Entries from November 2007 ↓

On this day a year ago, a young woman lay dying, in a cold and spartan house, in a village in South Africa’s remote Eastern Cape province.

Aids had eaten into her body. She weighed less than four-and-a-half stone (28.5kg).

Her limbs ached so much that she could barely leave her bed. Her mouth was infected with the thrush that makes it agonising to swallow food.

Her name was Prudence Radebe and she was resigned to her fate.

Today, Prudence is still alive. In fact, she is so full of life that it is hard to believe just how sick she was.

Her weight has shot back up, to teenage impotence stone. Her skin is smooth and shiny. She carries buckets of water from the well up the hill with no difficulty.

And, every so often, she likes to do stretching exercises on the little patch of land behind her house.

Prudence knows why she is still alive. “Anti-retroviral drugs saved my life,” she says, matter-of-factly.

Fluke of geography

I first met her in September 2004, when she started taking anti-retrovirals. Since then, I have been travelling down to the Eastern Cape every two months to follow her progress.

We do a lot of Aids stories in this part of the world but not many like this… with a happy ending.

It is estimated that five million people are HIV positive in S Africa

Prudence is a clever, cheerful person, with a loving family.

Her recovery leaves me with a warm feeling. It shows there is hope amid the dark, overwhelming despair of the Aids pandemic.

Prudence is, above all, lucky.

She heard that the charity Medecins Sans Frontieres had started an anti-retroviral project in a nearby town and she applied for treatment.

A fluke of geography, if you like.

There are almost one million HIV positive people in the Eastern Cape, and only 4,000 are receiving free anti-retrovirals.

Haunted by death

But Prudence is not just lucky. She had to convince the doctors that she was serious and dedicated. She had to learn about all the complexities of the drugs which she now needs to take every single day for the rest of her life.

She discovered that she might build up resistance if she does not take them properly, and that they can have painful side-effects.

Today she has the zeal of a convert and her language is peppered with the words and terminology of Aids treatment: CD4 count, viral-load, voluntary testing, nevirapine.

If Prudence took you round her village, you would realise just how fortunate she is.

This is one of the most beautiful parts of South Africa. Thatched huts cling to the steep, green hillsides, and children’s voices echo across the valleys.

But it is a landscape that is haunted by death.

Prudence is surrounded by tragedy.

Hopelessness

I feared the worst for her neighbour, Nontandozela, who had been in bed for the past six months, too weak to stand.

More than 300,000 HIV positive Africans are now on anti-retrovirals

Drug dysfunction erectile new sister, Victoria, was also sick and lying on the other side of the room.

Four months ago Victoria died.

Nontandozela’s daughters watched all this in silence. Their faces betrayed no emotions, but I could not imagine their fear and despair.

The men in the family - the fathers of these young girls - have drifted away.

Nobody knows how to contact them. And nobody has enough money to pay for a taxi to take Nontandozela to the clinic where Prudence started her treatment.

If nothing happens, Nontandozela’s days are numbered.

Torn apart

Another young woman with Aids, Lulama, lived further down the valley.

We went to see her in September. She was so weak she could barely speak, let alone leave her squalid bedroom.

In a rasping whisper she said she was worried about her two young boys, aged six and two.

Lulama did not even know what anti-retrovirals were, let alone how she could get them.

Aids is no longer an automatic death sentence in Africa

We got a phone call four days after we got back to Johannesburg.

Lulama had died.

I learnt later that an aunt took those two boys and is doing her best to raise them in a tiny shack in a grim township on the edge of the nearest big city, Durban.

Best body body fitness guide health lifelong mind mind personal sport are not miracle drugs but they can keep you alive and healthy for many years, provided you eat well and look after yourself. They buy you time.

Today Prudence is looking to the future, impatient to go back to work in Durban and making plans with her son.

Breaking the cycle

The World Health Applied disability handbook rehabilitation research series springer would like to have three million people in developing countries on anti-retrovirals by the end of this year.

It will not reach that target. It probably will not get anywhere near. But the fact is that something has changed in the Aids pandemic.

More than 300,000 HIV positive Africans are now on anti-retrovirals.

It is not much compared to the total infected population, but Aids is no longer an automatic death sentence in Africa.

After 20 years we are beginning to break the cycle of despair, and that is the significance of Prudence’s story.

From Our Own Correspondent was broadcast on Saturday, 14 May, 2005 at 1100 BST on BBC Radio 4. Please check the programme schedules for World Service transmission times.

Read more on News - Buying time to fight Aids

Levitra, the first market rival to the hugely profitable Viagra, is being manufactured by the German firm, Bayer AG, and marketed by the British firm GlaxoSmithKline (GSK) as an alternative oral therapy for erectile woman impotence.

Since its appearance in 1998, sales of Pfizer’s Viagra have risen to nearly $2bn a year.

Both pills work in the same manner and doctors warn that both can have serious side effects, especially for men with heart problems.

A third dictionary drug medication pill, Cialis, is expected to reach the US market later this year.

The US Food and Drug Administration (FDA) approved Levitra, an orange pill compared to Viagra’s blue, based on studies showing that men were on average five times more likely to achieve an erection suitable for intercourse when taking the pill compared with those given a dummy medicine.

Drug lookup medication reported that studies of several thousand men showed that Viagra helped more than 70% improve their
erections.

As well as the warnings to men with heart conditions, the FDA said Levitra was not for patients with who had suffered a recent heart attack or stroke who have very low blood pressure or uncontrolled high blood pressure.

For otherwise healthy men, Levitra’s main side effects
were headache, flushing and a stuffy nose and sometimes dizziness.

Lawson Macartney, head of strategic management of GlaxoSmithKline’s administration atlas clinical drug medication photo therapy, metabolic and urology drugs, said: “We know, from teenage impotence market research, that the
market is ready for new options”.

GSK expects Levitra to be available in September.

July 26, 2000 –Until last week, Jennifer Erickson was just an ordinary pharmacist, working at a drugstore in Seattle. Now, the 26-year-old married woman is the poster girl for women everywhere who have had to plunk down their own money to pay for birth control.

On July 19, Erickson, who says she would like to have children some day but is not ready yet, filed suit against her employer, Bartell Drug Co., charging them with sex free generic viagra for paying for other prescription drugs, but not prescription birth control. Erickson is one of approximately 42 million women in this country who use birth control. Although she has a good job and can afford the more than $300 per year that her prescription birth control pills cost, she doesn’t think she and millions of others should have to pay for them. And neither do plenty of medical professionals and health policy experts.

“Drug lookup medication is a fundamental part of health care, just like vaccinations,” says David A. Grimes, MD. “It’s good, pills, preventive health care.”

Grimes is vice-president of medical affairs at Family Health International, a nonprofit group in Research Triangle Park, N.C., that helps men and women get access to family-planning services and methods. He says that from a corporate viewpoint, contraception makes sound economic sense. By averting a birth, the company saves money, especially if that birth is premature or there are other complications, he tells WebMD.

Approximately half of all large group insurance plans will not pay for any form of prescription birth control. Only about a third of health-insurance policies include oral impotence lipitors in their prescription drug coverage. Most HMOs do cover the Pill, but only about 40% cover the other four FDA-approved contraceptive options: IUDs, diaphragms, Depo-Provera shots, and Norplant implants.

“As women, we’ve been excluded from so much,” says Karen Rashke, staff attorney for the Center for Reproductive Law and Policy. “We’ve just sort of taken it in stride. I don’t think a lot of us thought much about this until recently.”

Although plenty of women have complained for years about being refused coverage for what many see as a basic health need, until the Erickson lawsuit was filed last week, no single person had ever stood up to an employer and demanded that they pay. Erickson’s lawsuit seeks birth control coverage for herself and all other non-union female employees of Bartell Drug Co., which has more than 45 pharmacies in the state of Washington.

In a statement to the media, representatives of Bartell Drug Co. said they believe their insurance plan is “lawful and drug dysfunction erectile new.” They point out that they do not pay for Viagra, infertility drugs, drugs for weight reduction, immunization agents, drugs for cosmetic purposes, and various other items.

Roberta Riley of Planned Parenthood of Western Washington, who is the lead attorney in Erickson’s, case, says her client repeatedly asked her employer to change its policy and cover birth control. When they continued to refuse, she decided to sue.

“I think it was only a matter of time before something like this happened,” says Cynthia Dailard, senior public policy associate at the Alan Guttmacher Institute in Washington, D.C. “If the lawsuit is successful, it will put many employers on notice that they could face similar lawsuits if they do not cover contraceptives, and that it is a matter of gender discrimination.”

Both Planned Parenthood of Western Washington and Planned Parenthood Federation of America, which is also representing Erickson, say birth control prevents unintended pregnancies and reduces the need for abortion.The group cites 1998 statistics showing that nearly half of all pregnancies in the U.S. are unintended, and many of these pregnancies end in abortion.

Experts who spoke to WebMD agree that one thing that has increased women’s anger over this lack of coverage is the advent of Viagra.

“Viagra is covered by many [insurance] programs and was scooted onto the market so quickly, while women have been struggling for decades to get coverage of contraception,” Grimes says. He believes the discrepancy amounts to nothing less than discrimination against women, many of whom cannot afford $20-$30 per month for birth control pills.

It is estimated that women of childbearing age pay about 68% more out of their own pockets for medical expenses than men. And now, even the Viagra pills — at $10 apiece — are often covered, while birth control is not. According to estimates, paying for birth control would cost insurers only about $1.43 per month for each female employee. That would provide them with all available FDA-approved forms of contraception; the cost would be even less if the employer only provided coverage for some methods.

Some in Congress are trying to force change by passing a law that would require all employers and insurance companies to pay for birth control. Progress has been slow, but individual states have passed such laws on their own. States that require companies who pay for other prescription drugs to pay for prescription birth control include Maryland, Georgia, Vermont, Maine, Nevada, Connecticut, North Carolina, Hawaii, New Hampshire, California, Iowa, Delaware, and Rhode Island. But nine of the 13 states have provisions that let employers, enrollees, or insurers who object to such coverage on “religious grounds” off the hook.

Most experts say individual states will probably continue to pass laws, and people will keep a close eye on the progress of Jennifer Erickson’s lawsuit. But what can a woman who is paying for her own birth control do in the meantime?

“Employees have the ability and the right to speak to their benefits manager,” attorney Rashke says. “There’s no reason an employee can’t go to the benefits manager and say, ‘I notice in my prescription coverage there’s an exclusion for contraception.’ That’s the first step.” If you don’t want to do it on your own, Rashke advises talking to other women you work with to see if they will take the concerns to the benefits manager as a group.

“One person can do a lot by raising the issue at cocktail parties, writing a letter to the editor … just point out this lack of coverage that so many of us haven’t even thought about,” she says.