South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
-
The recent substantial price reductions in insulin therapy by major manufacturers prompt an examination of their impact on South Africa (SA)'s healthcare. While Eli Lilly, Novo Nordisk, and Sanofi cut prices on long-acting basal insulin, among others, significantly, these insulins are not on SA's Essential Medicines List (EML) for primary healthcare. ⋯ The introduction of smart insulin pens adds a technological dimension, but concerns persist about equitable access. Urging policy-makers to re-evaluate guidelines and decolonise the EML, the article emphasises enhancing patient quality of life and reducing the disease burden.
-
Primary ciliary dyskinesia (PCD) is an inherited ciliopathy that results in impaired mucous clearance and affects primarily the respiratory tract, causing upper airway disease, bronchial inflammation and bronchiectasis. The prevalence of PCD in low- and middle-income settings, including South Africa (SA), is unknown, largely owing to challenges with diagnosis, and identifying children or adults with PCD is challenging in a setting with a high prevalence of other infectious diseases, including lower respiratory tract infections and tuberculosis. No single test is diagnostic of PCD, and while some tests are costly, others are labour intensive and require highly specialised laboratory expertise. ⋯ In this commentary, we provide a pragmatic approach to identifying which children and adults require further investigations for PCD using a range of diagnostic tests or tools that are available. Furthermore, we recommend that designated centres of expertise for PCD diagnosis are created in SA. This would be an important step towards improving accessibility of diagnostic tests and developing local expertise to improving PCD diagnosis, especially in early childhood, to prevent long-term irreversible respiratory sequelae.
-
Effective pandemic decision-making depends on scientific expert evidence, transparency about public health policy decision-making, its rationales and the evidence on which it is based. The South African government laudably committed its COVID-19 response to be guided by science and evidence. ⋯ This submission analyses the time elapsed between the submission of COVID-19 Ministerial Advisory Committees memoranda to the Minister of Health, and the Department of Health's subsequent publication of these for the period August 2020 - January 2024. It also summarises the outcomes of the Health Justice Initiative's access to information legal action against the department on expert advice and government decision-making during the pandemic.