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South African judge reaffirms judgement to expand access to AIDS drug
POLICY AND PEOPLE
Croatia opens a national centre for the prevention of smoking n an effort to improve national tobacco control measures the Croatian government has helped a public hospital to open a centre that will help people to stop smoking. Cigarette smoking is increasing in the countries in post communist transition. In Croatia, burdened not only by economic difficulties but also the after effects of war, there are 1·2 million smokers—a quarter of the population. To meet the needs of more than 80% of smokers who say they wish to quit smoking but don’t know how, the Andrija Stampar School of Public Health of the Zagreb University School of Public Health, the central Croatian educational and research institution in public health, has opened the centre for the prevention of smoking. The centre has a free telephone line on which 40 physicians, psychologists, and social workers will answer questions on smoking and provide support to those who have decided to try and stop smoking.
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The centre is a part of a national campaign that goes by the motto of “Yes to No Smoking” and is led by the Croatian Ministry of Health, the Australian Embassy in Zagreb, and Andrija Stampar School of Public Health. The clinic is also sponsored by Croatian public television, which regularly broadcasts a programme on how to stop smoking. The show is produced by Australian programme makers and is shown in more than 130 countries worldwide. Stjepan Oreskovic, director of the Andrija Stampar School of Public Health, told The Lancet that the antismoking campaign was not going to be negative and derogatory to smokers but will be aimed at individuals’ responsibility towards themselves and their environment. “Out of eight million medical diagnoses per year, three million are related to the respiratory diseases, and there are 2500 new cases of lung cancer each year. With this campaign . . . we aim to decrease the rate of coronary heart disease and increase
life expectancy, which is now 7 years shorter than in the European Union”, said Oreskovic. The campaign’s main target will be teenagers because research from the European School Survey Project on Alcohol and Other Drugs has shown that 90% of new smokers in Croatia were younger than 20 years; about 70% of 15-year-olds had tried smoking; and 30% smoked regularly. The campaign will introduce educational programmes on healthy lifestyles in schools. For those who already smoke, the clinic will open on March 18, with a team of psychiatrists, neurologists, pulmologists, and ENT specialists to provide education and assistance to quit the habit. Andrija Stampar school has also launched a website dedicated to antismoking initiatives and plans to provide training programmes for physicians and other health personnel so they can better support people who want to quit smoking. Ana Marusic
South African judge reaffirms judgement to expand access to AIDS drug
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n March 11, the Pretoria High Court ordered the South African government to provide nevirapine to HIV-positive pregnant women at all state facilities with the capacity for testing and counselling with immediate effect. Health Minister Manto Tshabalala-Msimang had not yet decided, at the time of going to press, whether or not to appeal against the decision but the Treatment Action Campaign
(TAC) said state lawyers had indicated they would appeal. Judge Chris Botha’s ruling gives effect to his judgment in December in which he granted an application brought by the TAC, paediatrician Haroon Saloojee of the Save Our Babies campaign, and the Children’s Rights Centre for an order that nevirapine should be made available at state facilities outside the 18 pilot sites. On March 1, the TAC applied to
South African doctor sacked for giving antiretrovirals to rape survivors A South African doctor has appealed against his dismissal for “insubordination” for allowing an anti-rape organisation to work from his hospital. Mpumalanga provincial health boss Sibongile Manana fired Thys von Mollendorff on Feb 15 for not following hospital protocol by giving the Greater Nelspruit Rape Intervention Project offices at the Rob Ferreira Hospital where they provide counselling and antiretrovirals (ARVs) to rape survivors. Manana’s spokesman Dumisani Mlangeni told The Lancet that the charge was that the doctor did not follow the right procedures—he said a charge regarding the provision of ARVs was dropped. However, Von Mollendorff said his disciplinary hearing in January focused almost exclusively on his decision to allow doctors, in contravention of government policy, to prescribe ARVs to the rape survivors. 477 rapes were reported last year in the Greater Nelspruit area, which has a population of 260 000, and 25% of rape survivors tested were HIV positive.The World Medical Association said on March 8 that “it is unacceptable that patients are being denied treatment for solely political or economic reasons.” Von Mollendorff said: “I am frustrated because there is a serious shortage of state doctors. I feel ethically bound to serve patients and I cannot turn my back on life-saving drugs”. Manana, who earlier accused Von Mollendorff of trying to “poison” the rape victims, has until the end of March to set a date for the appeal hearing. Adele Baleta
the court to have the ruling enforced pending the government’s appeal to the Constitutional Court to have the December judgment set aside. This appeal is only likely to be heard by the Court in June. The TAC’s Mark Heywood called on the government not to appeal Botha’s order saying that up to 100 lives a day could be saved. Saloojee said it was a victory for the autonomy of health professionals. Botha said in his judgment: “If the order was suspended and the [TAC] appeal were to fail it is manifest that it will result in the loss of lives that could have been saved. It would be odious to calculate the number or lives one could consider affordable in order to save the respondent [the government] the sort of inconvenience that they foreshadow. I find myself unable to formulate a motivation for tolerating preventable deaths for the sake of sparing the respondents [the government] prejudice that cannot amount to much more than organisational inconvenience.” Adele Baleta
954
THE LANCET • Vol 359 • March 16, 2002 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.
Croatia opens a national centre for the prevention of smoking n an effort to improve national tobacco control measures the Croatian government has helped a public hospital to open a centre that will help people to stop smoking. Cigarette smoking is increasing in the countries in post communist transition. In Croatia, burdened not only by economic difficulties but also the after effects of war, there are 1·2 million smokers—a quarter of the population. To meet the needs of more than 80% of smokers who say they wish to quit smoking but don’t know how, the Andrija Stampar School of Public Health of the Zagreb University School of Public Health, the central Croatian educational and research institution in public health, has opened the centre for the prevention of smoking. The centre has a free telephone line on which 40 physicians, psychologists, and social workers will answer questions on smoking and provide support to those who have decided to try and stop smoking.
I
The centre is a part of a national campaign that goes by the motto of “Yes to No Smoking” and is led by the Croatian Ministry of Health, the Australian Embassy in Zagreb, and Andrija Stampar School of Public Health. The clinic is also sponsored by Croatian public television, which regularly broadcasts a programme on how to stop smoking. The show is produced by Australian programme makers and is shown in more than 130 countries worldwide. Stjepan Oreskovic, director of the Andrija Stampar School of Public Health, told The Lancet that the antismoking campaign was not going to be negative and derogatory to smokers but will be aimed at individuals’ responsibility towards themselves and their environment. “Out of eight million medical diagnoses per year, three million are related to the respiratory diseases, and there are 2500 new cases of lung cancer each year. With this campaign . . . we aim to decrease the rate of coronary heart disease and increase
life expectancy, which is now 7 years shorter than in the European Union”, said Oreskovic. The campaign’s main target will be teenagers because research from the European School Survey Project on Alcohol and Other Drugs has shown that 90% of new smokers in Croatia were younger than 20 years; about 70% of 15-year-olds had tried smoking; and 30% smoked regularly. The campaign will introduce educational programmes on healthy lifestyles in schools. For those who already smoke, the clinic will open on March 18, with a team of psychiatrists, neurologists, pulmologists, and ENT specialists to provide education and assistance to quit the habit. Andrija Stampar school has also launched a website dedicated to antismoking initiatives and plans to provide training programmes for physicians and other health personnel so they can better support people who want to quit smoking. Ana Marusic
South African judge reaffirms judgement to expand access to AIDS drug
O
n March 11, the Pretoria High Court ordered the South African government to provide nevirapine to HIV-positive pregnant women at all state facilities with the capacity for testing and counselling with immediate effect. Health Minister Manto Tshabalala-Msimang had not yet decided, at the time of going to press, whether or not to appeal against the decision but the Treatment Action Campaign
(TAC) said state lawyers had indicated they would appeal. Judge Chris Botha’s ruling gives effect to his judgment in December in which he granted an application brought by the TAC, paediatrician Haroon Saloojee of the Save Our Babies campaign, and the Children’s Rights Centre for an order that nevirapine should be made available at state facilities outside the 18 pilot sites. On March 1, the TAC applied to
South African doctor sacked for giving antiretrovirals to rape survivors A South African doctor has appealed against his dismissal for “insubordination” for allowing an anti-rape organisation to work from his hospital. Mpumalanga provincial health boss Sibongile Manana fired Thys von Mollendorff on Feb 15 for not following hospital protocol by giving the Greater Nelspruit Rape Intervention Project offices at the Rob Ferreira Hospital where they provide counselling and antiretrovirals (ARVs) to rape survivors. Manana’s spokesman Dumisani Mlangeni told The Lancet that the charge was that the doctor did not follow the right procedures—he said a charge regarding the provision of ARVs was dropped. However, Von Mollendorff said his disciplinary hearing in January focused almost exclusively on his decision to allow doctors, in contravention of government policy, to prescribe ARVs to the rape survivors. 477 rapes were reported last year in the Greater Nelspruit area, which has a population of 260 000, and 25% of rape survivors tested were HIV positive.The World Medical Association said on March 8 that “it is unacceptable that patients are being denied treatment for solely political or economic reasons.” Von Mollendorff said: “I am frustrated because there is a serious shortage of state doctors. I feel ethically bound to serve patients and I cannot turn my back on life-saving drugs”. Manana, who earlier accused Von Mollendorff of trying to “poison” the rape victims, has until the end of March to set a date for the appeal hearing. Adele Baleta
the court to have the ruling enforced pending the government’s appeal to the Constitutional Court to have the December judgment set aside. This appeal is only likely to be heard by the Court in June. The TAC’s Mark Heywood called on the government not to appeal Botha’s order saying that up to 100 lives a day could be saved. Saloojee said it was a victory for the autonomy of health professionals. Botha said in his judgment: “If the order was suspended and the [TAC] appeal were to fail it is manifest that it will result in the loss of lives that could have been saved. It would be odious to calculate the number or lives one could consider affordable in order to save the respondent [the government] the sort of inconvenience that they foreshadow. I find myself unable to formulate a motivation for tolerating preventable deaths for the sake of sparing the respondents [the government] prejudice that cannot amount to much more than organisational inconvenience.” Adele Baleta
954
THE LANCET • Vol 359 • March 16, 2002 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.