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(2) AIDS
SURPASSES BLACK DEATH AS
DEADLIEST DISEASE
IN HISTORY
(3) AN HIV VACCINE IS WITHIN REACH
(4) COULD
DRUG COMPANIES HELP WIN THE
FIGHT AGAINST
AIDS?
(1) SURGICAL ADVANCES
PREVENT DEATHS
IN OLDER HEART BYPASS PATIENTS
(Time trends in survival and readmission
following
coronary artery bypass grafting
in Scotland,
1981-96: retrospective observational
study)
http://bmj.com/cgi/content/full/324/7331/201
The age of patients undergoing heart bypass
operations has risen sharply, yet the
risk of death
within two years of the operation has
declined,
finds a study in this week's BMJ.
Researchers in Scotland identified all
25,229
coronary artery bypass operations performed
in
Scottish NHS hospitals from 1981 to 1996.
The
percentage of operations performed on
patients
aged over 65 increased from 2% to 30%
in men
and from 16% to 45% in women.
After adjusting for age, they found that
the risk of
death up to two years after the operation
and the
need for readmission to hospital declined
significantly in men. Similar time trends
were seen
in women, but were not significant. However,
this
may simply reflect the fact that fewer
procedures
are carried out in women, say the authors.
These improvements are likely to reflect
advances
in surgical and anaesthetic techniques,
they
conclude.
Contact:
Jill Pell, Honorary Clinical Senior Lecturer,
Department of Public Health, Greater Glasgow
Health Board, Glasgow, Scotland
Email: jill.pell@gghb.scot.nhs.uk
(2) AIDS SURPASSES
BLACK DEATH AS
DEADLIEST DISEASE IN HISTORY
(Reducing heterosexual transmission
of HIV in
poor countries)
http://bmj.com/cgi/content/full/324/7331/207
In terms of illness and death, AIDS is
worse than
the Black Death of the 14th century. Ninety
five
per cent of new infections of HIV are
in the world's
poor countries and heterosexual transmission
is
responsible for most of these, reports
Peter
Lamptey, in this week's BMJ.
Programmes to change behaviour and promote
condoms and treatment of sexually transmitted
infections are effective in preventing
the spread of
HIV. However, large scale prevention efforts
have
been successful in only a few countries,
mainly
because of inadequate resources and lack
of
international commitment, argues the author.
HIV/AIDS is likely to surpass the Black
Death as
the worst pandemic ever, as without access
to
drugs, most of the 40 million people currently
living
with HIV will die, writes the author.
We urgently
need an effective and safe vaccine, an
affordable
cure, and intensified prevention, care,
and support
programmes, he concludes.
Contact:
Peter Lamptey, President, Family Health
International AIDS Institute, Arlington,
USA
Email: Plamptey@fhi.org
(3) AN HIV VACCINE IS WITHIN REACH
(The search for an HIV vaccine)
http://bmj.com/cgi/content/full/324/7331/211
An effective, affordable, and accessible
HIV
vaccine is 7-10 years away, according
to scientists
at the Medical Research Council of South
Africa,
in this week's BMJ. However, its success
depends
on a complex interplay of politics, science,
and
public-private partnerships.
Equitable public-private partnerships between
researchers, manufacturers, and distributors
and
partnerships between rich and poor countries
are
the best strategy for the development
of the
vaccine, say the authors. Successful vaccine
development also entails adequate investment
in the
countries that carry the burden of the
HIV/AIDS
pandemic.
Vaccines are the only hope for the control
and
possible elimination of HIV infection.
How we
distribute the vaccine will also be a
test of our
international ethics and humanitarian
objectives,
they write.
If we fail to provide the world with an
effective
HIV vaccine, future generations will judge
us
harshly, because this failure will not
be due to lack
of ability or resources but to politics,
they
conclude.
Contact:
Malegapuru William Makgoba, President,
Medical
Research Council of South Africa, Cape
Town,
South Africa
Email: malegapuru.makgoba@mrc.ac.za
(4) COULD DRUG
COMPANIES HELP WIN THE
FIGHT AGAINST AIDS?
("We all have AIDS": case for reducing
the cost of
HIV drugs to zero)
http://bmj.com/cgi/content/full/324/7331/214
Drug companies could influence the fight
against
the AIDS epidemic by reducing the cost
of HIV
drugs in poor countries to zero, writes
Donald
Berwick in this week's BMJ.
He argues that modern drugs can improve
the lives
of people with HIV by years, even decades,
yet
their high costs are often used as an
excuse for
poor countries not to develop effective
infrastructures for the care of patients.
Richard Sykes, chairman of GlaxoSmithKline,
says
that it is easy ± although misguided ±
to assume that
cost is the main barrier to people in
poor countries
having greater access to effective drugs.
His
company offers its medicines to poor countries
at
prices up to 90% lower than those charged
in rich
countries, yet he has not seen a considerable
uptake in the use of these medicines.
The international community's lack of political
will
to provide drugs to people with HIV and
AIDS is
a greater danger than the South African
President's
belief that poverty is the cause of AIDS,
argues
Zackie Achmat of South Africa's Treatment
Action
Campaign.
He believes that a global health fund will
be a start
in providing treatment, supporting HIV
prevention
efforts, demonstrating political commitment,
and
reaffirming the principle that everyone
has the rights
to life, freedom, dignity, and equality.
Contacts:
Donald Berwick, President and Chief Executive
Officer, Institute for Healthcare Improvement,
Boston, USA
Email: dberwick@ihi.org
Richard Sykes, Chairman, GlaxoSmithKline,
Middlesex, UK
Email: tft28919@glaxowellcome.co.uk
Zackie Achmat, Chairperson, Treatment Action
Campaign, Cape Town, South Africa
Email: zackie@pixie.co.za
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