Thousands gather at TB meet in S. Africa
Wed, 07 Nov 2007 13:24:08 GMTBy CLARE NULLIS, Associated Press Writer
CAPE TOWN, South Africa - Old drugs. Outdated tests. Empty promises. New threats. Such is the bleak reality surrounding an international tuberculosis conference opening Thursday in a city scarred by a killer combination of TB and AIDS: an already nightmarish scenario worsened by the spread of untreatable strains.
The 3,000 delegates will spend four days discussing the challenges posed by the dual epidemics of TB and HIV — which are still often treated separately although they feed off each other. About one-third of the world's 40 million people infected with the AIDS virus have TB, the vast majority of them in Africa. TB kills more than 1.6 million people every year.
"Unlike bird flu, the global threat of HIV/TB is not hypothetical. It is here now. But the science and coordination needed to stop it are utterly insufficient," said Veronica Miller, director of The Forum for Collaborative HIV Research, in a report released ahead of the Cape Town conference.
The only available vaccine was invented more than 85 years ago and fails to protect most people beyond childhood. Antibiotics used to fight TB are more than 40 years old. Test methods used in most developing countries were developed 120 years ago, are notoriously slow and often fail to spot TB in AIDS patients.
Health activists charge that rich countries and their pharmaceutical industries have shown little interest in developing more effective drugs because TB primarily affects poor people in poor countries. There are some new drug development and diagnostics initiatives but the activists say it's too little too late.
In a report issued Wednesday, the New York based advocacy Treatment Action Group accused the United States and other donor nations of backsliding on commitments made last year to step up the fight against TB.
It said that international spending for TB research and development remained stagnant at US$413 million — less than half the amount called for in a much-vaunted 2006 Global Plan to Stop TB to increase funding for research on new TB diagnostics, drugs.
The contribution from the U.S. National Institutes of Health — the biggest funder — declined slightly to US$120 million, it said. Mark Harrington, executive director of the Treatment Action Group, said that with the U.S. budget problems and overspending in Iraq, TB wasn't "even on the radar" of the Bush administration.
"Current funding levels for TB research and development are vastly out of proportion with the scope of the TB epidemic," said Dr. Mario Raviglione, Director of the World Health Organization's Stop TB Department.
The Treatment Action Group said the lack of funding was especially alarming given the global spread of multidrug resistant and extensively drug-resistant TB , which was identified in 2006 and is now present in more than 40 countries.
The spread of the drug resistant forms of TB is largely the result of poorly managed TB care and patients who don't take the full six-month course of treatment.
In South Africa, for instance, the cure rate for patients who stick to their treatment is just 50 percent, way below WHO's target of 85 percent. In some areas, it is as low as 30 percent, according to Greg Hussey, head of the University of Cape Town's Institute for Infectious Diseases. People who are not properly cured are prone to develop MDR-TB which requires a two year treatment regimen.
South Africa hit the headlines last year when 53 people at a clinic in Tugela Ferry in KwaZulu-Natal were diagnosed with HIV/XDR-TB. Nearly all of them died within two weeks because of their weakened immune systems.
Because of the poor diagnostics, there are no reliable statistics on the number of South Africans who have been infected with XDR-TB. The majority of them die before they can be tested or treated, according to Gilles van Cutsem, a project coordinator for Medecins Sans Frontieres in the poor Cape Town suburb of Khayelitsha, one of the hardest hit areas.
Little is known about the situation in neighboring countries like Swaziland and Mozambique, which also have high HIV and TB rates but don't have proper laboratory facilities. But MSF and other organizations say they fear the worst.
Report Abstinence programs dont work
Wed, 07 Nov 2007 15:50:36 GMTBy H. JOSEF HEBERT, Associated Press Writer
WASHINGTON - Programs that focus exclusively on abstinence have not been shown to affect teenager sexual behavior, although they are eligible for tens of mil lions of dollars in federal grants, according to a study released by a nonpartisan group that seeks to reduce teen pregnancies.
"At present there does not exist any strong evidence that any abstinence program delays the initiation of sex, hastens the return to abstinence or reduces the number of sexual partners" among teenagers, the study concluded.
The report, which was based on a review of research into teenager sexual behavior, was being released Wednesday by the nonpartisan National Campaign to Prevent Teen and Unplanned Pregnancy.
The study found that while abstinence-only efforts appear to have little positive impact, more comprehensive sex education programs were having "positive outcomes" including teenagers "delaying the initiation of sex, reducing the frequency of sex, reducing the number of sexual partners and increasing condom or contraceptive use."
"Two-thirds of the 48 comprehensive programs that supported both abstinence and the use of condoms and contraceptives for sexually active teens had positive behavior effect," said the report.
A spending bill before Congress for the Department of Health and Human Services would provide $141 million in assistance for community-based, abstinence-only sex education programs, $4 million more than what President Bush had requested.
The study, conducted by Douglas Kirby, a senior research scientist at ETR Associates, also sought to debunk what the report called "myths propagated by abstinence-only advocates" including: that comprehensive sex education promotes promiscuity, hastens the initiative of sex or increases its frequency, and sends a confusing message to adolescents.
None of these was found to be accurate, Kirby wrote.
Instead, he wrote, such programs improved teens' knowledge about the risks and consequences of pregnancy and sexually transmitted diseases and gave them greater "confidence in their ability to say 'no' to unwanted sex."
The sponsors of the study praised Kirby for his "thorough research" and for being "fair and evenhanded," but they also acknowledged that ETR Associates developed and markets several of the sex education curricula reviewed in the report. Several of the previous studies that were reviewed also were written by Kirby.
The report noted that there continues to be "too high levels of sexual risk-taking among teens" with 47 percent of all high schools students reporting having sex at least once and 63 percent saying they have engaged in sex by the spring semester of their senior year.
"Many teenagers do not use contraceptives carefully and consistently," said the report. About 40 of every 1,000 girls age 15 to 19 gave birth in 2005, the last year for which data was available, the report said.
Battle over natural food designation
Wed, 07 Nov 2007 08:18:53 GMTBy ANDREW BRIDGES, Associated Press Writer
WASHINGTON - It's a fight that has the nation's largest chicken producers squabbling, Big Sugar and Big Corn skirmishing and Sara Lee mixing it up with Farmer John. Lawmakers, too, have joined the fray, which already is thick with dueling petitions and at least one lawsuit. Meanwhile, government food regulators are uncertain how to proceed.
The question is at face value a simple one: When can food products, from chicken breasts to soda pop, rightfully be labeled as "natural?"
Wrapped up in it, however, are some far trickier questions: Is it ethical to charge for saltwater that increasingly pumps up supermarket chickens? Is the sodium lactate used as a flavoring and preservative in sliced roast beef "natural?" How about the high-fructose corn syrup that sweetens sodas?
Equally simple answers appear elusive.
"It's worth bringing in the rabbis to analyze these situations because it's complicated, it's subtle. You can argue from both sides. It has fine distinctions," said Michael Jacobson, executive director of the Center for Science in the Public Interest.
The watchdog group's take on the matter is clear: It has threatened to sue soft-drink companies like 7-Up producer Cadbury Schweppes Americas Beverages for promoting as "100 percent natural" drinks sweetened with high-fructose corn syrup.
It also has complained that chicken producers are pumping up their "all-natural" birds with salt water and broth, a growing practice that 40 members of Congress recently called misleading and deceptive.
Poultry giant Tyson Foods Inc. says its marinated chickens are all natural because they contain no artificial ingredients. And its survey work suggests consumers prefer marinated chicken over "conventional chicken" anyway since it's tender and juicier, company spokesman Gary Mickelson said.
Tyson competitors, like Sanderson Farms Inc., say not so fast.
"Under any definition of the term, natural chicken does not contain salt, phosphates, sea salt, preservatives, carrageenan, nor is it pumped with up to 15 percent solution and other ingredients," Lampkin Butts, president and chief operating officer of Sanderson Farms, told a federal hearing last year.
Still, even Tyson supports revisiting the Agriculture Department's definition of "natural." In the mean time, it proposes a two-tier definition that would cover chicken, beef and pork that contains no added ingredients, plus those meats prepared with all-natural ingredients.
Other food companies have chosen their own sides in the debate. They have lodged petitions, comments and lawsuits with the government and are holding out that a definitive answer on what is natural is forthcoming.
At stake is a shot at increasing their share of the estimated $13 billion-a-year market for "natural" foods and beverages — a market whose 4 percent to 5 percent annual growth outpaces that of the overall grocery category, according to Packaged Facts, a market research company.
Any sort of federal ruling would, alternately, either narrow or broaden current rules and regulations that govern use of the "natural" label.
A critic maintains that the push is a bald-faced bid to manipulate federal policy for financial gain, something the feuding parties are quick to accuse each other of doing, and not to add to the public good.
"What looks like a neutral issue or question, such as the meaning of 'natural,' is not neutral at all," said former Labor Secretary Robert Reich, who tackles the issue in the recently published "Supercapitalism."
Reich says the issue "has profound competitive consequences. Certain companies — sometimes whole sectors of a whole industry — will be advantaged or disadvantaged by how agencies define words that may appear in labels."
Meanwhile, the Food and Drug Administration and Agriculture Department both say they are weighing how to move forward.
The FDA generally allows foods to be labeled as "natural" if such a claim is truthful and not misleading and the product does not contain added color, artificial flavors or synthetic substances, spokeswoman Kimberly Rawlings said. Agriculture Department policy roughly mirrors the FDA's, though it adds that "natural" meat and poultry products cannot be more than minimally processed.
That's not good enough for industry.
The Sugar Association, in a February 2006 FDA petition seeking clarity on the issue, claims the original chemical state of sweeteners like high-fructose corn syrup — made by its arch rivals — is altered so significantly during processing that "the allowance of a 'natural' claim is exceedingly misleading," trade group president and CEO Andrew Briscoe III wrote the agency. The group represents producers of sucrose, made from sugar beets and cane.
The Corn Refiners Association fired back in opposition, saying the sugar industry's claim would draw an unjustified and inconsistent distinction between sucrose and the high-fructose corn syrup its member companies make — and which presumably would no longer be considered "natural."
"The Sugar Association's petition is a thinly veiled attempt to obtain a marketing advantage for sucrose over ," Corn Refiners president Audrae Erickson said in November 2006 comments to the FDA.
Meanwhile, in October 2006, Hormel Foods Corp., the maker of Farmer John and other brands, filed its own "natural" petition with the Agriculture Department, seeking in short to outlaw any natural claim on luncheon and other meats that contain sodium lactate.
The corn-derived additive is used as a flavoring and preservative. Only when a meat product uses sodium lactate as a flavoring, however, can it still be considered for a "natural" label, said Laura Reiser, a spokeswoman for the Agriculture Department's food safety and inspection service, citing a recent department decision.
"The change in the definition of 'natural' creates an exception for sodium lactate that misleads consumers who believe they are buying a product free of chemical preservatives, when they are not," Hormel spokeswoman Julie Craven said.
In January 2007, in clarifying remarks filed with the USDA in support of Hormel's petition, the Sugar Association's Briscoe weighed in and said providing a precise definition of what's natural "would help eliminate misleading competitive practices" — a clear swipe at his corn-syrup competitors.
Sugar produced from sugar beets and cane has lost ground to high-fructose corn syrup, which now accounts for a majority of the sweeteners shipped to the food and beverage industry, according to USDA statistics.
Sara Lee Corp. then followed in April 2007 with a petition to the FDA that presses that agency to define "natural" in a way consistent with the USDA. The Sara Lee petition also makes a case for considering sodium lactate "natural." The company's Hillshire Farms brand, for example, uses it as an ingredient.
"Natural preservatives, such as sodium lactate sourced from corn, are derived from plants, animals, and/or microflora and, thus, are 'natural' ingredients," its petition reads in part.
Hormel fired back in late September, filing a lawsuit that seeks a court order in part to force the USDA to rescind past approvals of "natural" labels on meat and poultry products that use sodium lactate as a preservative.
"The 'natural' thing has always been such a morass," said Urvashi Rangan, a Consumers Union senior scientist and policy analyst.
