China's anti-AIDs campaign

China's anti-AIDs campaign

"Back to sleep" Public health officials in in USA BPA rethinking commercial sponsorship have reduce sudden Washington campaign The British Pae...

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"Back to

sleep"

Public health officials in

in USA

BPA rethinking commercial

sponsorship

have reduce sudden

Washington

campaign The British Paediatric Association will infant death syndrome (SIDS) by advising reconsider its policy of accepting funds parents and care givers to put infants from commercial concerns. The decision, down to sleep on their backs or sides, and ’, taken at its council meeting last week, follto avoid the use of fluffy bedding under ’, owed inquiries into how and why the them. In 1992, after reviewing studies ’, association had accepted a Cl40 000 from other countries the American Acadegrant from Nestle without consulting my of Pediatrics recommended that most its council, and why the donor had been healthy, full-term infants sleep on their listed as anonymous in the association’s ’., back or side (Pediatrics 1992; 89: 1993 annual report. : 1120-26), reversing the previous recomDr Anthony Costello, paediatrician at mendations of most US paediatricians. the Institute of Child Health, London, Since then, the percentage of US babies and convenor, International Child Health sleeping prone has fallen from 73% to Group had written to association presi43%. The US SIDS rate has remained dent Prof Roy Meadow pointing out that nearly unchanged at 1-5 per thousand live many BPA members were opposed to births. Meanwhile, public health camfinancial links with infant formula milk paigns promoting non-prone sleeping in that break the WHO IntemaAustralia and the UK have pushed SIDS companies tional Code on the Marketing of Breast rates in those countries from above the Milk Substitutes and that there was eviUS rate to below US rates, with no evidence that Nestle had consistently done dence of adverse outcomes. In January so. He argued that BPA members could this year, acting on these data, an NIH surely have expected a discussion among panel recommended increased effort to themselves or their representatives before reduce prone sleeping in US infants (Pedi- : any deal with Nestle was finalised, and atrics 1994; 93: 814-20). Surgeon-Generthat the failure to disclose sensitive and al Joycelyn Elders said the target of the financial information to the membership campaign is to have over 90% of US required a full and detailed explanation. : infants sleeping non-prone. There are When Costello’s letter received press v other risk factors for SIDSs, and it is not coverage, Nestle’s manager of corporate known how large the effect of changing affairs wrote to BPA council members : sleep position will be in the US. SIDS is thought to be the result of the absence or weakness of the reflex that tells Task force conclusion on the sleeping infant to turn its head in begun

to

a

response

to

hypoxia

Necropsy often reveals arcuate

nucleus,

a

or

hypercarbia.

the hypoplasia centre medullary of

Vivien Choo

syndrome

campaign

as

.

The Council was satisfied that there had been no intent to mislead the membership. According to Meadow there had been a clerical oversight in circulating the relevant minutes of the financial committee meeting to council members. The decision to list the donor as anonymous, he added, probably stemmed from the fact that the donation had been made through Charities Aid Foundation, and the plan to inform members of the gift at the annual general meeting fell through because the treasurer’s report was curtailed. The BPA is setting up a working group to consider again the policy on commercial sponsorship. The group is to report to the Council’s next meeting in October.

membership.

agents had been used in the conflict or that any US service members were Gulf War exposed to such agents, except for "one soldier who was blistered, plausibly from A special Pentagon task force has conmustard gas, after entering a bunker in cluded that there is insufficient evidence Iraq during the post-war period". to support the claim that there is a true The panel noted that several cases of Gulf War syndrome (see Lancet Feb 5, the syndrome resembled chronic fatigue p 348 and May 7, p 1150). In its report syndrome and one of its recommendathe Defense Science Board Task Force on tions was that "it would be advantageous Persian Gulf War Health Effects says that to co-ordinate further research on veter"there is no persuasive evidence that any ans’ illness in this category with ongoing of the proposed etiologies caused chronic studies of ’CFS’ in the civilian populaillness on a significant scale in the absence tion". of acute injury at initial exposure." In particular, the panel said, there was no evidence that chemical or biological warfare Michael McCarthy

involved in this response. Face-down sleeping is thought to be a risk partly because of the risk of frank airway obstruction, but most importantly because of the risk of rebreathing of air trapped in the bedding beneath the infant’s face. The Consumer Product Safety Commission, a partner in the Back to Sleep Campaign, has moved to ban fluffy bedding intended for use by infants. Supine or lateral sleeping is not recommended for certain infants. Premature infants with respiratory distress oxygenate better when prone. Certain craniofacial China’s anti-AIDs abnormalities predispose the infant to airway obstruction when sleeping on its ; back. Infants with excess gastrooesophageal reflux vomit less when placed China last month announced a new antiprone, but, contrary to previous belief, the AIDS campaign, focusing on health education, publicity, and monitoring of those risk of aspiration pneumonia or asphyxiaat risk. The country has 1361 HIV-position for most infants when supine is now tive to be persons recorded to date, of whom 40 nil. : thought have developed AIDS and 22 have died. Prospective studies are underway, These figures refer to what officials call a attempting to link SIDS risk to airway "small scope" test-programme-on some shape via the sound of the infant’s cry, million 300 people! Over the whole of and there are several disorders of cardiohealth officials estimate, the numChina, pulmonary regulation that are suspected ber of HIV-positive people may be as high to increase the risk. : Paul M Rowe

saying that in confirming the donation, the company had made it clear to the then BPA president that it wished to receive appropriate recognition for its contribution. He also said that when the firm noticed it had been listed as anonymous, it made representation to the association. After its meeting the BPA issued a press release confirming that its honorary officers had acted properly and in keeping with association policy in accepting Nestle’s gift, but that errors had been made in reporting this donation in the standard way to the Council and to the

10 000. Interviewed

a health service official Sun Xinhau said that the AIDS problem is spreading, particularly in Yunnan province, which accounts for 80% of all HIV cases and where drug abuse by injection is particularly prevalent. In other

Ming Pao,

high-incidence areas-Shanghai, Beijing, Fujian and Guangdong-sexual contact with foreigners is the main route of infection, either within China,

or

when work-

visiting relatives abroad. Sun ing emphasised the need for strengthening administrative measures and overcoming prejudice. or

:

by the Hong Kong paper Vera Rich

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