VZCZCXRO0586
RR RUEHDU RUEHJO RUEHMR
DE RUEHSA #1195/01 0831118
ZNR UUUUU ZZH
R 241118Z MAR 06
FM AMEMBASSY PRETORIA
TO RUEHC/SECSTATE WASHDC 2362
INFO RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY
RUCPDC/DEPT OF COMMERCE WASHDC
RUEATRS/DEPT OF TREASURY WASHDC
RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA 1102

UNCLAS SECTION 01 OF 03 PRETORIA 001195 
 
SIPDIS 
 
SIPDIS 
 
DEPT FOR AF/S; AF/EPS; AF/EPS/SDRIANO 
DEPT FOR S/OFFICE OF GLOBAL AIDS COORDINATOR 
STATE PLEASE PASS TO USAID FOR GLOBAL BUREAU KHILL 
USAID ALSO FOR GH/OHA/CCARRINO AND RROGERS, AFR/SD/DOTT 
ALSO FOR AA/EGAT SIMMONS, AA/DCHA WINTER 
HHS FOR THE OFFICE OF THE SECRETARY/WSTEIGER, NIH/HFRANCIS 
CDC FOR SBLOUNT AND DBIRX 
 
E.O.  12958: N/A 
TAGS: ECON KHIV SOCI TBIO EAID SF
SUBJECT:  SOUTH AFRICA PUBLIC HEALTH MARCH 24 2006 ISSUE 
 
 
Summary 
------- 
 
¶1.  Summary.  Every two weeks, Embassy Pretoria publishes a 
public health newsletter highlighting South African health 
issues based on press reports and studies of South African 
researchers.  Comments and analysis do not necessarily reflect 
the opinion of the U.S. Government.  Topics of this week's 
newsletter cover:  SA Health Department Short of its Goals; 
Traditional Cure Advocated However Still in Research Stages; 
New Pharmaceutical Dispensing Fees Proposed; Heart Drug 
Introduced in South Africa; Rapid Increase of Youth in Drug 
Treatment Centers; North West Province Begins TB Information 
Campaign; and Survey Results of Workplace Peer Educators.  End 
Summary. 
 
SA Health Department Short of its Goals 
--------------------------------------- 
 
¶2.  More than 500,000 South Africans require antiretroviral 
(ARV) treatment, according to Fatima Hassan of the Aids Law 
Project at the University of the Witwatersrand.  Less than half 
are receiving the medication, despite substantial increases in 
public funding for ARV treatment.  A government fact sheet 
issued in November 2005 titled "Implementation of the 
Comprehensive Plan on Prevention, Treatment and Care of HIV and 
AIDS" noted that 85,000 people were receiving ARV treatment in 
the public health sector by September of 2005.  Hassan 
estimated that an additional 70,000 to 80,000 persons were 
being treated privately by August 2005.  In November 2003, the 
Operational Plan for Comprehensive HIV and Aids Care, 
Management and Treatment for South Africa, noted that 381,177 
persons were supposed to be on government-funded ARV treatment 
in the 2005/2006 period.  According to the Treasury Department, 
112,000 were enrolled for ARV therapy by end December 2005.  In 
addition, not many children are on treatment, according to 
Hassan.  At least 50,000 children need ARV treatment now, but 
currently only about 10,000 are receiving ARV treatment. 
Shortages of doctors and nurses also pose a problem.  According 
to Rotimi Sankore, from the Center for Research, Education and 
Development of Freedom of Expression and Associated Rights, 
about 100,000 health professionals, half of them doctors, had 
left Africa since the 1990s for global employment.  Source: 
Sapa-IPS IOL, March 15. 
 
Traditional Cure Advocated However Still in Research Stages 
--------------------------------------------- -------------- 
 
¶3.  Recent press reports have portrayed ubhejane as both a 
possible cure and unproved treatment in combating HIV/AIDS. 
Zeblon Gwala, who makes ubhejane from a mixture of 89 African 
herbs, has claimed that the pre-clinical assessment tests 
conducted by the University of KwaZulu-Natal, Dr. Nceba 
Gqaleni, have shown that ubhejane has potent activity against 
opportunistic infections associated with HIV/AIDS.  KwaZulu- 
Natal (KZN) Health Minister Piggy Nkonyeni, eThekwini (Durban) 
mayor Obed Mlaba and Professor Herbert Vilakazi, special 
advisor to KZN's premier, have encouraged ubhejane's use, 
saying that it improved conditions of HIV/AIDS patients. 
Professor Salim Abdool Karim, UKZN Pro Vice-Chancellor for 
Research, said while the university supported research on 
traditional medicines, it would not allow its reputation to be 
abused through false claims.  According to Karim, new 
procedures were being enforced at the university to prevent 
people making false claims from its research findings.  Dr. 
Gqaleni asserted that claims of effective treatment of ubhejane 
for AIDS are unfounded and misrepresent findings of preliminary 
research.  His research on the activity of ubhejane on cell- 
lines only used test tubes and could not conclude about the 
potential action of Ubhejane in humans. 
 
¶4.  Gwala, the manufacturer of ubhejane, claims that the recipe 
came from his traditional healer grandfather in dreams and that 
he personally mixes 89 African herbs manually.  Initial 
treatments are 2 two-liter bottles costing R 342 ($60), which 
lasts four weeks. According to Gwala, he offers patients a 
choice between using his product and antiretroviral drugs. 
While Gwala keeps patient records, he could not supply details 
of those who had improved their CD4 counts and decreased their 
viral loads since taking ubhejane.  Source:  Sapa, Sunday 
Tribune, City Press, March 19; Mail & Guardian, March 17. 
 
PRETORIA 00001195  002 OF 003 
 
 
 
New Pharmaceutical Dispensing Fees Proposed 
------------------------------------------- 
 
¶5.  Health Minister Manto Tshabalala Msimang announced new 
draft regulations for pharmacies' dispensing fees.  The 
dispensing fees will be on a sliding scale.  Under the draft 
regulations, where the manufacturer's price (or single exit 
price of medicine) is less than R75 ($12), the maximum 
dispensing fee that may be charged is R7 plus 28% of the price. 
Where the single exit price is more than R75, the dispensing 
fee would be R23 plus 7% of the price.  Where the exit price is 
between R150 and R250, the fee would be R26 plus 5% of the 
single exit price.  Where the exit price is more than R250 the 
fee would be R31 plus 3%.  These dispensing fees would serve as 
a ceiling on drug prices, where lower dispensing fees could be 
charged at the discretion of the pharmacist.  In October 2005, 
the Constitutional Court upheld the government's medicine 
pricing regulation, but ordered a review of the previous 
proposed dispensing fee of a maximum of R26 for medicines 
priced over R100 and 26% for those under R100.  A final 
dispensing fee would only be announced after the comments have 
been considered.  Consumers would receive an invoice that gave 
the single exit price of a medicine and the dispensing fee. 
According to Anban Pillay of the Health Department, the 
department relied on information submitted by pharmacies to 
determine the dispensing fee ceilings.  The department had sent 
questionnaires to all 2,532 pharmacies in South Africa, 
receiving only 162 analyzable questionnaires back.  The 
questionnaires revealed that some pharmacies would close, no 
matter what the level of the price ceiling.  Source:  Sapa, 
March 9; Cape Times, March 10. 
 
Heart Drug Introduced in South Africa 
------------------------------------- 
 
¶6.  Astra-Zeneca, a global pharmaceutical manufacturer, plans 
to introduce Crestor, a drug that blocks the production of 
cholesterol and reduces the amount of plaque in blood vessels, 
in South Africa by the end of 2006.  Jasvanti Bhana, the 
medical adviser for Astra-Zeneca said Crestor also increased 
the level of good cholesterol in the blood, thus helping to 
reduce the risk of fatty deposits in the arteries, which can 
lead to heart attacks, stroke and vascular disease.  Launched 
globally in 2003, Crestor is awaiting approval for registration 
by South Africa's Medicines Control Council.  Prof Abdul Mitha, 
chairman of the Heart Association's KwaZulu-Natal branch, said 
it would be premature to call Crestor a wonder drug.  It lowers 
cholesterol more than other drugs have done, however he sees no 
evidence of better results in terms of deaths and recoveries. 
Results of an international study released at the American 
College of Cardiology annual conference in Atlanta show that 
two years of treatment with Crestor, whose chemical name is 
rosuvastatin, cut cholesterol levels by more than half and 
reduced the thickness of the atheroma (or fat deposits in 
arteries) by 6.8%.  The research also showed four out of five 
patients showed some form of reduction in atheroma.  Crestor 
has been the focus of controversy after evidence emerged that 
it could cause a muscle-wasting disease. 
 
¶7.  Heart disease kills 200,000 people a year in South Africa 
and affects more than two million.  South Africa's Indian, 
Jewish and Afrikaner communities are among the world's highest 
risk populations when it comes to cardiovascular diseases. 
Source:  Sunday Tribune, March 19. 
 
Rapid Increase of Youth in Drug Treatment Centers 
--------------------------------------------- ---- 
 
¶8.  In the past five years, there has been a rapid increase in 
the patterns of alcohol and other drug use in South Africa, and 
significantly more young patients are being admitted to 
treatment centers for drug-related problems.  According to 
statistics released by the Hospital Association of South Africa 
(HASA) there was a growing number of patients younger than 20 
being admitted to treatment centers, as well as an increase in 
the number of young people, some as young as 14, dying from 
substance-abuse-related causes.  In Durban, East London and 
Gauteng the average age of Mandrax users was 21. Across the 
country, the mean age for dagga (marijuana) use ranged from 19 
to 21.  In the Western Cape Province, 42% of patients younger 
 
PRETORIA 00001195  003 OF 003 
 
 
than 20 used Tik (crystal meth) as their primary drug of abuse. 
In KwaZulu-Natal Province, 50% of admitted patients in 
treatment centers younger than 20 used dagga, while 25% used 
alcohol, 20% used Mandrax (20 percent).  Treatment and demand 
for dagga and Mandrax-related problems across South Africa is 
generally higher for people younger than 20 than for older 
patients.  Forty percent of children who are admitted for 
substance abuse have a dual diagnosis: addiction which is the 
primary illness and a secondary or underlying psychiatric 
condition such as clinical depression or bipolar mood disorder. 
In these cases, rehabilitation aimed at reducing the use of 
drugs is only one component of the treatment.  Claire Savage, 
Senior Information Officer at the South African Council on 
Alcoholism and Drug Dependency Center, asserted that their 
center is admitting increasing numbers of younger patients for 
rehabilitation.  Between 2004 and 2005, more than 30% percent 
of patients were under the age of 20.  Source:  The Mercury, 
March 16. 
 
North West Province Begins TB Information Campaign 
--------------------------------------------- ----- 
 
¶9.  The North West Health Department is beginning a 
Tuberculosis (TB) information-sharing campaign aimed at the 
media to inform communities about the disease.  There has been 
a significant increase in TB cases around the country since 
¶1995.  In 1995, just over 500 cases of TB were registered, 
while by 2000, over 25,000 cases were noted.  In the North West 
province, 617 out of every 100,000 people had TB in 2005.  The 
North West currently ranks 5th in the national caseload of the 
disease.  Eighty percent of the TB case loads were reported in 
Kwa Zulu-Natal, Western Cape, Eastern Cape and Gauteng 
provinces.  People aged between 35 and 44 years suffered from 
TB the most.  Health MEC Nomonde Rasmeni said organizing the 
Media Open Day/TB Awareness Campaign was important, as it 
equips journalists with information about the disease to help 
educate communities.  The mycobacterium tuberculosis, a germ 
that causes the disease, is present in the sputum coughed up by 
those that have TB of the lungs.  The germ destroys the soft 
tissue of the lungs, causing cavities and resulting breathing 
difficulty.  Source:  BuaNews, March 12. 
 
Survey Results of Workplace Peer Educators 
------------------------------------------ 
 
¶10.  Wits University's Business School conducted a study of 
peer educators from five large companies involved in the 
mining, retail, finance and the auto manufacturing sectors. The 
companies have a workforce of over120,000.  The number of peer 
educators surveyed totaled 1,780.  Dr David Dickinson, a Senior 
Lecturer on HIV/AIDS in the workplace at University of 
Witwatersrand Business School and author of the report, stated 
that the study tried to establish who the peer educators are in 
the workplace.  The study found that the peer educators were 
similar to the typical profile of the workforce with two 
differences.  African women are over-represented as peer 
educators compared to their profile in the work-force and an 
almost total absence of top and senior management amongst the 
ranks of peer educators.  Dr Dickinson gives two explanations 
of women's over-representation.  More Africans have HIV/AIDS 
and there is a gendered concern about the disease's effects 
taken from the home into the workplace along with peer 
education.  Dickinson gives supervisors' importance on 
maintaining production as reasons for low senior management 
participation in peer education programs.  He asserts that peer 
education programs must be given official recognition, with 
formal opportunities provided by supervisors and materials, the 
information and the resources to run education and training 
programs.  Researchers won't reveal the identities of the 
companies involved in the survey.  Source:  Health E-News, 
March 10. 
 
TEITELBAUM