Monthly Archives: March, 2010

The Commonest Disease in China

In South Africa, its HIV/AIDS; but the commonest ailment in China is diabetes. According to the BBC, China faces a diabetes epidemic, what with almost one in 10 adults having the disease, while more cases remain undiagnosed.

Given China’s huge population, this means that there are some 90 million diabetics; more than anywhere else in this planet. Even the US, with a similar prevalence of 1 in 10 plays second fiddle in terms of numbers simply because of China’s sheer size.

This represents a major public health problem for the authorities in Beijing as diabetes is a major factor in illnesses such as heart disease, stroke and kidney disease. Add to this the fact that this disease does not have many symptoms during the early stages and we have a potential gigantic health problem in the next few decades.

The reason for this upsurge in diabetes is the rapid economic development in China where a combination of urbanisation, lack of exercise, changing eating habits and higher stress have all resulted in obesity and sedentary lifestyle. Prosperity has resulted in the average Chinese going from a situation where he has not enough food and has to resort to manual labour to eke out a living, to a situation of having enough (or too much) food and doing less exercise.

Urbanisation & Rising Living Standards cause change in Eating Habits of the Unhealthy Kind

As if not to make matters worse, diabetes is a disease which is difficult to diagnose in the early stages, largely because it is silent and wreaks serious damage before symptoms appear. It basically affects every blood vessel in the body and therefore will damage practically every organ in the body. Read more here.

A Drop of Blood is all it takes to diagnose Diabetes

Given the difficulty in diagnosing diabetes early, an extremely simple test to see whether you have diabetes is by measuring the amount of glucose in the blood. This is easily done by doing an instant finger-prick test at the pharmacy.  If the result is suspicious, further blood tests will have to be done at the doctor’s office to confirm.

Obama’s Health Bill – Guess Who’s Unhappy Now?

Making history, President Obama signed into law the healthcare bill yesterday, making it the first time that there is healthcare coverage for every American. Well, this certainly made the Republicans unhappy, they citing that the phenomenal costs involved will drive the nation deeper in debt.

Putting Pen to Paper - President Obama transforms the bill to law

Also not looking forward to the new law will be all the private health insurance companies, who for years have been making handsome profits, mainly by including various escape clauses to exclude payments for health expenditure where it mattered most, such as in claims for pre-existing illnesses.

Even so, one of the more unpublicised facts from the new law, hidden within the massive pages of the bill, is a requirement that will make calorie counts mandatory for thousands of restaurants. More than 200,000 fast-food and chain restaurants will now have to state the number of calories each item on their menu has, the idea being to inform the consumer the number of calories they are consuming.

Chain restaurants,like Starbucks, will have to state Calorie Counts on all items on the menu

Grumblings are also being heard from doctors. The new law introduces curbs on doctor-owned hospitals and promotes an independent payment advisory board that does not include doctors, However, it does not include a performance-based payment system and does not address reforms meant to reduce medico-legal litigation costs (this being arguably one of the main reasons why heathcare costs are so high).

While the healthcare bill has become law with the President’s signature, storm clouds are looming –  attorneys general from 13 states – 12 Republicans and one Democrat – have begun legal proceedings against the federal government seeking to stop the reforms on the grounds that they are unconstitutional. So it does look like the ‘victory’ is not yet sealed in stone..

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Healthcare Nowadays..


The 2010 World Cup’s Biggest Threat?

With the World Cup tournament, soccer’s holy grail, opening soon  in South Africa, June 2010, several threats to its success have been forecasted – incomplete facilities, dwindling attendances and terrorism to name a few.

A Big Worry is whether the 10 venues will be completed in time

But perhaps the greatest threat of all will be on the health front – the fact that one in every five adults in South Africa have HIV/AIDS. With an estimated 500,000 visitors expected (including an estimated 40,000 prostitutes)during the month-long soccer tournament, the South African authorities have been far from naive and complacent. They are  raising fears of a rise in prostitution and sex trafficking from neighbouring countries and eastern Europe, and creating a potential HIV timebomb.

A South African teenage prostitute holds on to her one remaining condom (pic from The Guardian)

This fear has been translated into action – in a recent visit to the UK, President Jacob Zuma appealed for an extra 1 billion condoms as part of a HIV prevention drive aimed at the influx of visitors during the tournament. The British government responded positively with a pledge to donate 42 million condoms worth GBP 1million as part of the HIV prevention drive.

Another controversial measure being implemented by the South African government is the legalization of prostitution, thereby marginalising criminal operators and bribery, at the same time allowing the police to concentrate on other more serious crime prevention duties.

1 billion condoms for half a million visitors – that works out to 2,000  each – might seem to be a bit of an over-estimate. One thing for sure, better to be safe than sorry!

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5 Best-Selling Medications In The World – One Is Not That Effective

My curiosity was raised recently when a news report claimed that one of the top 5 medicines in the world has recently been found to be not that effective.

First of all, the top five are:

1. Lipitor – the wonder drug for lowering blood cholesterol. USD 13 billion sales annually.

2. Plavix –  the blood-thinner that works by preventing blood platelets from sticking together. USD 6 billion annually.

3. Seretide – aka Advair, is a combination steroid-betaagonist( to relax the air passages in the lungs) that is inhaled by asthma patients. USD 6 billion.

4. Nexium – the wonder drug for the treatment of stomach ulcers and gastritis. USD 5 billion .

5. Norvasc – the top-selling medication for blood pressure. USD 4.8 billion.

Its interesting to see that many side-effects have been reported worldwide when using the above drugs, which brings one to the maxim – all drugs have side-effects and using it is a balance between its benefits and its risks. Some of these side-effects are quite harmless, like feet swelling up with Norvasc, but others can be potentially life-threatening.

Such is the case with one of the above –  Plavix aka clopidogrel – which has recently been issued a “black box” warning by the FDA here. A boxed warning is the FDA’s toughest warning and appears prominently at the top of a drug’s label to warn users of a serious warning. In the case of Plavix, 2-14% of users will not respond to its benefits (the anti-clotting action) and therefore will be at risk of a blood clot forming in the arteries of their heart or brain despite taking the medication. The inefficacy is determined genetically and its possible for potential users to have themselves screened in the near future to see whether they should take the medication or not.

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Electronic Mosquito Repellents Don’t Work

Electronic plug-in anti-insect gadgets that claim to emit high-frequency sounds inaudible to the human ear have been sold for quite a few years. If its any judge of their popularity, they have also been put on as an  item to purchase in in-flight sales of many of the world’s popular airlines, Singapore Airlines and British Airways included.

Claimed to drive away female mosquitoes because these devices emit a high-frequency sound (males do not bite humans), these devices are ubiquitously displayed in most home improvement shops. I recently purchased one after being convinced on the label that there has been “extensive scientific research undertaken to confirm the efficacy of this product”. The promo blurp adds that it was  harmless  to humans…apart from a possible dent to one’s pockets, that is.

I should have known better..after proclaiming many times about the necessity of solid scientific evidence to back various cures and remedies.

An article in the Cochrane Library ( a reputable resource for doctors for evidence in healthcare decision-making) quickly dispelled the lack of effectiveness of these devices. After compiling 10 studies, it found that there was no evidence in the field studies to support any repelling effects of these repellents;  hence there was no evidence to support their promotion or use.

This has led to some of the major airlines like KLM literally pulling the plug on its sale on-board. Anyone looking for a slightly-used electronic repellent?

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Healthcare Nowadays..

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Where Health Tourism Is NOT Welcomed

While many countries in the Far East are welcoming visitors who want to use their medical facilities, a few in Europe dread the presence of these health tourists. Take the United Kingdom, for instance. Despite the NHS in England earning 25 million pounds sterling from health tourists annually, it accrues 5 million pounds in unpaid bills.

Travel To the UK - passport, visa and now insurance card?

So now, according to BBC News, the Department of Health is  proposing that visitors to the UK could be required to hold health insurance before they can enter the country. In a separate immigration review, the UK could also refuse entry to foreigners owing money for health care. This ruling however does not apply to visitors from the EU.

The department conceded that, while the unpaid debts were small in relation to overall NHS spending, it was “important that we maximise recovery, not least to discourage deliberate abuse by a small minority of visitors”.

Hmm..this will be a retrogressive step if applied, as health tourism has been a source of substantial foreign earnings for those countries actively promoting it, and the UK could do with some foreign direct investments. While I can understand the rationale behind this move, there are alternatives which might not be too difficult to implement, instead of checking every visitor for a valid insurance card at Immigrations.

For instance, improving the payment processes at the point of admission to hospitals, by having a deposit or a credit-card guarantee, can mitigate payment defaulters before the problems start. In essence, the NHS has to get out of its socialized medicine mentality and begin to function as a corporate entity in the way a Hospital trust should.

Meanwhile, if this must-have-insurance rule is applied, it wouldn’t be too far away before health issues pertaining to human  rights will be raised, should any visitor be deprived of healthcare which is generally considered a basic human right.

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