Tag Archives: ARV

Global Health News Last Week

POLITICS AND POLICY

  • South Africa’s government has set out its plans to introduce a universal health care scheme with a pilot program in 10 areas by 2012 and nationally over the next 14 years.
  • The U.N. must make reducing salt intake a global health priority, sayUK scientists. Writing in the British Medical Journal they say a 15% cut in consumption could save 8.5 million lives around the world over the next decade.
  • IRIN reports on the story of Daniel Ng’etich, a Kenyan man who was arrested and jailed for not continuing his TB treatment.
  • Dr. Jill Biden is leading a high level American delegation toKenya, which includes Raj Shah, to look into the American response to the famine crisis in the Horn of Africa.
  • A report on the state of maternal health in South Africa by Human Rights Watch has uncovered some alarming trends.

PROGRAMS

  • WHO has launched a new website to help those combating malnutrition. eLENA, a new e-library, gathers together evidence-informed guidelines for an expanding list of nutrition interventions. It is a single point of reference for the latest nutrition guidelines, recommendations and related information.

RESEARCH

  • A TB vaccine designed for those with HIV enters phase IIb trials this week in Senegal. The vaccine works by boosting response of T cells already stimulated by the traditional BCG vaccine.
  • Female smokers are more at risk for heart disease than male smokers, finds a systematic review and meta-analysis published in the Lancet.  This is a concern, as smoking rates are increasing in young women worldwide.
  • Scientists are in the second phase of research into using microwaves to kill malaria parasites in mice.
  • A USC researcher has developed a lentiviral vector that can track down HIV infected cells which can potentially act as a marker for targeted elimination of infected cells.
  • People living with HIV who receive the proper ARV treatment have no greater risk of death compared to people without HIV, finds Danish researchers.
  • Around 30 genetic risk factors for developing multiple sclerosis have been discovered by a UK-led team.
  • A new study, showing that a simple blood test can accurately determine the sex of a fetus 95 percent of the time, is great news for parents at high risk of having a baby with rare genetic diseases. But it is bad news to those concerned that the tests could be used to abort a fetus based on gender.
  • British researchers have discovered that the introduction of spermless male mosquitoes can lead to fewer malaria carrying females.
  • A device which can test blood for HIV/AIDS in a matter of minutes has been developed by University of Columbia scientists.

DISEASES AND DISASTERS

  • As if it did not have enough problems already, Somalia is now facing cholera epidemic, World Health Organization officials said.
  • In an August 4 article, Trustlaw’s Lisa Anderson exposes the “silent health emergency” faced by child brides around the globe.  Not yet physically mature, they face grave danger in childbirth, due to narrow pelvises. Girls younger than 15 years of age have a five times greater risk of dying during delivery than women over 20; most of these deaths occur in developing countries that lack adequate and accessible pre- and postnatal care.
  • Amid contradictory government statistics, a volunteer group in Japan has recorded 500,000 radiation points across the country.
  • A Mexican teenager is the first officially known person to die from vampire bat induced human rabies infection. The 19-year-old victim was a migrant farm worker in theUnited States.
  • An estimated 500,000 people in West Africaare infected with lassa fever every year, the World Health Organization (WHO) said on Wednesday, amid calls for more money to be spent on preventing its spread.
  • Over at Global Pulse, Human Rights Watch researcher Katherine Todrys guest blogs on the HIV epidemic in Uganda’s penitentiaries.Uganda, she explains, has often been presented as a success story in the global fight against HIV/AIDS, and has received over $1 billion from the US for AIDS programs. Many HIV-positive Ugandans have been excluded from these efforts, though, including gay men, drug users, sex workers, and prisoners.
  • Sleep apnea, a fairly common and treatable disorder that causes people to stop breathing momentarily while they sleep, may lead to cognitive impairment and even dementia.
  • Although cases of sexual violence have been under-counted during some wars, during others, such as the ongoing unrest in Libya, they have been vastly over-counted.
  • All patients getting cancer treatment should be told to do two and a half hours of physical exercise every week, says a report by Macmillan Cancer Support.

Global Health News Last Week

The Supercourse team at the University of Pittsburgh has taken the initiative to spread the WHO’s definition of health, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”  They have translated the definition into over 60 different languages using Google translate and have asked health professionals to review them to make sure they are correct.  This global health knowledge campaign is being developed by the Supercourse team, WHO Collaborating Centre, University of Pittsburgh.  Please contact Dr. Ronald LaPorte, Director, Professor of Epidemiology, University of Pittsburgh, for more information.

July 28 was the first-ever World Hepatitis Day.

POLITICS AND POLICY

  • As the UN gears up for its Summit on Non-Communicable Diseases this September, blogger Michael Hodin argues that by focusing on this issue, the world body has a “new shot at relevance” in an era where its importance is decreasing (and countries contemplate cutting its funding).
  • Former U.S. Ambassador on HIV/AIDS Jack Chow says the CIA’s fake vaccination scheme in Pakistan, aimed at locating Osama Bin Laden, threatens to undermine a broad set of American global health initiatives.
  • The U.S. government and the Gates Foundation were responsible for 85% of the steep increase in malaria funding between 2007 and 2009. Richard Tren argues that we need to diversify funding sources and focus on control efforts.

PROGRAMS

  • The Bill & Melinda Gates Foundation has teamed up with FC Barcelona to promote the polio eradication campaign.
  • To raise awareness about violence against women in Europe, the UN has opened up a contest to design a newspaper advertisement in support of the UN Secretary-General’s UNiTE to End Violence against Women campaign. View submissions and the winning entries here.
  • Seattle-based development blogger Tom Paulson continues to raise some interesting issues regarding the Gates Foundation’s funding of media coverage for global health issues.  Their latest venture is a weekly program on the BBC.

RESEARCH

  • Researchers have cracked the DNA code of the strain of E. coli that originated in German sprouts and killed over 50 people this summer.
  • A cell phone that doubles as a blood-oxygen tester is one of the 77 mHealth innovation finalists for the Saving Lives at Birth: A Grand Challenge for Development competition.
  • A study conducted by the WHO found that France, the U.S., the Netherlands, and India have the highest rates of depression in the world, while China has the lowest.  Detailed interviews were conducted with over 89,000 individuals in 18 countries.
  • It is becoming more apparent that one of the most effective ways to deal with HIV/AIDS is to address neglected tropical diseases, argues the Public Library of Science in Eureka Alert.
  • A study of the lifespan of HIV patients receiving combination ARV therapy by researchers at University of Ottawa has found that patients can expect to live a near normal lifespan.
  • Researchers at Oklahoma University believe that a protein-based vaccine could prevent many cases of childhood pneumonia.
  • Dutch researchers have found that children who were not breastfed were more likely to develop respiratory problems such as asthma.
  • The first stage of trials for a new malaria vaccine by Swiss researchers in Tanzania have shown promising results.
  • Has announced in a study in Pediatrics that the varicella vaccine for chickenpox has reduced the annual death toll in the United States from 105 to 14. Tests are in progress that could lead to major family planning advances. The New York Times reports on some innovations in male contraceptives that could offer safe and effective contraception.

DISEASES AND DISASTERS

  • The Agbogbloshie slum outside of Accra, Ghana, is a major electronics waste dump.  This site is an example of what happens to “donated” discarded electronics: residents burn them to extract precious metals and simultaneously exposed to a host of hazardous chemicals, as the goods release lead, mercury,
    thallium, hydrogen cyanide, and PVC.
  • A recent article by a global panel uses startling images to call attention to the woeful state of neglect and inadequate treatment of mental illness in developing nations.

Global Health News Last Week

POLITICS AND POLICY

  • Attacks on aid workers are on the increase and one writer believes this largely due to the current “integrated mission” focus of the UN and other donors.
  • If the Global Fund is to avoid further adverse media coverage and further consequent donor nervousness, it must urgently implement a more effective and fine-tuned approach to the issues of corruption and transparency.
  • The families of two women who died in childbirth are starting a legal action against the government of Uganda, alleging that the inadequate care and facilities provided for pregnant women caused the deaths and violates their country’s constitution and women’s rights to life and health.
  • The results of a recent bombshell study revealing the impact of taking ARVs and the spread of HIV has the Obama administration doing some serious pondering over the impact of a policy change.
  • The elimination of mother-to-child transmission has become the focus of Rwanda’s ministry of health for reducing the rate of HIV.
  • The states in India have been directed by the central government to provide free healthcare to pregnant women and sick neonatal children effective June 1.
  • The Global Fund to Fight AIDS, Tuberculosis and Malaria has frozen payments on hundreds of millions of dollars worth of disease-fighting grants to China, one of the charity’s biggest recipients, in a dispute over China’s management of the grants and its hostility toward involving grass-roots organizations in public health issues.
  • Government think-tanks in China and India have recommended a jointly funded initiative to strengthen traditional medicine innovations in both countries.

PROGRAMS

  • In Ghana, the Oxytocin Initiative Project has begun testing whether community health workers can safely and effectively prevent postpartum hemorrhage.
  • ‘Tupange’ is the name of a new outreach program in Kenya that hopes to increase and sustain contraceptive use among urban women.

RESEARCH

  • Researchers discuss the new developments in vaccines for HIV/AIDS, malaria and TB in the scientific journal Nature.
  • Vuvuzelas – the horns used by football fans celebrating last year’s World Cup – not only cause noise pollution but may also spread diseases, say experts. In crowded venues one person blowing a vuvuzela could infect many others with airborne illness like the flu or TB. Mercifully, organisers are considering whether to ban them at the 2012 London Olympics.
  • Published by the Institute for Economics & Peace, the Global Peace Index tries to measure peace. This year has seen the world become less peaceful for the third year in a row – and highlights what it says is a continuing threat of terrorism.
  • It may be against the law, but wealthier, better-educated families in India are choosing more and more often to abort pregnancies if the child is female, researchers in Canada and India report in the Lancet.
  • Researchers at The University of Texas Health Science Center at Houston find that diabetics have a higher risk of contracting TB.
  • Lancet once called it “potentially the most important medical advance of the 20th century.” But today, oral rehydration therapy (ORT) — a simple treatment often consisting of a home solution of sugar, salt and water — is under-used, causing untold deaths of children.

DISEASES AND DISASTERS

TOTALLY UNRELATED TO ANYTHING ELSE: Apparently, to Nigerians, Bill and Melinda Gates do not look like rich people.

Global Health News Last Week

May 18 was HIV Vaccine Awareness Day.

POLITICS AND POLICY

  • Hundreds of Kenyan AIDS activists held a protest on 18 May in the capital, Nairobi to demand that the government meet its commitment to increase annual health and HIV funding.
  • In response to the mutual expulsion of diplomats, the UK’s DFID announced that it has frozen new aid to Malawi.
  • DDT has made a controversial re-appearance in Uganda.

PROGRAMS

RESEARCH

  • The World Health Organization has just launched a new web-based information resource tool that should be of interest to many in global health and development community, the Global Health Observatory.
  • According to the World Health Organization, the worldwide prevalence of obesity has more than doubled between 1980 and 2008.
  • New research has found that a variant in one gene can lead to a 30 percent lower risk of developing cerebral malaria.
  • A new study from Bangladesh concludes that most of the world’s pregnant women don’t need vitamin A supplements.
  • American scientists have tested a treatment regimen for tuberculosis which will reduce the amount of time it takes to complete the full treatment as compared to current plans.
  • A new report from the Guttmacher Institute finds that that 7 in 10 women in Sub Saharan Africa, south central Asia and south east Asia who want to avoid pregnancy, but are not using modern methods give reasons for non-use which suggest available methods do not fulfill their needs.
  • Average life expectancy across much of the world — except Iraq and South Africa — is steadily climbing and infant deaths dropped across the world during the first decade of the 21st century, according to figures released by the World Health Organization.
  • The Clinton Health Access Initiative and Gates Foundation have teamed up to support research into developing a cheaper version of the drug Tenofovir.

DISEASES AND DISASTERS

  • China has reduced its AIDS mortality by two-thirds since it began distributing free antiretroviral drugs in 2002; however, the improvements were seen largely in patients who acquired HIV through blood transfusion, rather than through sex or drug use. On a darker note, Chinese authorities ordered an AIDS activists’ web site shut down after it had published an open letter from a retired senior official concerning news restrictions placed on a 20th-century public health scandal.
  • Dr. Orin Levine looks at a disturbing global trend: Infectious killers that had been beaten back by aggressive immunization efforts are making a comeback in places long thought to be safe havens.

WORLD HEALTH ASSEMBLY

The IH Blog was featured in the “Buzzing in the Blogs” section of the Healthy Dose this week! Thanks to Tom Murphy for reading and tweeting us!

Global Health News Last Week

May 12 was International Nurses Day.
USAID’s Frontlines magazine is running an exclusive interview with Dr.

Margaret Chan, the WHO Director-General, in which she discusses current global health priorities and systems strengthening.

Peoples-uni, an open-access education initiative, offers open-access resource and online learning materials for capacity-building in low- and middle-income countries.

POLICY

  • Excessive bleeding following childbirth is the leading cause of maternal deaths in the developing world, but the World Health Organization (WHO) has now approved the use of misoprostol, a drug that considerably reduces this risk.
  • Shanghai’s health authority and local hospitals are seeking to reduce the rate of births by cesarean section this year after a recent report showed that far more Shanghai women are undergoing the procedure than is recommended by the World Health Organization (WHO).
  • For the fifth time, at next week’s WHO General Assembly, countries will debate whether or not to destroy the last two known stockpiles of smallpox.
  • The Director General of Nigeria’s drug and food regulator, Dr. Paul Orhii, was in London last week where he lodged a strong case before members states of the World Health Assembly to institute a legal platform to combat the spread of counterfeit drugs.

PROGRAMS

  • Humanosphere’s Tom Paulson writes that funding for childhood vaccinations is not keeping up with the need and is struggling to compete with more high-profile priorities.
  • The phenomenon of “poverty tourism” – in which charities and aid organizations take donors on trips to “experience poverty” and meet their beneficiary – is coming under increased scrutiny and generating controversy.
  • John Donnelly, writing in GlobalPost, characterizes the Obama Administration’s Global Health Initiative as off to “a slow, stumbling start” in a short series called “Healing the World.”
  • Last Wednesday, the WHO launched a campaign to reduce the huge but largely unrecognized burden of traffic deaths and injuries over the next decade.

RESEARCH

  • An HIV-positive person who takes anti-retroviral drugs after diagnosis, rather than when their health declines, can cut the risk of spreading the virus to uninfected partners by 96%, according to a study.
  • New research has revealed that a bacteria present in the gut of mosquitos may be another tool to fight the spread of malaria.
  • An experimental drug helped monkeys with a form of the Aids virus control the infection for more than a year, suggesting it may lead to a vaccine for people, or even a cure.
  • A study by US scientists, published in the American Journal of Public Health, found that 400,000 females aged 15-49 were raped over a 12-month period in the DRC 2006 and 2007. That comes out to an average of 48 women and girls being raped every hour.
  • A new report by MSF argues that switching from using quinine to artesunate to treat malaria could save up to 200,000 lives a year.
  • A US study has suggested that homosexual men are more likely to have had cancer than heterosexual men.
  • According to the findings of the last Pakistan Demographic and Health Survey, getting pregnant soon after childbearing, miscarriage or abortion places mothers and newborns at a higher risk of health complications or even death.
  • Results announced today by the United States National Institutes of Health show that if an HIV-positive person adheres to an effective antiretroviral therapy regimen, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96%.

DISEASES AND DISASTERS

  • According to statistics released by the National Coordinator of the Nigeria’s National Malaria Control Program (NMCP), Dr. Babajide Coker, Nigeria contributes a quarter of the malaria burden in Africa, and a staggering 90 per cent of its citizens are at risk for contracting the disease.
  • Johnson & Johnson’s recalled at least 11,700 bottles of HIV/AIDS drug Prezista in several countries, after discovering trace amounts of a chemical emitting offensive odors in five batches of products sold in the U.K., Ireland, Germany, Austria and Canada.
  • In China, around 1.5 million people require organ transplants, but just 10,000 receive them each year, as few Chinese agree to donate their organs upon death. Illegal organ traffickers have stepped in to fill that gap.

TOTALLY UNRELATED TO ANYTHING ELSE: Princess Beatrice’s atrocious weird attention-grabbing hat, worn to the royal wedding, is now being auctioned on eBay for UNICEF and Children in Crisis. Um, yay?

Global Health News Last Week

Note: I apologize for the hiatus in the news round-up; I went to a major conference for work in April and was very busy with preparations and then wrap-up afterwards.

April 25 was World Malaria Day. According to the WHO, world malaria deaths have fallen 20% from 2000 to 2009.

The Global Health Hub has developed a really nifty global health timeline. It is interactive and open – meaning it can be edited by anyone.

POLICY

RESEARCH

  • Scientists have isolated the tuberculosis enzyme that destroys lung tissue, MMP-1. The discovery could speed up the search for treatments, as current regimens do not prevent the lung damage caused by TB infection.
  • Results from a recent study indicate that advances in antiretroviral therapy over the last 15 years have considerably improved outcomes for children with HIV who are entering adolescence and young adulthood.

DISEASES AND DISASTERS

  • Aging populations on Japan’s northeast coast are struggling to recover from last month’s devastating earthquake and tsunami, and health officials are concerned about increased incidence of pneumonia, influenza, respiratory illenss, and blood clots in the legs of older individuals.
  • The first WHO Global Status Report on Non-communicable Diseases found that these diseases are the leading cause of death worldwide.

Global Health News Last Week

POLICY

  • Assistant Senate Majority Leader Richard Durbin (D-IL) and Senator Bob Corker (R-TN) introduced the Water for the World Act of 2011, a bill in the Senate which will make providing safe and clean drinking water around the world a priority for US foreign aid.
  • More than 60 world nutrition experts met at WHO headquarters last week to revise guidelines and to identify solutions to tackle the growing problems of both malnutrition and obesity around the world.
  • Ministers of health and other high-level health officials from throughout the Americas called for a series of actions to reduce the toll of chronic noncommunicable diseases, in a declaration issued last week in Mexico City.
  • The Global Fund announced that former President of Botswana Festus Mogae and former U.S. Health and Human Services Secretary Michael O. Leavitt have agreed to lead a high-level panel of experts that will conduct an independent and thorough review of the Global Fund’s financial safeguards.
  • UN agencies are concerned that reduced donor funding due to the recession, combined with free trade agreements, will reduce the availability of low-cost HIV medications in developing countries.
  • The United Nations General Assembly will convene a high-level meeting in September this year to discuss the financial burden caused by non-communicable diseases (NCD) on countries.

RESEARCH

  • A study done is Malawi by the World Bank attracted attention (and criticism) from Businessweek. Young women were given to stay in school and deter them from accepting money and gifts from “sugar daddies” in exchange for sex. The study found that HIV infection rates were 60% among schoolgirls who received cash compared to those who received nothing.
  • A recent review of malaria treatment clinical trial results, published in the Chochrane Library, shows that artesunate was more effective that quinine at treating severe malaria.
  • A personalized text messaging reminder service significantly boosted antiretroviral (ARV) adherence over a six-week period compared with a standard beeper reminder system, according to a study published in the March issue of AIDS Patient Care and STDs.
  • About 600 people gathered at the Global Health Metrics and Evaluation conference in Seattle to discuss issues surrounding the evaluation of effectiveness of health programs.

PROGRAMS

  • Global health blogger Alanna Shaikh discusses how micro-credit and the Green Revolution, two of international development’s biggest successes, are being re-evaluated.
  • The Nepalese government is planning launch a large vaccination campaign against elephantiasis in 40 high-risk districts.
  • Dubai’s Ministry of Health introduced Pneumococcal Conjugate Vaccine PCV13, a vaccine that protects young children from the worst effects of illnesses including pneumonia, blood infections and meningitis.
  • The National Influenza Center of the Chinese Center for Disease Control and Prevention has been designated as a World Health Organization Collaborating Centre for Reference and Research on Influenza, making China the first developing country to house such an institution.

DISEASES AND DISASTERS

  • Europe is concerned by the growing incidence of drug-resistant TB, particularly in children.
  • The world continues to follow the aftermath of the earthquake and tsunami in Japan, including the unfolding situation at the Fukushima Dai-ichi nuclear power plant. The WHO has assured that there is no danger to individuals being exposed to radiation in nearby nations (e.g. China).
  • As if Haiti needed any more bad news, a study published in the Lancet says that the UN estimate of 400,000 cholera cases in Haiti this year is nearly half of what the real projection should be for the recovering nation. Meanwhile, health officials in Lagos have called on residents to observe high standards of personal and environmental hygiene and have designated emergency numbers to call in case of suspected cases; the Ghana Health Service has set up cholera centers in Accra to deal with the outbreak there; and the interim federal government of Somalia on Tuesday denied reports of an outbreak of cholera in the country, responding to an Associated Press story over the weekend that Somali doctors had reported that more than 20 people had died from the disease.
  • In the February 2011 issue of PLoS Neglected Tropical Disease Journal, contributing editor Serap Aksoy discussed the triumphs behind the control of human African trypanosomiasis, or African Sleeping Sickness.
  • Although women get diagnosed for tuberculosis (TB) later than men, treatment outcomes among women are better than men with higher TB treatment success rate and lower default (drop-out) rate in the female patients. The finding was announced at a meeting on TB and women in New Delhi, India.
  • While the total number of newly reported HIV positive people and AIDS patients are still low in Japan compared with other countries, the number of newly HIV-infected people in Japan has doubled in the past decade due to public complacency and lower awareness.

Drug Wars: What does a free trade agreement between India and the EU mean for generics?

When I was a junior in college, I had to give a presentation for my honors Molecular Genetics class. The hot topics that year were avian influenza and HIV. I had just been accepted into the School of Rural Public Health’s MPH program, so I decided to get in the HIV-line, but with a twist: rather than present a paper on the mechanism of infection or a mutant viral protein, I would pull the lens back and look at the disease from a public health standpoint. It was an eye-opener for a lot of my classmates, most of whom were biochemistry majors whose only exposure to HIV had been through pictures of Western blots in peer-reviewed journal articles. Some of the strongest reactions were to cost of care, especially drug prices: when I cited several drugs that entered the market at $25 (darunavir), $29 (tipranavir), or even $61 (efuvirtide) for one day’s dose in the U.S., eyes widened and jaws dropped across the room.

A round white pill.

Flickr, doug88888

The war on drug prices is a long-standing, bitter battle between the pharmaceutical industry and humanitarian groups and lobbyists, with governments and regulators perpetually caught in the middle. International health and humanitarian organizations argue that access to inexpensive medicines is vital to the survival of the poor who need them, and that Big Pharma is driven by greed and cares only for its profit margins. Pharmaceutical companies counter that intellectual property protection and patents encourage innovation and the development of newer and better drugs. The solution to this dilemma in developing countries, including India and many African nations, has been generics. India’s patent laws make it easy for regulators to deny drug patent applications, allowing Indian pharmaceutical companies to use the data from clinical trials already performed to get approval to produce cheap generic versions of patented medications. India is the world’s leading producer of inexpensive generic drugs – its pharmaceutical industry makes most of its money by producing generic versions of drugs patented by Western companies – which has earned its reputation as “the pharmacy of the developing world.” India supplies 80% of the medicines distributed by medical humanitarian organizations in poor countries; in particular, 93% of ARVs going to HIV patients in these countries are Indian-made.

The EU is currently negotiating a free-trade deal that may change all of this: in addition to agricultural tariffs and work visa agreements, Europe is trying to negotiate a period of exclusive access to pharmaceutical companies’ research and clinical trial data. No specific amount of time has been finalized, but without information from the clinical trials already conducted, generics manufacturers would have to conduct their own testing to register their products. Opponents of this provision fear that this will drive up the cost of generic medicines and make them unaffordable for the poor. Médicins sans Frontières (Doctors without Borders) has launched their “Europe! HANDS OFF our Medicine” campaign specifically against this component of the agreement. The WHO and the UN’s special rapporteur on the Right to Health Anand Grover are also concerned, and the Indian generic pharmaceutical industry is predicting a global health crisis if the trade agreements lead to production restrictions. The European Commission insists that the negotiations will not negatively impact India’s generics industry, but worries will persist until a draft of the agreement is released.

The ever-continuing debate underscores the need to find a balance between encouraging economic growth and innovation, and ensuring affordable access to medicines for those who need them. Though the start-to-finish cost of producing drugs can admittedly cost billions of dollars, the question of whether it justifies such high new value benchmarks has not yet been settled. The fact that so many millions wait in line for these drugs begs this ever-persistent question: what is the point of charging so much for drugs that so many need if so few can afford them?

Whoonga: South Africa’s New Crack

Question: What costs $3, contains AIDS medication and rat poison, and is smoked with marijuana?
Answer: One day’s dose of whoonga, South Africa’s latest, and most tragic, drug craze.

The word “whoonga” is more of an exclamation than an actual name. Invented in Durban, South Africa, this cream-colored powder is hustled by drug dealers who charge 20 rand ($3) for one day’s dose. This mixture of detergent, rat poison, and antiretrovirals (ARVs) is initially taken up as just another addition to a cheap array of recreational drugs for the unskilled and unemployed. For some, it helps them relax or get to sleep; for others, it makes them feel like the “the best person ever.” But this pleasant high soon turns nasty. The drug is extremely addictive, and users report cravings and withdrawal symptoms after the very first hit ranging from stomach cramps and night sweats to depressed heart and lung function. Addicts need several hits to make it through the day. What begins as a way to pass the time becomes an all-consuming habit that drives people to steal, commit crimes, or worse – steal or sell HIV medications.

South Africa has the highest HIV burden of any country in the world. As it finally begins to make meaningful progress against the disease, whoonga could not have come at a worse time. The South African government provides free ARVs to AIDS patients who qualify for economic assistance, and this has now become an unfortunate source of drug supply. Corrupt health workers and clinic staff are selling ARV medications on the whoonga market. AIDS patients have been robbed as they leave clinics with their pills. In some cases, they are selling their own medications to whoonga dealers. And now reports are emerging of desperate addicts intentionally trying to get infected when they can no longer support their habits through petty crime. The cruel irony of it all is that there is no evidence that the HIV medications actually do anything to create or enhance the high.

South African officials are aware of the problem, and so far, the drug has not spread outside of KwaZulu-Natal. However, the implications of the drug’s spread are frightening. What makes whoonga particularly insidious and difficult to combat is lack of information: many experiment with it without realizing what they are getting themselves into. One small organization, Project Whoonga, is confronting it head-on. Run by Vumani Gwala, this community-based support group is based in Kwadebeka, a large township outside of Durban, and has 45 addicts in recovery. While admirable, the organization needs all the help it can get in taking on this tragic menace. “This drug has turned our beloved township into a jungle,” laments Gwala. “Families with addicts live in constant fear of vigilantes that threaten to get rid of this crime using violence and families have gotten their homes burned down.”