South Africa makes progress in HIV, AIDS fight

JOHANNESBURG (AP) — In the early ’90s when South Africa‘s Themba Lethu clinic could only treat HIV/AIDS patients for opportunistic diseases, many would come in on wheelchairs and keep coming to the health center until they died.

Two decades later the clinic is the biggest anti-retroviral, or ARV, treatment center in the country and sees between 600 to 800 patients a day from all over southern Africa. Those who are brought in on wheelchairs, sometimes on the brink of death, get the crucial drugs and often become healthy and are walking within weeks.

“The ARVs are called the ‘Lazarus drug’ because people rise up and walk,” said Sue Roberts who has been a nurse at the clinic , run by Right to Care in Johannesburg’s Helen Joseph Hospital, since it opened its doors in 1992. She said they recently treated a woman who was pushed in a wheelchair for 3 kilometers (1.8 miles) to avoid a taxi fare and who was so sick it was touch and go. Two weeks later, the woman walked to the clinic, Roberts said.

Such stories of hope and progress are readily available on World AIDS Day 2012 in sub-Saharan Africa where deaths from AIDS-related causes have declined by 32 percent from 1.8 million in 2005 to 1.2 million in 2011, according to the latest UNAIDS report.

As people around the world celebrate a reduction in the rate of HIV infections, the growth of the clinic, which was one of only a few to open its doors 20 years ago, reflects how changes in treatment and attitude toward HIV and AIDS have moved South Africa forward. The nation, which has the most people living with HIV in the world at 5.6 million, still faces stigma and high rates of infection.

“You have no idea what a beautiful time we’re living in right now,” said Dr. Kay Mahomed, a doctor at the clinic who said treatment has improved drastically over the past several years.

President Jacob Zuma’s government decided to give the best care, including TB screening and care at the clinic, and not to look at the cost, she said. South Africa has increased the numbers treated for HIV by 75 percent in the last two years, UNAIDS said, and new HIV infections have fallen by more than 50,000 in those two years. South Africa has also increased its domestic expenditure on AIDS to $ 1.6 billion, the highest by any low-and middle-income country, the group said.

Themba Lethu clinic, with funding from the government, the United States Agency for International Development and the President’s Emergency Plan for AIDS Relief, is now among some 2,500 anit-retroviral therapy facilities in the country that treat approximately 1.9 million people.

“Now, you can’t not get better. It’s just one of these win-win situations. You test, you treat and you get better, end of story,” Mahomed said.

But it hasn’t always been that way.

In the 1990s South Africa’s problem was compounded by years of misinformation by President Thabo Mbeki, who questioned the link between HIV and AIDS, and his health minister, Manto Tshabalala-Msimang, who promoted a “treatment” of beets and garlic.

Christinah Motsoahae first found out she was HIV positive in 1996, and said she felt nothing could be done about it.

“I didn’t understand it at that time because I was only 24, and I said, ‘What the hell is that?’” she said.

Sixteen years after her first diagnosis, she is now on anti-retroviral drugs and her life has turned around. She says the clinic has been instrumental.

“My status has changed my life, I have learned to accept people the way they are. I have learned not to be judgmental. And I have learned that it is God’s purpose that I have this,” the 40-year-old said.

She works with a support group of “positive ladies” in her hometown near Krugersdorp. She travels to the clinic as often as needed and her optimism shines through her gold eye shadow and wide smile. “I love the way I’m living now.”

Motsoahae credits Nelson Mandela’s family for inspiring her to face up to her status. The anti-apartheid icon galvanized the AIDS community in 2005 when he publicly acknowledged his son died of AIDS.

None of Motsoahae’s children was born with HIV. The number of children newly infected with HIV has declined significantly. In six countries in sub-Saharan Africa — South Africa, Burundi, Kenya, Namibia, Togo and Zambia —the number of children with HIV declined by 40 to 59 percent between 2009 and 2011, the UNAIDS report said.

But the situation remains dire for those over the age of 15, who make up the 5.3 million infected in South Africa. Fear and denial lend to the high prevalence of HIV for that age group in South Africa, said the clinic’s Kay Mahomed.

About 3.5 million South Africans still are not getting therapy, and many wait too long to come in to clinics or don’t stay on the drugs, said Dr. Dave Spencer, who works at the clinic .

“People are still afraid of a stigma related to HIV,” he said, adding that education and communication are key to controlling the disease.

Themba Lethu clinic reaches out to the younger generation with a teen program.

Tshepo Hoato, 21, who helps run the program found out he was HIV positive after his mother died in 2000. He said he has been helped by the program in which teens meet one day a month.

“What I’ve seen is a lot people around our ages, some commit suicide as soon as they find out they are HIV. That’s a very hard stage for them so we came up with this program to help one another,” he said. “We tell them our stories so they can understand and progress and see that no, man, it’s not the end of the world.”

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South Korea November exports show fragile, uneven global recovery

SEOUL (Reuters) – South Korean exports last month marked their first back-to-back growth of the year, but demand from the advanced economies was weak, data showed on Saturday, indicating any global recovery would be fragile at best.

November exports grew by 3.9 percent over a year earlier to $ 47.8 billion on top of a revised 1.1 percent rise in October, while imports last month rose by 0.7 percent to $ 43.3 billion, the Ministry of Knowledge Economy data showed.

The November data, released for the first time by a major exporting economy, and the robust survey findings in China disclosed earlier in the day offered fresh signs of the global economy regaining some momentum.

Shipments to China and the southeast Asian countries posted sharp gains over a year earlier, whereas demand from the United States and the European Union shrank, according to break-down figures for the November 1-20 period released later.

“Robust data from China and today’s Korean data increase the chances for Korean exports maintaining a modest recovery,” said Park Sang-hyun, chief economist at HI Investment & Securities.

RARE ANNUAL DROP IN EXPORTS

Data released earlier on Saturday showed China’s manufacturing sector activity was at a seven-month high in November, while South Korea’s October industrial output also expanded for the second straight month.

“But as Europe and the U.S. are not getting any stronger soon, any global recovery will be an uneven and fragile one for the time being,” Park added.

Analysts in a Reuters survey had forecast November exports would grow a median 2.6 percent over a year before on top of a revised 1.1 percent gain in October, when overseas sales posted their first growth in four months.

The ministry’s data showed South Korea ran a trade surplus of $ 4.48 billion for November, compared with a revised surplus of $ 3.73 billion in October. The country’s trade balance has been in black for all but two months since early 2009.

Meanwhile, exports for the January-November period were 0.8 percent less than the comparable period of 2011, making it highly likely the country will miss its export target of a 3.5 percent gain set for the whole of 2012.

Reuters calculations show South Korean exports this year would post an annual loss unless shipments in December grow 9 percent or more on a year-on-year basis. The country’s exports grew in all but three years for the past 50 years at least.

South Korea is home to some of the world’s largest suppliers of cars, smartphones and ships. It sends roughly a quarter of its total exports to China and about 10 percent each to the European Union and the United states.

(Editing by Ron Popeski)

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Cargo plane crashes in Brazzaville, 3 dead

BRAZZAVILLE, Republic of Congo (AP) — A cargo plane owned by a private company crashed Friday near the airport in Brazzaville, the capital of the Republic of Congo, killing at least three people, officials said.

The Soviet-made Ilyushin-76 belonged to Trans Air Congo and appeared to be transporting merchandise, not people, said an aviation official who requested anonymity because he was not authorized to speak to the media.

The plane was coming from Congo‘s second-largest city, Pointe Noire, and tried to land during heavy rain, he said.

Ambulances rushed to the scene in the Makazou neighborhood, located near the airport, but emergency workers were hampered by the lack of light in this capital, which like so many in Africa has a chronic shortage of electricity.

“At the moment, my team is having a hard time searching for survivors in order to find the victims of the crash because there is no light and also because of the rain,” Congolese Red Cross head Albert Mberi said.

He said that realistically, they will only be able to launch a proper search Saturday, when the sun comes up.

Reporters at the scene fought through a wall of smoke. Despite the darkness, they could make out the smoldering remains of the plane, including what looked like the left wing of the aircraft. A little bit further on, emergency workers identified the body of the plane’s Ukrainian pilot, and covered the corpse in a blanket.

Firefighters were trying to extinguish the blaze of a part of the plane that had fallen into a ravine. They were using their truck lights to try to illuminate the scene of the crash. Although the plane was carrying merchandise, emergency workers fear that there could be more people on board.

Because of the state of the road connecting Pointe Noire to Brazzaville, many traders prefer to fly the roughly 400 kilometers (250 miles).

Africa has some of the worst air safety records in the world. In June, a commercial jetliner crashed in Lagos, Nigeria, killing 153 people, just a few days after a cargo plane clipped a bus in neighboring Ghana, killing 10.

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New job posting suggests Nokia may still be considering Android after all

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Glen Campbell considering more live shows in 2013

NASHVILLE, Tenn. (AP) — Glen Campbell may be wrapping up a goodbye tour but that doesn’t mean he’s done with the stage.

Campbell is considering scheduling more shows next year after playing more than 120 dates in 2012.

The 76-year-old singer has Alzheimer’s disease and has begun to lose his memory. He put out his final studio album, “Ghost on the Canvas,” in 2011 and embarked on the tour with family members and close friends serving in his band and staffing the tour.

Campbell’s longtime manager Stan Schneider said in a phone interview from Napa, Calif., where the tour wrapped for the year Friday night, that recent West Coast shows have been some of the singer’s strongest. Campbell will break for the holidays and if he still feels strong he’ll begin scheduling more shows.

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Online:

http://glencampbellmusic.com

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Ukraine fights spreading HIV epidemic

BUCHA, Ukraine (AP) — Andrei Mandrykin, an inmate at Prison No. 85 outside Kiev, has HIV. He looks ghostly and much older than his 35 years. But Mandrykin is better off than tens of thousands of his countrymen, because is he receiving treatment amid what the World Health Organization says is the worst AIDS epidemic in Europe.

Ahead of World AIDS Day on Saturday, international organizations have urged the Ukrainian government to increase funding for treatment and do more to prevent HIV from spreading from high-risk groups into the mainstream population, where it is even harder to manage and control.

An estimated 230,000 Ukrainians, or about 0.8 percent of people aged 15 to 49, are living with HIV, the virus that causes AIDS. Some 120,000 are in urgent need of anti-retroviral therapy, which can greatly prolong and improve the quality of their lives. But due to a lack of funds, fewer than a quarter are receiving the drugs — one of the lowest levels in the world.

Ukraine’s AIDS epidemic is still concentrated among high-risk groups such as intravenous drug users, sex workers, homosexuals and prisoners. But nearly half of new cases registered last year were traced to unprotected heterosexual contact.

“Slowly but surely the epidemic is moving from the most-at-risk, vulnerable population to the general population,” said Nicolas Cantau of The Global Fund to Fight AIDS, Tuberculosis and Malaria, who manages work in Eastern Europe and Central Asia. “For the moment there is not enough treatment in Ukraine.”

Stigma is also a big problem for those with HIV in Ukraine. Liliya, a 65-year-old woman who would give only her first name, recently attended a class on how to tell her 9-year-old great-granddaughter that she has HIV. The girl, who contacted HIV at birth from her drug-abusing mother, has been denied a place in preschool because of her diagnosis.

“People are like wolves, they don’t understand,” said Liliya. “If any of the parents found out, they would eat the child alive.”

While the AIDS epidemic has plateaued elsewhere in the world, it is still progressing in Eastern Europe and Central Asia, according to Cantau. Nearly 21,200 new cases were reported in Ukraine in 2011, the highest number since the former Soviet republic registered its first case in 1987, and a 3 percent increase over 2010. As a result of limited and often delayed treatment, the number of AIDS-related deaths grew 17 percent last year to about 3,800.

Two years ago, Mandrykin, the prisoner, was on the verge of becoming part of that statistic, with his level of crucial CD4 immune cells — a way to measure the strength of the immune system — dropping to 11. In a healthy person, the CD4 count is usually over 600.

“I was lying in the hospital, I was dying,” said Mandrykin, who is serving seven years for robbery, his fourth stint in jail. “It’s a scary disease.”

After two years of treatment in a small prison clinic, his CD4 count has risen to 159 and he feels much better, although he looks exhausted and is still too weak to work in the workshop of the medium-security prison.

The Ukrainian government currently focuses on testing and treating standard cases among the general population. The anti-retroviral treatment of more than 1,000 inmates, as well as some 10,000 HIV patients across Ukraine who also require treatment for tuberculosis and other complications and all prevention and support activities, are paid for by foreign donors, mainly the Global Fund.

The Global Fund is committed to spending $ 640 million through 2016 to fight AIDS and tuberculosis in Ukraine and then hopes to hand over most of its programs to the Ukrainian government.

Advocacy groups charge that corruption and indifference by government officials help fuel the epidemic.

During the past two years, Ukrainian authorities have seized vital AIDS drugs at the border due to technicalities, sent prosecutors to investigate AIDS support groups sponsored by the Global Fund and harassed patients on methadone substitution therapy, prompting the Global Fund to threaten to freeze its prevention grant.

Most recently, Ukraine’s parliament gave initial approval to a bill that would impose jail terms of up to five years for any positive public depiction of homosexuality. Western organizations say it would make the work of AIDS prevention organizations that distribute condoms and teach safe homosexual sex illegal and further fuel the epidemic. It is unclear when the bill will come up for a final vote.

AIDS drug procurement is another headache, with Ukrainian health authorities greatly overpaying for AIDS drugs. Advocacy groups accuse health officials of embezzling funds by purchasing drugs at inflated prices and then pocketing kickbacks.

Officials deny those allegations, saying their tender procedures are transparent.

Much also remains to be done in Ukraine to educate people about AIDS.

Oksana Golubova, a 40-year-old former drug user, infected her daughter, now 8, with HIV and lost her first husband to AIDS. But she still has unprotected sex with her new husband, saying his health is in God’s hands.

“Those who are afraid get infected,” Golubova said.

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African Union asks UN for immediate action on Mali

DAKAR, Senegal (AP) — In an open letter Thursday to U.N. Secretary-General Ban Ki-moon, the president of the African Union urged the U.N. to take immediate military action in northern Mali, which was seized by al-Qaida-linked rebels earlier this year.

Yayi Boni, the president of Benin who is also head of the African Union, said any reticence on the part of the U.N. will be interpreted as a sign of weakness by the terrorists now operating in Mali. The AU is waiting for the U.N. to sign off on a military plan to take back the occupied territory, and the Security Council is expected to discuss it in coming days.

In a report to the Security Council late Wednesday, Ban said the AU plan “needs to be developed further” because fundamental questions on how the force will be led, trained and equipped. Ban acknowledged that with each day, al-Qaida-linked fighters were becoming further entrenched in northern Mali, but he cautioned that a botched military operation could result in human rights abuses.

The sprawling African nation of Mali, once an example of a stable democracy, fell apart in March following a coup by junior officers. In the uncertainty that ensued, rebels including at least three groups with ties to al-Qaida, grabbed control of the nation’s distant north. The Islamists now control an area the size of France or Texas, an enormous triangle of land that includes borders with Mauritania, Algeria and Niger.

Two weeks ago, the African Union asked the U.N. to endorse a military intervention to free northern Mali, calling for 3,300 African soldiers to be deployed for one year. A U.S.-based counterterrorism official who saw the military plan said it was “amateurish” and had “huge, gaping holes.” The official insisted on anonymity because he was not authorized to speak on the matter.

Boni, in his letter, said Africa was counting on the U.N. to take decisive action.

“I need to tell you with how much impatience the African continent is awaiting a strong message from the international community regarding the resolution of the crisis in Mali. … What we need to avoid is the impression that we are lacking in resolve in the face of these determined terrorists,” he said.

The most feared group in northern Mali is al-Qaida in the Islamic Maghreb, or AQIM, al-Qaida’s North African branch, which is holding at least seven French hostages, including a 61-year-old man kidnapped last week.

On Thursday, SITE Intelligence published a transcript of a recently released interview with AQIM leader, Abu Musab Abdul Wadud, in which he urges Malians to reject any foreign intervention in their country. He warned French President Francois Hollande that he was “digging the graves” of the French hostages by pushing for an intervention.

Also on Thursday, Islamists meted out the latest Shariah punishment in northern city of Timbuktu. Six young men and women were each given 100 lashes for having talked to each other on city streets, witnesses said.

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Associated Press writer Virgile Ahissou in Cotonou, Benin and Baba Ahmed in Bamako, Mali contributed to this report.

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The Xbox 720 Is Coming Sooner Than Anyone Anticipated

After almost three years without an update, and with Windows 8 sales flailing, Microsoft will release a new Xbox just in time for Christmas next year, sources told Bloomberg’s Dina Bass and Ian King. Last year Microsoft had said that it wouldn’t release a new version of the gaming system “anytime soon,” with other sources talking up a date sometime in 2013 “at the earliest.” This new Christmas launch makes perfect sense for the video-game nerd anticipated “Xbox 720,” as the rumorers refer to it. An Xbox is one of those it toys that gets people lining up at 3 a.m. during holiday shopping craziness. Even the aging 360 console has managed to double the sales of the new Nintendo Wii so far this holiday season, according to numbers from the NDP Group. Microsoft hasn’t put out an entirely new console since 2005, which led to riots during Black Friday of that year.

RELATED: Foxconn Is Still a Hard Place to Work

And Microsoft needs a super-anticipated something, since Windows 8 sales fell so flat this year. After whispers that the new operating system wasn’t selling well, NDP research group found that sales fell 21 percent for new computers running Windows. The research group doesn’t measure sales from Microsoft stores or online, but Microsoft has said most of its sales come from third-party retailers like Best Buy anyway. Windows 8 tablet sales were almost “nonexistent” said the report, making up just 1 percent of all Windows 8 sales. Yeesh. However, Microsoft CEO Steve Ballmer has said he is playing the long game on this one, claiming that people will get used to the new look and when they do fall in love with it. Maybe the people will line up for Windows 8 next year, too? 

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If not, though, the new Xbox sounds like an upgrade that will get gamers excited and buying. As for what exactly the gadget will look like, the rumorers say it will be cheaper and smaller than the 360, which retails starting at $ 300. In addition, it will have an udpated Kinect controller, a quad core processor, 8GB Ram, Blu-Ray, and augmented reality glasses, according to “leaked reports.” 

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Producer sues Pythons over ‘Spamalot’ royalties

LONDON (AP) — It’s no joking matter.

A producer of the film “Monty Python and the Holy Grail” is suing the British comedy troupe over royalties from the hit stage musical “Spamalot.”

Producer Mark Forstater wants a bigger share of proceeds from the show, which is based on the Pythons’ 1975 movie spoof of the legend of King Arthur.

Lawyers for Monty Python are contesting Forstater’s claim and will present their arguments later. Python members Eric Idle, Michael Palin and Terry Jones will give evidence during a five-day hearing that began Friday at London’s High Court.

Forstater is suing the trio and the two other surviving Python members, John Cleese and Terry Gilliam. The sixth member of the troupe, Graham Chapman, died in 1989.

Forstater’s lawyer, Tom Weisselberg, said that under an agreement made when the film was produced, “for financial purposes Mr. Forstater was to be treated as the seventh Python” and entitled to the same share of “Holy Grail” merchandising and spin-off income as the other members.

But the lawyer said Forstater had not received his fair share of royalties from the stage show, which has been a hit around the world. It ran on Broadway for almost four years to 2009 and is still playing in London’s West End.

Weisselberg said Forstater, who was declared bankrupt earlier this year, had been forced to go to court because of his “difficult financial circumstances.”

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Deaths more common on popular heart drug: study

NEW YORK (Reuters Health) – People with a common type of abnormal heart rhythm were more likely to die within several years if they had been prescribed digoxin, a drug used to help control abnormal heart rates, in a new analysis.

The research involved 4,060 people with atrial fibrillation, in which the heart’s upper chambers quiver chaotically instead of contracting normally. More than two-thirds of the participants were treated with digoxin at some point either shortly before or during the 3.5-year study.

Dr. Samy Claude Elayi, from the University of Kentucky in Lexington, said digoxin – which is widely available in generic form – may benefit some people who have heart failure in addition to a heart arrhythmia.

“But in patients that have no heart failure and (have) atrial fibrillation, I think there is no reason to use this drug as a first line,” added Elayi, who worked on the study.

Another cardiology researcher, however, said the new study isn’t robust enough to warrant changing treatment strategies, and that earlier studies have shown digoxin is safe.

Elayi and his colleagues re-analyzed data from a past trial of people with atrial fibrillation and a high risk of stroke that were treated with a variety of drug combinations, including beta blockers and calcium channel blockers.

Over the study period, 666 people died, according to results published in the European Heart Journal.

People who had taken digoxin in the previous six months, the study team found, were 41 percent more likely to die of any cause and 61 percent more likely to die from a heart rhythm problem, in particular.

That increased risk of death was seen in people with and without heart failure, and in both men and women.

DIZZINESS, FAINTING

Digoxin works by helping to stabilize the upper heart chambers affected by atrial fibrillation, Elayi said – but it can also cause problems by creating a bad rhythm in the heart’s lower chambers. That can lead to dizziness, fainting and heart palpitations.

The researchers noted that they didn’t have data on what dose of digoxin people were prescribed – or how closely they stuck to those prescriptions.

Because the trial wasn’t originally intended to measure the negative effects of digoxin, and people weren’t assigned randomly to one arm or the other, the analysis also can’t prove that digoxin caused the extra deaths.

Dr. Ali Ahmed, who has studied digoxin at the University of Alabama at Birmingham, called that a major limitation of the new study.

He said an earlier randomized controlled trial – considered the gold standard of medical research – did not find more deaths among people with heart failure taking digoxin. Other research, Ahmed added, has suggested that low doses of the drug can actually lower the risk of death among some patients.

An analysis like this one can’t fully account for the likelihood that sicker patients are prescribed certain drugs more often, he said.

“When you do non-randomized studies, you always wonder, was it really digoxin or was it the other confounders” such as patients’ chronic diseases, that led to more deaths.

“This should be taken with extreme caution, because of the potential for confounding and bias from a variety of sources,” Ahmed, who wasn’t involved in the new research, told Reuters Health.

“The fundamental thing is you cannot overrule the findings of a randomized controlled trial with non-randomized data.”

‘NOT A KILLER’

Digoxin can be bought for about $ 10 for a month’s supply. It’s been used worldwide for decades to help control heart rate, the researchers said.

Elayi said the findings don’t mean that people with heart failure and atrial fibrillation shouldn’t be taking the drug.

But based on his team’s study, he said he would recommend other heart medications before digoxin for people without heart failure. However, if an atrial fibrillation patient also has very low blood pressure – which makes drugs such as beta blockers and calcium blockers unsafe – digoxin might be a reasonable second choice, he added.

In that case, doctors should prescribe digoxin at low doses and keep a close watch on the amount of the drug in patients’ blood, Elayi told Reuters Health.

In addition, he said, “From the patient perspective, if doctors put them on the drug they should check their rationale for that.”

But according to Ahmed, patients and doctors shouldn’t worry about taking or prescribing the drug because of this study. Digoxin, he said, “is not a killer.”

SOURCE: http://bit.ly/99ohTH European Heart Journal, online November 27, 2012.

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