Why Earlier HIV Treatment Lengthens Survival: More Compelling Evidence

A study showing improved survival of starting antiretroviral treatment earlier than current U.S. recommendations is being reported in the April 30 issue of the New England Journal of Medicine. The study found that not starting HIV patients at a CD4 count greater than 500 cells per cubic millimeter increased risk of death by 94 percent.

“The question of when to start antiretroviral therapy has been one of the key controversies in HIV care for over a decade” said University of Washington’s Dr. Mari Kitahata, the lead researcher on the study. “Our study adds weight to the growing body of evidence that starting treatment earlier in HIV disease saves lives.”

Current U.S. guidelines recommend treatment for asymptomatic patients who have a CD4 count of less than 350. However, these guidelines lack data from randomized clinical trials regarding the timing of antiretroviral therapy.

Since 1996, when potent antiretroviral therapy was introduced and recommended for asymptomatic HIV patients with a CD4 count less than 500 cells per cubic millimeter, there has been uncertainty about when to start treatment.

The article, “Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival,” reports on two analyses of 17,517 asymptomatic patients with HIV infection receiving care between 1996 and 2006. The data were gathered through a recent collaboration of 22 research groups in more than 60 sites in the United States and Canada — the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

In order to study the impact of earlier initiation of therapy, researchers needed a large number of patients at high CD4+ counts who are observed for a long period of time to a definitive endpoint of death. Because of the combined effort of one of the largest collaborations of HIV cohorts in the world, researchers had the data to examine the effect of early HIV treatment.

Results from the first analysis were announced Oct. 2008 at the 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy/46th Annual IDSA Meeting Washington DC. Among the 8,632 patients with a CD4+ count+ 351 to 500, those who deferred antiretroviral therapy until the CD4+ count was below 350 had an increase of 69% in the risk of death.

Results from the second analysis were announced Feb 2009 at the 16th Annual Conference on Retroviruses and Opportunistic Infections in Montreal, Canada. Among the 9,155 patients with a CD4+ count above 500, those who deferred antiretroviral therapy until the CD4+ count was below 500 had an increase of 94% in the risk of death.

About 1.1 million people in the United States are infected with HIV, the virus that causes AIDS, according the U.S. Centers for Disease Control and Prevention. Worldwide, about 33 million people are infected with HIV, according to UNAIDS.

Recommendations for when to start antiretroviral therapy shifted to waiting until later in HIV disease to low CD4+ counts because of concern for resistance and toxicities of treatment. The drugs are now safer and the evidence mounting from our data and other data suggests it makes sense to start therapy earlier and that the side effects of treatment are less deleterious than untreated HIV infection, said Kitahata.

Additional benefits of earlier therapy for HIV include greater likelihood of achieving a normal CD4+ count and reduction in inflammation and immune activation that result in potentially irreversible immune-system and end-organ damage, such as cardiovascular, liver and renal disease.

The decision to begin antiretroviral therapy is one each individual makes in consultation with their doctor. Kitahata said that If an asymptomatic individual has a CD4+ count greater than 500 and is ready to begin therapy, we should be prepared to start therapy in conjunction with ongoing monitoring for potential side effects that could arise.

“For years, we have started patients on HIV therapy when their immune systems were already compromised. It is becoming clear that early institution of antiretroviral therapy, before the immune system is heavily damaged, saves lives.”


Mari Kitahata, MD MPH, Associate Professor in the Division of Allergy and Infectious Diseases at the University of Washington, is the lead author of a major article in the NEJM that strongly supports this concept.

Original Article:


Mari Kitahata, MD, MPH

University of Washington – Health Sciences/UW News, Community Relations & Marketing

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UNAIDS Concerned About Effects Of Violence In Kenya On People Living With HIV And Potential Risk Of New HIV Infections

The Joint United Nations Programme on HIV/AIDS
(UNAIDS) is concerned about the short and long-term impact of the recent disruption in
Kenya on the country’s response to the AIDS epidemic.

In recent years, Kenya has made significant progress in responding to AIDS with trends
showing a clear decline in HIV prevalence-estimated to have dropped to 6.1% (5.2% – 7%)
in 2005 from a high of 10% in the late 1990s. Critical HIV services have also been scaled-up
resulting in a greater awareness of HIV transmission and a significant increase in access to
antiretroviral treatment. However, UNAIDS is concerned that the recent events in the country
could pose potential setbacks to Kenya’s AIDS response.

Immediate concerns are for people following antiretroviral treatment regimens, particularly
those who have been displaced by the violence or who have not been able to access
treatment. There are also concerns that the displacement and violence (including sexual and
gender-based violence) has made people more vulnerable to the risk of HIV infection.
“Although concerted efforts have been made by the Kenyan authorities and partners to
minimize disruption in people accessing antiretroviral treatment and other essential HIV
services, we are still very concerned,” said Dr Erasmus Morah, UNAIDS Country
Coordinator in Kenya. “While it has been reported that many people receiving treatment
took enough supplies of their drugs to take them through the December holidays, we also
know that some people left their homes in a hurry, without their medication and/or treatment
records,” he added.

One of the main concerns over prolonged disruption to antiretroviral treatment and anti-TB
treatment is the potential development of resistance to the drugs. There is an urgent need to
assess the extent of treatment disruption and adequacy of the current response.
There are also reports of high levels of sexual and gender-based violence, and that
disruption to social and family networks has forced some women and children to engage in
commercial and transactional sex in exchange for shelter, food or protection. These reports
not only raise serious human rights concerns but also fears of an increase in new HIV
infections. Efforts will need to be focused to increase HIV prevention and address the
protection of women and children and victims of sexual and gender-based violence.
“It is too early to say what the full impact the recent events will have on Kenya’s AIDS
epidemic, this may only become apparent much later,” said Dr Morah. “UNAIDS will continue
to support Kenya through this difficult period to help ensure that Kenya sustains its response
to the epidemic and continues the advances it has achieved in recent years.”

UNAIDS is an innovative joint venture of the United Nations, bringing together the efforts and resources
of the UNAIDS Secretariat and ten UN system organizations in the AIDS response. The Secretariat
headquarters is in Geneva, Switzerland-with staff on the ground in more than 80 countries. Coherent
action on AIDS by the UN system is coordinated in countries through UN theme groups, and joint
programmes on AIDS. UNAIDS’ Cosponsors include UNHCR, UNICEF, WFP, UNDP, UNFPA,
UNODC, ILO, UNESCO, WHO and the World Bank.


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About 9.7M Children Under Age Five Die Annually From Preventable Diseases, Including HIV/AIDS, UNICEF Report Say

About 9.7 million children worldwide under age five die annually from preventable and treatable causes, including HIV/AIDS, according to a UNICEF report released on Tuesday, Reuters reports.

According to the report, titled “The State of the World’s Children 2008,” although the annual number of deaths among children under age five is below 10 million for the first time, more than 26,000 children worldwide still die daily. Nearly half of sub-Saharan African countries have had either stable or worsening rates of child mortality since 1990, and only three sub-Saharan African countries — Cape Verde, Eritrea and Seychelles — are on track to meet the U.N. Millennium Development Goals’ target for child survival, according to the report (Nebehay, Reuters, 1/22). The goal calls for reducing by two-thirds the 1990 child mortality rate by 2015, according to BBC News (BBC News, 1/22). According to the report, the current rate must be reduced by 50% to meet the target (Engeler, AP/Google, 1/23).

The report found that in Sierra Leone, 270 children of every 1,000 die before age five, compared with three children per 1,000 in the best-performing countries, including Singapore and Sweden (BBC News, 1/22). The child mortality rate in sub-Saharan Africa has decreased by 14% since 1990, and the region contains 28 of the 30 countries with the highest child mortality rates, the report said (AP/Google, 1/23).

The report also found that inadequate progress on child survival has been made in the Middle East, North Africa and South Asia. Mortality rates in East Asia, the Pacific, Latin America and the Caribbean have almost halved to 27 deaths per 1,000 live births, meaning these regions are on track to meet MDG targets, according to the reports.

According to the report, child mortality could be reduced through “simple, reliable and affordable interventions” that are “readily available” and have the “potential to save two-thirds of the children currently at risk.” Such interventions include breastfeeding, providing immunizations and distributing insecticide-treated nets. Obstacles to implementing the interventions include disease-specific approaches to health care in developing countries, the low profile of maternal and child health, inadequate financing and a lack of political will, the report found (BBC News, 1/22). In addition, there are challenges associated with efforts to increase children’s life expectancies in countries highly affected by HIV/AIDS that have weak health systems (Reuters, 1/22).

The report adds that more needs to be done to increase access to treatment for HIV/AIDS and other diseases, including malaria and pneumonia. In addition, the report calls for:
Collaboration with community-based groups;

Integrated health systems;

Mainstreaming of maternal, newborn and child health into national strategic planning programs; and

Improved quality and increased, predictable funding (UNICEF release, 1/22).

The report is available online.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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FDA Extends Review Timeline For Additional Indication For Antibiotic DORIBAX(TM)

Johnson & Johnson Pharmaceutical
Research & Development, L.L.C., announced that the U.S. Food and Drug
Administration (FDA) has extended the review timeline for the second New
Drug Application for the antibiotic DORIBAX(TM) (doripenem for injection).
The application, submitted in June 2007, seeks approval to market DORIBAX
to treat nosocomial, or “hospital-acquired,” pneumonia and
ventilator-associated pneumonia, which occurs in patients who are on
mechanical ventilation because they cannot breathe on their own.

The FDA extended the review period by three months to provide time for
a full review of the application after receiving additional information it
had requested from the company.

DORIBAX is already FDA-approved to treat complicated urinary tract and
complicated intra-abdominal infections and is marketed by Ortho-McNeil(TM),
Division of Ortho-McNeil-Janssen Pharmaceutical Services, Inc., in the U.S.
The use of DORIBAX to treat complicated urinary tract and complicated
intra-abdominal infections and nosocomial pneumonia, including
ventilator-associated pneumonia, currently is under regulatory review in
Europe, Canada and in other countries. DORIBAX is licensed from Shionogi &
Co., Ltd.


DORIBAX is indicated as a single agent for the treatment of:
complicated intra-abdominal infections caused by susceptible strains of E.
coli, K. pneumoniae, P. aeruginosa, B. caccae, B. fragilis, B.
thetaiotaomicron, B. uniformis, B. vulgatus, S. intermedius, S.
constellatus or P. micros, and for the treatment of complicated urinary
tract infections, including pyelonephritis, caused by susceptible strains
of E. coli, including cases with concurrent bacteremia, K. pneumoniae, P.
mirabilis, P. aeruginosa, or A. baumannii.

To reduce the development of drug-resistant bacteria and maintain the
effectiveness of DORIBAX and other antibacterial drugs, DORIBAX should be
used only to treat infections that are proven or strongly suspected to be
caused by susceptible bacteria. When culture and susceptibility information
are available, they should be considered in selecting and modifying
antibacterial therapy. In the absence of such data, local epidemiology and
susceptibility patterns may contribute to the empiric selection of therapy.


DORIBAX is contraindicated in patients with known serious
hypersensitivity to doripenem or other carbapenems or in patients who have
demonstrated anaphylactic reactions to beta-lactams.

Serious and occasionally fatal hypersensitivity (anaphylactic) and
serious skin reactions have been reported in patients receiving beta-lactam
antibiotics. These reactions are more likely to occur in individuals with a
history of sensitivity to multiple allergens. If an allergic reaction to
DORIBAX occurs, discontinue the drug. Serious acute anaphylactic reactions
require emergency treatment with epinephrine and other emergency measures,
including oxygen, IV fluids, IV antihistamines, corticosteroids, pressor
amines and airway management, as clinically indicated.

Carbapenems may reduce serum valproic acid concentrations to
subtherapeutic levels, resulting in loss of seizure control. Serum valproic
acid concentrations should be monitored frequently after initiating
carbapenem therapy. Alternative antibacterial or anticonvulsant therapy
should be considered if serum valproic acid concentrations cannot be
maintained in the therapeutic range or seizures occur.

Clostridium difficile-associated diarrhea (CDAD) has been reported with
use of nearly all antibacterial agents and may range in severity from mild
diarrhea to fatal colitis. CDAD must be considered in all patients who
present with diarrhea following antibiotic use. Careful medical history is
necessary since CDAD has been reported to occur over two (2) months after
administration of antibacterial agents. If CDAD is suspected or confirmed,
ongoing antibiotic use not directed against C. difficile may need to be

When DORIBAX has been used investigationally via inhalation,
pneumonitis has occurred. DORIBAX should not be administered by this route.

Safety and effectiveness in pediatric patients have not been

The most common adverse reactions (greater than or equal to 5%)
observed in clinical trials were headache, nausea, diarrhea, rash and

For more information visit DORIBAX.

Ortho-McNeil(TM) is committed to providing innovative, high-quality
prescription medicines and resources for healthcare providers and their
patients in hospitals and other care facilities. For more information,
visit ortho-mcneil.

Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
(J&JPRD), is part of Johnson & Johnson, the world’s most broadly based
producer of healthcare products. J&JPRD is headquartered in Raritan, NJ,
and has facilities throughout Europe and the United States. J&JPRD is
leveraging drug discovery and drug development in a variety of therapeutic
areas to address unmet medical needs worldwide.

Johnson & Johnson Pharmaceutical Research & Development, L.L.C.

View drug information on Doribax.

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Giant Food To Offer Generic Antibiotics At No Cost For Three Months

Giant Food stores and stores of its sister chain Stop & Shop will provide no-cost generic antibiotics to customers with prescriptions for three months beginning Jan. 2, the Washington Post reports. Numerous popular antibiotics, such as amoxicillin, penicillin and ciprofloxacin, will be included. Medications that treat common viral illnesses, such as the flu and the common cold, will not be included. According to the Post, such medications often are not available in generic form and are more costly.

Giant officials did not estimate the cost or potential utilization of the program. The Post reports that the pharmacy market has become “increasingly competitive” since Wal-Mart in 2006 began offering about 300 generic prescription medications for $4. In response, Giant Food lowered its price for a 90-day supply of generic medications to $9.99 this past summer. According to consulting firm Willard Bishop, pharmacy sales make up about 10% of revenue at grocery stores. Retail experts say the strategy is a new and aggressive approach to entice shoppers amid the economic recession, the Post reports.

Robin Michel, executive vice president for Giant Food, said, “If this is the way that we can help most people, why not?” Ron Paul, president of food consulting firm Technomic, said the program likely will foster good will among Giant Food shoppers. “Anything you can do to suggest that [businesses] do care about more than just … making money is probably good citizenship,” he said (Mui, Washington Post, 12/31/08).

NPR’s “All Things Considered” on Friday reported on the announcement by Giant. The segment featured comments from Giant General Manager Robin Michelle and a physician (Aubrey, “All Things Considered,” NPR, 1/2).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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AACE/AIUM Join Forces To Enhance Quality And Safety In Thyroid/parathyroid Ultrasound Procedures

The American Institute of Ultrasound in Medicine (AIUM) and the American Association of Clinical Endocrinologists (AACE) announced today a joint agreement for enhancing training, safety, and policies and procedures in ultrasound examinations. In the joint announcement, Dr. Lennard Greenbaum, President of AIUM, said that its Clinical Standards Committee had completed an extensive review of the AACE course requirements for thyroid/parathyroid ultrasound certification and recertification, and determined that those endocrinologists successfully completing the AACE course will be recognized by AIUM as having demonstrated satisfactory training in thyroid/parathyroid ultrasound examinations.

AACE President, Dr. Steven M. Petak, said that AACE is pleased to have the course recognized by AIUM, a preeminent national ultrasound accreditation body, as having met the educational standards for quality and patient safety in the performance of ultrasound procedures. AIUM standards serve as a benchmark for professionals seeking to meet nationally accepted protocols in performing ultrasound examinations. Dr. Petak said, “Achieving recognition by AIUM for meeting these high educational standards in ultrasound is a tremendous accomplishment, and a clear demonstration of AACE’s commitment to helping endocrinologists provide the highest quality care in the diagnosis and treatment of their patients with thyroid disorders.”

Dr. Petak added that, since 1998, AACE has conducted a rigorous course curriculum in ultrasound for endocrinologists performing diagnostic evaluations for patients with thyroid and parathyroid disorders, which includes both diagnostic ultrasonography (US) and ultrasound guided fine needle aspirations (UGFNA). AACE offers this course in order to aid physicians in achieving the highest level of expertise, clinical skills, and capabilities in the performance of US and UGFNA for optimal patient care. Dr. Petak noted that AACE is also pleased to collaborate with AIUM in offering its members the opportunity to participate in the practice accreditation program, administered by AIUM, which would enable physician practices to participate in the volunteer peer review program to demonstrate competency in all aspects of their ultrasound operation, including education and training of physicians in sonography, ultrasound equipment maintenance, document storage, policies safeguarding the patients and personnel, and accuracy in diagnosis.

Dr. Greenbaum pointed out that the two societies’ programs compliment each other. The AACE physician certification and recertification process will ensure that endocrinologists have access to ongoing training in the latest advances in thyroid ultrasound technology and procedures. Participation in the AIUM practice accreditation program will help physicians maintain the highest standards for performing these services in a practice setting. “The ultimate beneficiary of the agreement will be the patient through enhanced quality and safety in ultrasound procedures,” Greenbaum said.


AACE is a national professional medical organization with over 5,500 members in the United States and 84 other countries. Founded in 1991, AACE is dedicated to the optimal care of patients with endocrine disorders. AACE initiatives inform the public about endocrine disorders. AACE also conducts continuing education programs for clinical endocrinologists, physicians whose advanced, specialized training enables them to be experts in the care of endocrine disease, such as diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, hypertension and obesity.

AIUM is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of guidelines, and accreditation. AIUM’s members include physicians and sonographers from varying specialties, scientists, and engineers. AIUM has established standards for the accreditation of ultrasound practices which serve as a benchmark for professionals seeking to meet nationally accepted protocols for performing ultrasound related examinations. Practices accredited by the AIUM have demonstrated competency in every aspect of their operation.

Contact: Jennifer Hilderbrand

American Institute of Ultrasound in Medicine

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‘Jumping gene’ helps explain immune system’s abilities

A team led by Johns Hopkins scientists has found the first clear evidence that the process behind the human immune
system’s remarkable ability to recognize and respond to a million different proteins might have originated from a family of
genes whose only apparent function is to jump around in genetic material.

“Jumping genes” essentially cut themselves out of the genetic material, and scientists have suspected that this ability might
have been borrowed by cells needing to build many different proteins from a specific, single set of instructions — the key
to recognizing a million immune-stimulating proteins. But until now, no jumping gene was known to behave just right.

Writing in the Dec. 23 issue of Nature, the researchers show that a jumping gene called Hermes, still active in the common
house fly, creates changes in DNA very much like those created by the process behind antigen recognition.

“Hermes behaves more like the process used by the immune system to recognize a million different proteins, called antigens,
than any previously studied jumping gene,” says Nancy Craig, Ph.D., professor of molecular biology and genetics in Johns
Hopkins’ Institute for Basic Biomedical Sciences and a Howard Hughes Medical Institute investigator. “It provides the first
real evidence that the genetic processes behind antigen diversity might have evolved from the activity of a jumping gene,
likely a close relative of Hermes.”

Recognition of so many antigens allows the immune system to fight infection and distinguish friend from foe. The “big
picture” behind this ability is that cells build proteins called antibodies that bind to particular antigens, but the early
steps of that process have been difficult to study. Hermes should help reveal some secrets of this process, the researchers

“The immune system takes an approach to protein building similar to that of diners creating a meal at a cafeteria, but how
the immune system’s ‘a la carte’ process happens is still murky,” says Craig.

But the a la carte approach provides great diversity from a limited number of choices, whether in the immune system or in a
cafeteria. For example, at a cafeteria, one diner could have a meal of mashed potatoes, broccoli and a pork chop, and another
French fries, salad and a hamburger, and so on through all the possible combinations of offerings.

While the choices aren’t as tasty, immune cells select sections of certain genetic instructions in order to make instructions
for a protein that will recognize a particular antigen. Machinery snips out unwanted genetic sections and reconnects the
leftover ones, creating a unique gene (the cellular equivalent of the diner’s meal). Snipping out different sections will
lead to a different gene, carrying instructions for a different protein that will recognize a different antigen, and on and

This a la carte process, known as V(D)J recombination, is similar to the excision of jumping genes, but none had matched one
of its characteristic oddities: As the unwanted DNA is being removed, the remaining DNA forms a tiny loop.

Unexpectedly, when Hermes is being cut out of the DNA, the leftover DNA also forms a hairpin loop, temporarily doubling back
on itself, postdoctoral fellows Liqin Zhou, Ph.D., and Rupak Mitra, Ph.D., discovered in experiments in test tubes and with
E. coli bacteria.

Although this loop distances Hermes from its well-studied cousins, the Hermes protein still has an important family trait,
the researchers report. Colleagues at the National Institutes of Health found that a few key building blocks in the protein’s
DNA-snipping crevice are identical to those in other jumping genes’ proteins, even though the overall sequence is quite

“Because of its similarities both to V(D)J recombination and to other families of jumping genes, Hermes is the first real
link between the two processes,” says Craig. “It also is likely to be a good model to figure out what’s happening early on in
V(D)J recombination.”

Understanding how Hermes and other jumping genes work also holds clues to fighting bacterial infections, improving gene
therapies and tackling disease-carrying insects, Craig notes. Bacterial jumping genes can protect bacteria from certain
antibiotics. Scientists also are studying jumping genes as vectors to carry gene therapies and as potential modifiers to
disrupt the growth-controlling genes of organisms such as mosquitoes and medflies.

The Hopkins researchers were funded by the Howard Hughes Medical Institute. Authors on the paper are Zhou, Mitra and Craig of
Hopkins; Peter Atkinson of the University of California, Riverside; and Alison Burgess Hickman and Fred Dyda of the National
Institute of Diabetes and Digestive and Kidney Diseases.

On the Web: nature/nature

Contact: Joanna Downer
Johns Hopkins Medical Institutions

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New Safefood Campaign Warns Consumers Of Food Hygiene Dangers In The Home

safefood today launched a new advertising campaign to highlight common and widespread poor food hygiene practices in the home as new research (1) revealed that 84% of people did not thoroughly wash their hands after handling raw chicken. The campaign titled “Don’t Take Risks” focuses on key messages of proper hand washing, proper cleaning of cooking utensils and thorough cooking, steps all of which can help minimise the risks of food poisoning in the home. The research also revealed that 72% failed to properly wash a knife used in preparing raw chicken before its reuse on salad vegetables, and 56% did not check if the chicken was cooked properly.

The safefood study recorded the food hygiene practices of 120 participants across the island of Ireland while they prepared two meals – a homemade beef burger and a warm chicken salad. The research findings revealed poor food hygiene behaviours, with more than a third of what participants considered to be “cooked” beef burgers being contaminated with raw meat bacteria. In addition, more than half of consumers did not thoroughly wash the chopping board used to prepare raw mince before reusing it to prepare salad.

Speaking at the launch of the campaign, Martin Higgins, Chief Executive, safefood said “There is clear evidence that consumers are not following basic hygiene rules in the kitchen when they are preparing food, therefore putting loved ones at risk from food poisoning. This campaign is a powerful, visual reminder to consumers of the dangers of poor food safety behaviour, as they may often be unaware of how their day to day food preparation habits can cause themselves and others harm. By following some simple food hygiene practices, consumers can help prevent the spread of food poisoning bacteria around the kitchen”.

The safefood “Don’t Take Risks” campaign reinforces three golden rules: cook chicken and minced meat thoroughly until piping hot all the way through with no pink meat remaining and the juices running clear; always wash hands in warm, soapy water after handling raw meat or chicken; and always wash utensils such as knives and chopping boards thoroughly after use with raw meat and chicken and before reuse with ready to eat foods such as salads.

Dr. Gary Kearney, Director Food Science, safefood added “Our research highlighted real food safety issues in the kitchen relating to food preparation and hygiene, which are addressed in a dramatic way in this campaign. safefood commissioned this study to look at the way in which people prepare meals in their homes. This study also highlights inadequate hand washing habits, as one third of participants still had raw meat bacteria contamination on their hands after preparing the meals. We would urge all consumers to consider these significant findings, examine their own food preparation behaviours and to take these easy steps to always prepare food safely”.

“Don’t Take Risks” is a two year campaign and consists of three, 20 second live action television advertisements with the themes of “Knife”, “Hands” and “Flame”. This phase of the campaign comprises two bursts of activity; the first launching on 13th July for three weeks on television and a second burst in September for a further three weeks on television. The campaign will also be supported by online activity at safefood.eu and PR and Direct Marketing activity.

For more information on food safety in the home, please visit safefood.eu.


(1) “Identification of Critical Control Points during Domestic Food Preparation”, University College Dublin and the University of Ulster at Jordanstown, 2008


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Malaysia Health Ministry Cannot Promote Condom Use To Prevent Spread Of HIV, Official Says

Malaysia’s Ministry of Health cannot openly promote condom use to prevent the spread of HIV because it could be misinterpreted as advocating promiscuity, deputy director for the Ministry of Health Jalal Halil Khalil said Sunday in conjunction with International AIDS Memorial Day, Malaysia’s New Straits Times reports. Promotion of condom use will be handed over to nongovernmental organizations, including the Malaysian AIDS Council and its 37 affiliates, Khalil said.

According to the Times, there are about 75,000 HIV-positive people living in Malaysia, 70% of whom are injection drug users (Darshni, New Straits Times, 5/21). In addition, the government has said that transmission through heterosexual sex is increasing and noted a trend of increasing HIV incidence among women in the country (Kaiser Daily HIV/AIDS Report, 2/13). Current efforts to combat the spread of the disease have targeted IDUs, commercial sex workers and men who have sex with men, the Times reports.

According to Khalil, the health ministry and the government are concerned about the increasing number of HIV cases recorded annually. However, the government cannot be seen as an advocate of condom use because it could be misinterpreted, Khalil said. “We realize that we are in an Islamic country, and we have to do things carefully,” he said, adding, “That is why we have given this duty to nongovernmental organizations.” According to Khalil, the government is aware that condoms are an effective method of preventing the spread of HIV, especially among marginalized groups like IDUs, MSM and sex workers. “The important thing is to prevent HIV/AIDS from spreading,” he said, adding, “We have to give enough information to all levels of society. But changing knowledge to behavior is not easy.”

Datuk Zaman Khan, trustee of the Malaysian AIDS Foundation, said he agreed that promoting condom use is the best method of controlling the spread of sexually transmitted infections, including HIV. He added that there are “so many taboos in this country,” but “in reality, [premarital sex] happens.”

MAC President Adeeba Kamarulzaman said, “Delaying sexual practices and having monogamous relationships are ideals, but these do not necessarily happen in real life. We have to match that with pragmatism.” She added, “We know what works, and we have to get people to realize that they have to protect themselves, … it’s about protecting public health and educating the young” (New Straits Times, 5/21).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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UNICEF And Gates Foundation Join Forces To Support Angola’s Efforts To Eradicate Polio

The Bill & Melinda Gates Foundation and UNICEF announced that Mr. Anthony Lake, UNICEF Executive Director, and Dr. Tachi Yamada, president of the Global Health Program of The Gates Foundation, will arrive this weekend in Angola, where the government is poised to mount a renewed effort to halt an ongoing polio outbreak centered in Luanda.

The visit by Dr. Yamada and Mr. Lake aims to boost the Government of Angola’s efforts to stop transmission of polio in the country by increasing vital immunization coverage. The government has faced several challenges following the aftermath of the war, including massive rural migration to the urban areas which strained health and sanitation services and harbored conditions for the spread of polio.

In 2010, 32 people contracted polio in Angola, a disappointing turnaround from 2004, when Angola celebrated three consecutive years free from the virus and the country stood ready to be declared polio-free. But by May of 2005, the disease returned and quickly spread to Namibia (2006), DR Congo (2006, 2008 and 2010), and the Republic of Congo (2010). This sequence of events shows that children remain at risk everywhere as long as polio transmission is not interrupted globally.

“Every new case of polio is a personal tragedy, and every new case is a setback in our global fight to defeat this crippling, deadly disease,” said Mr. Lake. “UNICEF is committed to supporting Angola’s efforts to stop transmission of the deadly polio virus by ensuring that every child is vaccinated.”

While in Luanda, Mr. Lake and Dr. Yamada will meet with senior government officials and partners in the fight against polio to urge an increased commitment of all levels of society. They will also discuss how to support national, provincial and municipal efforts in Angola to interrupt transmission. As part of the mission, they will visit families, volunteers and health services in peri-urban areas of Luanda, visiting the frontline in the fight against the virus and observing what action communities are taking.

“We support the government as it commits to strengthening the polio program in the country and pursues a polio-free Angola,” said Dr. Yamada. “Winning against polio can also set the stage to save Angolan children from all vaccine-preventable diseases.”



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