HIV AIDS, Whoonga and Probiotic yoghurt

I write this latest post on the back of reading a news story on the current ‘Whoonga’ drug craze that is gripping South Africa. A drug that has antiretroviral drugs, the drugs used to treat HIV incorporated into it. HIV and AIDS have been at epidemic proportions in Africa, in particular in sub-Saharan Africa where 22.5 million people are currently infected. South Africa is currently home to 5.6 million people infected with HIV and AIDS with the highest prevalence found in 33% of women between the ages of 25-29, and 25% of men between the ages of 30-35 infected with HIV and/or AIDS. Although the incidence rate in South Africa is reducing (the number of new cases per year) there are still clearly a huge number of people living with HIV and AIDS and the associated consequences of a highly stigmatised condition.

‘Whoonga’ is a very potent mix of antiretroviral drugs (the drugs used to treat HIV) rat poison, detergent and marijuana all crushed and mixed together before being smoked, with the individual smoking the drugs very quickly hooked. However, conflicting stories have come out over whether ‘Whoonga’ does actually contain antiretroviral drugs, and even if they did they wouldn’t deliver the high that conventional narcotics do. What is clear is that the dealers selling the drugs at 30 Rand per packet (anyone who has been to South Africa knows this is a hefty price for anyone from a township) claim that the antiretroviral (ARV) drugs are present and as such installing a mentality to the users that the ARV’s is what they crave. Stories have emerged that ‘Whoonga’ users are stealing ARV’s from hospitals, clinics, and mugging patients for their potentially life extending drugs. This, although deplorable, could be expected from an incredibly poor population addicted to a fairly common, free prescriptive drug, yet which is very expensive buying illegally from dealers. However, what this drug craze is fuelling is an underground market of drug cartels stealing antiretroviral drugs from hospitals and selling them to dealers. A Johannesburg police officer has already been implicated in such a crime. This is something that could compromise South Africa’s fight against HIV and AIDS with ARV’s becoming more difficult to get hold of for both clinics and patients because of a fear of theft and misuse.

With drugs more difficult to get hold of, the needy patient may become more desperate and seek more traditional and unconventional modes of treatment. I myself spent some time in Ghana a couple of years ago, and am familiar with this. Routinely, people claiming to be doctors would be selling HIV and AIDS soap – ‘wash away your HIV.’ The ‘doctors’ would visit small rural villages, visit those who couldn’t get to hospitals, and these locals would buy the soap. Of course there is no science behind anti-HIV soap and it is a complete con. One which even the hardiest of holistic/pseudoscience/complementary medicine Gillian McKeith supporters would find hard to defend. But desperate people do desperate things.

I recently watched an excellent programme by Sir Paul Nurse, the new president of the Royal Society. One of the people he met whilst investigating how science is portrayed and understood was an American man who had HIV and was given a prognosis of 3 years. He discarded his ARV drugs as soon as he was given them and began a diet comprising of a high number of probiotic yoghurts... 13 years later he is still alive and kicking... I don’t think I need to explain that neither bifidus digestivum or L.Casei Danone have antiretroviral properties, although it seems there may be a niche for an anti-HIV soap in the American market...

I believe that the current Whoonga craze in South Africa could detrimentally affect the fight against HIV and AIDS although what is far more important is the education of young people in transmission and safety.

“Those that know, do. Those that understand, teach.”

Aristotle.

Unfortunately, statistics are hard to find on the impact of ‘Whoonga’ due to it being a fairly recent development. Many of the stories are anecdotal and possibly open to interpretation. Having said that, the statistics I laid out in the first paragraph over the prevalence and incidence of HIV and AIDS in sub Saharan Africa are not open to interpretation and should be food for thought for everyone.

Big Issue!

Happy new year to everyone! This being the first nanosized blog post of the year, I felt I should write about a subject which is ever increasing in size. This topic is of immense importance as well as proportions in a time of cash strapped governments squeezing budgets to accommodate agenda’s. The topic I refer to is the big one – obesity.

I felt this post was aptly timed. New year is a time of resolution and change for many, with ‘must get fit this year’ often bandied about by individuals, some even lace up their trainers and go for a run, a very commendable achievement after one too many festive mince pies. Alternatively, you could do as Paul Mason is and sue the NHS for ‘allowing’ him to achieve his hefty former title of Britain’s fattest man, weighing 70 stone. I will try to resist this blog post becoming a rant about Mr Mason’s lack of personal responsibility and the cost to the general public for keeping up his sizeable weight (£5000 to reinforce the hospital floors before his £30,000 gastric band surgery, on top of the ca. £500,000 per year for general care.) But I feel this case may be just the beginning of the biggest challenge the NHS and our society faces in the coming years.

Levels of obesity in the UK have been rising for a number of years due to the availability of cheap high calorie food, reduced levels of exercise amongst the masses all accompanied by a poor level of knowledge regarding diet and exercise. The most recent NHS figures suggesting 66% of men and 57% of women are overweight with around 25% of the adult UK population classed as obese. A couple of quick points for those who are unaware... The method of measurement remains the body mass index (BMI) which is the weight of the individual in kilograms divided by their height in metres squared. A BMI of 25-30 is classed as overweight, 30 and above is classed as obese. The current UK average stands at around 27kg/m². And can anyone tell me what a calorie is? (This is a fantastic question that many people have no idea about but will happily use the word ‘calorie’ frequently) A calorie is simply a unit of energy. Specifically it is the amount of energy required to raise the temperature of 1 litre of water by 1°C = 4.18 Joules. Consider yourself learned – no more excuses.

Now, aside from the potentially increased financial costs of feeding an overweight family, being overweight comes with a massive increase in health risks, everything from heart disease to various forms of cancer. These increasing levels of obesity and accompanying co-morbidities puts an ever increasing strain on already thinly spread NHS resources. Something that cannot continue forever. The NHS have already sold off car parks and allowed commercial reality take hold within the hospital with privatisation inside major hospitals – including commercial giants that are part of the problem. I know from personal experience Southampton General Hospital has inside its doors a set of solicitors specialising in, among other things, medical malpractice. As well as a well known fast food burger chain - an eerie place where patients will wheel their drips and overweight frames to pick up a bacon double cheeseburger.

I don’t know how as a society we have got to the stage where hospitals have fast food restaurants and their obese customers can consider suing the NHS that provides their frequently required care, but clearly something has gone wrong somewhere. Personally I would happily consider the suggestion of making obese patients pay for their NHS care. Although I can already see the difficulty with where you would draw the line with this method – do smokers pay for care too? What about those who drink too much? All I know is that the current trends cannot continue. Thankfully the obesity trend amongst children seems to have levelled off or even reduced (depending on which figures you look at) a very encouraging sign indeed. Hopefully today’s children will reduce the levels of obese adults in the near future. Regardless of how this impacts on future levels of obesity I believe everyone should take a little more personal responsibility. And what a time to do so. New year new you? Why not.