Categories : Healthcare Politics and RegulationsTags : Leave a comment

Participatory Democracy: What Will Be on the Line When the Country’s Highest Court Turns to NHI in May?

On By ModernMedia
Photo by Bill Oxford on Unsplash

By Sasha Stevenson

From 5–7 May, the Constitutional Court will hear two of the multiple challenges to the NHI Act. Sasha Stevenson, Executive Director of SECTION27, considers what will be on the line in these first potentially landmark cases that deal with the process that led to the Act.

The public discussion on National Health Insurance has gone from abstract; to alternatively excited or worried about implementation; to dizzying references to a range of court cases filed over the course of 2024 and 2025. It can be difficult to keep up with what NHI may mean for our health system and when the promised system reform may happen.

We may now be approaching a decisive moment, with the Constitutional Court set to hear two of the NHI challenges.

From 5–7 May 2026, the Constitutional Court will be hearing challenges brought by the Board of Healthcare Funders and the Premier of the Western Cape. These two challenges deal with public participation in the making of what is now the NHI Act.

In February 2026, parties challenging the constitutionality of specific sections of the NHI Act agreed with government to put their cases on hold, pending a decision of the Constitutional Court in the May 2026 public participation challenges. The parties bringing constitutional challenges include the South African Private Practitioners Forum, the Hospital Association of South Africa, the South African Medical Association, and the Health Funders Association, among others. They agreed to hold off because a decision of the Constitutional Court on public participation could make the constitutional challenges unnecessary.

So for now, all eyes are on the Constitutional Court, whose judges will decide whether government must go back to the drawing board and follow a different procedure, or whether it may go ahead (and face a slew of constitutional challenges).

The Western Cape’s case

The Western Cape government is challenging the NHI Act because it argues that consultation with the Western Cape government, over legislation that restructures health services provided by provinces, was lacking. They argue that the National Council of Provinces (NCOP) failed to respond to a request for an extension for the Western Cape to submit the outcome of its provincial consultation on the NHI Bill and its voting mandate, and then went ahead without the Western Cape documents.

The NCOP also did not, the Western Cape government alleges, consider or debate any proposed amendments to the NHI Bill arising from the public participation in other provinces. When the Western Cape government submission and public participation report came in, the NCOP merely confirmed its earlier decision to approve the Bill.

In essence, the Western Cape’s challenge is about the NCOP’s role of ensuring that provinces and their residents have a say in the making of new laws, and whether that role was properly played. It argues that the NCOP’s failure to play its constitutional role should result in the NHI Act being declared unconstitutional and invalid.

The Board of Healthcare Funders case

While the Western Cape challenge does not deal with public participation in the NHI law-making writ large, the Board of Healthcare Funders (BHF) case fills this gap.

The BHF argues that both the National Assembly and the NCOP failed to comply with their constitutional obligations to facilitate meaningful and effective public involvement in the NHI law-making process. The BHF contends that the public was not provided with sufficient information to allow for meaningful engagement (such as details about the costs and the benefits package of the NHI Fund); and that law makers were not open to persuasion in the participation process.

The BHF asks that the NHI Act is declared invalid and set aside.

Why should we care about public participation?

The Constitutional Court has held that “[i]t is apparent from the preamble of the Constitution that one of the basic objectives of our constitutional enterprise is the establishment of a democratic and open government in which the people shall participate to some degree in the law-making process.”

There was a huge amount of public participation in the law-making process for the NHI Act, with roadshows, written submissions and oral presentations. Government respondents in the BHF case point to the fact that 338 891 written submissions were made at various stages, and many oral presentations were heard by Parliament. Few could argue that, if you wanted to, you did not have a chance to have your say on the NHI Bill.

But is being able to say something enough?

In a constitutional democracy where citizens participate in law-making between elections as a way of directly influencing the law, if there is no chance of having that influence, merely being able to speak is insufficient.

There is, of course, no obligation on government to adopt proposed changes as a result of public participation. Parliament cannot be required to agree with all submissions, and the validity of a process does not turn on whether amendments were made to take into account submissions. But when few or no amendments are made, it inevitably raises eyebrows.

In the case of the NHI Bill, while there were limited changes to the Bill when it went through the National Assembly, no changes at all were made following the NCOP public participation process. Given the hundreds of thousands of submissions, many of which were substantive, the small number of amendments is surprising. Particularly given that some submissions that were consistently made are now being conceded by the Department of Health, in public or in private. These include submissions related to the position of asylum-seekers, transitional provisions, and the role of medical aids.

SECTION27 and the Treatment Action Campaign made submissions at Draft Bill stage, before the National Assembly, and before the NCOP. As health activists and health rights lawyers, our submissions were carefully considered and proposed amendments to bring the Bill in line with the Constitution and the needs of healthcare users. Our experience was of MPs engaging to a very limited extent with the substance of the submissions, focusing rather on whether we were ‘for’ or ‘against’ the NHI, or their party’s position on it. It was an experience that brought into question how seriously real public participation was being taken.

The Constitutional Court will now be able to consider whether the public participation processes on the NHI Act were in line with the constitutional call for participatory democracy; or whether they were an unconstitutional tick box exercise. Its decision will determine if the NHI Act will be further scrutinised for substantive constitutionality through litigation, or if it should be returned to the legislature for further consideration and participation.

Either way, what NHI may mean for our health system is a question that may yet take some time to answer. On the other hand, what participatory democracy requires of parliament (arguably an even more consequential question) may soon be answered by the Constitutional Court.

*Stevenson is a human rights lawyer and executive director of SECTION27. SECTION27 is representing the Treatment Action Campaign in an application to be admitted as amicus curiae in a court case relating to the NHI.

Note: Spotlight is published by SECTION27, but is editorially independent – an independence that the editors guard jealously. Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.

Republished from Spotlight under a Creative Commons licence.

Read the original article.

Categories : PaediatricsTags : Leave a comment

Family Environment Shapes Life Outcomes Across Generations

On By ModernMedia
Source: CC0

Adopted children who have grown up in more favourable family environments than their siblings are at lower risk of mental health issues, criminality and social problems – benefits that, in some cases, extend to the next generation. These are the findings of a new study of Swedish siblings published in The BMJ.

Children who grow up in difficult family circumstances are at greater risk of experiencing problems later in life. These may include mental health issues, difficulties at school or criminal behaviour. 

To determine the extent to which these factors can be influenced, researchers at Karolinska Institutet studied pairs of siblings in Sweden where one sibling was adopted away from a high-risk family while the other remained with and grew up with their biological parents. This allowed them to compare the long-term effects of different family environments while taking genetic factors into account.

“Our study shows that a more favourable home environment can make a big difference, particularly for children who start life with clear risk factors,” says Erik Pettersson, associate professor at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet.

Followed over 12 000 siblings

The study is based on Swedish population registers and covers just over 12 000 full and half-siblings born between 1950 and 1980. All come from families where at least one parent had experienced some form of psychiatric or social issue, such as mental illness, criminality or attempted suicide, and where at least one child had been given up for adoption before the age of ten. Families who took in adopted children often had greater resources and higher socio-economic status.

The results show that the adopted children had a lower risk of mental illness, criminality and dependence on social security benefits as adults, compared to their siblings who grew up with their biological parents. They also performed better at school and, on average, attained a higher level of education. Furthermore, men who had been adopted performed better during military conscription, both on intelligence tests and in interviews measuring stress resilience and social adaptability.

May affect the next generation

The researchers also investigated whether these differences were passed on to the next generation. In total, nearly 22,000 children of the sibling pairs were studied. 

On average, the children of adopted siblings displayed higher functioning than their cousins, for example a lower risk of criminality and financial problems. The effects were weaker than in the previous generation, but pointed in the same direction.

“This suggests that improved living conditions benefit not only the individual, but also the next generation,” says Erik Pettersson.

Value of support measures

He emphasises that the results should not be seen as an argument for adoption, which is currently uncommon in Sweden. However, he believes the study highlights the value of interventions for children in vulnerable environments.

“Research into the effects of various support measures aimed at giving children a better upbringing is both limited and fragmented,” he says. “Some studies show significant long-term benefits; others show little or none at all. Our study suggests that the potential is considerable, even though we cannot say which measures are most important.” 

Source: Karolinska Institutet

Categories : PaediatricsTags : Leave a comment

Common Fluid Treatments for Paediatric Sepsis Found to Have Similar Efficacy and Safety

On By ModernMedia

Trial found that balanced fluids and saline solution are equally effective for treating patients and reducing the risk of major adverse kidney events

Photo by Furkan İnce

A major study, led by researchers at Children’s Hospital of Philadelphia, Nemours Children’s Health, and Children’s National Hospital, found that different types of crystalloid fluid resuscitation were equally effective for staving off the most serious adverse kidney events after the treatment of paediatric patients with suspected septic shock. The findings of this large clinical trial are detailed in a study published by The New England Journal of Medicine and are being presented at the Pediatric Academic Societies (PAS) Meeting in Boston.

Sepsis is a life-threatening response to infection that causes organ failure. The combination of the body’s immune system and the infection together cause an abnormal response, which can prevent different organ systems from working normally. While many decades of research and improvements in clinical care have significantly improved outcomes for paediatric sepsis patients, about 1 in 10 children in the US with sepsis or septic shock are still at risk of dying.

In some previous multi-centre studies, researchers found that critically ill adults who received balanced crystalloid fluid – an intravenous (IV) treatment meant to exhibit similar properties to human plasma – resulted in lower risk of complications and death compared with a standard 0.9% saline IV solution. This prompted researchers to explore whether a similar study could determine whether one fluid treatment was superior for pediatric sepsis patients.

“We knew we were going to need thousands of patients to answer this question, which we knew would be a challenge,” said co-lead author Fran Balamuth, MD, PhD, an attending physician and Division Chief of Emergency Medicine at CHOP. “Yet we were excited to proceed because these fluids are inexpensive and universally available around the world, meaning that we wouldn’t have decades of waiting to take action once the study was complete; we could be pragmatic and take immediate action based on the results that we found.”

Because suspected cases of sepsis are uncommon among the general population, Balamuth, co-lead author Scott L. Weiss, MD, attending physician and Division Chief of Critical Care at Nemours Children’s Hospital, Delaware, and their colleagues required the collaboration of many hospitals to achieve the data standards needed for meaningful conclusions. For this, they collaborated with Nathan Kuppermann, MD, Executive Vice President and Chief Academic Officer of Children’s National Hospital and Director of the Children’s National Research Institute, who has a history of running successful clinical trials in acutely ill children, and served as the senior author.

“This trial demonstrates the power of large collaborative research networks to answer important clinical questions for children,” Kuppermann said. “By enrolling thousands of patients across multiple countries, we were able to provide the kind of evidence clinicians need to guide care for children with suspected septic shock.”

In the end, a total of 47 emergency departments across five countries were represented in the study, with more than 9000 patients enrolled who received either balanced fluid or 0.9% saline.

The primary outcome of the study was Major Adverse Kidney Events by 30 days (MAKE30), an important outcome for kidney injury that accounts for death, new renal replacement therapy or persistent renal dysfunction. The researchers found that MAKE30 occurred in 3.4% of patients enrolled in the balanced fluid group and 3.0% in the 0.9% saline ground. The study found biochemical differences in children treated with the two fluids, including a higher frequency of elevated blood chloride levels in the 0.9% saline group, and higher lactate levels in the balanced fluid group. Both groups had 23 median hospital-free days of 28, and there were no differences in mortality or other safety outcomes or adverse events. 

“This trial confirms that either balanced fluid or 0.9% saline are effective and safe for the initial resuscitation of children with suspected septic shock, and that a fluid strategy that reduces hyperchloraemia does not necessarily translate to improved patient outcomes,” said Weiss, an attending physician and Division Chief of Critical Care at Nemours Children’s Hospital, Delaware. “We also did not identify differences across subgroups. However, despite the large number of participants, it is important to note that we cannot exclude the possibility of benefit of one fluid or the other in a subset of children with the most severe illness.”

“A large trial like this definitively answers a question we’ve had in our field for many, many years,” Balamuth said. “In an emergency department with a child with suspected sepsis, you can treat the child with whichever fluid is readily available. And we think that’s great news for children around the world.”

Source: EurekAlert!

Categories : Cardiovascular DiseaseTags : Leave a comment

Genetic Study in Indians Finds New Pathways Involved in Cardiometabolic Disease

On By ModernMedia

Study of 3000 Punjabi Sikhs may yield new targets for treating Type 2 diabetes and other disorders

Photo by Sangharsh Lohakare on Unsplash

A study conducted in an Indian population has identified new molecular pathways that contribute to cardiovascular disease, which had not been reported previously in studies of Europeans. Dharambir Sanghera of the University of Oklahoma Health Sciences Center, US, led the new study, which was published April 23rd in the open access journal PLOS Medicine.

Worldwide, rates of cardiometabolic disease, which includes obesity, Type 2 diabetes and heart disease, are on the rise, and South Asian people living abroad appear to be especially susceptible. Previous studies have looked for genes that influence the levels of various breakdown products of lipids in the blood and their connection to different diseases, but most of this research has been conducted in people of European ancestry.

In the new study, researchers looked at how genetics influenced the levels of 516 lipid metabolites in the blood of 3000 Punjabi Sikh individuals, in an effort to better understand how these genetic pathways contribute to disease in different ethnic groups. They compared their findings to previous results from more than 1 million Europeans and 15 000 individuals with Indian ancestry. The team identified new genetic pathways that link specific lipid metabolites to disease. Notably, they confirmed that one metabolite, LPC O-16:0, which is known to be involved with immune cell signaling and inflammation, influences Type 2 diabetes risk. They also identified a genetic variant that may protect Indians from developing heart disease by modulating levels of the metabolite PC 38:4.

These findings offer new insights into the diverse molecular origins of cardiometabolic disease and provide potential pathways to be explored for designing innovative therapies. The researchers conclude that including more non-European participants in this type of research would help in identifying distinct disease subtypes linked to different genetic pathways. These advances would likely be beneficial in clinical practice by enabling more personalised therapies and preventive strategies for people from different backgrounds.

The authors add, “This study reveals new genetic pathways and lipid markers that contribute to type 2 diabetes and heart disease, specifically emphasising how immune system signaling affects metabolic health. By identifying unique genetic signatures in Asian Indians, the research advocates for ancestry-specific medical approaches to address chronic immuno-vascular conditions in cardiometabolic disease.”

Provided by PLOS

Categories : Metabolic DisordersTags : Leave a comment

Vitamin D May Help Prevent Diabetes – Depending on Genetics

On By ModernMedia

New analysis of a major clinical trial finds supplementation reduced diabetes risk in prediabetic adults with certain variations in the vitamin D receptor gene

Photo by Michele Blackwell on Unsplash

Prediabetes is a condition marked by higher-than-normal blood sugar levels that often leads to type 2 diabetes. A new study finds that vitamin D may help delay or prevent that progression – but only in people with certain genetic variations.

The study, published today in JAMA Network Open, found that prediabetic adults with certain variations in the vitamin D receptor gene had a 19% lower risk of developing diabetes when taking a high daily dose of vitamin D.  

The researchers analysed data from the D2d study, a large, multi-site clinical trial that tested the effect of 4,000 units of vitamin D per day versus placebo in more than 2000 US adults with prediabetes to see if a daily high dose of vitamin D would lower the chance of these particularly high-risk individuals developing diabetes.

The original trial did not find a significant reduction in diabetes risk across all participants.  

“But the D2d results raised an important question: Could vitamin D still benefit some people?” said Bess Dawson-Hughes, M75, the study’s lead author and a senior scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. “Diabetes has so many serious complications that develop slowly over years. If we can delay the time period that an individual will spend living with diabetes, we can stop some of those harmful side effects or lessen their severity.”

Through an earlier analysis, the D2d research team found that blood levels of 40 to 50 ng/mL of 25-hydroxyvitamin D or higher were linked to substantial and progressively larger reductions in participants’ risk of developing diabetes.  

Vitamin D circulating in the blood is converted into its active form in the body before binding to the vitamin D receptor, a protein that helps cells respond to the vitamin. The researchers wondered whether genetic differences in this receptor might explain why some people benefited from vitamin D while others did not. The pancreas’s insulin-producing cells have vitamin D receptors, suggesting the vitamin may help influence insulin release and blood sugar control.  

For the new study, Dawson-Hughes and her colleagues analysed genetic data from 2098 trial participants who had consented to DNA testing according to two groups: participants who appeared to benefit from vitamin D supplementation and those who did not. They then compared response rates by subgroups of patients sorted according to three common variations in the vitamin D receptor gene. 

This analysis revealed that adults with the AA variation of the ApaI vitamin D receptor gene (about 30% of the study population) did not respond to daily treatment with a high dose of vitamin D, compared with placebo. In contrast, the analysis found that the same treatment in adults with the AC or CC variations of the vitamin D receptor gene saw a significantly reduced risk of developing diabetes compared with those taking a placebo. 

“Our findings suggest we may eventually be able to identify which patients with prediabetes are most likely to benefit from additional vitamin D supplementation,” said Dawson-Hughes. “In principle, this could involve a single, relatively inexpensive genetic test.”

By Genevieve Rajewski

Source: Tufts University

Categories : Cardiovascular Disease PaediatricsTags : Leave a comment

Benefits of Physical Activity May Outweigh Risks for Kids with Cardiomyopathy, ICDs

On By ModernMedia

With proper assessment and monitoring, the risk of serious heart events during physical activity may be lower than previously believed for children and adolescents with certain heart conditions, according to a new American Heart Association scientific statement

Photo by Annie Spratt on Unsplash

Physical activity in children and teenagers with cardiomyopathy (conditions that affect the heart muscle’s structure and function, impairing its ability to pump or fill effectively), as well as children with implantable cardioverter-defibrillators (ICDs) may be safer than previous research suggested, according to a new scientific statement from the American Heart Association, published today in the Association’s flagship peer-reviewed journal Circulation.

While physical activity and exercise are essential for childhood development and long-term health, they have been traditionally discouraged among children and adolescents with cardiomyopathies and ICDs (implantable devices that detect life-threatening abnormal heart rhythms and deliver electrical shocks) due to concerns that they could worsen heart function or lead to sudden cardiac death.

“While safety is always paramount, halting all physical activity among children with cardiomyopathy or ICDs has at times led to unintended consequences. The latest research indicates that restricting children’s movement can negatively affect their heart health, physical fitness levels, mental well-being and social development, and quality of life,” said Jonathan B. Edelson, MD, MSCE, chair of the scientific statement writing group, an associate professor of paediatrics and medical director of the sports cardiology program and heart transplant and ventricular assist device programs in the division of cardiology at Children’s Hospital of Philadelphia.

What do parents and caregivers need to know?

Ensuring safe participation in physical activity requires thoughtful, individualized planning and ongoing collaboration among clinicians, families and patients.

  • Personalised approach: Tailored risk assessments based on diagnosis, risk profile, genetic profile and clinical evaluations are critical to better guide decisions about prescribing physical activity for children with different types of cardiomyopathies. Various diagnostic screening tools, such as echocardiograms, cardiac imaging and exercise stress tests, can be used to assess symptoms at rest and with activity. Genetic testing and family screening can also be helpful to assess individual risk.
  • Shared decision-making: Clinicians, families and (when developmentally appropriate) children or adolescents with cardiomyopathy and/or ICDs can work together to balance a patient’s risk, patient- and family-tailored goals and values. It is important for clinicians to disclose when risk evidence is based on adult data.
  • Close follow-up and reassessment: Ongoing monitoring is important to track potential shifts in risk, assess if symptoms progress and evaluate if heart function improves or deteriorates. The recommendations for safe physical activity must evolve as the child grows, activities change and the disease progresses.


Close follow-up and reassessment: Ongoing monitoring is important to track potential shifts in risk, assess if symptoms progress and evaluate if heart function improves or deteriorates. The recommendations for safe physical activity must evolve as the child grows, activities change and the disease progresses.

What types of activities can be considered?

The new scientific statement aims to shift from adopting a one-size-fits-all approach to physical activity limitations to considering ways for youth with heart conditions or an ICD to safely participate in physical activities – from low-intensity daily activities to high-intensity training and sports in select cases – after a detailed individualised risk assessment.

Light-to-moderate intensity exercise (such as walking, light cycling or swimming) may be appropriate to maintain physical fitness, social development and quality of life, with regular monitoring of their condition. Structured physical activity, such as fitness classes, strength training, running, biking, hiking or organised sports programs, may be reasonable for some children and adolescents with heart conditions. For some carefully selected paediatric patients with certain cardiomyopathies, participation in physical activity including competitive sports may be reasonable after expert assessment and shared decision-making discussion about the risks and benefits. Emergency action plans, including AED (automated external defibrillator) access and bystanders trained in CPR, are essential during organised sports. Additional guidance for specific types of cardiomyopathies are detailed in the manuscript.

“Children with cardiomyopathy should not automatically be sidelined from participating in physical activity, including recreational or competitive sports,” Edelson said. “Most children should be physically active – with individualised evaluation, monitoring and planning. Physical activity is important for their long-term health, physical and social development.”

The statement notes more research is needed about childhood cardiomyopathies because most of the findings in the statement are based on observational studies in adults; therefore, findings should be applied cautiously to a paediatric population. In addition, outstanding questions remain, such as how moderate or vigorous exercise may affect the long-term progression and how risk varies across different types of cardiomyopathies.

Source: American Heart Association

Categories : Expert Opinion Healthcare Politics and RegulationsTags : Leave a comment

Leadership, Transparency and Culture Shifts Are Key to Improving Public Sector Healthcare Quality

On By ModernMedia
COHSASA CEO, Jacqui Stewart (left), moderates the panel discussing “Quality in the Public Sector”. From left:  Dr Siphiwe Mndaweni, CEO of the Office of Health Standards Compliance (OHSC), Professor Sabelile Tenza, Associate Professor, Patient Safety and Healthcare Quality, North-West University, Professor Sibusiso Zuma, Chair of the Department of Health Studies at UNISA and Dr Arthur Manning, CEO of Rahima Moosa Women and Children’s Hospital.

Strong leadership, functional governance and an honest culture of reporting are among the critical factors needed to improve and sustain quality care in South Africa’s public health sector, experts said during a panel discussion at the Hospital Show Conference hosted by COHSASA in Sandton recently.

The session, moderated by COHSASA CEO Jacqui Stewart, brought together senior voices from regulation, academia and hospital management to unpack the persistent gaps – and opportunities – in public sector healthcare delivery.

Professor Sibusiso Zuma of UNISA set the tone, noting that quality varies widely across public hospitals and is often determined by how effectively leadership teams work together.

“In my experience, the level of care depends on how heads of departments—nursing, pharmacy and clinical leadership , function as a team,” he said. “They need to identify problems  and address them collectively. Management must also be visible, regularly engaging with what is happening on the ground.”

Dr Siphiwe Mndaweni, CEO of the Office of Health Standards Compliance (OHSC), reinforced the central role of leadership and governance structures, drawing on inspection findings.

“Where leadership is weak or absent, quality suffers,” she said. “Infrastructure is another major challenge. Many facilities are old, and maintenance budgets are often diverted elsewhere, meaning planned upkeep simply does not happen.”

She added that even basic resources remain a concern. “Without essentials like soap, effective infection prevention and control is impossible.”

Dr Mndaweni also highlighted shortcomings in clinical governance, linking these directly to rising litigation. “Facilities may have clinical committees on paper, but if they are not meeting to interrogate lapses in care, the system fails.”

Security risks, poor community engagement and underutilised strategic plans further compound the problem. “Too often, documents are developed and then filed away. Facilities lose sight of their strategy and have no real understanding of patient satisfaction.”

However, she noted that where leadership is engaged – actively interacting with staff and patients – outcomes improve significantly.

Responding to questions on balancing regulatory compliance with quality improvement, Dr Arthur Manning, CEO of Rahima Moosa Mother and Child Hospital, argued that compliance should be seen as a starting point rather than an endpoint.

“Standards are a benchmark, but they are not the ceiling,” he said. “Our experience shows that it is possible to move beyond them.”

Professor Zuma agreed, cautioning against a compliance-driven mindset that fades once certification is achieved. “Facilities often put in intense effort to meet regulatory requirements, then step back afterwards,” he said. “Quality improvement cannot be a once-off exercise or confined to a single ‘quality person’. It must be everyone’s responsibility.”

He advocated for broader training in Total Quality Management and regular six-monthly audits involving all staff. “Quality must be continuous,” he said.

Professor Sabelile Tenza of North-West University pointed to a deeper cultural issue undermining progress: performative compliance.

“There is a tendency to be compliant on paper rather than in practice,” she said, citing research in which hospitals borrowed equipment to pass inspections, only to return it afterwards.

She described a culture of concealment, where staff hesitate to report shortages or failures. “There is fear of exposing the truth, even to boards that could advocate for improvements,” she said. “If we remove that fear, we can move forward.”

Professor Tenza also raised concerns about the reporting of adverse events, stressing the need to protect healthcare workers. “Clinicians ask why they should report incidents when they see no feedback or improvement,” she said.

She criticised the gap between policy and practice around “Just Culture” frameworks. “We talk about it, but confidentiality is not adequately protected. Without anonymity, reporting systems will not work “The focus should be on the incident, not the individual,” she said. “That is how  a learning culture is created.”

Although the National Department of Health has developed free online reporting tools, uptake remains low. Professor Tenza said the system needs to be more user-friendly and accessible via mobile devices, with less duplication between paper and digital processes.

“The focus should be on the incident, not the individual,” she said. “That is how systems learn.”

Dr Mndaweni acknowledged that regulation can be perceived as punitive but stressed that enforcement is a last resort. “The OHSC is designed to support compliance and improvement, not punishment,” she said. “But where there is persistent non-compliance, enforcement becomes necessary—even to the point of revoking a facility’s licence to operate.”

She added that the regulator is repositioning itself to play a more active role in quality improvement, rather than acting solely as an enforcer.

Dr Manning rejected the notion that compliance and quality improvement are competing priorities. “Regulatory standards define the minimum acceptable level of care,” he said. “Meeting them should be business as usual. The real goal is to exceed them – there should be no trade-off.”

Categories : RheumatologyTags : Leave a comment

Study Finds Common Medication Brings Little Relief in Osteoarthritis

On By ModernMedia
Photo by Towfiqu barbhuiya

The University of Tasmania’s Menzies Institute for Medical Research has found that commonly prescribed medication, Diacerein, does not improve knee osteoarthritis symptoms, following a national study.

Diacerein, a medication derived from plants such as rhubarb and aloe vera, has long been recognised for its anti-inflammatory properties and is commonly used to treat osteoarthritis in Europe and Asia.

Led by Associate Professor Dawn Aitken, head of the Musculoskeletal Research Group at Menzies, the DICKENS trial is the largest study globally to investigate Diacerein’s ability to reduce pain in people with knee osteoarthritis who also have inflammation within the joint (effusion synovitis).

“We designed this large trial to test Diacerein in a group of osteoarthritis patients who we thought would have the best chance at benefiting from the drug and found that it did not improve pain or function or decrease local knee inflammation.

“We were hoping that if the drug was effective, it could be included on the Australian Register of Therapeutic Goods (ARTG) as an approved treatment for osteoarthritis in Australia,” Associate Professor Aitken said. “Unfortunately, it’s back to the drawing board to find more effective drug therapies.”

Osteoarthritis is the most common form of arthritis, affecting one in five Australians over the age of 45 and is a major cause of pain, disability, and joint replacement surgery. Despite its widespread burden, very few effective drug treatments exist.

Associate Professor Aitken said the publication of the trial in JAMA Internal Medicine – one of the world’s most prestigious medical journals – highlighted both the significance and rigour of the work.

“While the findings weren’t what we expected or hoped for, publishing this work in JAMA Internal Medicine reinforces the global importance of high-quality research, and we are proud that Menzies is contributing to the global effort to better understand and treat osteoarthritis.”

Associate Professor Aitken is hopeful that other promising drugs in the development stage will become available to bring relief to those suffering chronic pain, but highlighted that non-drug therapies are available.

“Chronic pain has a huge impact on the lives of those who live with it, and the lack of effective drug treatments is frustrating.

“While we currently lack drug treatments for chronic pain, we know that the most effective therapies include education, exercise, weight management and psychological support.”

Despite these findings, patients should not stop taking Diacerein without talking to their treating doctor first.

Source: University of Tasmania

Categories : Lab Tests and ImagingTags : Leave a comment

Adcock Ingram Critical Care and Olympus Partner to Expand Medical Innovation in Southern Africa

On By ModernMedia
Ronald Boueri (Olympus Middle East and Africa) and Colin Sheen (Adcock Ingram Critical Care) signing the strategic partnership agreement.

JOHANNESBURG, (Apr. 23, 2026) – Adcock Ingram Critical Care (AICC), a leading manufacturer and supplier of hospital and critical care products in Southern Africa, and Olympus, a global MedTech company committed to advancing endoscopy-enabled care, are strengthening their focus on improving patient care through a strategic partnership.

The partnership will expand access to Olympus’ advanced endoscopy solutions and broader medical and surgical technologies across South Africa and the Southern African region. Through this collaboration, AICC will support healthcare professionals with innovative solutions and services for early detection, diagnosis and minimally invasive treatment, while also strengthening access to clinical support, training and education.

Olympus has appointed Adcock Ingram Critical Care as its authorised distributor in South Africa, reinforcing its commitment to delivering high-quality products, reliable service and strong local support to healthcare professionals and institutions. With a global focus on clinical excellence and a comprehensive medical and surgical portfolio, Olympus continues to partner with organisations that share its aim of improving patient safety and outcomes and elevating the standard of care in targeted disease states.

“We are confident that our collaboration with Adcock Ingram Critical Care in South Africa will enhance service levels, expand market reach, and ensure seamless access to Olympus products and expertise,” says Ronald Boueri, Vice President and Managing Director, Olympus Middle East and Africa. “Most importantly, this partnership will support healthcare professionals with the high standards of quality, service and support they rely on, while contributing to improved patient outcomes and advancing healthcare across the country.”

For decades, AICC has delivered essential medical solutions across a range of therapeutic areas, including hospital care, renal care, transfusion therapies, infusion systems, and advanced wound care. This partnership further strengthens AICC’s ability to connect global innovation with local healthcare needs, ensuring that all South Africans have access to critical, life-enhancing technologies, supported by strong clinical expertise and service.

“This partnership marks an important step forward in our ongoing commitment to improving access to quality healthcare across Southern Africa,” says Colin Sheen, Managing Director of Adcock Ingram Critical Care. “Through our collaboration with Olympus, we are equipping healthcare professionals with innovative solutions that support early detection, accurate diagnosis and minimally invasive treatment, helping to enhance clinical outcomes and strengthen healthcare delivery across the region.”

Categories : Cardiovascular Disease NeurologyTags : Leave a comment

Combo Pill Shown to Cut Risk of Recurrent Stroke by 39%

On By ModernMedia
Haemorrhagic stroke. Credit: Scientific Animations CC4.0

Treatment with GMRx2, a single pill combination of three low-dose blood pressure medicines, significantly reduced the risk of another stroke in patients with intracerebral haemorrhage and high blood pressure. Results from the TRIDENT randomised controlled trial, led by The George Institute for Global Health, are published in The New England Journal of Medicine.

Professor Craig Anderson, Principal Investigator and Senior Professorial Fellow at The George Institute, said, “Lowering blood pressure is the only proven method to prevent another stroke, yet achieving good blood pressure control is a real challenge. One big issue is that the number and doses of antihypertensive medications are not increased when needed and doctors and patients struggle with complex pill regimens.

“Our study showed that GMRx2, a once-daily triple combination pill, cut the risk of another stroke by 39%. These findings could translate to important treatment benefits for the millions of people affected by intracerebral haemorrhage worldwide who face a high risk of having another one.”

The international study involved 1670 patients who had experienced intracerebral haemorrhage and had systolic blood pressure (SBP) of 130–160 mmHg. They received GMRx2, a single pill combination containing telmisartan 20mg, amlodipine 2.5mg, and indapamide 1.25mg, or a placebo, alongside standard care.

During an average period of follow-up of three years, stroke occurred in 4.6% of patients receiving GMRx2 compared to 7.4% in the placebo group. This equated to a 39% lower risk of recurrent stroke. Overall, the results showed one stroke was prevented for every 35 patients treated with GMRx2.

The GMRx2 group achieved better blood pressure control, with mean SBP levels 9mmHg lower than the placebo group. Patients treated with GMRx2 also experienced reduced rates of major cardiovascular events (non-fatal stroke, non-fatal heart attack and cardiovascular death) by 33% versus placebo. Serious adverse events were comparable between the treatment and placebo groups, affecting 23.8% and 26.8% of patients, respectively. Concerns of fatigue, dizziness and falls were infrequent and occurred similarly between the GMRx2 and placebo groups.

Almost 17 million people worldwide have experienced intracerebral haemorrhage, and there are over three million new cases each year. Among patients who survive this type of stroke, approximately one quarter will later die from recurrent stroke or cardiovascular disease. The condition disproportionately affects people in low- and middle-income countries (LMICs), where there is often poorer control of high blood pressure. Intracerebral haemorrhage is one of the most dangerous types of strokes, occurring at almost twice the rate in LMICs compared to high-income countries.

Professor Jeyaraj Pandian, President of the World Stroke Organization, said, “TRIDENT is a major advance in showing the enormous benefits of effective blood pressure control after an intracerebral haemorrhage, and a simple and effective strategy in which this can be achieved, with relevance to patients all over the world.”

Professor Anderson added, “These study results have the potential to mark a real shift in how we manage blood pressure following a stroke. This single-pill triple combination helped patients reach target blood pressure levels.

“We hope GMRx2 is approved for this indication by regulatory authorities throughout the world, and if so that it is widely used as an effective approach with the potential to improve the outcome for patients affected by intracerebral haemorrhage, and also ischaemic stroke, across the globe.”

Source: The George Institute for Global Public Health