Health

Some recent unpublished letters to the newspaper….

I must be losing my touch. It used to be that the newspapers would publish every letter I wrote to the editor. Sometimes this would amount to one or two a month.

For some reason – which I will get to shortly – our local morning daily, the Cape Times, has not published a single letter for quite some time. I am starting to wonder whether I have lost my touch. I do know that there is a new editor and owner and probably a new letters editor, which may have something to do with it.

Perhaps this is not so. Perhaps my letters cut more and more to the real issues and the printed media does not want to deal with the real issues? Maybe it prefers to dabble on the surface and not really immerse itself into the swamp of greed into which the world has sunk.

This may not be so and perhaps the years have transformed me into a verbose, curmudgeonly old fart with nothing worthwhile to say.

In case I am wrong I share the last few letters, with some background context, for those who care to read. After all each of them follow the theme of this blog: trying to make the world a better place. And maybe that is not what newspapers are really about anymore. But that is far too cynical and a dark place to go and visit, no?

Questioning big pharma:

This letter was in response to correspondence which questioned Complimentary Alternative Medicines (CAM), with all of the usual biases shown in that debate around how CAM is unscientific and untested. Which is crap…

I am happy that Sidney Kaye (letters 5 June) wishes to fine-tune his mechanistic body with assistance from the medical industrial complex rather than the world of complementary medicine, or apparently, of common sense.
He may be interested to learn that poor medical practices and medical side effects, also known as iatrogenics, conservatively caused 210 000 deaths per year 2008-2011 in the USA, according to a study published by the Journal of Patient Safety. This was a sharp increase from the 98 000 “lost” in 1999.

A single pharmaceutical, Merck’s “Vioxx,” has been deemed responsible for some 50 000 fatalities. Its forced withdrawal from the market has been credited with saving nearly half a million lives. Over the last three years the US government has fined the pharmaceutical industry alone over $11 billion for illegal sales, marketing, drug contamination and manipulating research.

Conversely, remarkably little research is directed by toward solving our most pressing global health challenges. Malaria research is funded primarily through philanthropic, non-medical sources because industry deems it insufficiently profitable.

Yet a new front line malaria drug, artemisinin, is sourced from a plant, Artemisia annua, as was the first, Quinine. Nearly half of existing pharmaceutical drugs are sourced from plants. Extensive research has been conducted on plant based bio-compounds, thousands indicating proof of efficacy.

I would personally prefer to choose natural and complimentary medicines. They are rarely conclusively linked to contra-indications. When these occur they are usually between plant compounds and chemical pharmaceuticals. These cases are routinely hyped up by the medical-industrial complex, blaming natural medicines, not pharmaceuticals.

South Africa struggles to regulate even conventional pharmaceuticals. The Medicines Control Council (MCC) is essentially dysfunctional. To overburden the MCC by forcing it to regulate harmless, yet often useful complimentary medicines is a reactionary response, actively encouraged misinformed and avaricious interests allied to conventional medicine.

While Kaye may wish to tune his “mechanical” organism through conventional medicine, others clearly prefer to first employ individual approaches. Our increasing knowledge of natural and alternative medicines has provided profound revelations how these substances help maintain the delicate balances within our complex, individual metabolic processes. We are not uniform, Cartesian machines.

Yes, there certainly is a place for conventional, allopathic medicine. But to claim the unalloyed superiority of reductionist Cartesian perspectives appears misplaced. Doctors are not gods, neither is the medical industry infallible.

Most importantly, complimentary, alternative and traditional medicines still have a very real role to play in our lives. It is democratically abhorrent to limit our free choice in this matter.

~~~

Next was a long letter which examines the increasingly pro-development bent of our City Council, under the control of the liberal (even neo-liberal) Democratic Alliance, who have rolled out a “red carpet for red tape” for developers:

The excellent reports in your newspaper by (reporters) Melanie Gosling and Zara Nicholson, along with related consequent correspondence in the letters column regarding the alienation of important agricultural land in the Phillipi area for housing and industrial use refers.

The decision by the City of Cape Town Mayoral Committee (Mayco) to allow development in an important component of the Philippi Horticultural Area (PHA) flies in the face of several established city policies. These include the recently promulgated and widely consultative Spatial Development Framework and its associated city zoning scheme, the groundbreaking Urban Agriculture policy (the first such policy in sub-Saharan Africa), the Integrated Metropolitan Environmental Policy, the Urban Edge as well as several other regional and international policies. It is counterproductive to broadly consult, at great expense, develop policies and then disregard them.

The misleading justifications of this bizarre about face proffered by Cllr. Bloor illustrate three things: Firstly his poor grasp of integrated planning principles, exacerbated by a poor comprehension of what constitutes a sustainable city; secondly, his unsuitability as a committee member for Economic, Environmental and Spatial Planning (EESP) and finally and most seriously, the inherent conflict between political party funding, combined with the toxic relationship between the Western Cape Property Development Forum (WCPDF) and the DA, city and provincial authorities with their “red carpet for red tape” policy. I will deal with each of these serious issues in turn.

Urbanisation is a major global trend, although it is predicted to slow in South Africa. Cities, long perceived as unsustainable entities, have been re-imagined to provide emerging models for sustainable development. For this to occur cities need to fulfil several criteria, including due care of environmental resources, in this case those related to urban food security. Cities are unsustainable if they simply import food from distant areas.

Philippi is therefore a critical environmental resource. It produces more than 90 000 tonnes of food per year, on around 1500 hectares of land, through up to 5 crops per annum. This land is amongst the most productive in the country, yielding on average over 50 tonnes per hectare. To even consider building on land of this quality, especially when there are numerous other alternatives already identified in the area, not only epitomises unsustainable practice, it borders on the criminally insane. Mayco ought to relocate, en masse, to a familiar urban landmark with a green roof (the local asylum) for even considering this development proposal.

Second, Councillor Bloor appears unable to differentiate his categorically conflicted roles on the EESP. His pursuit of economic development through house and industrial development illustrates a constrained world view. He is clearly ill-equipped and untrained to represent environmental interests, which fundamentally conflict with the objectives of economic development, especially when viewed through his lens of economics training. Like most conventional neo-liberal economists, especially adherents of the discredited Chicago and Austrian schools which he aligns himself with as a member of the Mount Pelerin Society, he believes that the environment both stands in the way of economic growth, while simultaneously providing huge economic benefits through exploitation. This thinking highlights the disjuncture in his official position.

If Cape Town is to become a sustainable city – and we are most certainly a long way from one at present – we have to pursue and encourage sustainable practices. The PHA, which supplies half of our fresh vegetables, is an essential part of our city’s foodbowl. Bloor’s colleague Cllr. Smit likewise shows an inability to recognise the contradictions in his thinking, which appears to be that if there is uncontrolled squatting, let’s not control it but simply use it as justification for further development outside the designated urban edge. This is akin to allowing developers let large tracts of land go to ruin under alien vegetation and then claim it has no intrinsic botanical value hence should be developed. Instead of going down that particular rabbit hole, we should rather police the urban edge, not permit uncontrolled squatting or loss of agricultural land.

Finally and possibly most importantly we need to follow the money. The reality is that party political funding is the Achilles heel of our democratic system, across the board. This has been demonstrated by the ANC with its Chancellor house relationships and also by the DA with its chequebook influenced decision making structures.

Elected DA representatives are not simply expected to attract funding, they are impelled to do so. Failure brings censure and possible loss of lucrative positions. The relationship between the DA, councillors, officials and the WCPDF is inherently conflictual. The WCPDF even goes so far as to declare that it aims to become a statutory body. Imagine that; development policy dictated by developers.

The cosy relationship between councillors, officials, decision makers and the WCPDF is unacceptable. It actively undermines the intents and purposes of the agreed upon Spatial Development Framework, notably the aspects that deal with agriculture and the concept of sustainability.

That the WCPDF has been granted direct access to power is at odds with open democracy. This relationship undermines transparent public participation, especially given that there is no countervailing information flow with civil society organisations and representatives.

In reality we do not have a city that works for us. Instead our city works for developers, who lobby and undermine public processes in return for short term capital gain and profits.

A strong argument can be made that there should be public hearings, if not a commission of enquiry into the relationship between the WCPDF and the DA, our elected representatives, city officials and other decision makers. This is an unhealthy relationship which must be curtailed.

~~~

The next was along similar lines, questioning why the city has even considered an unsolicited bid to build a massive exurb to the north of Cape Town, driven by the same development interests:

A number of events lead me to a firm conclusion that environmental planning and developmental analysis in this city is under unprecedented attack through collusion between political and commercial interests.

The first event is the out- of-the-blue initiative by a consortium of developers to initiate a massive exurb on the northern periphery of Cape Town. This initiative has been roundly condemned by all well informed independent planning academics and experts. It is doubly ironic that the consortium made this proposal on the virtual eve of Cape Town becoming the design capital of the world in 2014 – nothing could be as far removed from good design as this pretentious pustule of poor planning.

The second is the increasing cosiness between the DA led City and Province and the Western Cape Property Development Forum (WCPDF). The proposed “red carpet” to smooth planning proposals, while ostensibly sensible, is simultaneously a massive threat to proper integrated planning, as evinced above. The stated goal of the WCPDF is to become “A body that represents development that is recognized by authorities and which will ultimately become a statutory recognised body.” Its tentacles already appear to control too many administrative levers of power.

To even consider having a forum, guided, run and controlled by property developers as a statutory, recognised body should send chills down our collective backs. This is centralised planning epitomised. The reality behind party political funding should ring additional alarm bells in our collective conscience.

The third event is the unilateral concentration of planning administration in the City in one central office, removing planning decision making from the various sub-councils. This and the gutting of SPELUM, the Spatial Planning, Environment and Land Use Management Committee by the mayoral executive committee are even more sinister from a democratic perspective.

The fourth and final warning bell is the tabling of a Proposed Amendments to Systems
of Delegations for Economic, Environmental and Spatial Planning before the City Council in order to further facilitate planning centralisation in the city. In this proposal, one individual, the Executive Director: Economic, Environmental and Spatial Planning will effectively hold centralised control over all metropolitan planning authority.

What appears to be underway is an unprecedented takeover of the planning and development of our city by developers and building companies which hold massive power through their non-transparent funding of political parties and power. The Competition Commission has already investigated the building industry for collusion and found it wanting. What is emerging is the potential for collusion and corruption on an almost unimaginable scale.

All of the above is profoundly undemocratic and is counter to our fundamental constitutional rights. Section 152 of the Constitution states that “The objects of local
government are to provide democratic and accountable government for local communities.” What is occurring, let alone what is proposed, is the very antithesis of this. It is also antithetical to the proper administration of the Municipal Systems act which must provide democratic and accountable local government that encourages community involvement.

The DA led City and Province effectively indicate a desire to enable developers and construction firms to undermine our collective democratic rights. This is in line with that parties liberal principles which prioritise unfettered business and commercial rights, in this case from an urban planning and development perspective. This is not speculation – the evidence is clear.

The DA is simply showing its true colours as a profoundly anti-democratic party which supports the interests of free and unfettered enterprise above and beyond those of individual or of collective constitutional rights. A collective Princess Vlei awaits us all, a chilling situation indeed.

~~~

This next letter was a broadside at our monopoly power producer Eskom, the fifth largest power producer in the world and the third largest emitter of CO2, along with our coal to oil converter, Sasol, which runs the worlds biggest single point emitter of CO2 in Secunda. These two entities are both attempting to avoid clean air regulation.

Your editorial of Friday October 4, “Air waves”, refers.

It is beyond the pale that long-term polluters like Eskom and Sasol, who have each enjoyed years of externalising the costs and impacts of their activities on humans and the environment, have the temerity to apply for exemptions to the National Environmental Management: Air Quality Act (NEMAQA).

Both Sasol and Eskom rely on coal as feedstock. Coal is the dirtiest fuel on the planet, bar none. Considering the cost of the impacts of mercury emissions from coal alone, South Africa is the second largest emitter of mercury in the world after China. Mercury is a persistent, cumulative toxin, with serious health impacts. Neither is mercury coal’s only serious pollutant.

Industry has delayed the implementation of NEMAQA for years through legal appeals against the law and its regulations, which effectively remain ongoing. Representatives from the energy, chemicals, petroleum, cement and forestry sectors have thrown huge resources at weakening and delaying the implementation of meaningful regulation of dangerous airborne pollution, placing profit above public interest and benefit.

A similar situation occurred in 1980’s in the USA when the government sought to limit sulphur emissions that caused acid rain in Canada. The power utilities fought tooth and nail against any regulation. Yet when emissions were eventually controlled, the costs over the first decade came to between $8 and $9 billion. The benefits were valued at between $101 and $119 billion – a ten-fold benefit.

We have good environmental laws. We can no longer be held to ransom by obstructionist industries which profit by externalising the impacts of their activities. Besides the inherent immorality of the matter is that these large corporations are squandering our own, limited public resources by shamelessly spending vast sums to endlessly delay the due and proper implementation of an act signed into law almost a decade ago.

Time to revise our overuse of antibiotics

Antibiotic End Game: Some Implicationss

By Glenn Ashton · 26 May 2014

Antibiotic resistant bacteria have brought humanity to the dawn of a new era of medical uncertainty and risk. This has emerged through a simple evolutionary trend, where some of the most basic organisms on earth have managed to thwart our ingenuity over the course of slightly more than half a century.

Recent medical and scientific progress has extended human longevity well beyond the traditional biblical time-span of 70 years, across many parts of the world. One of the most important medical interventions of the last 70 years was the widespread availability of antibiotics to cure previously untreatable infections.

At the end of the Second World War there were less than 2.5 billion people. Today the earth is home to over seven billion. Besides improved nutrition and vaccines, a significant proportion of this growth can be attributed directly to antibiotics. Yet these wonder drugs are increasingly being outsmarted by the simple bacteria they initially vanquished. How has this happened?

Bacteria multiply incredibly fast; one of the most common antibiotic resistant microbes Staphylococcus aureus, commonly known as staph, divides every half hour. In five hours, a single bacterium can formed a colony of over 1000; five hours later it will be over a million strong.

Evolution is driven by genetic mutation; this is how organisms adapt to their environment. Given the size of staph’s genetic code, we can expect about 300 mutations in the first ten hours. In less than a day and a half the genome theoretically has the potential to exhibit every single possible mutation in that new colony.

This is the consequence of the exponential power of rapid cell division and mutation. The result is the inevitable adaptation of bacteria to environmental pressures, which in the health field include antibiotics. We use antibiotics to extinguish dangerous bacteria that have infected our bodies. But once bacteria have adapted, the antibiotic becomes ineffective.

This basic explanation illustrates our vulnerability to these rapidly adapting organisms. More specifically it highlights how vulnerable we are to the over-use and abuse of these medicines that revolutionised health care over the past three human generations.

It is not a matter of if we are going to lose our existing antibiotics, it is when. Our careless misuse of these medicines illustrates our inability to deal with the perilousness of our situation. We are so blasé we casually feed them, at sub-therapeutic levels, to livestock in order to accelerate growth. The result is a slew of resistant bacteria emerging from these livestock production facilities, directly into the animal products we consume.

Antibiotics are also excessively prescribed. This is encouraged by the conservative medical approach of doctors, dogged by litigation, who wish to reduce risks wherever possible. Improper use, such as not completing a full course, further encourages resistance.

This has led to elevated infection rates through even relatively minor medical procedures. High human and animal population densities harbour and incubate increased bacterial loads. Today, as in the time of our grandparents, we are under a real threat of serious infection through something as innocuous as a scraped knee or an infected insect bite.

Antibiotics have saved my own life several times. A septic foot as a child, a particularly nasty tropical infection as an adult, a bad tooth abscess and an agonising gut infection were all treated by antibiotics. The same goes for most of us. Statistically, antibiotics are prescribed more than once a year to every resident in some parts of the USA.

What happened before we had antibiotics? Nearly one in three cases of pneumonia were fatal. One of nine skin infections. Half a percent of mothers giving birth. I would probably not be here to write this article.

How bad are things presently? Let’s examine our example of staph infections: In 1974 2% of US infections were methicillin resistant. By 1995 it was 22% and by 2004 it had reached 64%. By 2007 more people in the US were dying from staph infection than from AIDS. Combine HIV, AIDS, TB and resistant staph and other bacteria and you have a ticking time bomb. This is of particular interest to Sub-Saharan Africa, along with other developing regions.

HIV and AIDS compromise our immune systems. Antibiotics therefore effectively become a substitute defence mechanism. As this region lies at the global epicentre of the pandemic it is clearly essential not to compromise the utility of antibiotics.

The same goes for what is known as drug-resistant and multiple drug-resistant (MDR) TB. This emerged mainly through patients failing to complete the full course of antibiotics. This caused the tubercular bacillus to rapidly evolve resistance to almost every known antibiotic. Today MDR TB can only be treated in isolation, along with the monitored dosing of patients by astronomically expensive medications.

Health experts and the medical fraternity are profoundly concerned by the rapid evolution of antibiotic resistance. Steps have been taken to address the problem, yet our present antibiotic arsenal has limited and shrinking possibilities.

The reality is that we have to explore new alternatives. The pharmaceutical industry is reluctant to do so because of the expense and increasingly short-term usefulness of new antibiotics; bacterial resistance has evolved more and more rapidly to the most recent antibiotics. If drugs are not sufficiently profitable, big pharma is indifferent to developing them. Consequently a strong argument has been made for state intervention in the research for new antibiotics.

Promising new antibiotic resources have been isolated in soil meta-genomes. Some of these are associated with the rich biota of the Fynbos region of Southern Africa, along with other mega-biodiverse regions. Other useful discoveries have been made through analysing various marine organisms.

Such opportunities need urgent funding for research. It would be useful, in the case for South Africa, for the generous existing government subsidies to biotech research to focus carefully on research toward development of new antibiotics. These could be rolled out by leveraging similar finance streams as used with new HIV and AIDS drugs, which access both public and private funding and keep eventual costs low.

We urgently need to see this situation for what it is – an emerging global crisis with potentially catastrophic possibilities for humanity. There are solutions but we must explore novel, practical methods to deliver them into the public health system. This challenge demands our immediate attention.

This article was first published on SACSIS, the website of the South African Civil Society Information Service – http://www.sacsis.org.za
Should you wish to republish this SACSIS article, please attribute the author and cite The South African Civil Society Information Service as its source.
The article is licenced under a Creative Commons Attribution Licence:
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