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Tough anti-tobacco legislation moves forward in South Africa
POLICY AND PEOPLE
US election results promise health-policy changes bortion-rights supporters and advocates for managed-care regulation were the clear winners in the mid-term Congressional elections on Nov 3. Republicans were widely expected to add to their majorities in the US House and the Senate, both because of the President’s difficulties and because the party that does not control the White House has gained in Congress in every mid-term election for the past 60 years. But Democrats defied all expectations and gained five seats in the House, while holding their numbers in the Senate. Although Republicans maintained majorities in both chambers—meaning they will chair all the committees and control what bills reach the floor
A
for votes—Democrats were quick to herald the elections as a message that voters want to talk more about issues and less about whether to impeach President Clinton. At the top of the Democrats’ agenda remains the “Patient Bill of Rights”, their version of managed-care regulation. While the House passed a minimal bill on the subject in July, Senate Republican leaders managed to prevent even a debate in that chamber. Despite election night polls showing that health care was not a major issue for most voters, Democrats and President Clinton announced on Nov 5 that the managed-care bill would be their first priority when the new Congress convenes in January.
Even more disappointed in the election results were abortion opponents, who had hoped to pick up the three votes in the Senate they needed to overcome President Clinton’s continuing opposition to legislation to bar a specific second-trimester and thirdtrimester abortion procedure. But even though five Senate seats switched abortion positions, in the end, abortion opponents only picked up one vote. In the House, abortion-rights backers actually gained a half dozen seats. But with abortion foes still with majorities in both the House and Senate, abortion is likely to remain an active issue in the next Congress. Julie Rovner
Tough anti-tobacco legislation moves forward in South Africa
T
ough proposed anti-tobacco legislation in South Africa moved a step closer to becoming law on Nov 4 when the Parliament’s National Assembly voted to ban tobacco advertising and outlaw smoking in public places. The highly controversial Tobacco Products Control Amendment Bill now only has to go to the National Council of Provinces next week for ratification of Assembly amendments before President Nelson Mandela signs it into law. The legislation also slaps a ban on the sponsorship of sporting and cultural events by tobacco companies. The government will also regulate the tar and nicotine content of tobacco products.
The only opposition group to support the ruling African National Congress in the 213 to 106 vote was the African Christian Democratic Party. The other parties said they supported the aim of the bill, to prevent children from starting to smoke˚, but rejected it because they said it was unconstitutional and would damage the economy. In a desperate bid to stop the bill, the tobacco industry took Health Minister Nkosazana Zuma to court but its case was summarily dismissed. The industry may now resort to the Constitutional Court. “We are very much aware that this is but the beginning of a titanic battle between us and those who profit from this substance tobacco”, Zuma said on Nov 3 as
she presented the bill to the National Assembly. She argued that the tobacco industry spent 240 million rand a year on advertising and promotions while at the same time claiming that it did not influence anyone to smoke. “This argument is preposterous”, she said. Tobacco industry representatives stressed during heated public hearings earlier that an estimated 15 000 jobs could be lost in the industry and many more in related fields if the bill was approved. But a determined Zuma fired back, saying money not spent on cigarettes would still be spent, but on other goods and services, thereby creating new jobs. Adele Baleta
Five countries targeted in new trachoma initiative his year’s World Health Assembly saw reaffirmation of trachoma-induced blindness as a realistic candidate for elimination. The year 2020 is the target.Trachoma remains endemic in 46 countries. A significant contributor to this Alliance for the Global Elimination of Trachoma is the International Trachoma Initiative, newly formed by the New York based Edna McConnell Clark Foundation and Pfizer Inc. On Nov 10, Pfizer and the Clark Foundation launched a $US 66 million programme aimed at eliminating trachoma in five developing countries. WHO has listed 16 countries meriting
T
THE LANCET • Vol 352 • November 14, 1998
special attention; leading contenders for ITI assistance are Morocco, Mali, Ghana, Tanzania, and Vietnam.
The ITI programme includes the donation of Pfizer’s single-dose
antibiotic azithromycin (Zithromax) but Antibiotic treatment is only part of the widely accepted SAFE strategy. The other three components are a simple 15-minute Surgical procedure for advanced trachoma, Face washing, and Environmental changes such as access to clean water. ITI’s expert committee is: Hannah Faal, D A Henderson, Adetokunbo Lucas, David Mabey, Nyi Nyi, Michael Reich, and Sheila West, with Bjorn Thyelfors from WHO. ITI is based in New York ([email protected] or http://www. trachoma.org). David Sharp
1609
US election results promise health-policy changes bortion-rights supporters and advocates for managed-care regulation were the clear winners in the mid-term Congressional elections on Nov 3. Republicans were widely expected to add to their majorities in the US House and the Senate, both because of the President’s difficulties and because the party that does not control the White House has gained in Congress in every mid-term election for the past 60 years. But Democrats defied all expectations and gained five seats in the House, while holding their numbers in the Senate. Although Republicans maintained majorities in both chambers—meaning they will chair all the committees and control what bills reach the floor
A
for votes—Democrats were quick to herald the elections as a message that voters want to talk more about issues and less about whether to impeach President Clinton. At the top of the Democrats’ agenda remains the “Patient Bill of Rights”, their version of managed-care regulation. While the House passed a minimal bill on the subject in July, Senate Republican leaders managed to prevent even a debate in that chamber. Despite election night polls showing that health care was not a major issue for most voters, Democrats and President Clinton announced on Nov 5 that the managed-care bill would be their first priority when the new Congress convenes in January.
Even more disappointed in the election results were abortion opponents, who had hoped to pick up the three votes in the Senate they needed to overcome President Clinton’s continuing opposition to legislation to bar a specific second-trimester and thirdtrimester abortion procedure. But even though five Senate seats switched abortion positions, in the end, abortion opponents only picked up one vote. In the House, abortion-rights backers actually gained a half dozen seats. But with abortion foes still with majorities in both the House and Senate, abortion is likely to remain an active issue in the next Congress. Julie Rovner
Tough anti-tobacco legislation moves forward in South Africa
T
ough proposed anti-tobacco legislation in South Africa moved a step closer to becoming law on Nov 4 when the Parliament’s National Assembly voted to ban tobacco advertising and outlaw smoking in public places. The highly controversial Tobacco Products Control Amendment Bill now only has to go to the National Council of Provinces next week for ratification of Assembly amendments before President Nelson Mandela signs it into law. The legislation also slaps a ban on the sponsorship of sporting and cultural events by tobacco companies. The government will also regulate the tar and nicotine content of tobacco products.
The only opposition group to support the ruling African National Congress in the 213 to 106 vote was the African Christian Democratic Party. The other parties said they supported the aim of the bill, to prevent children from starting to smoke˚, but rejected it because they said it was unconstitutional and would damage the economy. In a desperate bid to stop the bill, the tobacco industry took Health Minister Nkosazana Zuma to court but its case was summarily dismissed. The industry may now resort to the Constitutional Court. “We are very much aware that this is but the beginning of a titanic battle between us and those who profit from this substance tobacco”, Zuma said on Nov 3 as
she presented the bill to the National Assembly. She argued that the tobacco industry spent 240 million rand a year on advertising and promotions while at the same time claiming that it did not influence anyone to smoke. “This argument is preposterous”, she said. Tobacco industry representatives stressed during heated public hearings earlier that an estimated 15 000 jobs could be lost in the industry and many more in related fields if the bill was approved. But a determined Zuma fired back, saying money not spent on cigarettes would still be spent, but on other goods and services, thereby creating new jobs. Adele Baleta
Five countries targeted in new trachoma initiative his year’s World Health Assembly saw reaffirmation of trachoma-induced blindness as a realistic candidate for elimination. The year 2020 is the target.Trachoma remains endemic in 46 countries. A significant contributor to this Alliance for the Global Elimination of Trachoma is the International Trachoma Initiative, newly formed by the New York based Edna McConnell Clark Foundation and Pfizer Inc. On Nov 10, Pfizer and the Clark Foundation launched a $US 66 million programme aimed at eliminating trachoma in five developing countries. WHO has listed 16 countries meriting
T
THE LANCET • Vol 352 • November 14, 1998
special attention; leading contenders for ITI assistance are Morocco, Mali, Ghana, Tanzania, and Vietnam.
The ITI programme includes the donation of Pfizer’s single-dose
antibiotic azithromycin (Zithromax) but Antibiotic treatment is only part of the widely accepted SAFE strategy. The other three components are a simple 15-minute Surgical procedure for advanced trachoma, Face washing, and Environmental changes such as access to clean water. ITI’s expert committee is: Hannah Faal, D A Henderson, Adetokunbo Lucas, David Mabey, Nyi Nyi, Michael Reich, and Sheila West, with Bjorn Thyelfors from WHO. ITI is based in New York ([email protected] or http://www. trachoma.org). David Sharp
1609