs at dramatically more affordable prices.
If Novartis succeeds, drug prices will rise, and people will suffer greatly,” said Vineeta Gupta of SHAII (Stop HIV/AIDS in India Initiative). “Novartis should be ashamed.”
Oxfam says that India’s law reflects an important public health safeguard that was agreed at the World Trade Organization. No country has challenged the legality of India’s law at the WTO.

Most AIDS treatment programmes throughout the world rely on generic antiretroviral (ARV) medicines made in India, including more than 80% of the 80,000 patients treated by Doctors Without Borders in more than 30 countries.
And 70% of the ARVs purchased by UNICEF, the International Dispensary Association, the UN Global Fund, and the Clinton Foundation to treat patients in 87 developing countries come from generic Indian sources as well.
Generic competition is what brought prices down for antiretroviral (ARV) medicines for people living with HIV/AIDS from a staggering $10,000 to $136 a year.

Novartis must drop its controversial court case against India which started in Jan 29th/2007, says international agency Oxfam.
If Novartis wins its case, a lot of patients in developing countries, especially those suffering from HIV/AIDS, who mainly rely on affordable drugs from India, would not have access anymore to drugs, It is unacceptable that commercial interests of a company comes before the general health’s interests and the right of states to protect and promote public health.

Arguements on this case have been heard and judgement is expected in the following weeks, if you care about medication reaching and saving HIV/AIDS patients check this site (you can add your name)

Thursday, June 21, 2007

How ethical is the 'ethical' industry

I am in the middle of preparing a presentation on the innovative ('ethical') pharmaceutical industry. After just a few hours on the net, searching for misdeed, I stumbled about incident after incident after incident. Here's a bullet point list of some of the stuff I found:

Merck: VIOXX – withheld information about health risks from patients and regulators
Pfizer: Trovan – law suits by victims and Nigerian government pending
Bayer: Guilty of defrauding MedicAid in the USA
Pfizer: Neurontin – fraudulently promotes drug for unrelated uses
GSK: Paxil – lied about effectiveness and safety
GSK: Guilty of defrauding MedicAid
IMClone: Insider trading
TAP: Guilty of defrauding government by bribing doctors into prescribing its drugs instead of cheaper but equally efficient alternatives
GSK: Omitted to tell patients and doctors voluntarily that its diabetes drug Avandia results into a 43% higher likelihood of heart attacks
Schering-Plough: Criminal investigation – sold misbranded and unapproved drugs, bribed MCO & doctors to use its drugs

Tuesday, June 19, 2007

Compulsory HIV testing for pregnant women in NJ on the cards

Anita Kleinsmidt sent this news item... interesting.

New Jersey Aims At Compulsory HIV Test For New Borns, Pregnant Women

New Jersey plans to become the first state in the United States to make HIV testing mandatory for pregnant women and newborns, under a proposal introduced Thursday. The new proposal, which was suggested by Senate President Richard J. Codey, D-Essex, eyes at introducing legislation for compulsory HIV testing for all pregnant women and newborns, unless the mother refuses in writing.

Currently four states, Arkansas, Michigan, Tennessee and Texas, have a legislation that requires health-care providers to test a mother for HIV, unless the mother refuses to do so in writing. The only two states that have compulsory HIV test for newborns are Connecticut and New York.

Strongly advocating his views for a compulsory HIV test, the Democratic leader believes that early detection and treatment can save lives of many by reduce their infections and improve the quality of life.

The bill, if passed would make an HIV test compulsory for all pregnant women as early as possible in their pregnancy and again during their third trimester. Also, each birthing facility in the state would have orders to test every newborn in its care for HIV.

According to AP reports, the current law in the New Jersey only requires HIV testing to pregnant women. The Center for Disease Control and Prevention says that early detection can prevent many HIV-infected women from transmitting the virus to the infant.

Experts believe that drugs during pregnancy can minimize mother-to-child HIV transmission to 2 percent, compared to 13 percent if no drugs are used until labor and delivery. It was also found that the HIV risk was reduced to 25 percent if no drugs are ever used.

According to the Kaiser Foundation, New Jersey has about 17,700 AIDS cases, which includes about 5,800 women. It is the fifth-highest total for women in the United States. It was also found that 772 pediatric AIDS cases in the state make it the third highest in the nation behind New York and Florida.

New Jersey also had 409 child HIV cases in 2005, which is the second highest in the nation behind New York.

Article © Copyright All Headline News, Inc. - all rights reserved.

Monday, June 18, 2007

2007 Failed States Index Released


The Fund for Peace published its most recent list of failed states. Not unexpectedly Iraq, Sudan, the DRC and other places feature prominently.
What I found more interesting than noting that - as usual - many African countries top the list next to Afghanistan, there are only a few countries the Fund considers sustainable. Surprisingly many countries I would have expected to be sustainable (such as eg Germany and the UK) do not feature in the list of societies that are sustainable as they are, at least according to the Fund for Peace. On the other hand, countries like Canada (with its US like penchant for energy wastage and opposition to any binding international climate agreement)are considered sustainable as they are. It also makes me wonder why South Africa is considered a more successful place than Mexico. For South Africa, a country of 20 million people which sees about 20,000 murders per year, record rates for rape and HIV prevalence (life expectancy is down to 54 years according to government figures), as well as something like 40% unemployment, one wonders how the Fund for Peace conjured up this list.

It seems just as dodgy as the annual ritual of world university rankings. Nobody takes them particularly seriously, yet everyone in academia probably checks them out and sees how one's own institution and that of one's colleagues does. Pretty silly, but that's us... all too human :).

Monday, June 11, 2007

Stuart Rennie on HIV Prevention

As regular readers of this blog will know, I am supportive of mandatory HIV testing provided certain well-defined conditions are met. Stuart Rennie seems to disagree. Here I reproduce his take on the issue. It's well worth reading. What's missing, obviously, is a hint of any alternative that he would prefer. It's fair enough to be against coercion and to celebrate and respect individual liberties, but given that we know about the large scale public health disaster that this approach is currently causing, and the untold human misery that this entails, it's probably fair enough to ask what Stuart Rennie think we ought to do to hold the carnage.

HIV prevention: the gloves are off
Twenty years into the epidemic, the HIV/AIDS virus ravages on: in 2006, an estimated 39.5 million people in the world were living with HIV, 4.3 million were newly infected, and 2.9 million AIDS-related deaths. Of the deaths, 2.1 million occurred in sub-Saharan Africa. As for new HIV infections, South Africa alone is estimated to have 1500 ... per day. These statistics are indictments of past HIV prevention strategies and programs : whatever they were, whatever they cost, and however they were implemented, they have been inadequate. The question then becomes: what strategy changes should be adopted?

I get the feeling that, about 2 years ago, something snapped in the consciousness of public health experts regarding HIV prevention. Enough was enough. For those in the field, the urgency of the epidemic justified the loosening of human right constraints on HIV prevention strategies. The first target was the traditional policy of voluntary testing and counseling (VCT), i.e. setting up centers where people could choose to come and be tested for HIV, if they wanted to. Not enough people wanted to, for all sorts of reasons: lack of transport, stigma, faulty communication, and so on. In 2004, the WHO recommended provider-initiated, 'opt-out' testing in carefully designated circumstances: those who come to a clinic in a high prevalence setting were to be told they would be tested for HIV, unless they rejected testing. The CDC soon followed suit with similar policies. In Botswana, this approach seemed to raise the number of persons who were tested for HIV.

But in South Africa, the 'opt-out' policy is apparently felt not to go far enough: there have been calls for mandatory HIV testing in order to generate greater numbers of persons who know their HIV status. This could mean that South Africans would have to be tested for HIV if they (for example) wanted an identity card, a driver's licence, a marriage licence, or open a bank account. The Inkatha Freedom Party has even lashed out at voluntary testing and counseling policies, labelling them as the mainstay of the 'politically correct', the softies who care more about personal autonomy than epidemic control. VCT, in other words, is for pussies. Not everyone is buying it, of course.

Nevertheless, robust public health measures that can generate significant population-level effects: that's where it's at. Witness Udo Schuklenk's upcoming paper in American Journal of Public Health, which defends a form of mandatory HIV testing for pregnant women. Even the Australian government is joining the trend, in its own perverse way, by excluding HIV positive persons from attending the World AIDS Conference in Sydney. Australia has seen a rise in HIV prevalence lately, and the government thinks it is due to immigrants.

Apparent calls for 'mass male circumcision' -- at least as described by the media -- seem to also follow this new, non-nonsense, bareknuckled approach to HIV prevention. Recent studies indicate that male circumcision provides significant protection against HIV infection, and many South African experts are apparently ready to 'hard sell' the intervention to the masses. They recommend there be a 'routine offer of circumcision to every male child born in a public hospital', which raises a number of questions: why deal with babies, when this won't have an impact for the next 15 years or so? How will communities respond to such aggressive policies? Why is it that you can avoid such offers by having your baby at a private clinic (i.e. being wealthy)? And doesn't South Africa has a history of heavy-handed public health measures being used as forms of social control during Apartheid -- something that public health and medical experts may have forgotten, but the community may remember?

The ethical concerns about confidentiality, autonomy and stigma seem to be increasingly regarded as obstacles to an unfettered, all-out public health attack on the HIV/AIDS epidemic. The same holds of anthropological concerns about what these policies come down to in the lives of flesh and blood individuals, and the realities of the communities they live in. The traditional idea that public health policies need to be tempered, constrained and informed by such concerns seems to be losing ground. Will these 'tough love' approaches to HIV prevention turn the tide? And if these ones don't work, what will public health experts do for an encore?

Sunday, June 10, 2007

Paris Hilton --- it's Sunday today after all


Apologies to all and sundry who expect something reasonably important in this spot ------ every day :). It's Sunday today. I just read in the German news magazine SPIEGEL a truly well written story about Paril Hilton's stint in prison. Of course, most readers of this blog will not read German and there's not too much point rehashing the story of the spoilt heiress to a huge fortune who was finally sentenced to 40+ days in jail for repeated drunk-driving offences. This sort of behaviour (drunk-driving) translated into nearly 20,000 surplus deaths in the USA last year alone. Anyway, check out this offer on a 'free paris movement's' website... a pink 'Free Paris' bracelet for 9.99 US$. It well and truly defies belief. Enjoy the rest of your Sunday if you're reading this during the weekend.

Friday, June 08, 2007

The people of Nigeria vs Pfizer Inc

Nigeria's federal government seeks $7 billion from Pfizer over drug study

By: BASHIR ADIGUN - Associated Press

ABUJA, Nigeria -- The Nigerian government filed a lawsuit Monday
against Pfizer Inc., asking for $7 billion in damages over allegations
the pharmaceutical company conducted a drug experiment that led to
deaths and disabilities among children more than a decade ago, court
papers showed.

The civil case filed in the capital, Abuja, is separate from a legal
challenge launched in the northern state of Kano that seeks $2 billion
from Pfizer, although all the cases stem from the same mid-1990s drug
study.

Pfizer has denied the charges in the Kano case, which are
substantively similar to those in the Abuja-based suit.

In the civil suit filed in Kano, authorities allege Pfizer illegally
conducted a drug experiment on 200 children during a meningitis
epidemic in the state's main city, also called Kano, in 1996,
resulting in deaths, brain damage, paralysis and slurred speech in
many of the children.

Pfizer treated 100 meningitis-infected children with an experimental
antibiotic, Trovan. Another 100 children, who were control patients in
the study, received an approved antibiotic, ceftriaxone -- but the
dose was lower than recommended, the families' lawyers alleged.

Up to 11 children in the study died, while others suffered physical
disabilities and brain damage.

Pfizer has insisted its records show none of the deaths was linked to
Trovan or substandard treatment. That civil suit is asking the judge
to award Kano state $2 billion. Both that case and a related criminal
action against Pfizer officers were both postponed Monday after the
plaintiff's counsel failed to show up for the initial court hearing.

The judge hearing the case said criminal proceedings lodged against
company officers would now begin July 4, while a related civil case
seeking the monetary damages was to begin July 9.

State and company officials were not immediately available for
comment. Nigeria's government is in disarray after the May 29
inauguration of new governors, state assemblies and elected federal
officers, including a new president.

In the Abuja civil case, the government is asking for $500 million for
treatment, compensation and support for the victims of the drug test
and their families. Another $450 million is earmarked for damages
related to money spent to overcome societal misgivings related to the
test, and $1 billion is sought to pay for health programs. The federal
government is also seeking $5 billion as general damages.

New York-based Pfizer, the world's largest drug maker, has denied any
wrongdoing. A federal court in Manhattan dismissed a 2001 lawsuit by
disabled Nigerians who allegedly took part in the study, but the case
is under appeal.

Authorities in Kano state are blaming the Pfizer controversy for
widespread suspicion of government public health policies,
particularly the global effort to vaccinate children against polio,
which has met strong resistance in northern Nigeria.

Islamic leaders in largely Muslim Kano had seized on the Pfizer
controversy as evidence of a U.S.-led conspiracy. Rumors that polio
vaccines spread AIDS or infertility spurred Kano and another heavily
Muslim state, Zamfara, to boycott a long-term campaign to vaccinate
millions.

Vaccination programs restarted in Nigeria in 2004, after an 11-month
boycott. But the delay set back global eradication -- the boycott was
blamed for causing an outbreak that spread the disease across Africa
and into the Middle East.

-- Associated Press Writer Salisu Rabiu contributed to this report
from Kano, Nigeria.

Wednesday, June 06, 2007

British Medical Association Medical Ethics Committee on Access to Abortion

The British Medical Association's Medical Ethics Committee has issued a day or two ago a position statement on access to abortion in the UK. The organisation has been in favour of women's legal right to abortion since the 1970. I excerpt here the BMA's key opinions. In a number of key areas the organisation proposes to make access to abortion easier for pregnant women. This is quite significant, seeing that it comes immediately in the aftermath of public debate in the UK about the Roman Catholic Church's hierarchy clamouring to have abortion outlawed altogether. You can find the whole report here.

The MEC supports the revision of the Abortion Act 1967 so that, in the first trimester:
• women are not required to meet medical criteria for abortion
• the requirement for two doctors is removed
• suitably trained and experienced nurses and midwives may carry out both medical and surgical abortions
• as long as safety is ensured, premises do not need to be approved to carry out first trimester abortions.

The MEC believes:• that changes in relation to first trimester abortion should not adversely impact upon the availability of later abortions
• that health professionals with a conscientious objection to abortion should retain the right to opt out of providing abortion services, but should make their views known to patients and enable them to see another doctor without delay.

The MEC believes that the requirement for medical criteria should be removed for first trimester abortions.

The MEC believes that the requirement for two doctors’ opinions should be removed for abortions within the first trimester.

The MEC believes that the level of training and experience a person has is the most important factor in determining which procedures should be undertaken by which professions. The MEC has no objection, in principle, to nurses and midwives, with appropriate training and competence, carrying out abortions.

The MEC has no objection in principle to removing the requirement for premises to be “approved” for first trimester abortions and allowing medical abortions to take place at home where that is the woman’s wish.

Robert Mugabe, mass murderer and failed statesman loses honorary doctorate


The University of Edinburgh will move today to strip Dr (hc) Robert Mugabe's honorary doctorate. He received it from the venerable institution in 1984 for his services toward education in Africa. Well, he also happened to have been master minding the Matabeleland massacres on his home turf at about the same time. Here's a recent report from a Catholic Church organisation in Zimbabwe about the issue. It took Edinburgh University only 20 or so odd years to discover this small matter. The university now is about to decide to strip Dr (hc) Robert Mugabe of his honorary title. Bit late, but good on them.

Monday, June 04, 2007

Rethinking mandatory HIV testing



Bioethics expert calls for mandatory HIV testing


A Queen’s philosophy professor and expert in bioethics is calling for a public policy shift towards mandatory HIV testing of pregnant women in areas where the disease is rampant.

In a paper published on-line from the July issue of the American Journal of Public Health, Dr. Udo Schuklenk, a world leader in the study of health-care ethics related to policy, argues that a mandatory approach to testing and treatment could significantly reduce perinatal transmission of HIV – which results in babies with an average life expectancy of only two years. He also promotes the view that mandatory testing is morally necessary if a number of conditions can be met.

“The scale of the problem demonstrates individual tragedies on an overwhelming scale and a threat to the public health of the communities in question,” says Dr. Schuklenk, Ontario Research Chair in Bioethics. In 2004, this mode of transmission resulted in up to 2.8 million HIV-infected children worldwide.

Co-author of the paper is Anita Kleinsmidt, a human rights law expert from Witwatersrand University in South Africa. Dr. Schuklenk was a professor with Glasgow Caledonian University when the paper was written.

About 35 per cent of newborns born to HIV-infected women contract the virus from their mothers if efforts to prevent mother-to-child transmission are not in place. While research has focused on obstetric care of pregnant women in high-prevalence areas, “treatment is contingent upon the pregnant woman seeking antenatal care, being screened for HIV, and agreeing to medical intervention,” says Dr. Schuklenk. “The continuing high number of children born with HIV attests to failures at various stages of this process.”

The authors suggest several conditions that must be met before the introduction of any mandatory testing and treatment programs:

· The woman has voluntarily chosen to carry the fetus to term
· She would have had a reasonable alternative to this course of action (e.g. abortion
at least until the point of fetal viability)
· Continuing voluntary treatment with HAART (highly active antiretroviral therapy)
would be available to her
· Ideally, the confidentiality of the woman’s HIV status is maintained, during as well as after her pregnancy.

Dr. Schuklenk proposes pilot studies introducing mandatory testing and treatment programs at a number of sites in Botswana and South Africa, where the HIV antenatal prevalence rate is 30 per cent. “This would allow us to establish how such programs can best be implemented, and to investigate stigmatization as it affects women giving birth within these programs,” he notes.

While not a panacea for the “continuing pandemic” of perinatally-transmitted HIV, mandatory testing and treatment regimes should be considered, whenever feasible, by governments and other health-care providers, says Dr. Schuklenk.

Right of Reply: Dr Girish Kotwal

I reported on July 03, 2006 on this blog a paper published in the prestigious journal nature medicine. It pertained to activities Dr Girish Kotwal, at the time at the University of Cape Town, was engaged in. Dr Kotwal has since contacted me and requested that I either withdraw the blog entry or offer him the opportunity of a reply. I am unable to investigate the matter further currently one way or another. I have chosen therefore to publish here Dr Kotwal's response. As the old saying goes, 'let the buyer beware'. Your call.

--------------------------------------------------------------------------------------

Dear Prof. Schuklenk
Thank you very much for the opportunity to respond to your highly misleading blog which has been around for close to a year unnoticed by me, about my role in testing natural products and Secomet in particular. I would like to protest the highly unethical practice of journalists and in this particular case by an editor, Dr. Juan Carlos of a high impact journal viz. Nature Medicine, a number of newspapers and a website called AIDStruth of presenting a one sided story weaved without first checking the facts with the person whose human rights violation the false allegations happen to be. Nature Medicine first published an article that was poorly researched by a free lance journalist, Ms Natasha Bolognesi, with no basic background in Virology and no prior article in any prestigious journal but a mean manner of playing and placing words, to distort the impressions and conclusions, exagerating linkages and trying to malign the hard earned reputation of a person who had no intention to deceive, profit or make false claims for personal gains but to do something about the most politicised and prevailing evil of a devastating disease known to humankind. Someone at Nature Medicine must have received some favours in this regard to allow a complete novice to come up with this misinfomation and lies, while several top scientists with years of research experience do not even get an opportunity to have their articles peer-reviewed . My repeated attempts to ask Nature Medicine to rectify the falsehoods in the article have not been appropriately addressed. Instead of publishing my letters to the editor, the editor would just hand them over to Ms Bolognesi material for new articles that concealed the fact that there was misinformation and downright lies in the original article. This I thought was another unethical behaviour, to me it was like taking the original ideas of one person and handing it over to another to publish them. The other newspapers just had a party and did not check the scientific facts and apart from one newspaper, which after presented a whole lot of thrashy lies allowed me to respond, only to cut short my response and twist it again. So here are the facts as I know them.

I had at the beginning of 2001, etablished a capability in my laboratory to test in vitro (in cell culture) several natural products for antiviral activity including lectins, mucins, herbal medicines, pomegrante juice, plant acids etc. Secomet was one on them. I did convene the First International Conference on Natural Products to encourage my colleagues to evaluate using evidence based science the potential of therapeutic activity. The speech of the democratically elected Hon Health minister of South Africa was read at the end of the meeting and she did not promote any alternatives to HIV in the speech and she did not thrash ARVs. I therefore resent the impression that your blog gives a reader with a cartoon of the minister that it was the meeting where garlic and beet root was promoted. It was not. The speech is on the web site and it empahsizes the value of researching and exploring traditional and natural medicine and of regaining cultural asset of South Africa.

The human treatment was carried out by Secomet Pvt. ltd. under the supervision of qualified and reputed physicians Drs. Brink, Arbuckle and Hellstorm. I did not administer the treatment to any of the many patients who have received the treatment and continue to receive it. I have not seen a single patient who received the treatment. I did not recruit the patients and I did not recommend the treatment to anyone. I have never endorsed the product but have advocated that proper clinical trials are needed in order to fully explore the potential from laboratory work and I had strived to develop a safer product than the original that was first given to me. .

I did not work for Secomet under my personal capacity and was not a holder of equity, shares and received no personal gains. The University of Cape Town did have a royalty agreement but I was not a personal beneficiary.The University conducted an extensive investigation and none of the final investigations found me guilty of any ethical misconduct. There were some procedures used by Secomet which I believed in good faith were appropriate but the University committees felt that some of the procedures could have been done differently. The law unforcement authority of the Medicine Control Council of South Africa extensively investigated Secomet Pvt ltd and made recommendations to amend claims made on labels but there was no punitive action. I have been informed that all the 3,000 compliant patients are surving and leading almost normal lives. Overall, Nature Medicine article made a mountain out of a molehill. No laws were broken and deliberate attempts to subvert an ethical issues. There was definately no malicious intent. On the other hand Professor Greg Hussey, Director IIDMM either lied or made a false statement or the statement was falsely included by Ms Bolognesi of Nature Medicine about my working with Secomet in my personal capacity when there was an overwhelming record contrary to that and the University had an agreement and a memorandum of understanding for evaluating and developing their antiviral products. There was also a statement from a Professor at the Stellenbosch University which was placed out of context and with the false presumption that I had something to do with the human patients.

I did not rely on my data alone to make any conclusions and instead there was a worldwide collaborative network that provided confirmation and further investigation.

I believe then and I do now that HIV in South Africa is not going to be eradicated by a one track extremist policy of providing antiretroviral supervised and unsupervised treatment to all the patients. Instead, I believe that one needs a multipronged approach. Kindly take the time to read a scientific paper authored by a person with 27 years of experience working on several different viruses by one of the most prestigious medical journal viz. The Journal of the Royal Soc. of Medicine, which calls for a multipronged approach, which includes evidence based natural medicine as one of the potential prongs. The free web link is as follows.
http://www.jrsm.org/cgi/content/full/97/1/1

So before anyone indulges in an unethical practice of jumping to conclusions and defaming the hard earned reputation of people based on tabloid style thrashy journalism, please do your research carefully and do not rely on journalists with no background in public health or medical sciences but working as a mouth piece of some organisation with a set biased agenda. Thank you for at least having your email available. There is a website called aidstruth which should be in reality AIDS mistruth does not even give an opportunity to respond. Good luck with your work, I will forgive you for this blunder but keep ethics in center stage, it cuts both ways and finally, I would like to make a statement that ethics is in the eyes of the beholder and if the beholder decides to exploit an ethical issue whether real or not it tarnish another person or bring down another person for personal gains that in my eyes is the most unethical misconduct and that should also be exposed and not tolerated.

Sincerely, Girish J. Kotwal, Ph.D..

Saturday, June 02, 2007

Kidney Transplant TV Show Is a Hoax

Nice story came via Associated Press last night. It's to do with a Dutch TV show (designed by the infamous Endemol production company (creator of Big Brother among other programmes). The idea was that several contestants in need of a donor organ would compete (on air) for the kidney of a dying woman. The winner would receive the kidney and thereby be spared infinite dialysis (and likely premature death). There has been a huge outcry over this internationally. - It turns out, the story (and show) was a hoax. Here's the AP item:

Saturday June 2, 2007 12:46 AM


By TOBY STERLING
Associated Press Writer

AMSTERDAM, Netherlands (AP) - A television show in which a woman would
donate a kidney to a contestants was revealed as a hoax Friday, with
presenters saying they were trying to pressure the government into reforming
organ donation laws.

Shortly before the controversial program was to air, Patrick Lodiers of the
``Big Donor Show'' said the woman was not actually dying of a brain tumor
and the entire exercise was intended to put pressure on the government and
raise awareness of the need for organs.

The three prospective recipients were real patients in need of transplants
and had been in on the hoax, the show said.

The program concept had received widespread criticism for being tasteless
and unethical.

But Lodiers said that it was ``reality that was shocking'' because around
200 people die annually in the Netherlands while waiting for a kidney, and
the average waiting time is more than four years. Under Dutch rules, donors
must be friends, or preferably, family of the recipient. Meeting on a TV
show wouldn't qualify.

``I thought it was brilliant, really,'' said Caroline Klingers, a kidney
patient who was watching the show at a kidney treatment center in Bussum,
Netherlands.

``I know these transplant doctors, and I thought they'll never go and
actually do it. But it's good for the publicity and there are no losers.''

During the show, 25 kidney patients were vetted by ``Lisa,'' and most were
quickly dismissed for being too old, too young, smokers, ex-smokers or
unemployed. Contestants gave moving pleas for why they should receive the
organ.

``It really hurt watching that,'' said Tim Duyst, whose wife is awaiting a
transplant and cannot work. ``You're dismissed in a wave of the hand.''

Viewers were called on to express an opinion or vote for their favorite
candidate by SMS text message for 47 cents.

The show was produced by Endemol, which created ``Big Brother'' in 1999.

The Royal Netherlands Medical Association, known by its Dutch acronym KNM,
had urged its members not to participate and questioned whether the program
might just be a publicity stunt.

``Given the large medical, psychological, and legal uncertainties around
this case, the KNMG considers the chance extremely small that it will ever
come to an organ transplant,'' it said.

All seven of the country's transplant centers had said they not cooperating
with the program, KNMG spokeswoman Saskia van der Ree.

Earlier in the week, the Cabinet declined suggestions from lawmakers to ban
the program, saying that would amount to censorship.

Friday, June 01, 2007

Celibate man in dress continues to ramble on about abortion

Well, this bloke is Keith O'Brien, the Roman Catholic Church's CEO in Scotland. He also goes by the designation of Cardinal (which is an old word that translates loosely in modern English into CEO). Anyway, CEO O'Brien gave a sermon (that's a speech in modern English) the other day to his flog of supporters in Edinburgh. Having recently lost an important policy battle in the country (his organisation may not discriminate against gay people - pretty shocking to our dress wearing celibate), O'Brien turned his theological gaze toward another one of his company's favourite topics, abortion. He compared the number of abortions taking place on a daily basis in Scotland to the Dunblane massacre. In Dunblane, sixteen kids and a teacher were shot by a lone gunman. Obviously to the man who likes to wear red dresses in public there is no significant moral difference between abortion and the murder of children, teenagers and adults. All the same to him.
I have no intention to get into the pro's and con's of abortion again. In a way, being a card-carrying humanist, I don't mind O'Brien rambling on like this. The more hysterical, and, frankly, silly, his public utterances become, the greater the irrelevance of the organisation he runs in Scotland is likely to become. And that, probably, is a good thing. The less people listen to 'moral' pronouncements, and the kind of bullying and hectoring that emanates from characters like Mr O'Brien the better for our societies.
I am concerned, however, by the overwhelmingly negative response he received from the media. Many commentators suggested that he overstepped the mark and that he shouldn't try to influence elected politicians' views and votes on this issue. Here I disagree as a matter of principle. Mr O'Brien is essentially a lobbyist for a conservative organisation. The organisation is known to hold radical views on abortion, euthanasia and many other issues. Surely in a democratic society lobbyists like Mr O'Brien are entitled to campaign for their views. It is up to mainstream society to reject their message. End of story. It would be a sad indictment of our democracy indeed, if Mr O'Brien could not have his say.