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Archive for the ‘Health’ Category

Nechama Brodie Weighs in on the Banting Debate: The Science of LCHF is Not as Miraculous as it Seems

The Joburg BookNechama Brodie recently wrote an article for Men’s Health about Tim Noakes’ popular Banting diet.

The editor of The Joburg Book: A Guide to the City’s History, People and Places takes on the science behind the low-carb high-fat diet, which was first practised by doctor William Banting 150 years ago.

Brodie takes stock of the state of the nation’s health – nearly two thirds of South Africans are overweight – dives into the fats versus carbs debate and analyses the risk factors of adopting an LCHF-lifestyle.

Read the article:

It’s tempting to buy in to this theory – that Noakes is the maverick; the only one brave enough to challenge The Man, take on the status quo.

Except that Noakes is the one with a brand and a book and a website and a massive following online; and the professionals who disagree with him tend to work, largely anonymously, in research and public health and aren’t trying to sell anything.

And, when you set personalities and the deliciousness of lamb chops aside, the science of LCHF is nowhere near as simple or miraculous as its advocates would have you believe.

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Richard Ballard Speaks at the Launch of South African AIDS Activism and Global Health Politics

South African AIDS Activism and Global Health PoliticsProfessor Richard Ballard from the Department of Population Studies and Development Studies at the University of KwaZulu Natal spoke at the launch of Mandisa Mbali’s South African AIDS Activism and Global Health Politics in Durban.

Ballard has shared his speech on Democracy in Africa, in which he commends Mbali on her multifaceted approach to Aids activism, the depth of her research and her prose, which he says is “clear, direct, efficient, and yet unhurried.”

Thanks very much for asking me to speak on this occasion. My job here this evening is an easy one because Mandisa has produced a wonderful book for us. It is impressive, firstly, because of its scope. One expects it to be a story of the Treatment Action Campaign but in fact the TAC is located within a much greater universe of doctors, scientists, gay activists, gender activists, international activists, multilateral organisations, and politicians that precede and exceed the TAC. The book represents the subject in something approaching its multifaceted entirety rather than privileging some actors’ roles.

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Mandisa Mbali Launches South African AIDS Activism and Global Health Politics

Mandisa Mbali

Stellenbosch academic and Rhodes scholar Mandisa Mbali cut an imposing figure at the The Book Lounge last week at the launch of her book, South African AIDS Activism and Global Health Politics. Joined in a fascinating conversation by Steven Robins, she held the audience captive as she spoke to a number of topics covered in the text, including the issue of “medical apartheid” and the historic role that the Treatment Action Campaign (TAC) had in securing moral legitimacy for AIDS activists internationally, thus enabling them to push for new and improved models of global health diplomacy and governance.

Mandisa Mbali and Steven RobinsSouth African AIDS Activism and Global Health PoliticsShe recalled the political funerals held in the 1980s where young Americans, mainly gay men who were dying of AIDS, elected to have their coffins placed or their ashes scattered outside public buildings in a bid to raise greater awareness about the need for the federal government to develop anti-retroviral drugs. Mbali focused on the historic links and symbolic standpoints between the anti-apartheid movement in South Africa and AIDS activism in America. In South Africa, the moral and political credibility of key founder members carried significant weight.

She highlighted how Zackie Achmat, Mark Heywood and other activists came from anti-apartheid political backgrounds, which informed the successful human rights-based litigation and its effective popularisation of AIDS-related science. So too, the gay and lesbian activism and consciousness-raising from women’s organisations informed the movement.

Mbali Mandisa read two extracts from her book that give a fuller flavour of the work:

On 19 April 2001, cheers, song and dance erupted in a packed room in the Pretoria High Court. The world had just witnessed a dramatic turn in the latest legal challenge faced by Nelson Mandela and his government. Just moments before, lawyers acting for South Africa’s Pharmaceutical Manufacturers’ Association (PMA), which represented 40 multinational pharmaceutical companies, had informed Judge Ngoepe that it was unconditionally withdrawing its case against the country’s government and that it would bear all costs in the matter. The Mandela administration was now free to pass the Medicines and Related Substances Amendment Act (hereafter, the Medicines Act) to enable wider access to cheaper generic and imported patented drugs. Civil society activism had forced one of the most powerful industries in the world to retreat in a high-profile legal dispute with the government of a middle-income developing country. Moreover, this successful campaign against the court case had meaningful impacts for poor patients in developing countries. This favourable outcome permanently altered the politics of HIV drug pricing and, in a broader sense, global health in developing countries. The pharmaceutical industry – which was also sometimes informally referred to as ‘pharma’ – introduced substantial reductions to the prices of certain branded ARV drugs, which facilitated a significant widening of global access to this treatment, especially in sub-Saharan Africa. Similarly, as discussed in Chapter 7, it also altered global health governance in terms of the World Trade Organization’s (WTO’s) Doha declaration of 2001: a development which was inconceivable without the activism surrounding the court case, especially as it clarified states’ public health-promoting rights to take the very same measures contained in South Africa’s Medicines Act that had been challenged by the industry Association’s litigation.

This chapter describes how the transnational activists in the TAC contributed a specifically South African type of moral capital to the international HIV treatment access movement’s challenge to the industry association’s case. This chapter uses the term ‘moral capital’ in the sense suggested by Christopher Brown to describe how a civil society campaign can frame a policy as unethical in a politically impactful manner (2007, p. 29). It argues that the South African activists’ moral capital had three main components: the effective use of anti-apartheid or ‘struggle’ symbolism to equate the actions of the pharmaceutical industry with those of the country’s former racist regime; the presentation of legally convincing arguments based on the socio-economic right to access to health care; and the demonstration that there was a large, visible constituency of affected and aggrieved people.

The ‘struggle’ background of many of the TAC’s leaders, such as Zackie Achmat, enabled the South African and international movements to convincingly deploy anti-apartheid-derived narratives to claim moral legitimacy for their cause. Achmat’s leadership of the TAC provided powerful moral justifications for the American AIDS activists’ solidarity actions which targeted Vice-President Al Gore during the early months of his election campaign because of his support for threats of US trade sanctions against South Africa for passing the Act. In South Africa, anti-apartheid narratives deployed by the TAC during its first civil disobedience campaign used the ‘struggle symbolism’ of the ANC’s 1950s Defiance Campaign to generate domestic support for its advocacy on drug pricing. As we shall see, the South African and international movements had to challenge the dominant development consensus which was opposed to wider provision of combination ARV therapy in developing countries because of utilitarian arguments that it was not ‘cost-effective’ to do so and arguments that Africans lacked the ‘cultural competency’ to adhere to them. Locally, there were also suspicions and misunderstandings about the safety and efficacy of ARV therapy which the TAC overcame through careful treatment literacy programmes which explained how the drugs worked.

The TAC successfully argued to be admitted as an amicus curiae in the case. It deftly used legal arguments based upon the constitutionally enshrined socio-economic right to access to health care. This litigation strategy was an important legal factor in the industry association’s decision to drop the case. International allies such as James Love of the Consumer Project on Technology (CPT) and Eric Goemare of Médicines Sans Frontières (MSF) provided critical expert testimony on international trends in drug pricing. Litigation based upon the socio-economic right to access to health care was new in the history of South African AIDS activism. The movement invoked these rights to press for the state and pharmaceutical industry to play a more substantive role in fulfilling their positive obligations in law in terms of the right to access to health care. By contrast, earlier AIDS activism in the country had emphasized the right to privacy, a ‘negative’ right, which generally provided that the state should refrain from taking various actions in relation to individuals.

She read from a chapter later in the book too:

Activist opposition to the PMA’s court case reveals key patterns in the development of the international HIV treatment access movement. The TAC’s transnational nature – as manifest in the international activist alliances that the South African movement forged – proved vital in forcing the 40 major multinational pharmaceutical corporations to drop their case. This was also a critical moment in the founding and consolidation of the international HIV treatment access movement. As this chapter shows, the TAC contributed to a specifically South African form of moral capital to the international movement. When the international and domestic movements were first formed, the overwhelming ‘development consensus’ among donor governments, UNAIDS and the World Bank was that widespread provision of HIV treatment in resource-constrained settings failed the utilitarian test of ‘cost-effectiveness’ and that it was anyway unfeasible due to health systems-related issues and Africans’ ‘cultural differences’.

It was easy for South African and American activists to equate the industry’s actions with those of the apartheid regime: the case was brought only a few years into South Africa’s post-apartheid period; the country had one of the highest numbers of people living with HIV globally; the case was brought against the Mandela administration, and it was aimed at advancing the interests of a small, but powerful, constituency at the expense of the well-being of millions of poor patients. But the fact that South Africa also had the TAC – a new social movement of affected and aggrieved people led by an openly HIV-positive former anti-apartheid activist – lent additional credibility to international solidarity actions, including those of American activists. American activists effectively used the political opportunities presented by Gore’s presidential bid to advocate for a change in US trade policy. This was a critical early victory in the campaign against the pharmaceutical industry association’s case, as it robbed them of critical political and diplomatic support from the US government.

Within South Africa itself, the movement was heavily shaped by its origins in anti-apartheid activism in ways which were also beneficial to the international movement. The TAC’s growing credibility as a movement, which was evident in its expanding membership, depended heavily on the anti-apartheid backgrounds of key leaders such as Achmat. The movement’s growth can also be attributed to organizers’ treatment literacy activities, which popularized the science around the epidemic and their work to sew the TAC’s advocacy onto the social and political quilt of township life which was tailored around the country’s (apartheid and anti-apartheid) history.

In addition, the TAC had a deft legal strategy which involved invoking the socio-economic right to access to health care to be admitted as an amicus. This strategy was enabled by the new Constitution and it provided the TAC with an additional political forum to present its arguments against the PMA’s case. International allies played a critical role in the case in that they provided vital expertise on drug pricing and innovation in America and the generic drug industries in India and Brazil.

The TAC’s use of socio-economic rights-based legal arguments in this manner marked a critical shift in the history of South African AIDS activism. Whereas earlier activism in the country had prized the principle of the people living with HIV having a right to privacy (a concept grounded in negative freedom), the new AIDS activism encouraged voluntary openness about living with the disease. It did so to underline its campaigns which used the right to health, a concept grounded in a substantive understanding of freedom, to demand more state services and regulation of the pharmaceutical industry via health-advancing trade and patent policies.

The global HIV treatment access movement and the TAC had won its first important victory.

‘Pharma’ is the acronym for Pharmaceutical Research and Manufacturers of America but is also used colloquially to refer to the industry in general both in the United States and South Africa.

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Liesl Jobson tweeted live from the event using the hashtag #livebooks

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Cape Town and Durban Launches for South African AIDS Activism and Global Health Politics

South African AIDS Activism and Global Health PoliticsPan Macmillan presents two launches for South African AIDS Activism and Global Health Politics by Mandisa Mbali in Durban and Cape Town.

On Tuesday 28 May at 5:30 PM for 6 PM, Mbali will be in discussion with Richard Ballard of the University of KwaZulu-Natal’s School of Development Studies at Ike’s Books and Collectables.

The Book Lounge in Cape Town will host Mbali in conversation with Steven Robins on Thursday 30 May at 5:30 PM for 6 PM.

Don’t miss it!

Durban launch

Cape Town launch

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Mandisa Mbali Examines the History of the TAC in South African AIDS Activism and Global Health Politics

South African AIDS Activism and Global Health PoliticsSouth Africa has the world’s largest number of people living with HIV. South African AIDS Activism and Global Health Politics offers a history of AIDS activism in South Africa from its origins in gay and anti-apartheid activism to the formation and consolidation of the Treatment Action Campaign (TAC), including its central role in the global HIV treatment access movement.

What did South African AIDS activists contribute, politically, to early international advocacy for free HIV medicines for the world’s poor? Mandisa Mbali demonstrates that South Africa’s Treatment Action Campaign (TAC) gave moral legitimacy to the international movement which enabled it to effectively push for new models of global health diplomacy and governance. The TAC rapidly acquired moral credibility, she argues, because of its leaders’ anti-apartheid political backgrounds, its successful human rights-based litigation and its effective popularization of AIDS-related science.

The country’s arresting democratic transition in 1994 enabled South African activists to form transnational alliances. Its new Constitution provided novel opportunities for legal activism, such as the TAC’s advocacy against multinational pharmaceutical companies and the South African government. Mbali’s history of the TAC sheds light on its evolution into an influential force for global health justice.

About the author

Mandisa Mbali is a Lecturer in the Department of Sociology and Social Anthropology at the University of Stellenbosch. She is a Rhodes scholar and obtained her doctorate in Modern History at the University of Oxford, UK. Mbali completed postdoctoral training at Yale University, USA and has published a journal article and book chapters on post–apartheid AIDS activism and policy-making.

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Podcast: Chai FM Talks to Nicole Jaff About Menopause: Everything You Need to Know

MenopauseChai FM recently spoke to Nicole Jaff, author of Menopause: Everything You Need to Know. In the following podcast, Jaff discusses the symptoms and duration of perimenopause, the efficacy and risks of hormone therapy, and what menopause actually means:

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Introducing Menopause: Everything You Need to Know by Nicole Jaff

MenopausePan Macmillan is proud to announce the publication this month of Menopause: Everything You Need to Know by Nicole Jaff:

“…the simplest, most understandable, absolutely up-to-date and informative book on menopause and women’s health that I have ever read.” – Elizabeth Barrett-Connor, MD.

Nicole Jaff is an international menopause expert. She understands the pressures and confusion experienced by women in or approaching menopause and as acts as their guide through the maze of conflicting theories facing these women. Drawing on extensive research, the latest medical information and her experience as a menopause counsellor, Nicole provides the information that women need to manage their health and well-being during mid-life.

Currently working on her PhD on menopause and health risks in black South African women, at the Faculty of Health Sciences, at the University of the Witwatersrand, Nicole is a Registered Counsellor, a certified menopause practitioner with the North American Menopause Society and menopause counsellor at the Wendy Applebaum Institute for Women’s Health at the Wits Donald Gordon Medical Centre.

Her full-time career in menopause counselling and research began when an unnecessary hysterectomy plunged her into early menopause. Her mission is to empower women so they can take responsibility for their health in partnership with their doctors. She has written several books and hundreds of articles on menopause, has run numerous workshops for women, consults and speaks at women’s events in her drive to help women make the right choices about their health throughout the menopausal years.

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