Salvation is Cheap
http://www.guardian.co.uk/flash/mendel.swf
What is it like to be HIV-positive in South Africa? The Guardian's Gideon Mendel and colleagues tell us in a powerful multimedia presentation that is at once heart-wrenching, infuriating, and hopeful. The story is, of course, about access. “Close to five million South Africans are HIVpositive, more than in any other country,” writes Mendel in the opening page. But most are living with little more than antibiotics to ease bouts of diarrhoea.
Under the leadership of the Treatment Action Campaign project (http://www.tac.org.za/treatment) and with assistance from Médicins Sans Frontiéres (http://www.msf.org), South Africans have been actively campaigning for their right to treatment. The government recently acquiesced somewhat, tentatively approving a proposal to bring antiretroviral treatment to some 500 000 people.
Mendel undertook a formidable task: to tell the stories of South Africans whose lives are affected by HIV/AIDS. Using an amalgam of photographs—many of which can be navigated 360 degrees—text, and audio (especially affecting), he introduces site visitors to individuals with no access to treatment (figure, above); family and friends of those who have died from the illness; and people who are now receiving antiretroviral therapy.
The presentation begins with a 25-year-old HIV-positive woman who cannot afford treatment. “If I had enough money, I would be able to buy life, because seemingly nowadays life is for sale for people who have money,” she says. We hear her voice, briefly. “I wanted to be a nurse to be able to help sick people, but now I am one of those sick people myself. My life is full of pain. I think I am going to die anytime soon now.”
Shortly thereafter, we meet a 29-year-old woman whose husband died of AIDS. “After I lost him, his parents chased me out”, she says. “I don't have two cents or five cents from my husband. I stay with my mother and father and family, so my family support me. I need medication because I want to live with my children… I know the medication doesn't make the illness go to sleep altogether, it just keeps it sleeping for that moment.”
The show goes on—exploring cluttered kitchens, bedbound mothers and fathers, children both negative and positive, elementary schools in mourning, and activist patients. “This is a loud cry. Treat us before we perish, for God's sake”, say patients fighting for the “good cause”. “The government must stop saying that HIV/AIDS is caused by poverty”, they say, “because then why do rich people die?”
Users who stay with the presentation are rewarded with a hopeful ending, but no promises. “I get the drugs free because I am part of a pilot project”, says another 25-yearold woman. “I am so lucky to be on antiretrovirals… I am sad that other people who are very sick cannot get them.”
SARS guidance
http://www.cdc.gov/ncidod/sars/sarsprepplan.htm
The US Centers for Disease Control and Prevention (CDC) released a draft document to assist local and state public health and health-care officials in preparing for and responding “rapidly and decisively” to a possible re-emergence of severe acute respiratory syndrome (SARS). The document—available in PDF ormat—addresses key measures for SARS preparedness and response, and provides tools for local-level preparedness and response activities. Areas covered include command and control responsibilities; surveillance of cases and contacts; preparedness and response in health-care facilities; community containment measures, including non-hospital isolation and quarantine; management of international travel-related transmission risk; laboratory diagnostics; communication; and the role of information technology. The document is currently undergoing external review and will be updated as needed, incorporating comments from reviewers and reflecting increased understanding of SARS-coronavirus transmission and the availability of improved prevention tools. The CDC invites interested public health partners to submit comments.
Preventing resistance from antimicrobial drugs for animals
http://www.fda.gov/oc/antimicrobial/questions.html
The US Food and Drug Administration has released Evaluating the safety of antimicrobial new animal drugs with regard to their microbiological effects on bacteria of human health concern, the first evidence-based process for assessing the likelihood that antimicrobial drugs used to treat an animal may cause resistance problems in people who eat meat or other byproducts from that animal (figure). The guidance document encourages industry to use a threepronged risk-assessment process to help establish drug safety. The suggested pathway includes a “release assessment”, which examines the possibility that resistant bacteria will be present in animals as a result of using a particular drug; an “exposure estimate”, which gauges the likelihood that people would ingest the resistant bacteria; and a “consequence assessment”, which assesses the likelihood of adverse consequences to human health resulting from exposure to the bacteria. Scroll to the bottom of the page for the full guidance and Federal Register entry in PDF format and a downloadable slide show.