Photo: Manoocher Deghati/IRIN

Mineworkers in South Africa are highly vulnerable to TB

JOHANNESBURG,� – Findings from an ongoing South African study into preventative tuberculosis (TB) therapy suggest that prevention really may be the best medicine.

In the Thibela TB study, one of the largest of its kind, almost 40,000 gold miners in South Africa received a nine-month course of isoniazid, a standard first-line TB drug. None of the miners was actually suffering from TB, but the high prevalence of both HIV and silicosis in South African mines makes miners extremely vulnerable to the disease.

Isoniazid preventive therapy (IPT) is usually given to people living with HIV to reduce their risk of developing TB, but the Thibela study is testing the theory that treating an entire community with the drug could have a significant impact on TB rates for a period of about 10 years.

The study, which is being conducted in three of the country’s nine provinces, is only expected to conclude in 2012, but preliminary findings released on Wednesday suggest that isoniazid has already been effective in reducing TB incidence among participants.

“We’ve had very few subsequent infections in those taking the preventative treatment,” said Dr Dave Clark, deputy CEO of the Aurum Institute, the health research NGO conducting the study.

The results could also influence case management of HIV-positive people in South Africa, who are around 20 times more likely to develop TB than those who are HIV-negative � 75 percent of new TB patients are HIV-positive.

The World Health Organization (WHO) has recommended IPT for people living with HIV in countries with a high prevalence of TB, but less than one percent of HIV-positive people in South Africa are receiving it, according to Clark.

Although many feared the preventative treatment would increase the incidence of drug-resistant TB, the number of such cases in the study has been negligible. Most patients also showed a surprising wiliness to adhere to treatment.

Asking mineworkers, who are ostensibly well, to adhere to treatment is difficult, Clark said. We’ve had an 80 percent success rate to date with adherence, and it’s caught on. We’ve had cases where workers have asked, Is this something we can take back to our communities, to our wives?

Findings from the study might also influence the way health workers and policy-makers handle epidemics other than TB. If this methodology can work in this setting, there is huge potential that the approach would work in the case of other diseases, such as diabetes and hypertension, said Clark.�

In the latest global TB control report released by WHO on Tuesday, South Africa’s incidence of TB ranks second only to Swaziland’s, the highest in the world. South Africa also has the world’s fourth highest burden of multidrug-resistant (MDR) TB.

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Photo: Ben Parker/IRIN

U Nyi suffers from post-traumatic stress disorder; his wife, Khin Htwe, has been diagnosed with chronic asthma, and their 13-year-old child, Ye� Naing Aung, is disabled

UMPIUM,� – Several blue and white buses of the International Organization for Migration (IOM) are about to depart Umpium refugee camp of some 20,000 people in Thailand, close to the Myanmar border. The buses are filled with dozens of Burmese refugees who are beginning their resettlement journeys to countries as diverse as Australia, Norway, New Zealand and the United States. Most had fled Myanmar years, even decades, ago, fearing persecution and longing for a better life.

It is a scene that has been repeated hundreds of times since 2004 when the Burmese refugee resettlement programme first began. As of January 2009, some 43,000 have been resettled. Another 13,000 are expected to be resettled this year, according to the UN Refugee Agency (UNHCR).

In Umpium, relatives and friends crowd close to the bus windows; one man hands out Thai coins to his friend, not needing them any more.

Refugees who want to resettle are first identified by UNHCR and then individual countries decide who they will accept. IOM does everything from transporting the refugees for interviews, giving them a basic cultural orientation (how to change planes, use western-style toilets and kitchen appliances), to equipping them with “survival English” – key words and phrases to get them by as they enter a strange new world. Finally, it prepares the refugees for their travels and makes all flight arrangements.

All must receive medical clearance at the outset, and, according to Mohammad Razwari, an IOM physician, who conducts check-ups on the refugees at Pawo Hospital in Mai Sot, “The health assessment identifies any health problems or health risks as well as determining whether the patient is safe to fly and that they are not a health hazard to other travellers.

“If a patient has TB or psychological problems, he or she first receives treatment before resettlement,” said Razwari. “Those with HIV/AIDS are provided awareness training. All those with medical problems receive adequate treatment first and then are allowed to depart.”

Have skills, will travel

Photo: Brennon Jones/IRIN

At Umpium refugee camp on the Thai border close to Myanmar, a group of Burmese refugees say their goodbyes

Not surprisingly, many of the resettled refugees are those most skilled and educated.

Tun Khin, who has been in Nupo camp – one of nine along the Thai/Myanmar border – with his family since 1997, told IRIN he expected to be resettled soon. Both he and his wife are medics, who were trained in 1999 by Aide Medicale Internationale (AMI), a French NGO in charge of the health sector in Mae La and other refugee camps.

“We have applied to be resettled in the United States and already have relatives there, in South Dakota. We want to go,” he says, “because we want to give our children a good education.”

However, according to Kitty McKinsey, UNHCR senior regional public information officer for Asia and the Pacific: “Some countries, like Denmark, Finland, Norway and the Netherlands, actually seek out refugees with serious medical conditions. They do it strictly on humanitarian grounds.”

There are others: U Nyi, 58, a former farmer from Mon State in Myanmar, is headed to the United States with his family.

Photo: Brennon Jones/IRIN

As of January 2009, some 43,000 Burmese have been resettled in more than 11 countries

U Nyi suffers from post-traumatic stress disorder (PTDS) following his involvement in the 1988 political confrontation with the Burmese government. He can hardly speak, according to IOM officials, and is heavily sedated. His 53-year-old wife, Khin Htwe, has been diagnosed with chronic asthma and their 13-year-old child, Ye’ Naing Aung, has birth defects that have left him physically and mentally disabled.

Khin Htwe told IRIN, “My husband, U Nyi, has not worked since fleeing Myanmar. He is mentally unfit.”

The US government selected the family for resettlement in the United States even before medical tests were conducted, according to IOM officials.

The US has taken in more than 14,000 border refugees since 2004 and says it welcomes even those families with serious medical needs. According to Tim Scherer, refugee coordinator in Thailand for the US State Department: “We accept Burmese for resettlement based on their legitimate refugee status and this includes even those with serious medical disabilities.”

Khin Htwe told IRIN she looked forward to going to the US. “I chose America because the weather will be good for my health and as my son is often hospitalised, want to go somewhere where the medical technology is good,” she said. “And I’ll do whatever work it takes [to make ends meet] – perhaps gardening or farming.”

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Hon. Speaker Kenneth Marende (above)�has a huge task today.

By Standard Team

The Speaker of the National Assembly holds the hopes of a nation this afternoon (Tuesday), when he rules over the Constitution and leadership of the House Business Committee.

Mr Kenneth Marende will have to offer a way forward out of the impasse between coalition rivals PNU and ODM. Its leaders, President Kibaki and Prime Minister Raila Odinga, have sharply disagreed over who should lead Government business in the House.

Chepalungu MP Isaac Ruto addresses the Press at Parliament Buildings after ODM and PNU assistant ministers and backbenchers met over the Leader of House Business Committee stalemate Tuesday. [PHOTO: BONIFACE OKENDO/Standard]���

Today’s ruling comes against the backdrop of the Speaker’s failed overtures to the two principals to resolve the stalemate through dialogue, and as ODM continued to beat the election drums.

Yesterday, ODM was consulting with lawyers over their next move, following Raila’s Sunday demand that fresh elections be held if PNU continues to frustrate it in Government. PNU had accused the PM of plotting a ‘civilian coup’ after totally failing in his premiership duties.

ODM said the fresh elections should be held in six-months, as a clutch of Cabinet ministers, including Deputy Prime Minister Uhuru Kenyatta, backed the President’s choice of ODM-Kenya leader Kalonzo Musyoka, who is also the Vice-President, to assume the mantle of leading the Government in the House.

Raila and his Orange party have maintained that the PM should automatically take the leadership because his party has the majority MPs.

Last night, it was clear that today would be a critical day in the life of the fledgling coalition that stares a premature death in the face.

Even as many Kenyans invested hope in Marende, a group of 50 MPs began an initiative to break the stalemate. They proposed to have the House Business Committee constituted and a member elected interim chairman.

The caucus of MPs from across the political divide, and which included Assistant ministers, allowed ODM to nominate 11 members to the HBC, against PNU’s 11.

The MPs, emerging from a two-hour marathon consultative meeting at Parliament Buildings, said Parliament would adopt the lists as presented by both ODM and PNU.

“We have resolved to adopt the lists as they will be presented by the respective parties to the House tomorrow (today),” Chepalungu MP Isaac Ruto, who spoke for the group, said.

“We decided ODM takes one more seat in the committee courtesy of its numerical strength in the House,” said an MP who attended the meeting.

Assistant ministers Kilemi Mwiria and Richard Onyonka said once Parliament adopts the list, HBC members would be expected to meet and elect an interim chairman.

“If they fail to agree on modalities and who should be the committee’s chairman, then we will call upon the entire House to intervene once again and elect a chairman � but after the Standing Orders are amended,” said Onyonka.

Efforts to bring the MPs together was mooted early in the day by Assistant minister Cecily Mbarire and Onyonka, who argued that allowing parliamentary parties to take positions was likely to aggravate the situation.

Agenda in abeyance

Yet as the politicians continue to wrangle, crucial House agenda is in abeyance. Sources said ODM was readying its superior majority in the House to frustrate Government business if it did not have its way today.

Already, the Government needs urgent release of Sh26 billion from the Consolidated Fund as part of the Supplementary Budget needed to run its activities.

Traditionally, the Supplementary Budget has been passed in March, three months to the close of the financial year. And with thousands of Kenyans facing starvation, the urgency with which Sh8.5 billion is required cannot be overemphasised.

ODM has 105 elected and nominated MPs, excluding the ones from affiliate parties, against PNU’s 45, excluding its affiliates. And with effective horse-trading, ODM can frustrate any Government plans in the House.

The country badly needs a new electoral body following disbandment of the discredited Electoral Commission of Kenya last December.

Already, the Parliamentary Select Committee on Constitutional Review has come up with the names of nine commissioners who are awaiting Parliament’s nod.

With a pending by-election in Bomachoge following the declaration of Mr Joel Onyancha’s election as null and void by the High Court, the electoral body is a necessity.

ODM’s call for fresh elections in six months is also an indicator that an electoral body must be urgently put in place.

And hopes for a new Constitution before the next polls could soon be a mirage.

Though the nine-member committee of experts have already started working, there is need for Parliament to amend the Constitution of Kenya (Review) Act to include the civil society in the process.

Former Justice Minister Martha Karua had indicated before her resignation that a proposal to amend the Act to include 30 members from the civil society as the reference group was on the cards, and Parliament’s approval would be required.

Most importantly, Parliament would be required to approve the budget for 2009/10 financial year in June, and ODM’s support would be crucial.

The HBC is a potent committee that defines the agenda of the House. It has been widely a preserve of Cabinet ministers but the new Standing Orders give backbenchers at least 30 per cent stake in the body.

Some backbenchers are, however, clamouring for 50 per cent stake to neutralise Government control of the powerful House organ.

It is understood that five ODM lawyers, including Mr Mugambi Imanyara, who met at the Prime Minister’s office yesterday morning, explored ways in which the party’s position on new polls could be sustained and be implemented.

Earlier, the PM had met Higher Education Minister Sally Kosgei on undisclosed discussions.

Later in the evening, the lawyers converged again at the Treasury at a meeting convened by the PM, where they met Immigration Minister Otieno Kajwang, his Lands counterpart James Orengo and East African Community Minister Amason Kingi.

Elsewhere, party Chairman Henry Kosgey justified the demand for fresh calls in six months to enable the country “to get the required stability and in order for it to attract investment and create jobs”.

No contest

During a Press conference at Orange House, Kosgey reiterated the party’s demand for Raila to become the leader of Government business in the House, adding: “This is not a contest between (Raila) and Vice-President Kalonzo Musyoka. The contest ended in 2007, and we know who won. This is a demand based on logic, common sense and fair play”.

Reacting to reports from PNU that Raila was an appointee of President Kibaki, Kosgey said: “The PM is an appointee of the people of Kenya. He is not PM because President Kibaki likes him but because he comes from the party with the numbers in the House”.

The Constitution says the leader of the party with majority members in Parliament shall become Prime Minister.

Karachuonyo MP James Rege said the party would not renege this time round nor climb down from their position. “We have reached the extreme end and we shall not cede on our position”.

He said, according to the accord, the party was right to claim the position of Leader of Government Business in the House because the PM “executes the function and affairs of the Government of Kenya”.

Fisheries Minister Paul Otuoma said the party’s position was very clear, and ceding ground would “be detrimental (to the party), especially from our supporters.”

MPs Rachael Shebesh, Elizabeth Ongoro, Yusuf Chanzu, Otieno Mbadi and ODM Whip Jakoyo Midiwo flanked Kosgey.

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As the 100 day mark approaches on Obama’s Presidency, media adoration is reaching fever pitch. The One graces the cover of Time for the thirteenth time and the majority of the leftist media are following the White House talking points that conclude that this man is indeed a miracle. Case closed.

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Just in case we missed the point, this lovely painting will be appearing on Wednesday in NYC Union Station on the eagerly awaited day 100. That’s Wednesday, for those of you who have actual lives. And yes, that’s actually a crown of thorns on Obama’s noble brow. BTW: Am I the only one offended by the symbolism?

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The above picture is just one of the many things that offend me about the media portrayal of King Obama. Call me a prude, but I really don’t care to see Obama’s Rippling Pecs on the cover of Washingtonian Magazine. I know, I know – He Won.

Meanwhile, back in the real world, the Obama administration decided to follow up the release of the CIA torture memos with 2,000 photos of supposed prisoner abuse. Congress followed up with calls for prosecution of the Bush officials that were responsible for this supposed ‘torture’. House Speaker Pelosi, though thoroughly briefed on the issue in 2002, took to the microphones denying it. Yes, Dorothy, she actually lied. Gasp.

A fund-raising letter has revealed one of the leading figures calling for all this America bashing and airing of dirty laundry in none other than billionaire and leftist financier George Soros. Moveon.org is going to have to change their name as they salivate at the chance to go back to the past to dredge up anything that will tar America and/or George Bush.

Nazis dig up mass grave of U.S. soldiers

I’m claiming writer’s perogative in order to insert a little context. A new photo has been unearthed showing Nazis digging up the graves of American soldiers that were used as slaves (can I say that?) during WWII. Golly, I hope they weren’t tortured!

Despite this, Obama remains unscathed and is portrayed as being above the fray. These guys are good…

GOVERNMENT AT WORK:

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President Barack Obama on Monday proposed a $100 billion U.S. loan to the International Monetary Fund to boost the IMF’s resources. The IMF then proceeded to double the borrowing limits of the poorest countries on Thursday, after the World Bank warned that the global economic crisis could push nearly 50 million people further into poverty this year. Hey, isn’t making loans to people who couldn’t afford them what got us into trouble in the first place?

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Meanwhile, the world’s intelligence agencies are quietly acknowledging that N Korea has become a full fledged nuclear power with the capability to wipe out entire cities in Japan and South Korea. Do you think Obama’s charm and dialogue will make them behave? I don’t either. But, hey, he won.

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Obama convened his first cabinet meeting and sternly ordered his department chiefs to cut a combined $100 million from their budgets. He then took to the airwaves to legitimize his self anointed role as a fiscal conservative and a guy willing to listen to the people’s call to cut government spending. As always, there’s one little catch. The proposed $100 million cut represents 1/35,000th of his proposed spending, proving once again, that it is possible to fool most of the people most of the time. This guy is really good…

As Obama deals with all the crises that seem to pop up right on time, the Democratic Congress decided to ignore any Republican input on the sweeping new health care legislation currently under consideration. Changing the rules in mid-stream, the Dems have opted to adopt a process called reconciliation to fast track health care.

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Sounds good, doesn’t it. Let’s all just reconcile. As always, the reality means something else. Reconciliation means Congress will only need Democrat votes in order to pass this landmark legislation. No Republican votes are needed. Translation: the 62 million folks that didn’t vote for Obama have absolutely no representation or say in our current government.

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Disney blasted over first animated black princess

CULTURE:

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The arrival of a black First Lady in the White House might have been greeted with celebration around the world, but the similarly historic debut of Walt Disney’s first black princess has not been received so warmly. The thoroughly discredited race card hasn’t stopped charges of racism being tossed at Disney.

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Speaking of racism, in Alabama, several Confederate flags placed on the graves of Civil War soldiers got pulled up by a black Auburn city councilman, who called them symbols of racism and hatred. I guess tolerance extends only so far.

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The virulently anti-American book that Chavez publicly gave to Obama last week has been identified on the syllabi of at least 20 U.S. colleges and universities since 2003, and it’s been taught for decades on American campuses.

The preference for sons in traditional Chinese families has led to a vast gender disparity in China: A study has found that there are currently 32 million more boys than girls under the age of 20.�

Photo: WHO

Malaria kills an estimated one million people annually, mostly children in Africa

NEW YORK,� – World Malaria Day on 25 April highlighted the vital importance of partnerships between the UN, governments, the private sector and civil society in fighting a disease that kills a child every 30 seconds.

“Public/private partnerships can really make a difference,” Amir Dossal, executive director of the UN Office for Partnerships, told IRIN, after attending meetings to mark the day. “The more people know of these public/private partnerships, the more opportunities they’ll get and they might even think of becoming partners in such efforts,” he added.

Medicines for Malaria Venture (MMV) is a non-profit public-private partnership established as a foundation in Switzerland in 1999. MMV, with Novartis, introduced the first Artemisinin-based combination therapy (ACT) for children, Coartem Dispersible, earlier this year. “It’s a three-day treatment, it’s sweet-tasting, it’s cherry-flavoured,” said MMV vice-president, corporate development, Antony Kalm, who attended the meetings in Washington and at UN headquarters in New Yorak.

Bitter taste

“One of the biggest problems … for doctors was that the existing medicine was quite bitter and difficult to swallow, so the children would often spit [it] out … and … die.
“Now, children like it, want to take it, they finish the entire six tablets over three days,” he told IRIN, noting that the cost for children under 5kg is 37 cents for the entire course, and for children over 5kg, 80 cents.

“Novartis, as part of their agreement with us, have agreed to make zero profit on it. Some 20 countries have already placed orders for the drug; we know that orders number in the tens of millions, so the drug has the potential to save literally millions of children’s lives.”

Resistance

Malaria kills an estimated one million people annually, mostly children in Africa, and affects more than 50 million pregnant women every year. Up to 250 million clinical cases of malaria are reported annually worldwide.

The mosquito-borne parasite has become resistant to many traditional drugs, which is why ACT, based on a Chinese remedy made from sweet wormwood, is so important – although there are signs of resistance building to it as well.

“MMV has a pipeline of drugs because we know that the parasite can outsmart the drug after a while, as we’ve seen with the previous generation,” Kalm said. “So we actually have 50 different drugs in the pipeline at different stages. Our objective is to get all of our drugs out of our pipeline and successfully and affordably to all those [who] need them.”

Coartem Dispersible is just one of the weapons in an arsenal that also includes insecticide-treated bed nets, which were highlighted at the meetings.

The International Federation of Red Cross and Red Crescent Societies reported that nearly 300,000 malaria deaths had been averted and 17.5 million people better protected against malaria since 2002 thanks to net distributions by its national members.

Price cuts

Roll Back Malaria, a partnership of more than 500 members, announced that an initiative to lower the price of ACTs – the Affordable Medicines Facility – would be rolled out in 11 countries this year.

The programme will cut the cost of ACTs, through a “co-payment” by the Global Fund directly to manufacturers on behalf of buyers, to US5 cents per course of ACTs.

It also reaffirmed the goal of achieving universal coverage with control tools by the end of 2010, and of reaching near-zero deaths by 2015, a goal endorsed by the United States at a meeting in Washington on Friday that launched a partnership between African and US faith leaders, policymakers and global health experts.

Some experts and civil partners on the frontline caution against overly optimistic predictions about the demise of malaria. “Each year there are new commitments that have some kind of measure assigned,” Kalm said, noting that the Gates Foundation in 2007 used “the e-word of eradication” for the first time since the 1950s.

“We say in our lifetime and we are comfortable in saying that. Now, of course, you don’t know the age of the person you’re speaking to. I guess what we’d say is in a generation or two.”

ma/mw source.www.irinnews.org

Photo: Naresh Newar/IRIN

More than 400 people worldwide have been infected with H5N1 (file photo)

DAKAR,� – Scientists at the US Centers for Disease Control and Prevention, Harvard Medical School and the Burnham Institute for Medical Research have engineered antibodies that can fight off multiple influenza strains, including the highly contagious H5N1 avian flu virus.

Researchers wrote that until now efforts to develop an all-purpose flu vaccine have been thwarted by the ever-mutating flu virus head, which tricks the body into producing antibodies that are only temporarily effective.

But the lab-created antibodies were able to attack in mice the virus’s hidden non-mutating neck, which prevented the virus from multiplying. Researchers have said it will be years before they learn if the antibodies will work in infected humans.

The H5N1 virus emerged in humans in Hong Kong in 1997; of the 408 cases confirmed since, 62 percent resulted in death, according to the World Health Organization as of 24 February.

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Photo: David Hecht/IRIN

New pig flu virus (file photo)

DAKAR,� – Health authorities in Senegal have reactivated an early warning health system put into place in 2006 following the resurgence of the H5N1 avian flu virus in Hong Kong� in response to a recent outbreak of swine influenza.

The swine influenza A/H1N1 viruses in the latest outbreak have not been previously detected in pigs or humans, according to World Health Organization (WHO).

Health workers in all districts have been on high alert to report suspicious cases, said Ministry of Health’s top advisor Assane Yaradou. Weekly health alerts have been upped to daily alerts warranted by the risk of a pandemic. The last high alert was in March 2009 in response to a regional meningitis outbreak, said Yaradou.

Doctors are to report any cluster of patients reporting flu-like symptoms.

We do not want to cause hysteria, and will issue within days more clarification on prevention. Yaradou said from earlier avian flu preparation, the country has on stock Tamilflu medication for treatment.

The health minister advisor told IRIN despite direct flights to Senegal’s capital from the United States, which has reported 20 confirmed cases of swine influenza as of 26 April, Senegal has not issued travel restrictions or changed surveillance of incoming passengers.

WHO is not recommending any travel or trade restrictions.

pt/aj
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By Maseme Machuka

US President Barack Obama has warned that political feuds put the country in serious jeopardy of renewed violence if the underlying causes are not rooted out.

Through the US Secretary of State Hillary Clinton, Obama has written to President Kibaki and Prime minister Raila Odinga asking them to hasten the reform process.

“I am writing to urge you to intensify your efforts to advance the reform and accountability agenda agreed by all parties last year,” the letter says in part.

The US also urges Kenya, “to hold corrupt officials and those responsible for facilitating post-poll violence accountable, including through the establishment of a credible special tribunal for Kenya.”

Clinton said the effects of corruption and lack of accountability undermined the country�s prospects for prosperity.

“The United States deeply values its relationship with Kenya. We stand ready to support your efforts to accelerate reform and lay the ground work for a peaceful future,” added Clinton.

The international community has maintained interest in the Coalition Government that was brokered by former UN Secretary General Kofi Annan.

The UN�s International Criminal Court, for instance, has put the Government on notice to set up a local tribunal to try post-poll offenders.

“Let me make it clear,” the ICC prosecutor Louis Moreno Ocampo said through his special adviser Beatrice le Fraper du Hellen last month, “we will act fast and relentlessly. Once we intervene we cannot be stopped.”

The move could also erode one of the highlights of the Kibaki administration of securing financial independence for the country.

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