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EQUALtreatment

December 2009Magazine for the Treatment Action Campaign

Yini eyenza ukuthi abantu bakholelwe emakhanjini okuthiwa ayelapha kodwa abe engathi shu okungamakhambi enziwa ngodokotela.

Izinyanga zendabuko kanye neSandulela Ngculazi (HIV)

Okufanele ukwazi ngesifo somdlavuza womlomo wesibeletho

Ukwenza umqondo Ukwenza u q

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OKUQUKETHWEIhlelo 31 Disemba 2009

IsiZulu

Amakhasi 27

Postal Address: PO Box 2069, Cape Town 8001. Physical Address: Westminster House, 122 Longmarket Street, 2nd Floor, Cape Town 8000. Phone: 0861 END HIVFax: +27 21 422 1720 Website: www.tac.org.zaProvincial and District TAC officesWestern Cape Province: 021 447 2593Khayelitsha District: 021 364 5489Ekurhuleni District: 011 873 4130Limpopo Province: 015 291 5448 Elim District: 015 556 3341Mpumalanga Province: 013 755 2298 Eastern Cape Province: 043 743 7143Lusikisiki District: 039 253 1951Queenstown District: 045 838 1364Kwazulu-Natal Province: 031 304 3673Pietermaritzburg District: 033 394 0845 Ilembe District: 032 552 5160

Gert Sibande: 017 811 5085

Equal Treatment is published by the Treatment Action Campaign.

Amakhasi 813

Amakhasi 1421

Amakhasi 2227

Isayensi kanye nokuthiwa kuyasebenza kungahloliwe ngodokotela Izinsuku zokungafuni ukwamukela uxhaso lukahulumeni kungenzeka ukuba seziphelile, kodwa emakhoneni emigwaqo nasezitolo ezidayisa izinto ezinempilo imithi okuthiwa iyasebenza ingasebenzi isekhona ngempela, iyaphila futhi iyingozi. Sihlola ukuthi kungani abanye abantu bekholelwa emakhanjini okuthiwa ayasebenza engasebenzi nokukhombisa ukuthi isayensi akusiyo eyaseNtshonalanga, kodwa iyithuluzi nje esingalisebenzisa ukuzinikeza amandla olwazi.

Umhleli: Marcus Low

Umhleli Wezithombe: Mara Kardas-Nelson

Umhleli Wekhophi: Cathy Goudie

Abafake isandla: Nathan Geffen, Adam Malapa, Poppy Riddle, Eduard Grebe, Lawrence Mbalati, Charles Moponya, Jonathan Berger, Jennifer Reid, milie Shuh, Catherine Tomlinson, Tandeka Vinjwa

Ukuthathwa kwezithombe: Samantha Reinders, Anso Thom/Health-E News Service, Adam Malapa, Tony Wills, www.mediaclubsouthafrica.com, Michael Wolf, Gallo Images/AFP, AFP, Moses Makhomisani, National Geographic/Getty Images, Tandeka Vinjwa

Isithombe sekhava: Lee-Ann van Wyk ovela elebhu i-Bioanalytical Research Corporation (BARC) uphakamisa ishubhu lokuhlola legazi elehlukanisiwe elisesisetshenzisweni sokuhlukanisa esibizwa nge-centerfuge. Igazi elijikelezayo ku-centerfuge lihlukanisa umantshu (plasma), amaseli egazi amhlophe nabomvu ngezingqimba ukususa kokulula kakhulu ukuya kokusinda kakhulu, Isithombe ngu-Sam Reinders

Sibonga ngokukhethekile ku-Dkt Ben Goldacre, Solwazi Lynette Denny, Dkt Justine Davies, Dkt Linda-Gail Bekker, Nathan Geffen, Sense About Science, Christie Heiberg ne-Desmond Tutu HIV Foundation Clinical Trials Unit, ne-Yvette Kramer nelebhu i-BARC, Cape Town.

Ukuhanjiswa: Kagiso Seleka

Ukuhlelwa kwamakhasi: Designs4development, www.d4d.co.za

Ukuphrinta: CTP Book Printers

Ihunyushwe ngu: Bohle Conference and Language Services

I-TAC izinikele ekunikezeleni abantu abane-HIV, imindeni yabo kanye nabanakekeli ulwazi olungenamaphutha ngemithi esindisa impilo kanye nokwelashwa. I-TAC kanye nabaholi bayo bazimele abekho ngaphansi kwemboni eyenza imithi kanye nezimboni zemithi yemvelo kanye neminye ehlukile futhi akunathando lwemali abanalo nabo.

Imithi yendabuko kanye nezinyanga Silandela indaba yokuthi umuthi wendabuko waseShayina waba kanjani umuthi wokwelapha oyisixazululo sikamalaleveva. Njengayo yonke imithi, isikhiye kwakuwukuhlola kwezesayensi. Bese sibheka Umthetho Wabasebenzi Bezempilo Bendabuko (Traditional Health Practitioners Act kanye neqhaza lezinyanga zendabuko ekulweni ne-HIV.

Indlela yezesayensi kanye nokulawula imithi Ukusuka ekuhloleni kwesigaba I ukuya kumazinga ka-p, sichaza indlela yezesayensi ngamatemu ozokwazi ukuwaqonda. Emva kokwazisa u-Lawurence Mbalati ngokungabi bikho kolawulo lwemithi eLimpopo, u-Jonathan Berger usazisa ngohlangothi lomthetho lokulawula.

Imijovo yokugomela i-HIV kanye nesifo somdlavuza womlomo wesibeletho Kulandela izihloko ezigqamile ezihehayo emaphephandabeni ezinyangeni ezisandakudlula, umbiko wenqubekela phambili yethu ukhombisa la esikhona khona ngempela nokufuna umjovo wokugomela i-HIV osebenzayo. Sibheka futhi nesifo somdlavuza womlomo wesibeletho, isifo esinomjovo wokusigomela osebenza ngempumelelo, nakuba bembalwa abantu abakwazi ukuwukhokhela.

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Umbono Umuntu ozenza umuntu onolwazi lwezokwelapha engenalo umuntu othuthukisa imithi engazange ihlolwe ngendlela efanele. Kungaba isenzo esiyingozi. Abantu abazenza abantu abangesibo benza imali ngokwesaba kwabantu kanye nezifo. Okubi kakhulu bangakukhohlisa uze ushone. ENingizimu Afrika yonke kunabantu abangowaka abathengisa amakhambi angahloliwe eNgculazi (AIDS) kanye nezinye izifo. Bayaqhubeka nokokwenza lokhu ngisho kaningi benza okungekho emthethweni.

I-Treatment Action Campaign (TAC) ithathe isenzo sokulwa nabantu abaningi abangowaka bodokotela. Isibonelo:

Sathola umyalelo wenkantolo wokumisa u-Matthias Rath ekukhangiseni ngama-multivithamin akhe njengomuthi wokwelapha i-AIDS. U-Rath wathi izidambisi gciwane (ama-ARV) anobuthi kanti ama-multivitamin odwa angayelapha i-AIDS.

Sathola futhi umyalelo wenkantolo ophikisana noNgqongqoshe Wezempilo wangaphambilini, uManto Tshabalala-Msimang. Watshelwa yinkantolo ukuthi makaphenye ngezinhlolo zokulinga zika-Rath azenza kubantu abane-HIV. Ngaphansi kukaTshabalala-Msimang uhulumeni weseka abantu abaningi abazenza abantu abanolwazi lwezokwelapha bengenalo. Siyabonga, lesi sikhathi esidumazayo emlandweni wethu kubukeka sengathi sesaphela, kodwa umonakalo yena kanye nabanye abasebenzi bakahulumeni abawenza uyohlala isikhathi eside.

Sesifake izikhalazo eziningi eziyimpumelelo ukulwisana nowaka abazenza abanolwazi lwezokwelapha bengenalo ku-Advertising Standards Authority (ASA). Maduze nje i-ASA isandokuphikisana nezikhangiso zikaZeblon Gwala, othengisa ikhambi leNgculazi elingahloliwe elibizwa ngokuthi uBhejane kubantu abakhathazekile ngama-R300 ngenyanga. I-ASA ilawula izikhangisi. Uma izikhangisi zenza izitatimende eziyiphutha, isibonelo ngeNgculazi, i-ASA inawo amandla amancane okumisa izikhangisi ezinjalo.

Abantu abane-HIV kaningi bayesaba ukuphuza ama-ARV ngoba abanalwazi olwanele ngawo noma bezwa izindaba eziyihaba ngemiphumela yawo emibi. Lokhu kwenza amathuba okuthi abazenza abazi ngezokwelapha bebe bengazi babathengisele ithemba eliyiphutha. Abantu abaningi bashonile ngokungenasidingo ngoba esikhundleni

sokuqala ama-ARV bamoshe isikhathi bephuza amakhambi owaka bezazi zokwelapha.

Amakhambi ngempela abantu abazenza abanolwazi lwezokwelapha wona ngokwawo kaningi awalimazi. Okuyingozi ukuthi kulahleka isikhathi esibalulekile kuzanywa le mithi esikhundleni sokusebenzisa ehlolwe ngokwezesayensi efana nama-ARV. Kodwa-ke, ngezinye izikhathi izithako ezisemithini yabazenza abanolwazi lwezokwelapha ziyingozi. Ngokungangabazeki, abantu abaningi bathola ushevu emithini engahloliwe ngonyaka. Futhi, eminye imithi ehlukile, njengogalikhi kuyo yonke imithamo noma i-St Johns Wort, ingahlangana kabi nama-ARV.

Uhlelo lwezempilo yomphakathi kufanele kuphela lunike abantu imithi ehlolwe ngendlela efanele futhi yavunywa Umkhandlu Wokulawula Imithi (Medicines Control Council). Kodwa esinye sezizathu ezinkulu zokuthi kungani abantu abane-HIV besebenzisa amakhambi abantu abazenza abanolwazi lwezokwelapha kungenxa yokuthi kaningi baphathwa kabi uhlelo lwezempilo yomphakathi. Imigqa emide, ukushoda kwemithi kanye nonesi abasebenza ngokweqile abathukuthele benza ukuthi abantu bangafuni ukusebenzisa imitholampilo yasezindaweni zabo. Esikhundleni salokho, baphendukela ethembeni elingamanga abalinikezwa abantu abazenza abanolwazi ngezokwelapha abanobungani. Ucwaningo lwakamuva

lwakhombisa lokhu ngqo: iziguli ezinolwazi olubi emitholampilo yazo kunokwenzeka kakhulu ukuthi ziyofuna usizo kubantu abazenza abanolwazi ngezokwelapha bengenalo abangowaka.

Kungakho nje uma sifuna ukulwa nobuwaka babazenza abanolwazi ngezokwelapha bengenalo, indlela enhle kakhulu okufanele siyenze ukwakha uhlelo lwezempilo lukahulumeni olusebenza ngempumelelo kakhulu nokungeke kwenzeke ukuthi lunyathele isithunzi sokuhlonipheka kwabantu.

uNathan GeffenUsikhwama we-TAC

Imithombo: Goudge, J. et al., Centre for Health Policy, School of Public Health, University of Witwatersrand Affordability, availability and acceptability barriers to health care for the chronically ill: longitudinal case studies from South Africa BMC Health Services Research (2009) http://www.ncbi.nim.nih.gov/pubmed/19426533.

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Umuthi wokwelapha Ingculazi ongamanga uBhejane owuthola KwaZulu-Natali awuhloliwe, njengamaphedi okukhipha ubuthi ezinyaweni noma imithi yokwelapha ngamakhambi emvelo ongayithenga eLondon noma e-New York ayihloliwe. Onke la makhambi ayafana ngokuthi abantu bathi angenza izinto angakwazi ukuzenza. Ubhejane noma itiye iRevivo akukwazi ukwelapha Ingculazi, kanti amaphedi ezinyawo okukhipha ubuthi awakaze ahlolwe ukuthi ayakwazi yini ukukhipha ubuthi emzimbeni. Umzimba wakho lokho ukwenza kahle kakhulu ngokwawo.

Njengoba ubuwaka bokwazi ngezokwelapha bungesibo obaseNtshonalanga noma obase-Afrika, ukuhlola kwezesayensi akusikho okwaseNtshonalanga noma okwase-Afrika, kodwa nje indlela engcono kakhulu esiyaziyo yokuthola ukuthi yini esebenzayo futhi yini engasebenzi. Abantu abaseNtshonalanga bayayisebenzisa, njengabantu abase-Afrika abayisebenzisayo. Singasebenzisa izindlela zesayensi ukuhlola ukuthi ingabe itiye iRevivo liyasebenza yini, njengoba singazisebenzisa ukuhlola izidambisi gciwane zakamuva (ama-ARV).

Ukuhlola kwezesayensi kungasindisa izimpilo. Kungenxa yokuhlola lapho esazi khona okokuqala ukuthi ama-ARV ayazisindisa izimpilo - kanti kusuka lapho azisindisile izimpilo eziningi. Ukuhlola kwezesayensi futhi kusiza ukwenza ama-ARV anemiphumela emibi embalwa.

Ucwaningo lwezesayensi alwenzeki kuphela ngaphesheya kwezilwandle eYurophu noma eMelika. Kwenziwa ucwaningo oluningi ningi e-Afrika, lwenziwa ngama-Afrika. Ulwazi esiluthola kulokhu kuhlola

Ukuhlola kwezesKungenxa yokuhukuthi ama-ARV kusuka lapho azikwezesayensi futanemiphumela e

Ucwaningo lwezengaphesheya kwKwenziwa ucwanngama-Afrika. U

Ubuwaka bokuzenza onolwazi lwezokwelapha kanye nesayensi mbumbulu kuza ngezindlela eziningi futhi akunamkhawulo ezweni elithize noma esikweni elithize. Akusikho okwaseNtshonalanga noma okwase-Afrika, kodwa okomhlaba wonke.

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Ngu-Marcus Low

Udadewabo kaNoluthando Magwebu, umuntu ophila ne-HIV eKhayelitsha owashona ngonyaka ka-2005 emva kokuba nemiphumela emibi eyayibangwa imithi yokwelapha eyanikwa yi-Dr Rath Health Foundation, ephethwe uwaka wodokotela odume kabi u-Matthias Rath. Lapha udadewabo ucabanga ngokufa kukaMagwebu eminyakeni eminingana emva kwalokho. UMagwebu wayetshelwe ukuthi amaphilisi e-Foundation azokwenza ukuthi i-HIV ibe ngcono kakhulu. Umyeni kaNoluthando, uZodani, watshela i-Health-E News Service ukuthi isonto emva kokuqala amaphilisi waba nemiphumela emibi wayeseshona emasontweni ambalwa ngokuhamba kwesikhathi. Isithombe nendaba u-Anso Thom/Health-E News Service.

ISENZO SEZOKWELAPHA ESINGALANDELI

OKUTHOLAKALE NGOKWESAYENSI

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busizungezilebengenaloabanolwazi lwezokwelapha

lusinika amandla okwenza izinqumo ngokwazi maqondana nezimpilo zethu.

Owaka abazenza abazi ngezokwelapha abathandi ukuthi kwenziwe ukuhlolwa kwesayensi emikhiqizweni yabo, kanti kaningi basebenzisa izaba zokuthi ukuhlola kwesayensi akuwalungele amakhambi abawathengisayo. Lokhu mhlawumbe kungenxa yokuthi bayesaba ukuthi ukuhlola kungakhombisa ukuthi la makhambi awasebenzi. Abanye owaka abazenza abazi ngezokwelapha bayayithemba imikhiqizo yabo ngisho nasemva kokuba ukuhlola

kukhombise ukuthi ayisebenzi.

Ukuphambana, isayensi iqhubekela phambili ngokuthi abacwaningi bahlole imikhiqizo kanye nokuvuleleka kunanoma yikuphi okutholakalayo. Ukufunda ukuthi umuthi wokwelapha othize

awusebenzi ngempumelelo kubalulekile kubacwaningi njengokufunda ukuthi into ethize iyasebenza. Yingakho nje okutholakele kushicilelwa ngokukhululeka kumajenali ezokwelapha. Abanye abacwaningi bangakuphinda ukuhlola

ukubona ukuthi umkhiqizo usebenza ngempela yini.

Isayensi mbumbulu ingabulalaNgaphansi koMongameli wangaphambilini uThabo Mbeki kanye noNgqongqoshe Wezempilo uManto Tshabalala-Msimang uhulumeni waseNingizimu Afrika wenza kancane ekwethuleni ama-ARV ohlelweni lwezempilo kahulumeni. Kunalokho, bakhuthaza okokwelapha okungamanga njengekhambi lobuwaka i-Virodene futhi beseka abakhohlisi abafana noMatthias Rath. Abacwaningi bahlambekisela ukuthi lokhu kwephuza kokutholakala kwama-ARV engxenyeni kahulumeni kwaholela ekufeni okungenasidingo okungaphezu kwezi-300,000.

Wonke uwaka ozenza owazi ngezokwelapha otshela abantu ukuthi bangaphuzi ama-ARV noma onikeza noma athengisele abantu imithi yokwelapha engahloliwe ubeka izimpilo engozini. Ama-ARV yiwona kuphela umuthi wokwelapha ohloliwe wokulwa ne-HIV. Kubalulekile ukuthi abantu abane-HIV baphuze imithi yabo njengoba beyalelwe ngodokotela babo noma abasebenzi bezempilo.

Ukuhlangana kwemithiEminye imithi, amakhambi mbumbulu kanye nezichibiyelo zamavithamini zingahlangana nezidambisi gciwane zakho (ama-ARV) bese kwenza ukuthi angasebenzi ngempumelelo. Yingakho nje kufanele uwaphuze la makhambi uma udokotela wakho noma umsebenzi wezempilo ethi kulungile.

Owaka abaningi abazenza abanolwazi ngezokwelapha abakwazi lokhu futhi bakhuthaza abantu ukuthi baphuze la makhambi kanye kanye nama-ARV noma esikhundleni sama-ARV. Lokhu kuwukunganaki okukhulu futhi kungabeka izimpilo zabantu engozini. Kufanele uphuze kuphela imithi owelulekwe ngayo udokotela wakho noma umsebenzi wezempilo.

UZodani Magwebu nezingane zakhe ezimbili. Umndeni wakwaMagwebu walahlekelwa unkosikazi wawo kanye nomama, uNoluthando, ngonyaka ka-2005 emva kokuba eqale ukuphuza amaphilisi avela ku-Rath Foundation okwakuthiwa azomsiza nge-HIV. Uthi, Selokhu ashona umkami, izinto bezizimbi lapha. Kuyakhula nokuba nzima kimi ukubheka izingane zami. UZodani uthi nangale kwamacala athweswa u-Rath yi-TAC, akukho muntu owake wamthinta ngokushona komkakhe. U-Rath kufanele aboshwe njengoba uyena obhekene nokushona komkami kanye nabanye abantu abaningi...Uma uhulumeni wayazi ukuthi kwakwenzekani akangenza lutho, kufanele baphendule. Isithombe nendaba u-Anso Thom/Health-E News Service.

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ISENZO SEZOKWELAPHA ESINGALANDELI

OKUTHOLAKALE NGOKWESAYENSI

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Ngu-Marcus Low

Owaka bodokotela bayakwazi lokhu, yingakho nje kaningi benza lezi zethembiso. Bayazi ukuthi sizizwa sikhathazekile nokuthi singafisa ukuzama noma yini. Babe sebesinika imithi yokwelapha engahloliwe bese besikhokhisa amanani entengo aphezulu ngayo. abasithatheli nje imali kuphela, basithengisela nethemba elingamanga futhi.

Kungani sizizwa singcono ngempelaIzifo eziningi, njengomkhuhlane ojwayelekile, ziba ngcono ngaphandle kokuthi kube khona imithi esiyiphuzayo. Imizimba yethu ingalwa nalezi zifo ngokwayo. Kodwa-ke, uma umkhuhlane uba mubi kakhulu, singaya kudokotela noma esangomeni noma mhlawumbe siphuze amavithamini nokokuqeda izinhlungu. Uma sesiba ngcono, kulula nje ukuthi sithi ukusinda kwethu kubangelwe amavithamini noma okokuqeda izinhlungu. Singaba nephutha-ke kodwa, njengoba umkhuhlane bewuvele uzoba ngcono nje.

Ngokufanayo, izimpilo zethu azihlali zisimeme ngokuphelele. Ngezifo eziningi kakhulu ezingelapheki izimpilo zethu zisazoguquguqka ekuhambeni kwesikhathi ngezinye izinsuku sizozizwa sikahle kanti ngezinye sizizwe singekho kahle. Uma into yenzeka ngaphambi ngokuthi sizizwe singcono, asizizwa singcono ngenxa yaleyo nto.

Kungaba nzima kakhulu ukuvuma ukuthi une-HIV, isifo somdlavuza noma isifo sikashukela. Kuyezwakala ukuthi ngezinye izikhathi siyaye sibe nethemba lomuthi wokwelapha ongumlingo. Uma umuntu ethembisa ukuthi inhlanganisela yakhe ingasisindisa, kuyasilinga kakhulu ukuthi simthembe.

R125.00500mlLikahle ngaphambi kuka-Agasti 2011

Konke Okwemvelo

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bekholelwa emakhanjiniKungani abantu

owakabodokotela

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Izingxeye zale athikili zibuye zasetshenzwa encwadini ka-Ben Goldacre Bad Science. U-Goldacre wayibukeza futhi i-athikili.

Ukuthi umkhuhlane uphele osukwini emva kokuba udle ipapa elinosawoti ngesikhathi sebhulakufesi akusho ukuthi ipapa elinosawoti liyawelapha umkhuhlane.

Owaka bodokotela bazokutshela ukuthi umkhuhlane wakho uphele ngenxa yamakhambi noma amavithamini abakunike wona, ekubeni umkhuhlane wakho ubuvele uzoba ngcono. Ukucabanga ukuthi uzizwa ungcono ngenxa yamakhambi kawaka kadokotela kwenza umqondo njengokuzizwa ungcono ngenxa yepapa elinosawoti. Yingakho nje singathi owaka bodokotela kaningi babongwa ngalokho imvelo ebizovele ikwenze.

Ukuthi amakhambi owaka bodokotela elapha imikhuhlane akulimazi kangako, kodwa uma bethi bangelapha ezinye izifo ezimbi kakhulu, kuba yingozi kakhulu. I-HIV, isifo somdlavuza noma isifo sikashukela akuvele kube ngcono nje ngokwakho. Kulezo zifo kufanele siqiniseke ukuthi imithi yokwelapha isebenza ngempela, kanti indlela kuphela yokukwena lokhu ukuthi ihlolwe ngendlela efanele ngokwesayensi.

Ngokuhlola, singathola ukuthi ngempela ipapa elinosawoti noma itiye elenza ukuthi umkhuhlane uphele noma ingabe umzimba wethu ubuzovele ulwe nawo nje.

Umphumela we-placebo Uma ososayensi behlola umuthi omusha, kaningi banikeza uhhafu wabantu abasocwaningweni umuthi omusha bese omunye uhhafu bewunika iphilisi eliwushukela elibukeka njengomuthi omusha. Iphilisi likashukela libizwa ngokuthi i-placebo. (Ama-placebo angaba futhi imijovo yamanzi anosawoti noma eminye imithi yokukhohlisa.) Kulezi

zifundo abahlanganyeli abazi ukuthi ingabe bathola iphilisi langempela yini noma i-placebo. Ososayensi bangabona-ke ukuthi ingabe abantu abathola iphilisi elisha benza kangcono yini kunabathola i-placebo. (Bheka amasi 1417 ukuthola olunye ulwazi ekuhloleni kokwelashwa.)

Ososayensi baphawulile ukuthi ngezinye izikhathi abantu bathi bazizwa bengcono kancane noma bezwa kukubi ngisho ngabe babenikwe i-placebo kuphela. Lokhu kwaziwa njengomphumela we-placebo. Umphumela we-placebo wenzeka ngoba uzwa umphumela omncane ngoba ulindele ukuthi umuthi usebenze hhayi ngenxa yomuthi wokwelapha ngokwawo. Ngesinye isizathu esenza ukuthi abantu kaningi bakholelwe emakhanjini owaka bodokotela.

Okumangazayo, umphumela we-placebo kubukeka sengathi uxhumene nokulindeleke ngokwesiko. Njengokuthi nje kukhonjisiwe ukuthi amaphilisi kashukela aluhlaza

Ukuzizwa ungcono kancane akusikho ukusindaUma ngabe okusankwethu noma isifo sohudo kumuntu one-HIV kuphela bese umuntu eqala ukuzizwa engcono, owaka bodokotela bathi bamsindisile umuntu one-HIV. Nanoma yisiphi isitatimede esinjalo asisilo iqiniso. I-HIV isekhona emzimbeni womuntu futhi izomenza ukuthi lowo muntu agule futhi uma engawaphuzi ama-ARV.

Kubalulekile ukuhlala uphuza ama-ARV akho noma imithi ye-TB njengoba uyalelwe udokotela noma umsebenzi wezempilo. Uma imithi yakho ungayiphuzi njengoba uyalelwe, kungenzeka ugule kakhudlwana kunokuba bewugula ekuqaleni.

awumuthi wokwelapha osebenza ngempumelelo kakhulu exhaleni kunamaphilisi kashukela abomvu. Akungenxa yokuthi kukhona into amaphilisi aluhlaza anayo, kodwa ngenxa yezinczelo zesiko ezihambisana nombala oluhlaza.

Ngokufanayo, izifundo ziye zathola ukuthi imijovo yamanzi anosawoti ingasebenza ngempumelelo kakhulu njengomuthi we-placebo kunamaphilisi anoshukela amhlophe hhayi ngoba kunento ewusizo ngemijovo yamanzi anosawoti, kodwa ngoba umkhosi wokujova uwukungenelela okukuyo yonke indawo, okunamandla nokubonakalayo. Ngendlela efanayo, abanye owaka bodokotela noma izinyanga zendabuko basebenzisa imigubho enemininingwane ephelele ukusenza sikholwe ukuthi umuthi wabo wokwelapha uzosebenza.

Imithi eminingi yowaka bodokotela yokwelapha i-HIV isebenzisa umphumela we-placebo. Umuntu okunikeza ikhambi ulokhu ekutshela ukuthi umuthi uzosebenza, uze nawe ngokwakho uqobo ukukholwe lokho. Kodwa yize umphumela we-placebo ukwazi ukuthi ukwenze uzizwe ungcono noma ukabi kakhulu okwesikhashana, angeke ukwazi ukwelapha nanoma yiziphi izifo. Yingakho nje uBhejane noma amakhambi emvelo angeke aze akwazi ukwelapha i-HIV noma ukuyelapha kahle njengezidambisi gciwane (ama-ARV). Ama-ARV awanciki kumphumela we-placebo ngoba asebenza ngqo emzimbeni wakho, hhayi ezinkolweni zakho.

Abanye abantu bazenza bakholwe ukuthi umuthi wokwelapha wowaka bodokotela uyasebenza. Bangaze bazizwe bengcono kancane okwesikhashana. Lokhu kungenzeka kakhulu uma uwaka kadokotela ebakhuthaza futhi ebatshela ukuthi kufanele bazizwe bengcono. Kungenxa yalesi sizathu ngezinye izikhathi sithola abantu abafakazayo ukuthi leli khambi noma lelo khambi lowaka kadokotela limsize kangakanani. Okudumazayo ke ukuthi uma laba bantu beyeka ukuphuza ama-ARV, izibalo ze-CD4 yabo ziyehla bese beshesha begula kakhulu.

Imithombo ethokozisayo: Ernst, E. and A.R. White Acupuncture for back pain: a meta-analysis of randomised controlled trials Archives of International Medicine 158 (1998); Kaptchuk T.J. et al. Sham device v inert pill: randomised controlled trial of two placebo treatments Brittish Medical Journal (2006).

ISENZO SEZOKWELAPHA ESINGALANDELI

OKUTHOLAKALE NGOKWESAYENSI

Amakhambi elapha zonke izinkinga

IZINDLELA EZIYISISHIYAGALOMBILI

ZOKUBONA UWAKA KADOKOTELA

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2. UKUNGATHANDI AMA-ARV Kaningi owaka bodokotela bagxeka izidambisi gciwane (ama-ARV). Akuvamile ukuthi baqonde ukuthi imiphumela emibi isebenza kanjani noma ukuthi ungalushintsha uhlelo lwemithi yama-ARV uma uba nemiphumela emibi. Abazi futhi ukuthi ama-ARV yiyona mithi yokwelapha i-HIV kuphela ehloliwe kanti ngaphandle kwayo, abantu bazosheshe bafe.

3.AMAKHAMBI ANGAHLOLIWE NGEMPELAOwaka bodokotela bahlale bethi amakhambi abo obuwaka ahloliwe, ekubeni angakaze ahlolwe. Ngakho-ke, uma bethi ayasebenza, abazi ngempela ukuthi ayasebenza yini, kodwa bethemba kanjalo noma bazenza ukuthi bakholwe ukuthi ayasebenza. Uma ubabuza ngawo, angeke bakukhombise izifundo ezishicilelwe kumajenali anegama elihloniphekile akhombisa ukuthi imikhiqizo yabo iyasebenza.

1. INKOLELO YOBUNTU BOMUNTU Owaka bodokotela kaningi babeka ubuntu babo esizindeni samabhizinisi abo. Abanye amabhizinisi abo bawaqamba ngabo. Bayathanda futhi ukuthi bethi baboniswe iqiniso, lapho banye bengazi ukuthi benzani.

4. INDLELA YOKUZIPHATHA NGOKUYIMFIHLO

Owaka bodokotela kaningi banemfi hlo. Abaningi abafuni ukusho ukuthi zithako zini ezisemakhanjini abo. Lokhu kubangelwa ukuthi bayazi ukuthi abantu abambalwa kabi abangawathenga uma bazi ukuthi la makhambi anazithako zini. Owaka bodokotela abafuni ukuthi amakhambi abo ahlaziywe elebhu noma ahlolwe ngokwesayensi.

8. BAZENZA AMAQHAWE

7. UKWENZA SENGATHI UYAZIOwaka bodokotela kaningi bathi ukuzizwa ugula kakhulu kuwuphawu lokuthi uba ngcono. Lena yindlela yokuzivikela bona ngokwabo. Uma uzizwa ungcono, bafuna ukunconywa ngakho, uma ugula kakhulu, bathi bekufanele kulindeleke. Ngale ndlela bangathi bayazi ukuthi kwenzekani ngempilo yakho ngisho bengazi.

5. AMANANI ENTENGO ANGATHETHELELEKIOwaka bodokotela kaningi babiza amanani aphezulu ngemikhiqizo yabo ngisho bazi ukuthi bathengisa kuphela amanzi noma amakhambi ajwayelekile. Lokhu kungenxa yokuthi abaningi bazifunela ukuceba nje. Kodwa-ke, owaka bodokotela abancane abenzi imali eningi. Ngokuvamile laba bantu bayakholwa ngempela ukuthi ikhambi abalithengisayo liyasebenza, ekubeni lingasebenzi ngempela. Abaningi kulaba bantu abathandi ukucabanga ngokuthi kungenzeka babe sephutheni.

6. IHABAOwaka bodokotela abaningi bathi bangelapha izinhlobo zezifo ezahlukene ukusuka ku-HIV nesifo sikashukela, ukuya esifeni samathambo kanye nokungavuki kwenduku. Abanye baze bathi bangakusiza ngezinkinga zakho zomthetho noma zomshado. Uma kuzwakala kuyihaba, mhlawumbe kuyilo. Owaka bodokotela ngezinye izikhathi bazizwa bekhathazekile, bese besebenzisa lokhu ngendlela engalungile ukuze bazizuzele ngokwezimali.

Immediate results!!!

Owaka bodokotela kaningi bathi bacindezelwa imithi ejwayelekile noma abanentshisekelo enamandla abafuna ukukhipha imikhiqizo yabo emakethe. Lokhu akunangqondo. Uma ngabe ikhambi lowaka bodokotela belisebenza ngempela, izinkampani bezizobe ziklelile zifuna ukusiza ukulithengisa zenze imali.

QUACK!QUACK!

QUACK!

Ukuphakamisa ukuthi i-HIV ingelapheka

Dr

Mat

thia

s R

ath

UMapungubwe uyinyanga yendabuko eyelaphela eceleni komfula omncane eTzaneen. Uthi angayelapha i-HIV ngoba ukuya ngaye, i-HIV neNgculazi akukho. Uthi i-AIDS uMakhuma, egcizelela ukuthi i-AIDS uMakhuma ngesiNtu. Uba ne-HIV kanye neNgculazi ngoba bewungalandeli indlela yokhokho yokwenza izinto. Lesi isijeziso esivela kokhokho ukuze ubuyele endleleni yabo. (Ngokuvamile, uMakhuma usho ukuthi awuhlanjululwanga emva kokuthi kube khona umuntu oshonile emndenini,)

Uma umuntu eza [ezongibona] okokuqala, ngithatha isinemfu ngikhulume nokhokho. Ngiyakwazi nokukhuluma nenyoka yami, etholakala ngaphakathi kwala manzi. UMapungubwe wathi okhokho bakhe bayamtshela ukuthi isiguli kufanele asinike luhlobo luni lomuthi wokwelapha. Ukuya ngaye, umuntu uzoqala ukukhombisa izinguquko ezinsukwini ezintathu zokwelashwa. Uma umuntu esegule izinyanga ezintathu noma ngaphezulu kungamthatha inyanga ukuthi asinde.

Iziguli zithola ikhambi lowaka bodokotela ngamabhodlela awu-1 litha. Batshelwa ukuthi baphuze inkomishi eyodwa ekuseni, uhhafu wenkomishi ntambama kanye nenkomishi egcwele ebusuku. La makhambi abandakanya izambane i-African potato, izimpande zenhlaba kanye nengxube yamaqabunga, enye ingxube enamandla kanye nomlotha. UMapungubwe uthi umuthi uzohlanza igazi lomuntu bese bebuyela esimeni sabo esejwayelekile.

Ezinye izinyanga zendabuko ziyakuphika ukuba khona kwe-HIV. Lezi zinyanga ezingowaka azinaki bese zibeka izimpilo engozini engenasidingo. U-Adam Malapa wavakashela enye edolobheni laseTzaneen.

Siyazi ukuthi i-AIDS ikhona nokuthi ibangwa i-HIV. Lokhu sekuqinisekiswe izifundo zaselabhorethri ezingenakubalwa futhi kuyiqiniso e-Afrika njengoba kuyiqiniso eYurophu noma e-Eshiya.

Nakuba izinyanga zesintu zinganikezela ngokwesekwa ngokwenhlalo emphakathini nangokwengqondo, angeke bakwazi ukuqeda noma ukwelapha i-HIV futhi akunangqondo ukuthi nanoma yimuphi kubo athi angakwazi. Umuthi wokwelapha osebenza ngempumelelo izidambisigciwane kuphela (ama-ARV), ngisho nama-ARV awakwazi ukuqeda i-HIV.

Ungasoli

UMapungubwe, inyanga yesintu esebenza eTzaneen, uthi angayiqeda i-HIV ngoba ukholelwa ukuthi i-HIV neNgculazi akukho. Kunalokho uhkolelwa ukuthi lezi zifo zingoMakhuma, noma zenzeka ngoba umuntu ubengalandeli indlela yokhokho. Nakuba izinyanga zesintu ziyingxenye ebalulekile yomphakathi waseNingizimu Afrika, izitatimende ezinjalo zingamanga kanti imithi yokwelapha uMapungubwe kanye nabanye abayithengisayo angeke isebenze njengomuthi wokwelapha i-HIV. Isithombe ngu-Adam Malapa.

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ISENZO SEZOKWELAPHA ESINGALANDELI

OKUTHOLAKALE NGOKWESAYENSI

Ngu-Poppie Riddle

imithi Kungani

kufanele ihlolweyesintu

Akunandaba ukuthi ingabe imithi eyaseNtshonalanga yini noma eyase-Afrika. Okunendaba ukuthi ingabe ihloliwe yini noma ayihloliwe.

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Isithombe ngu-Samantha Reinders.

IMITHI YENDABUKO

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Indaba eyimpumeleloUmuthi kamalaleveva i-artimisinin uyisibonelo esihle kakhulu somuthi wokwelapha osebenza ngempumelelo owaqala njengekhambi lendabuko. Namhlanje usetshenziswa ukwelapha umalaleveva i-Plasmodium falciparum, uhlobo olujwayeleke kakhulu lukamalaleveva emhlabeni. I-Artemisinin into esebenzayo engatholakala ezinhlotsheni ezithize zesimila i-Artemisia annua (umhlonyane wonyaka). Iminyaka engaphezu kwezinkulungwane, isimila se-Artemisia besisetshenziswa izinyanga zesintu zaseShayina ukwelapha izifo eziningi, kubandakanya nomalaleveva.

Eminyakeni yo-1960, ososayensi baseShayina bahlola cishe imithi yendabuko yamaShayina engama-200, yonke eyayisetshenziswa odokotela bamakhambi bendabuko ukwelapha umalaleveva. I-Artemisia yiyona kuphela eyatholakala ukuthi isebenza ngempumelelo. Kwakhonjiswa ukuthi iqeda imbungulu kamalaleveva emzimbeni ngokushesha kunanoma yimuphi umuthi owake wenziwa.

Kodwa-ke, ososayensi bathola ukuthi umzimba womuntu awukwazi uukumunc i-artemisinin kalula kakhulu, okunciphisa ukusebenza kwayo ngempumelelo. Ngakho-ke odokotela benza ezinye izinhlolo. Benza ezinye izinhlobo ze-artemisinin okwakulula ukuthi umzimba uzimunce. Inkinga kodwa ngalezi zinhlobo kwakuwukuthi emva kwehora noma amabili usemzimbeni ukusebenza kwawo ngempumelelo kwakuvele kwehle ngokushesha. Ngakho-ke ososayensi benza ezinye izinhlolo bathola ukuthi le nkinga kungahlanganwa nayo ngokunikeza i-artemisinini kanye kanye nomunye, umuthi olwa nomalaleveva ohlala isikhathi eside.

Lesi sibonelo sikhombisa ukuthi umuthi wendabuko ungaba usizo kakhulu ekulweni nesifo. Kodwa-ke, umlando we-artemisinin wona ukhombisa ukubaluleka kokuhlola imithi kubandakanya imithi yendabuko.

Emakhanjini endabuko kamalaleveva angama-200 ahlolwa ososayensi bamaShayina, laba lilodwa kuphela elasebenza ngempumelelo ekwelapheni isifo. Okunye, leli khambi

Imithi eminingi yesintu ihloliwe ngokwesayensi. Eminye kukhonjiswe ukuthi iyasiza ukuqeda izifo noma ukwelapha izimpawu. Eminye kutholakale ukuthi iyingozi kubantu. Eminye imithi yesintu kukhonjiswe ukuthi ayisiyo ingozi kubantu, kodwa ayisebenzi ekwelapheni izifo. Yingakho kudingeka ukuthi imithi yesintu ihlolwe, njengayo yonke eminye imithi. Ukuhlola kusivumela ukuthi siqinisekise ukuthi imithi esiyiphuzayo uma sigula izosisiza.

kwakufanele ukuthi liguqulwe bese lisetshenziswa namanye amakhambi uklenza ukuthi lube wusizo ngempela njengomuthi wokuqeda umalaleveva. Ososayensi kanye nodokotela babengeke bakwazi lokhu nge-artimisinin ngaphandle kokuhlolwa komuthi ngokwesayensi okufanele. Ngaphandle kwalokhu kuhlolwa, umhlaba wawungabe uncishwe elinye lamakhambi alwa nomalaleveva elihle kakhulu esinalo namhlanje.

Copyright 2006 mailer_diablo from Wikimedia Commons.

Isitolo Semithi Yendabuko YaseShayina

IMITHI YENDABUKO

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Phakathi koshevu nomuthi wokuphilisaUkuhlolwa kwemithi nakho kubalulekile ukunquma imithamo elungile. Kunanoma yimuphi omunye umuthi, uma umthamo umkhulu kakhulu, ungakulimaza noma ungakubulala; uma uphansi kakhulu, umuthi kungenzeka ungasebenzi.

Isithako i-digoxin, yesimila i-foxglove, iyisibonelo esihle salokhu. Eminyakeni engamakhulukhulu eyadlula, odokotela bendabuko basebenzisa i-foxglove ukwelapha isifo senhliziyo. Kwaze kwaba seminyakeni eminingi eyalandela lapho ososayensi bathola khona ukuthi isithako esiwusizo kulesi simila kwakuyi-digoxin. Kodwa-ke, bathola ukuthi yize i-digoxin yelapha izimo zenhliziyo ngemithamo emincane, ingababulala abantu uma umthamo uphezulu kakhulu.

Uma usebenzisa isimila kunzima ukuthola umthamo ofanele (kulesi simo ngenxa yokuthi ezinye izingxenye zesimila zine-digoxin eningi kunezinye). Ngakho-ke, ososayensi benza ukuhlola okwabenza bakwazi ukucwenga i-digoxin ku-foxglove. Bakwazi ukubala kahle ngqo inani elifanele elidingekayo lokwelapha abantu ngale kokubabulala.

Namhlanje, odokotela sebenika iziguli i-digoxin ngesimo sephilisi, ukuqinisekisa ukuthi umthamo ulungile. Ukuba ososayensi abazange bahlole i-foxglove, odokotela bebesalokhu bengezuba nesiqiniseko ngokuthi bazelapha kanjani ezimo ezithize zenhliziyo ngokuphepha.

Uma sigula sifuna ukuba ngcono. Sifuna umuthi esinesiqiniseko sokuthi uzosebenza. Yingakho nje ukuhlola imithi, okubandakanya imithi yendabuko, kubaluleke kangaka. Inkinga ngeminye imithi yendabuko ukuthi ayikaze ihlolwe ngokwesayensi, ngakho-ke asinaso isiqiniseko sokuthi ingabe iyasebenza yini noma cha. Kungani kufanele uphuze into ongayazi ukuthi izosebenza uma ukhona omunye umuthi owaziyo ukuthi uzokwenza ngcono?

Yize sazi, sibonga ukuhlola kwesayensi, ukuthi i-artemisinin umuthi wokwelapha ophephile nosebenza ngempumelelo, angeke sikwazi ukusho okufanayo ngamakhambi amaningi angahloliwe athengiselwa imiphakathi yethu.

Imithi engahloliwe iyingozi

Umuthi wokuqeda Ingculazi ongamanga uBhejane, ikhambi lemvelo elenziwa uZeblon Gwala, liyisibonelo esihle salelo khambi elingahloliwe. UGwala uthi uBhejane uqeda i-HIV/AIDS. Weluleka iziguli zakhe ukuthi ziyeke ukuphuza izidambisi gciwane (ama-ARV), imithi ehlolwe ngokwesayensi nekhombisa ukuthi iyayelapha i-HIV zisebenzise imithi yakhe, akawuthengisa cishe ngama-R340 ibhodlela. Akukwazeki ukuhlola uBhejane ngendlela efanele ngoba uGwala uyala ukusho ukuthi unazithako zini. Ososayensi abakuthola nje ukuthi ingxube yayingenabuthi kumaseli ayekhuliswe kumashubhu okuhlola. I-Treatment Action Campaign (TAC) yenza isikhalazo esiyimpumelelo sokuphikisana noGwala ku-Advertising Standards Authority yaseNingizimu Afrika, ngokukhangisa ngemuthi mbumbulu wokuqeda Ingculazi.

Ukuze uBhejane waziwe njengomuthi wokwelapha i-HIV/AIDS, kudingeka ukuthi uqhathaniswe nemithi esikhona (ama-ARV) ezigulini eziningi ezingamakhulukhulu. Akukaze kwenziwe lokhu. Ngakho-ke asinasizathu sokukholwa ukuthi uBhejane ungaba ngenye into ngaphandle kokuba ikhambi lowaka bodokotela. Ukuthi uGwala eluleke abantu ukuthi bayeke ukuphuza ama-ARV kwakuyinto ewubulima kakhulu futhi engaholela ekufeni okungenasidingo. Uma efuna ukusindisa abantu ngempela, uGwala kufanele akhuthaze ukuhlolwa kukaBhejane futhi akhululeke ngezithako zawo.

Abanye abantu bathi odokotela bezokwelapha basebenzisa imithi yaseNtshonalanga, kanti odokotela bendabuko basebenzisa amakhambi esiNtu, abathi athembeke kakhulu. Kodwa-ke, izibonelo ezingenhla zikhombisa ukuthi imithi

Njengoba izitshalo namahlamvu bekusetshenziswa njengamakhambi esintu eminyakeni edlule, kubalulekile ukuthi zonke izitshalo kanye namanye amakhambi kanye nemithi acwaningwe ngokwezesayence ukuze kutholakale ukuthi awanabo ubungozi futhi ayasebenza yini. Isithombe ngu-Tony Wills.

IMITHI YENDABUKO

yokwelapha akusiyo eyaseNtshonalanga noma eyendabuko (i-Artemisinin yatholwa amaShayina, i-foxglove/i-digoxin yayisetshenziswa izinyanga zamakhambi endabuko.)

Imithi eminingi okuthiwa ngeyaseNtshonalanga isebenzisa imikhiqizo yemvelo ebeyisetshenziswa esikhathini esedlule izinyanga. Amanye ama-protease inhibitors angaphambilini (asetshenziswa ezinhlanganiseleni zemithi yama-ARV) atholakala kuphrotheyini ye-soy etholakala kubhontshisi isoya. Kodwa-ke, imikhiqizo yemvelo isetshenziswa kuphela emithini eyenziwe ngokwesayensi uma iqale yahlolwa. Uma unikezwe umuthi udokotela wezokwelapha, uzokunikeza wona ngokusemthethweni ngoba ukuhlola kwesayensi, eyenziwa kumakhulukhulu abantu, kuzobe kukhombisile ukuthi lena indlela enhle kunazo zonke yokwelapha isifo

sakho.

Ibukezwe ngu-Dkt Justine Davies, i-Sense About Science kanye nenyuvesi yaseDundee.

Eminye imithi yokwelapha ehlukile edumile ikhangisa ukuthi inamandla okusindisa ngoba isuselwa noma ibandakanya izimila ezithakweni zayo. Ngezinye izikhathi izimila zikhangiswa ngokwazo njengezinezinto zokuphilisa. Yize ukusetshenziswa komlando kuphakamisa ukuthi ezinye izimila zinayo imiphumela yokuphilisa, kubalulekile ukuthi nanoma yimiphi leyo mithi yokwelapha ihlolwe ngokwesayensi njengamanye amakhambi ahlukile, izindlela zokuphilisa zendabuko, noma nanoma yimiphi imithi impela kufanele ihlolwe. Ngaphandle kokuhlola, angeke sikwazi ukuqinisekisa ukuthi imithi yokwelapha eyizimila isebenzisa ngempumelelo futhi iphephile ukuthi ingadliwa ngabantu. Isithombe umusa we-www.mediaclubsouthafrica.com.

Isithombe ngu-Michael Wolf.

I-SutherlandiaAmagama ajwayelekile: Insizwa, Unwele, Mukakana, Phetola, Lerumo-lamadi, cancer bush, kankerbos, kankerbossie.

I-Sutherlandia beyisetshenziswa izinyanga zendabuko ukwelapha izifo eziningi kubandakanya isifo somdlavuza, isifo sesifuba, isifo sikashukela, imfuluwenza, i-arthritis kanye ne-HIV. Asikho-ke kodwa isizathu sokucabanga ukuthi i-Sutherlandia ingaqeda nanoma yisiphi kulezi zifo nokuthi ingakwazi kuwuudedengu obukhulu kakhulu.

Okwamanje, ososayensi bahlola i-sutherlandia, ukubona ukuthi ingabe iwusizo yini ekwelapheni izifo ezithize. Bazama ukuqonda ukuthi i-sutherlandia inani ukuze babone ukuthi yiziphi izingxenye zayo ezingawusizo. Ososayensi futhi bahlola i-sutherlandia ezilwaneni ukuthi ingabe iyingozi yini kuzo noma cha futhi ingabe inazo yini izinto eziwusizo.

Ukuhlola kwangaphambili kukhombisile ukuthi i-sutherlandia inayo eminye imiphumela ewusizo. Kodwa-ke, kunobufakazi futhi obuphakamisa ukuthi izingxenye eziyingxube ezisesimileni ziphazamisa ukwelashwa ngama-ARV, ikakhulukazi ukuthi asetshenzwa kanjani umzimba.

Kudingeka okunye ukuhlola okuningi ukubona ukuthi i-sutherlandia iyasebenza yini. Njenge-artemisinin, kufanele ihlolwe ukuze kubonakale ukuthi ayisiyo ingozi yini, uma isebenza ngempumelelo ekwelapheni nanoma yiziphi izimo, futhi umthamo omuhle kuzoba yimuphi.

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IMITHI YENDABUKO

Izinyanga zendabuko zineqhaza elibalulekile okufanele zilibambe ekulweni ne-HIV. Nakhona lapho, angeke zikwazi ukuqeda i-HIV kanti ayikho imithi yazo ecishe isondele ekusebenzeni ngempumelelo njengezidambisi gciwane ekulawuleni isifo.

lezinyanga zendabukoIqhaza

12Isithombe umusa we- Gallo Images/AFP.

Ngu Marcus Low

IMITHI YENDABUKO

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INingizimu Afrika cishe inezinyanga zendabuko eziyi-190,000 futhi kuhlanjekiselwa ukuthi abantu abaningi ngangama-70% basebenzisa izinsizakalo zazo. Nakuba lezi zinamba kungenzeka zingathembeki kakhulu, asazi ukuthi baningi kangakanani abantu abaya ezinyangeni zendabuko futhi zinesandla esibalulekile okufanele zisifake ekunakekelweni kwezempilo kuleli zwe. Okunye ukuhlola kuphakamisa ukuthi inamba yabantu abavakashela izinyanga zendabuko seyehlile kancane eminyakeni yamaduze nje.

Abantu abaningi baya kubo bobabili udokotela wezokwelapha kanye nezinyanga zendabuko. Njengoba odokotela begxila kakhulu emzimbeni, izinyanga kaningi zigcizelela izinhlobo ezahlukene zezinto zomphakathi, amasiko kanye nenkolo. Isibonelo, isifo se-HIV ngezinye izikhathi singasolelwa emimoyeni emibi noma kokhokho abangajabule. Siyazi-ke kodwa ukuthi izidambisi gciwane (ama-ARV) ziyindlela kuphela yokulawula i-HIV ngempumelelo. Nanoma iyiphi inyanga yendabuko ephikisana nalokhu noma etshela abantu ukuthi bangasebenzisi ama-ARV iwuwaka wenyanga. Kunethemba lokuthi Umthetho Wezinyanga Zendabuko ungasiza ukuqeda laba zenzisi.

Izinyanga zendabuko njengengxenye yesixazululoEzinye izifundo ziphakamise ukuthi izinyanga zendabuko zingabamba iqhaza elibalulekile ekusizeni iziguli ze-TB ukuthi ziphuze imithi yazo njengoba kufanele. Emzameni ophathelene nakho, ezinye izinyanga zendabuko ziyaqeqeshwa ukuthi zibone izimpawu ze-HIV kanye nesifo se-TB ukuze zazi ukuthi zizedlulisela nini iziguli kodokotela bezokwelapha.

Kubalulekile ukuthi izinyanga zendabuko zidlulisele emtholampilo nanoma yiziphi iziguli ezingeke zikwazi ukuzelapha ngempumelelo. Izifo ezimbi kakhulu njenge-HIV noma isifo somdlavuza womlomo wesibeletho kufanele zelashwe udokotela ngokushesha okunokwenzeka. Kwezinye izimo ukusheshe welashwe kungenza umehluko phakathi kokufa nokuphila. Izinyanga zendabuko zingasindisa izimpilo eziningi ngokudlulisela abantu emtholampilo uma zibona izimpawu zezifo eziyingozi.

Inyanga yendabuko isanganikezela ngokweseka okufanele komphakathi nokwamasiko kulabo

abakudingayo. Ngenxa yezinsizakalo zangokwengqondo ezingekho engxenyeni

yomphakathi, lokhu kungasiza ezinye iziguli ukuthi zikwazi ukubhekana

nesimo zihlale zinethemba.

Yini ukwenziwa komsebenzi wezempilo wendabuko?Umthetho Wabasebenzi Bezempilo Bendabuko uchaza ukwenziwa komsebenzi wezempilo wendabuko njengokwenziwa komsebenzi, umsebenzi, uhlelo noma insizakalo encike kufilosofi yendabuko ebandakanya [ukusetshenziswa] komuthi wendabuko noma ukwenziwa komsebenzi wendabuko nonenhloso yawo

(a) ukunakekela noma ukubuyisela esimeni impilo noma ukusebenza komzimba noma kwengqondo; noma

(b) ukuxilonga, ukwelapha noma ukuvimbela isifo somzimba noma sengqondo; noma

(c) ukubuyisela umuntu esimeni, ukubenza bakwazi ukuqala futhi ukusebenza ngokujwayelekile emndenini noma emphakathini; noma

(d) ukulungiselela umuntu ngokomzimba noma ngokwengqondo isikhathi sokuthomba, sobudala, sokukhulelwa, sokuzalwa kwengane kanye nesokufa.

Umthombo: Umthetho Wabasebenzi Bezempilo Bendabuko.

Umthetho Wezinyanga Zendabuko Inhloso yoMthetho Wezinyanga Zendabuko yilena: ukwenza umkhandlu Wezinyanga Zendabuko WaseNingizmu Afrika wesikhashana, (b) ukunikezela ngokubhalisa, ukuqeqesha kanye nemisebenzi yabasebenzi bezempilo bendabuko kanye (c) nokwenza kanye nokuvikela izimfuno zabantu abasebenzisa izinsizakalo zabasebenzi bezempilo bendabuko.

Kodwa-ke, imininingwane yokulawula kanye nokunikeza izitifiketi ayikakacaci, futhi izigaba eziningi zomthetho azikakaqiniswa. Uma umthetho usiqinisiwe, izinyanga zendabuko zizoba nonyaka owodwa wokubhalisa. Uma behluleka ukwenza kanjalo, angeke baphinde bavunyelwe ukuthi basebenze njengezinyanga zendabuko. Izinyanga ezingabhalisile zizoba necala uma zithi zingaqeda i-HIV, isifo somdlavuza, noma ezinye izifo ezibulalayo.

IMITHI YENDABUKO

Besikwenza lokhu selokhu kwathi nhlo. Lokhu esikubiza ngesiko ulwazi kanye nemikhuba eyakhiwa ezinkulungwaneni eziningi zeminyaka. Kodwa-ke, isayensi uhlobo oluyisipesheli lolwazi olusandokufika emlandweni wabantu. Ibandakanya ukusesha ulwazi ngendlela ethize usebenzisa ucwaningo olulawulwayo, olwenziwa ngokwendlela yesayensi.

Indlela yesayensi isho ukwakha ithiyori ngokuthi izinto zisebenza kanjani nokuhlola le miqondo usebenzisa izinhlolo zokuzama ezilawulwayo. (ithiyori incazelo esemthethweni yokuthi into kucatshangwa ukuthi isebenza kanjani.)

Ucwaningo lwezokwelapha lusebenzisa indlela yesayensi ukuze lwenze impilo yabantu ukuthi ibe ngcono. Lungathola ukuthi yini ebanga isifo nokuthi yimiphi imithi yokwelapha esebenzayo. Ngeshwa umkhakha wezokwelapha ungaphazanyiswa yizo zonke izinhlobo zemisebenzi eyenziwayo engesiyo eyesayensi kanye nokushiwoyo. Ukuqonda isayensi yemithi kungasisiza ukubona umehluko phakathi kwemithi yokwelapha eyesekwe ubufakazi besayensi kanye namakhambi amaningi ancike ethembeni kuphela.

Ngu-Eduard Grebe

Ucwaningo lokwelapha luyigatsha lwesayensi

yezokwelapha ebhekene nokwenziwa kanye nokuhlolwa

kokungenelela kwezokwelapha njengemithi kanye

nezindlela zokuhlinza. Ngokwejwayelekile, uma umuntu

ephakamisa ukungenelela okusha, kufanele kuqinisekiswe

izinto ezimbili ngaphambi kokuba kungasetshenziswa.

Okokuqala, ukuthi abantu bangawuphuza ngokuphepha

(kubandakanya izimo lapho okungafanele uphuzwe khona

kanye nanoma yimiphi imiphumela emibi enokuba khona)

okwesibili, ukuthi uyasebenza ngempela. Kunemithetho

esizinzile yokucwaninga ukuphepha kanye nokusebenza

ngempumelelo kwemithi, izindlela zokuxilonga isifo

kanye nokungenelela okunye okusha. Uhlobo locwaningo

olubaluleke kakhulu lubizwa ngokuthi uhlolo lokwelapha.

Izinhlolo zokwelapha akusikho nje ukwenza okuhle

kocwaningo, zibalulekile endleleni amazwe amaningi

alawula ngayo imithi. Ngaphambi kokuba umuthi omusha

kwenziwa ukuthi utholakale, kufanele iziphathimandla

Ukukwazi kwethu ukuthola ulwazi, siludlulisele

kwabanye abantu futhi silwenze ngcono kungenzeka

kube yikhono ngokucacile kakhulu elehlukanisa abantu

kwezinye izilwane.

14

Isithombe ngu-Samantha Reinders.

ISAYENSI

ezifanele zinikwe ubufakazi bokuphepha nokusebenza kwawo ngempumelelo. ENingizimu Afrika, yonke imithi, ukuhlola kokuxilonga, impahla yezokwelapha, njll. kufanele kubhaliswe ne- Medicines Control Council (MCC). I-MCC ihlola imiphumela yohlolo lokwelapha kanye nolunye ulwazi oluqoqiwe lwesayensi ngaphambi kokuvuma ukusetshenziswa komuthi omusha.

Kubalulekile ukuqonda ukuthi akuzona zonke izifundo zokwelapha ezinikezana ubufakazi beqophelo elifanayo. Ukuthi kufanele sibeke ukubaluleka okungakanani emiphumeleni yocwaningo kuncike ezintweni eziningana. Okunye kwalezi zinto uhlobo locwaningo olwenziwayo. Isibonelo, uhlolo lokwelapha oluhlelwe kahle oluhlola ukungenelela ngokomzamo wokuhlola lunikeza ubufakazi obuqinaqinile kunocwaningo lokubheka. Ucwaningo lokubheka yilolo oluzama ukuthola umphumela womuthi wokwelapha ngokubheka ulwazi olutholakele ngokusebenzisa ukugcina amarekhodi okuyinjwayelo. Iqophelo lobufakazi nalo liyathinteka ngokuthi ingabe ucwaningo lulandela imithetho yohlelo locwaningo oluhle yini kanye nokusebenza. ezinye izinto zibandakanya inamba yabantu ababamba iqhaza ocwaningweni, kanye

nomphumela, noma isiphetho elisikalayo.

Ukwenziwa kwemithi emisha kudinga inani elikhulu locwaningo. Uma ngabe isithako esethembisayo sesitholakele, sicwaningwa elabhorethri futhi sifakwe ocwaningweni lwangaphambi kokwelapha. Lokhu kubandakanya izifundo ezenziwa ezilwaneni zokuthi ingabe umuthi kungenzeka yini usebenze kubantu, nokuthi unobuthi kangakanani. Ngaphambi kokuba kuqale izifundo kubantu, kufanele kutholakale imvume kuziphathimandla ezilawulayo, ezibukeza ulwazi oluqoqiwe ezifundweni zangaphambi kokwelapha. Kulesi sigaba umuthi waziwa ngokuthi umuthi omusha ophenywayo (investigational new drug (IND)). Izinhlolo zokwelapha nazo kufanele zigunyazwe ikomiti lezimilo noma ibhodi lezimilo. La maqembu abukeza uhlelo locwaningo olusemthethweni ukuqinisekisa ukuthi akugangwa ngamavolontiya noma abekwe engozini engadingekile.

Ucwaningo lokwelapha emithini emisha luvamise ukwenziwa ngezigaba ezine:

Isigaba I: Izifundo zokuphepha zenziwa kusetshenziswa inamba encane yamavolontiya aphephile. Abahlanganyeli kuvame ukuthi baqashwe ngaso sonke isikhathi. Ukwengeza ekuqinisekiseni ukuthi umuthi awunayo imiphumela eyingozi, kucwaningwa nezinye izimo ezibonakalayo zemithi yokwelashwa. Lokhu kungabandakanya ukuthi umzimba

umunca okungakanani, kuwuthatha isikhathi esingakanani ukusebenza nokukhipha imithi, njll. (pharmacokinetics).

Isigaba II: Uma umuthi omusha ophenywayo kubukeka sengathi uphephile ezinhlolweni zeSigaba I, abacwaningi bahlola ukuthi usebenza kahle kangakanani eqenjini elikhulu lamavolontiya (kuvama ukuba ama-200-300). Lezi zinhlolo ziyasiza futhi ukunquma imithamo emikhulu nokuqinisekisa ukuphepha komuthi.

Isigaba III: Lolu cwaningo luvamise ukuthatha isimo sezinhlolo ezilawulwayo ezingahleliwe (bheka ikhasi 17). Lwenziwa ezindaweni eziningi namaqembu amakhulu kakhulu eziguli (kuvamise ukuba ama-200 ukuya ezi-3000 noma ngaphezulu). Izinhlolo zeSigaba III zihlelelwe ukuhlola ngokungangabazeki ukuthi umuthi usebenza ngempumelelo kangakanani uqhathaniswa nomuthi ongcono kakhulu osetshenziswayo njengamanje. Imvume yokulawula ivamise ukudinga uhlolo lweSigaba III oluyimpumelelo olungaphezu kolulodwa.

Isigaba IV: Lezi zinhlolo zaziwa futhi ngokuthi ukugada kwangemuva kokumaketha - (post-marketing surveillance). Zenzelwe ukuqapha imithi emisha emva kokuba itholakala jikelele. Izinhlolo zibheka imiphumela elimazayo engajwayelekile kanye nokunye okukhathazayo kokuphepha. Ngezinye izikhathi lezi zinhlolo ziholela ekutheni imithi ibe nomkhawulo ezinambeni zeziguli ezincane. Ngokungajwayelekile, zingaholela ekutheni umuthi uhoxiswe emakethe.

Izinhlolo zokwelapha kuphikiswana ngokuthi ziwuhlobo olubaluleke kakhulu locwaningo lokwelapha, ngenxa yokuthi zisetshenziswa ukunquma ukuthi ingabe imithi iphephile futhi isebenza ngempumelelo yini. Ngakho-ke kubaluleke kakhulu ukuthi izinhlolo zokwelapha zihlelwe kahle ukuze sikwazi ukuyethemba imiphumela. Uhlolo

15

Isithombe ngu-Samantha Reinders.

ISAYENSI

1616

kufanele lube nohlelo lwenqubo olunemininingwane

ephelele umbhalo ochaza ngqo ukuthi iziguli zizokhethwa

futhi zelashwe kanjani, amarekhodi azogcinwa kanjani,

njll. Lokhu kubalulekile ikakhulu ohlolweni olwenziwa

ezindawweni eziningi. Kungenjalo, kunokwenzeka kakhulu

ukuthi imisebenzi yocwaningo ingehluka.

Ezimeni eziningi, uhlelo locwaningo oluhle kakhulu uhlolo

olulawulwayo olufihleke nxazombili olungahleliwe. Izinhlolo

eziningi kakhulu zesigaba II nezeSigaba III ezalolu hlobo.

Bheka ibhokisi ngencazelo enemininingwane yonke yalolu

hlobo lohlolo lokwelapha.

Ngokucacile, ngenxa yokuthi izinhlolo zokwelapha

ezokulinga kubantu, zibuza imibuzo yezimilo enzima.

Isibonelo, ukuphuza i-placeebo ekubeni kunemithi

eyaziwayo ukuthi iyasebenza kubi empilweni yesiguli.

Kwezinye izimo lolu daba kubhekwana nalo ngokusebenzisa

ukulawula okusebenzayo esikhundleni sokulawula

nge-placebo. Lokhu kusho ukuthi umuthi wokuhlola

uqhathaniswa nokwelapha okusetshenziswa njengamanje,

kunomuthi wokwelapha mbumbulu. Uma ngabe kuhlolwa

izidambisi gciwane ezintsha (ama-ARV), aqhathaniswa

nama-ARV akhona njengamanje.

Kuneziqondiso zezimilo kanye nemithetho esemthethweni

yezinhlolo zokwelapha, efana nezidingo zokuthola imvume

oyinikeza unolwazi kuzo zonke iziguli. Futhi, ngezinye

izikhathi amabhodi ezimilo ayazimisa izinhlolo uma kucaca

(Ukuqoqela ndawonye imiphumela yezifundo eziningi, noma ukwenza izifundo zeSigaba IV

uma umuthi sewuvele sewusemakethe)

(Izinhlolo ezinkulu zokusebenza kahle kubantu)

(Izinhlolo zokuhlolela ukuphepha, umthamo kanye nokusebenza kahle)

(Izinhlolo zokuphepha kubantu)

(Abantu basola ukuthi isimila noma umkhiqizo kungenzeka

welaphe isimo esithize kodwa akunabufakazi bangempela okwamanje.)

Ulwazi oluthembeke kakhulu

Ulwazi olungathembekile kakhulu

ukuthi umuthi uyasebenza futhi akuzukwemukeleka

ukuqhubeka nokunikeza ezinye iziguli ama-placebo.

Ukuze kukhonjiswe ukuthi umuthi uwusizo, kufanele ukuthi kube nomehluko wokubaluleka kwezibalo emiphumeleni phakathi kwamaqembu alashwayo kanye namaqembu e-placebo ohlolweni. Kunezikali zemethamethiki ezenziwe kahle ukunquma ngokubaluleka kwezibalo. Esijwayeleke kakhulu kulezi i-p-value exhunywe emphumeleni othize. I-p-value ikala ukwenzeka kokuthi umehluko phakathi kwamaqembu amabili eziguli ungenzeka ngeshansi kuphela. I-p-value ephansi ikhombisa ukuthi abantu bangawethemba kakhudlwana umphumela. Inamba yabahlanganyelui ocwaningweni inomthelela omkhulu ekutheni singayithola ngokwethembeka kangakanani futhi sikale imiphumela yomuthi wokwelapha. Lokhu kwaziwa njengamandla ohlolo ezibalo. Kodwa-ke, izinhlolo ezinkulu nazo ziyabiza kakhulu.

Ukuhlola okulandela uhlelo noma ukuhlaziya okungaphezulu kwezinhlolo izifundo ezihlanganisa

Ngesikhathi umuthi noma ukungenelela kwezempilo kufi nyelela phezulu kuleli lele, singasho ngezinga eliphezulu lokuqinisekisa ukuthi ingabe usebenza ngempumelelo yini noma cha. Imithi eminingi iphuma esigabeni saselabhorethri, uma sekucaca ukuthi ayisebenzi noma esigabeni sokuphepha, uma sekutholakala izingozi.

Ukwelashwa ngezidambisi

gciwane kokulawula i-HIV

Ukusoka kwabesilisa

njengengxenye yokuvimbela

i-HIV

Izinhlolo zomjovo wokugomela

i-HIV zaseNingizimu Afrika

I-sutherlandia yokulawula

i-HIV

UBhejane wokulawula i-HIV

(Kunciphisa amathuba okutheleleka ngama- 60%)

ISAYENSI

imiphumela yezifundo eziningana. Zonke lezi zifundo zibhekela isethi yeziphakamiso zocwaningo ezihambelanayo. Ukubukeza okulandela uhlelo lwezinhlolo zokwelapha konke kukala imiphumela yokwelapha okufanayo kuvumela abacwaningi ukuthi bazuze amandla amakhulu ezibalo kunanoma yiziphi izinhlolo ngazinye. Lokhu kubanika umqondo ongcono wobukhulu beqiniso bemiphumela yomuthi ngaphandle kokwenza ucwaningo olusha nolukhulu.

Ukubukeza okulandela uhlelo kuhlinzeka ngemiphumela ethembeke kakhulu. Ayindlela enhle kakhulu yokwenza isimo sobufakazi embuzweni othize. Lokhu kubukeza ngezinye izikhathi kunemiphumela engalindelekile. Isibonelo, kungakhombisa ukuthi umuthi uyasebenza uma eziningi zezifundo ngazinye kusengathi zikhombisa ukuhlukana (noma okuphambana nokunye). Umthombo ohloniphekile wokubukeza okulandela uhlelo wokungenelela kokwelapha i-Cochrane Collaboration. Isikhiqize ukubukeza okulandela uhlelo okuhle kakhulu okube nomthelela kakhulu emisebenzini yemithi yokwelapha. Isibonelo, Ukubukeza kwe-Cochrane kuhlanganise okutholakele kwezinhlolo ezintathu ezinkulu zokusoka. Kwakhombisa ukuthi ukusoka kunciphisa ingozi yokutheleleka nge-HIV kwabesilisa abathandana nobulili obuhlukile. Lokhu kwaholela ezincomeni zokuthi ukusoka kufanele kunikezelwe njengengxenye yezinhlelo zokuvimbela i-HIV.

Isayensi seyisihlinzeke ngolwazi lokwenza ngcono kakhulu ubude kanye neqophelo lempilo yabo bonke abantu. Kwezinye izimo lokhu kuthatha isimo somuthi oyindida wobuchwepheshe obuphezulu, kodwa kube nezinqubekela phambili eziningi kwezempilo yomphakathi okuncike

Ukubaluleka kwezibalo kukhonjiswa ngama-p-value

Ama-P value

Noma nini uma ufunda ucwaningo noma uzwa ngokutholakele okusha, kubalulekile ukuthi ufune i-p-value. Uma i-p-value iqinaqinile, singaba nokwethemba okukhudlwana kokutholakele. Uma i-p-value ingu-0.05 noma ibuthaka, okutholakele akusikho ukubaluleka kwezibalo.

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17Hhayi esikalini

Izinhlolo ezingahleliwe ezingaziwa nxazombili ezilawulwayo zenzelwe ukuqeda nanoma yimiphi imithombo enokwenzeka yokwenzelela noma izinto ezingenza ukubukeka okungamanga ukuthi ukungenelela kusebenza ngempumelelo kungasebenzi (noma ngenye indlela). Izinto ezibalulekile zalezi zinhlolo yilezi:

Ukulawula: Abacwaningi kudingeka ukuthi behlukanise umphumela womuthi ohlolwayo kuzo zonke ezinye izinto. Ukuze ufeze lokhu, abantu ababamba iqhaza ohlolweni bahlukaniswe baba iqembu elelashwayo elithola umuthi ohlolwayo kanye neqembu elilawulayo (lawa aziwa njenge-zingalo). Uhlelo lokwamukela umuthi (ukuthi ingabe umuthi ngokwawo kukhona yini umphumela onawo noma wenza iziguli eziningi ukuthi zingazizwa zingcono. Lokhu

kwaziwa njengomphumela we-placebo). Esimeni esihle ngokuphelele, iqembu elilawulayo lithola i-placebo noma umuthi mbumbulu (njengephilisi eliwushukela noma umjovo wamanzi nosawoti). Izinhlolo ezinjalo zilawulwa nge-placebo. Kwezinye izimo, umuthi uqhathaniswa nokwelashwa okusezingeni okusetshenziswayo njengamanje, kunomuthi wokwelapha mbumbulu. Lokhu kwaziwa njengokulawula okusebenzayo. Ezinye izinhlolo, njengalezo zokuqhathanisa imithamo ehlukene noma izindlela zokusebenzisa imithi esikhona, kunezingalo zokwelapha eziningi.

Ukungazi: Uma isiguli sazi ukuthi ingabe sithola umuthi wokwelapha ngempela yini, umphumela wokwelapha angeke ukwazi ukuhlukaniswa kumphumela we-placebo. Ngakho-ke kufanele kungakwazeki ukusho

umuthi wangempela ku-placebo. Isiguli akufanele sazi ukuthi sithola muphi. Kuwumqondo omuhle futhi ukufi hla kubasebenzi bohlolo ukuthi ingabe iziguli zithola umuthi wangempela yini kungenjalo zingakuveza lokhu zingaqondile ezigulini. Lokhu kwaziwa njengokungazi nxazombili.

Ukungahleli: Isiguli ngasinye sivele sifakwe engalweni kungahlelwanga (okungukuthi eqenjini elelashwayo noma elilawulayo). Lokhu kuqinisekisa ukuthi onke amaqembu, ukube abenganikwanga lutho, abezocishe abe ngcono noma mabi ngokulinganayo. Uma ucwaningo luhleliwe, nanoma yimuphi umehluko emphumeleni phakathi kwamaqembu kungaba owesinye isizathu ngaphandle kokuthi bathola umuthi osebenzayo yini.

ekungeneleleni okulula, njengemijovo yomgomo kanye nokwelashwa kwamanzi okuphuza. Kodwa-ke, kubantu abaningi kakhulu izinzuzo zesayensi yezokwelapha zisazofika. Kungumsebenzi obhekene nathi ukuqinisekisa ukuthi bonke abantu bayazuza kweyodwa yezimpumelelo zabo ezinkulu kakhulu.

18

Kunemithi ewubuwaka bodokotela yonke indawo. Eminye ihloliwe kwatholakala ukuthi ayisebenzi. Eminye ayizange ihlolwe kanti isetshenziswa ukwelapha i-HIV, nakuba ingaba yingozi. Owaka bodokotela abaningi beza emiphakathini yethu kanti imithi yabo kungenzeka inikeze abantu abane-HIV ithemba elingamanga.

Abelapha ngokuveza izimpawu zesifo bakholwa ukuthi bangaselapha isifo ngokunikeza iziguli imithamo emincane kakhulu ezigulini yezithako abathi zizokhiqiza izimpawu ezifanayo njengesifo uqobo lwaso. Ngokuvamile lokhu bakwenza ngokuxuba isithako namanzi. Basixuba kangangokuthi akusenasithako esisele emanzini. Abelapha ngokuveza izimpawu zesifo bathengisa la manzi ngamanani aphezulu.

I-World Health Organisation isandokwexwayisa ngokuthi ukwelapha ngokuveza izimpawu zesifo eselashwayo angeke kuyiqede i-HIV, i-TB, umalaleveva, noma ifl u. Ukwelapha ngokuveza izimpawu zesifo eselashwayo akukaze kukhonjiswe ukuthi kungaqeda nanoma yiziphi izifo ezinamandla futhi izifundo zithole ukuthi inzuzo encane ezinye iziguli eziyitholayo mhlawumbe ingenxa yomphumela we-placebo (bheka ikhasi 5 ukuze ubone okunye ngomphumela we-placebo).

I-Advertising Standards Authority of Southern Africa isandokukhipha umthetho wokuthi ukukhangisa isichibiyelo samakhambi e-Revivo kufanele sihoxiswe eNingizimu Afrika. Ukukhangiswa kwe-Revivo kwenza izitatimende ezingahloliwe zokuthi izichibiyelo zisebenza ukulwa ne-HIV, zikhulisa isibalo se-CD4 futhi yehlise ubungako begciwane egazini. I-Revivo ayikaze yenze uhlolo lokwelapha ebantwini futhi akunasisekelo sesayensi kulezi zitatimende. Abantu abane-HIV bayelulekwa ukuthi bangamoshi imali yabo ku-Revivo.

Izengezelelo zokudla zeSiprulina angeke zikwazi ukuqeda i-HIV, futhi akunabufakazi bokuthi ingasiza ukulawula izibalo ze-CD4 noma ubungako begciwane egazini.

Ucwaningo oluningi oluke lwenziwa ku-spirulina lwenziwa emalabhorethri noma ezilwaneni. Sizokwazi kuphela ukuthi ingabe izichibiyelo ze-spirulina zinosizo yini kubantu abane-HIV uma sekwenziwe izinhlolo ezinkulu, ezilawulwa nge-placebo, ezingaziwa nxazombili kubantu. Kuze kube lapho, akunasizathu sokucabanga ukuthi kukhona okuhle okuzokwenzela khona, noma abantu abathengisa lezi zingezelelo bangathini.

I-acupuncture ibandakanya ukufaka izinalithi ezilolongekile ezingxenyeni ezithize ngqo emzimbeni wesiguli ukuze ziqede ubuhlungu noma zelaphe isimo esithize ngqo.

I-acupuncture ayikwazi ukuqeda i-HIV. Futhi akunabufakazi obuthembekile bokuthi i-acupuncture ingenza ngcono izimpawu noma inciphise imiphumela emibi yokwelashwa ngama-ARV. Ezinye izifundo kodwa ziye zaphakamisa ukuthi i-acupuncture ingasiza ngezimo ezithize, kodwa lokhu okutholakele kuyaphikisana. Lapho i-acupuncture eletha khona inzuzo, kakhulu kucatshangwa ukuthi kungenxa

yomphumela we-placebo.

Bheka ikhasi 10 ukuze uthole okuthe xaxa ngekhambi lobuwaka bodokotela uBhejane kanye nekhasi 11 ukuze uthole okuthe xaxa ngeSutherlandia.

Imithombo: Liu, J.P. no-E. Mannheimer, M. Yang Herbal medicines for treating HIV infection and AIDS Cochrane Database System Review 3 (2005); Mills, E. and P. Wu, E. Ernst Complementary therapies for the treatment of HIV: in search of the evidence International Journal of STD and AIDS 16.6 (2005); Shang, A. and K. Huwiler-Muntener, L. Nartey, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of hom0eopathy and allopathy Lancet 366 (2005).

ISAYENSI

Isikhathi sokuphika i-AIDS soMbeki noTshabalala-Msimang kungenzeka ukuthi siphelile, kodwa emakhoneni asemgwaqeni nakuzo zonke izimakethe ezweni lonke isathengiswa imithi engahloliwe. U-Lawrence Mbalati uyabika esifundazweni saseLimpopo.

bodokotela

Ukuhluleka ukulawula imithi engahloliwe ngempumelelo ethengiselwa abantu abane-HIV kuyingqinamba enkulu ekulweni kwethu nobhubhane. I-Treatment Action Campaign (TAC) iye yakuphonsela inselele lokungabi bikho kwesimiso somthetho. Seyike yaba nokunqoba okuningana okubalulekile, ukunqanda owaka bodokotela ababalulekile ekuqhubekeni nokwenza izitatimene ezingamanga ngamakhambi abo angahloliwe. Inselele kodwa isekude ukuphela. Sisabona abantu abaningi abathengisa ngokukhululeka izingxube emigwaqeni kungekho muntu obanqandayo.

Okunye, eLimpopo, izindawo zokuhlala abantu abagula kakhulu zelapha abantu abane-HIV zisebenzisa amakhambi angahloliwe. Nangale kokuthi sekufe abantu abaningi kulezi zimo, akukho muntu obhekana nokufa kwabo.

Abantu abaningi abahlala eSifundazweni saseLimpopo benza izinqumo ngezimpilo zabo ezincike ezinkolweni zamasiko, zezenkolo kanye nezendabuko kunobufakazi besayensi. Uma abantu begula, kaningi baphetha ngokuthi bathakathiwe, kunokuthi bahlolelwe i-HIV, i-TB noma ezinye izifo ezingelapheki. Lokhu kuphuza ukuthola imithi yokwelashwa kungaba nemiphumela enamanddla ezimpilweni futhi lokhu kungabulala ngisho ukubulala.

Nanka amanye amakhambi angahloliwe kanye nezinsizakalo ezitholakala eLimpopo:

Amanzi angcweleLawa ngamanzi acolekile abiza i-R100 ngamalitha amahlanu. Umthandazi ophilisayo uyawakhulekela amanzi: Uma uqeda ukuwaphuza, kufanele ukhokhele amanye, ngoba umthandazi ukutshela ukuthi uwaphuze impilo yakho yonke. Inyanga iseSeshego (ilokishi laseLimpopo elikhulu kunawo wonke), lapho ithengisa khona amanzi ayo eSeshego Plaza nasemigwaqeni.

Nakuba amanzi ahlanzekile ebalulekile, amanzi akukhathalekile acoleke kangakanani angeke akwazi ukuqeda i-HIV, ukwehlisa ubungako begciwane egazini noma ukukhulisa isibalo se-CD4. Le nyanga yenkolo kuyacaca ukuthi iwuwaka osebenzisa

ukugula kwabantu ngendlela embi futhi bagcwalisa amaphakethe abo.

Izingxube ezingenamagamaLolu ketshezi luthengiswa ngamabhodlela amnyama esiphuzo esibandayo. Abakhiqizi abazivezi izithako ezisetshenziswe ukwenza lezi zingxube. Ngakho-ke, uketshezi lungaba nezithako ezinobuthi obuyingozi ezimpilweni zethu. La makhambi akhona ezindaweni eziningi kanti athengiswa emakhoneni emigwaqo ngama-R80 ilitha. Asikho isizathu sokucabanga ukuthi lezi zingxube zingasisiza. Abantu abane-HIV kufanele bakugweme ukubeka impilo yabo engozini futhi bamosha nemali yabo emakhanjni owaka bodokotela.

Izindawo zokunakekela abantu abanezifo ezibulalayoSiye sezwa ngezindawo okuthiwa ngezokunakekela abantu abagula kakhulu lapho izidambisi gciwane (ma-ARV) zingakhuthazwa khona. Eyodwa isesigodini saseSekhukhune kanti enye iseMhakweng. La mahosiphisi imizi yezinyanga zendabuko, ehlalisa abantu abagula kakhulu

abaphethwe yi-HIV.

Amasonto angafuni ama-ARVNjengakwezinye izifundazwe, amanye amasonto eLimpopo hhayi onke ngokuqinisekile athi angayiqeda i-HIV ngaphandle kwananoma yibuphi ubufakazi. Ezindaweni ezinjengakoModjadje, amasonto athize awabakhuthazi abantu ngisho ukukhuluma ngamakhondomu, ukwelulekwa ngokuzithandela ngokwengqondo nokuhlola, noma ukwelashwa. Bavela njengabakholwa ukuthi okugulisa abantu akusiyo i-HIV, kodwa uMakhuma (azangwe bahlanjululwe emva kokuba omunye emndenini wabo eshonile.)

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U-Charles Maponya we-TAC ukhombisa ukuthi kulula kangakanani ukuthenga imithi ehlukile nokuthi kubiza malini ukuthenga imithi yokwelapha ethembisa izithembiso ezinkulu engazange ihlolwe ngokwesayensi ukuthi ingakwenza. Lapha u-Charles uhambisa abafundi beMithi Elinganayo entambameni yokuthenga imithi yowaka bodokotela eNingizimu Afrika. Izithombe nguMoses Makhomisani.

U-Charles ukhombisa u-R100 oyiphepha odingeka ekuthengeni amanzi angcwele, i-Phuma Health Drink.

U-Charles uthola amanzi kanye nemiyalelo yomuthi kumthengisi. U-Charles utshelwa ukuthi kusukela manje kufanele aphuze la manzi kuphela futhi uzowaphuza impilo yakhe yonke.

Amanzi abizwa ngokuthi amanzi aphilisayo angakaze asetshenziswe, abandakanya uhlu lwezinto aziphilisayo.

Owaka

Inkulumo mpikiswano enkulu yomhlaba jikelele ngemithi igxile kokungenziwa

ukuqinisekisa ukuthi amanani entengo awavimbeli abantu ukuyithola. Kuncane

kakhulu kodwa okushiwo ngokuthi imithi ilawulwa kanjani.

Ngu-Jonathan Berger

ekusetshenzisweni koMthetho. Ukwengeza, isigaba 35 sinikeza uNgqongqoshe amandla okwenza umthetho ngokubonisana ne-MCC. Ngamanye amazwi, banegunya lamandla elihlanganyelayo lokwenza izimiso zomthetho.

I-MCC ayinamandla omthetho aqondile phezu kwethimba lonobhala, kubandakanya i-LEU yalo. Ayinamandla okuqasha nokuxosha abantu abasebenzela ithimba lonobhala. Ayikwazi ukwenza ukuthi u-Registrar Wemithi achaze inhloko yethimba lonobhala kanye nokuxhumana phakathi kwalo noMnyango Wezempilo . Lokhu kungenxa yokuthi u-Regitrar kanye nesekela noma amasekela akhe ukhethwa uNgqongqoshe emva kokubonisana ne-MCC. Okwenzekayo, u-Registrar ngokomlando ubengomunye wabasebenzela Umnyango Wezempilo.

Le nkinga iyoxazululeka uma ngabe sekwenziwe i-South African Health Products Regulatory Authority (SAHPRA). Lona ngumgwamanda omusha oyongena esikhundleni se-MCC. Akucaci ukuthi kuyokwenzeka nini lokhu, ngenxa yezizathu ezimbili. Okokuqala, kunezinkinga ezenzekayo nezomthethosisekelo ngesichibiyelo sika-2008, esenza i-SAHPRA. Okwesibili, imithetho emisha kanye nezinhlelo kufanele zifakwe ukuqinisekisa ukuthi i-SAHPRA ingakwazi ukwenza igunya layo lomthetho.

Ingxenye yokuguqukela emandleni amasha ibandakanya ukulungisa izinselele zamanje ze-MCC. Ukugxeka okunobulungiswa okuvela ezinkampanini zemithi kanye nezishoshovu ngokufanayo, ukuthi i-MCC yenza kancane kakhulu ekubhaliseni imithi emisha. Lokhu kubandakanya izinhlobo ezisezingeni ezishibhashibhile zemikhiqizo evele isikhona. I-MCC igxekelwa futhi ibanga layo elenza kancane lokugunyaza kwayo uhlolo lokwelapha. Ngaphandle kwale mvume, imithi angeke ikwazi ukuthengiswa noma ukusetshenziswa eNingizimu Afrika.

Isithombe esiphelele sezinselele ze-MCC senziwa yi-Medical Products Technical Task Team (MPTTT). I- MPTTT umgwamanda wongcweti owenziwe ekuqaleni kwalo nyaka nguNgqongqoshe Wezempilo wangaphambili, u-Barbara Hogan. Iqhaza layo kwakuwukweluleka ngenqubomgomo

ENingizimu Afrika, ukuphika kukaTh abo Mbeki, Manto Tshabalala-Msimang kanye noTh ami Mseleku kwaphoqa izishoshovu ze-AIDS nokunakekelwa kwezempilo ukuthi babhekane nokulawula imithi. Ukuphika kanye nobuwaka bodokotela obesekwa yilaba abathathu kwaveza ukuthi yize kudingeka ukulawula amanani entengo emithi, ukwenza njalo akuqinisekisi ukufi nyelela kuleyo mithi.

Umthetho i-Medicines and Related Substances Act 101 ka-1965, owachitshiyelwa ngo-2008, ungumthetho obalulekile olawula ukuthi imithi yenziwa kanjani, ibhaliswa kanjani nokuthi isebenza kanjani eNingizimu Afrika. Kanye kanye neminye imithetho, ikakhulukazi Izimiso Zomthetho Jikelele zika-2003, umthetho i-Medicines Act ulawula imithi kusukela ekuqaleni kuze kube sekugcineni. Lokhu ikwenza ngokwenza ukuthi imithetho ye-Medicines Control Council (MCC) isebenze.

I-MCC yaba khona ngenxa yoMthetho Wemithi. Isakhiwo sawo kakhulu sinqunywa yiZimiso Zomthetho Jikelele. Lapho uNgqongqoshe Wezempilo ekhetha amalungu ayo, i-MCC ngokwayo inamandla okuqasha abantu abaqeqeshelwe amakomiti ayo. I-MCC yenza izinqumo ezibophayo, kodwa umsebenzi omningi wenziwa amalungu ekomiti. Basizwa ithimba lonobhala (isisebenzi sokuphatha kuhulumeni) elakhiwa abasebenzi boMnyango Wezempilo.

Lesi sakhiwo esiyindida asibangi nje kuphela ukudideka ngemisebenzi okumele yenziwe, kodwa sibukela phansi nomsebenzi we-MCC. Ithimba lonobhala, ilisemnyangweni womqondisi eMnyangweni Wezempilo obhekene nokulawulwa kwemithi, libandakanya Uphiko Lokuqiniswa Komthetho (okwakhiwe abahloli abakhethwe Umqondisi Jikelele Wezezempilo. Yi-LEU hhayi i-MCC enamandla kanye nomsebenzi omkhulu wokuqinisa Umthetho Wezemithi.

Kodwa-ke, i-MCC iseneqhaza lokuqinisekisa ukuthi umthetho uyaqiniswa. Isibonelo, isigaba 2(2) soMthetho Wemithi unikeza i-MCC amandla okululeka ungqongqoshe nokunikezela ngombiko kungqongqoshe nganoma yiluphi udaba oludluliselwe emkhandlwini ngungqongqoshe ukuthi luyobhekwa oluvela

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ISAYENSI

yemithi, kubandakanya ukulawulwa nokutholakala (imithi itholakala kanjani). I- MPTTT inikeze uNgqongqoshe Aaron Motsoaledi umbiko wayo emva kokuba engine esikhundleni sikaNgqongqoshe Hogan ngoMeyi 2009. Lo mbiko wenza isisekelo sezenzo eziwuchungechunge kubandakanya iphrojekthi yokucacisa umsebenzi osalele emuva wokubhalisa ku-MCC.

Ukwengeza, ukulungiselela amandla amasha kubandakanya ukubukeza kukangqongqoshe kwesichibiyelo sika-2008 kuMthetho Wemithi. Umthetho osayinwe uMongameli Motlanthe wangaphambilini ungukwenza ngcono okukhulu ehlelweni elalethulwe nguTshabalala-Msimang. Noma kunjalo, akwanele okwenzayo ukubhekana nezinye izinkathazo ezibalulekile ezaphakanyiswa yi-Treatment Action Campaign (TAC) kanye ne-AIDS Law Project (ALP) ngesikhathi sohlelo lwasephalamende.

Ngaphansi kobuholi bukaNgqongqoshe Motsoaledi, izimiso zomthetho nokuthi zenziwa kanjani kuthola ukunakwa okuphuthumayo. Kodwa-ke, umonokala omkhulu owenziwa ngesikhathi seminyaka yoMbeki/Tshabalala-Msimang/Mseleku awukalungiswa. Abakhohlisi abaningi abazuza ngaleso sikhathi basenza umsebenzi bengahlolwa. I-LEU ihlala ingenabasebenzi abenele futhi ingenazimali ezanele.

Izishoshovu kufanele zihlale ziqaphile ukuqinisekisa ukuthi uNgqongqoshe, umnyango wakhe kanye ne-MCC benza izimiso zabo zomthetho. Kufanele futhi babambe iqhaza ekuqinisekiseni ukuthi imboni ihlonipha umthetho. Ukusebenza ngokulawulwa kwemithi - kungabe kusho ukubandakanyeka ohlelweni lokwenza umthetho noma izikhalazo ku- Advertising Standards Authority kufanele kuhlale kuqinile ku-agenda.

U-Jonathan Berger umcwaningi omkhulu oku-AIDS Law Project. Ungqongqoshe Wezempilo Dkt Aaron Motsoaledi waqokela u-Jonathan ku-MCC ngoJuni 2009. Ekuqaleni konyaka, owandulela uMotsoaledi u-Barbara Hogan waqokela u-Jonathan ku-MPTTT. U-Jonathan ubhalela i-Equal Treatment esikhundleni sakhe njengomsebenzi we-AIDS Law Project.

Usifaka kanjani isikhalazo ku-ASASAUma ubona izikhangisi ezenza izitatimende ezingamanga ngokwelashwa kwe-HIV noma esinye isifo ungafaka isikhalazo somthengi ku-Advertising Standards Authority of Southern Africa (ASASA).

Ukufaka isikhalazo somthengi kulula uma isikhangisi senza izitatimende ezingenaqiniso ngokwelashwa nokuqedwa kwesifo okubalwe kuSithasiselo F sekhodi yomsebenzi wokukhangisa. Lolu hlu lubandakanya i-HIV, isifo somdlavuza nesikashukela, phakathi kwezinye.

Vele ubhalele ku-ASASA, ukhalaze ukuthi isikhangisi sephula isithasiselo F. Izikhalazo zingathunyelwa ku: E-meyili: complaint@asasa.org.za Iposi: PO Box 41555, Craighall, 2024 Ifeksi: +27 11 781 1616

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Isithombe umusa we-AFP.

Isebenza kanjani imijovo yokugomaImijovo yokugoma ifundisa izivikeli mzimba zakho ukuthi zilwa kanjani nesifo esithathelanayo ngaphambi kokuba uhlangane naso.

Uma uthola igciwane, lingena emgudwini wegazi lakho bese lizalela ngokushesha. Umzimba wakho uphendula ngokuthumela amasotsha omzimba (abahlaseli bamagciwane) namaseli abulalayo (abahlaseli bamaseli athelelekile) enzelwe ukulwa nalelo gciwane. Uma izivikeli mzimba zisheshe zilazi igciwane, izingxenye zezivikeli mzimba ezilawula ukutheleleka zingasheshe zisebenze.

Uma ugonyiwe, inani elincane legciwane noma ikhophi yegciwane (elaziwa njengeyunithi encane) lethulwa egazini lakho ngehlelo elibuthaka, elibulewe noma elilingisiwe. Umzimba wakho uphendula ngokwenza amasotsha omzimba alungile kanye namaseli okubulala. Ahlala emgudwini wegazi lakho. Ngenxa yalokhu, ukube kwakufanele ubekeke egciwaneni langempela, amasotsha omzimba kanye namaseli okubulala abezobe esevele eselapho, elindele ukuhlasela.

Imijovo yokugoma ibe yimpumelelo ngokungakholakali ekulweni nezinye izifo, njengesimungumungwane. Emva kokuba kwenziwe umgomo wesimungumungwane, uhlelo lokugoma emhlabeni wonke lwasiqeda isifo. Akukho zimo ezintsha ezike zabikwa

Ukufunwa komjovo wokugomaImijovo yokugomela i-HIV beyinakwe kakhulu ezindabeni kamuva nje, imikhiqizo engama-30 ehlukene esezigabeni ezahlukene zokuhlolwa. Kodwa-ke kuze kube manje, ucwaningo lomjovo wokugomela i-HIV beluhamba kancane futhi lungaphumeleli kakhulu.

Ngu-Jennifer Reid

Umjovo wokugoma awusiwo umuthi wokuphilisa Imijovo yokugoma ilawula ukusabalala kwembangela yesifo (pathogen) (into ebanga isifo, isibonelo igciwane). Kodwa umjovo wokugoma awuselaphi isifo osibangayo (bheka umbhalo osezansi ngemijovo yokugoma eyelaphayo).

Ukuqedwa kokutheleleka nge-HIV kungafezwa ngezindlela ezimbili: ngokuqeda isifo kusetshenziswa umjovo wokugoma kubantu abangathelelekile nge-HIV ovimbela ukutheleleka ngama-100% esikhathi, noma ngokuba nomuthi wokwelapha ukusindisa abantu abane-HIV. Umuthi wokuqeda isifo uzodinga ukuqeda yonke imithonselana yegciwane kuzo zonke izingxenye zomzimba, ngisho kumanodi okunzima ukufinyelela kuwo e-lymph kanye nezinye izilondolozi ezijulile kuzivikeli mzimba. Okwamanje, imithi yokwelapha ilawula ukutheleleka nge-HIV kodwa ayikuqedi. Ngakho-ke, akekho kuze kube manje osesindile esebenzisa imithi eyizidambisi

gciwane ekhona.

Kahle hle, umjovo wokugomela i-HIV uzovimbela abantu abangenayo i-HIV ukuthi bathole igciwane nje kwasekuqaleni. Kuze kufezeke lokhu, kungaba wusizo ukuthi kube nomjovo wokugoma ongavimbeli ukutheleleka nge-HIV ngokuphelele kodwa, uma umuntu egonyiwe etheleleka, wenze ukuthi isifo singabi sibi kunokuba besingaba sibi.

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Okutholakele emgomeni omushaOkutholakele kwakamuva ohlolweni (olubizwa RV 144) lwabantu abangaphezu kwe-16,000 eThailand kudonse amehlo kakhulu. Imibiko yokuqala ithi inhlanganisela yomgomo isusa ingozi yokutheleleka nge-HIV ngama-13.2%. Nakuba kubuthaka, lokhu okutholakalayo kubukeka sengathi kuwubufakazi bokuqala obuphathekayo bokuthi umgomo we-HIV unokwenzeka. Kodwa-ke, ukuhlaziya okwenziwe ngokucophelela kakhulu kuyenziwa ngesikhathi sokuya kwabamaphepha.

Uhlolo olwahlolelwa ukuvikeleka kokulwa nezinhlobo ezincane ze-HIV B no-E. E-Afrika eseNingizimu kakhulu sithola uhlobo oluncane u-C. Asazi ukuthi ingabe umjovo womgomo kukhona yini ukuvikeleka ozokunikeza ukulwa nohlobo oluncane u-C.

Sizokwazi masinyane ngomphumela ngqo walolu hlolo. Okwamanje, zonke lezi zinhlolo zokwelapha zabantu zengeza emgwamandeni wolwazi esiwudingayo ekugcineni ukwenza nokusebenzisa umgomo wokuvimbela ophephile nosebenza ngempumelelo.

kusukela ngeminyaka yasekuhambeni kwama-1970 kanti manje ukugomela isimungumungwane akusenasidingo.

Imijovo yokugoma iphephileAbanye abantu besaba ukuthi umjovo wokugoma uzobagulisa, kodwa akuvamile lokhu. Kunokwenzeka kuphela ngemigomo enezimo eziphilayo zegciwane (njalo aba buthaka). Ngisho nalapho, izimpawu zijwayele ukuba kahle. Isibonelo, kungenzeka uthole imfiva encane noma ingalo ebuhlungu. Kubalulekile ukuthi umgomo wokuvimbela uphephe kakhulu futhi awunamiphumela emibi njengoba uzonikezelwa kubantu abangenaso isifo. Imigomo eminingi ayiphili futhi akukho ngozi nhlobo yokuthola igciwane kuyo. Imikhiqizo yomjovo wokugomela i-HIV ayisoze ibe namagciwane aphilayo noma abulewe. Njalo ayoba nezingxenye ezincane kuphela zegciwane le-HIV elingeke likwazi ukuzizalelela ngokwalo, ukuqinisekisa ukuthi akukwazeki ukuthola isifo se-HIV ngokugomela ngomkhiqizo wokugomela i-HIV kokulinga.

Awukho umgomo we-HIV ozosebenza ngempumelelo Ukwenza umgomo we-HIV osebenza ngempumelelo kunzima kakhulu. I-HIV iguquka masinyane kakhulu. Uma umzimba wakho ukhiqiza amasotsha omzimba, i-HIV ingaguquka bese kudingeka ukuthi ukhiqize amasotsha omzimba amasha. Izivikeli mzimba zakho njalo zizama ukulinganisana nalo. Yingakho nje isibonelo somgomo osezingeni kuze kube manje besingaphumeleli. Ngezingcindezi eziningi ze-HIV, ososayensi bazodinga ukuthola into efana kuzo zonke lezi zingcindezi okufanele kwesekwe kuyo umjovo womgomo.

Ososayensi abaningi bakholwa ukuthi ukuze wenze umjovo womgomo oyimpumelelo, kudingeka kwaziwe okuningi nge-HIV, ukuthi isebenza kanjani noma ukuthi kungani inamba encane yabantu kungathi ivikelekile kuyo.

Kudingeka isikhathi esiningi kanye nemali ukwenza umgomo, kanti kunzima ukuthola izimali ezintsha zokuxhasa ucwaningo lomgomo. Ukuxhumana phakathi kwamaqembu ocwaningo ahlukene kaningi kunomkhawulo. Abanye abafuni ukushiyelana ngocwaningo olubalulekile ngaphambi kokuba kubonakale impumelelo. Konke kulezi zinselele kwenza ukuthi kungabonakali ukuthi umgomo we-HIV uzoba khona eminyakeni eyi-10 kuya kweyi-15 ezayo.

Umlando wemigomo ye-HIVNgonyaka ka-1984, abanye abacwaningi kwakulindeleke ukuthi babe nomgomo ngo-1986. Ngaphezu kweminyaka engama-20, sesibone izinhlolo eziningi kanti zonke zehlulekile.

Umgomo owenziwe abacwaningi baseNyuvesi yaseKapa usacwaningwa manje kumjikelezo wokuqala kubantu

bohlolo eBoston e-United States, eKapa naseSoweto. Umgomo usebenzisa indlela entsha, ngokunokwenzeka okubili komgomo okusetshenziswa kukho kokubili ukulungiselela nokwakha izivikeli mzimba. Njengokunye okunokwenzeka, amayunithi amancane kuphela egciwane asetshenziswa kule mikhiqizo ngakho-ke abantu ababambe iqhaza ocwaningweni abanangozi yokuthola i-HIV. Uhlolo lwenziwa ngokuhlanganyela yi-South African AIDS Vaccine Initiative (SAAVI) ne-US National Institute of Allergy and Infectious Diseases (NIAID). Ngonyaka olandelayo, abacwaningi bazokwazi ukusho ukuthi ingabe lezi zinhlolo kufanele yini ziqhutshwe. Uma beya esinyathelweni esilandelayo (isigaba 2 sezinhlolo zabantu), eminyakeni embalwa bangahle bakwazi ukunquma ukuthi ingabe umgomo usebenza ngempumelelo yini noma cha.

Imiphumela ecace kahle kakhulu ocwaningweni lwamaduze e-Thailand lokhumbisa izethenjiswana zokuthi umgomo unokwenzeka, kodwa akusho ukuthi sekuseduze. (See box for details of this trial.)

Okwamanje, sisazi kakhulu ngalokho okungeke kusebenze kumgomo we-HIV kunalokho okuzosebenza. Iminyaka emihlanu elandelayo ukuya kweyishumi izobaluleka ukuvala igebe empilweni ye-HIV kanye nokwenza umgomo. Sinethemba, imiphumela yohlolo lwakamuva isondela ngasendleleni efanele.

Izingxoxo eziningi zemigomo zigxila emigomeni yokuvimbela. Lena yimigomo evimbela ukutheleleka kubantu abangathelelekile. Okungavamile kakhulu, imigomo iyelapha ngamanye amazwi, yenza ngcono ezinye izimpawu zezifo ezingapheli. Kwenziwa olunye ucwaningo kule migomo. Le athikili ixoxa ngemigomo yokuvimbela kuphela.

Imithombo: Duerr, A. and J. Wasserheit, L. Corey HIV Vaccines: New Frontiers in Vaccine Development Clinical Infectious Diseases 43 (2006) http://www.journals.uchicago.edu/doi/pdf/10.1086/505979 ; Graham, B. and J. Ledgerwood, G. Nabel Vaccine Development in the Twenty-First Century: Changing Paradigms for Elusive Viruses Nature Publishing Group 86.3 (2009) http://www.nature.com/clpt/journal/v86/n3/pdf/clpt2009128a.pdf ; South African AIDS Vaccine Initiative Questions and Answers: SAAVI 102/HVTN 073 HIV Vaccine Clinical Trial (2009); Thomas, C. Roadblocks in HIV Research: five questions Nature Medicine (2009) http://www.nature.com/nm/journal/v15/n8/pdf/nm0809-855.pdf.

Lubukezwe ngu-Dkt Linda-Gail Bekker, Iphini Lomqondisi e-Desmond Tutu HIV Centre nomphenyi omkhulu wophiko lwase-Cape Town lwezinhlolo zomgomo zaseNingizimu Afrika.

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Yini umdlavuza Womlomo wesibeletho?Umdlavuza womlomo wesibeletho ngelinye igama lomdlavuza womlomo wesibeletho. Umlomo wesibeletho ingxenye ephansi yesibeletho exhumana nesitho sowesifazane sangasese. Lolu hlobo lomdlavuza lwenzeka uma amaseli omlomo wesibeletho engajwayeleki bese eqala ukukhula ngokungalawuleki. Kulula ukuwuvimbela nokuwelapha uma usheshe watholakala.

Umdlavuza womlomo wesibeletho umdlavuza ojwayeleke kakhulu otholakala kwabesifazane abaphila emazweni athuthukayo. Lokhu kakhulu kungenxa yezinhlelo zokuhlunga ezisebenza ngempumelelo (njengokuhlolwa kwe-Pap smear) ukuthola izinguquko masinyane emlonyeni wesibeletho kungenzeka ukuthi

azikho noma abesifazane abazitholi.

Yini ebanga umdlavuza Womlomo wesibeletho? Ukutheleleka komlomo wesibeletho ngezinhlobo eziyingozi kakhulu ze-human papillomavirus (HPV) kuyadingeka ezinguqukweni kuthishu yomlomo wesibeletho okungathi ngokuhamba kwesikhathi ube umdlavuza womlomo wesibeletho. Abanye abantu

abatheleleke nge-HPV isifo siziphelela ngokwaso ngaphandle kokuthi babe nezimpawu zaso. Abanye akwenzeki; lokhu kuyiqiniso ikakhulukazi kubantu abaphila ne-HIV nalabo abanezivikeli mzimba ezimbi. Okubaluleke kakhulu, abesifazane abane-HIV kungenzeka kakhulu ukuthi babe ne-HPV. Babhekene

nengozi ephezulu yezifo ze-HPV ezingelapheki kalula futhi ezingaphinde zibuye. Futhi kunokwenzeka ukuthi kube nezinguquko emlonyeni wesinye ezingaba

umdlavuza uma zingelashwa.

Yini i-HPV? I-HPV igciwane elidluliswa ngesitho sowesifazane sangasese, ngomlomo noma ngocansi lwasendunu nangokuthintana kwezikhumba zezitho zokuzalana. Lokhu kusho ukuthi amadoda nawo asengozini yezifo ze-HPV. Lezi zifo zingabanga futhi izinsumpa zezitho zokuzala noma zibe umdlavuza wepipi, wendunu noma wezitho zokuzala. Amadoda nawo angayedlulisela i-HPV kubalingani bawo. Wonke umuntu oyayo ocansini usengozini. Kunezinhlobo eziyi-100 ze-HPV. Izinhlobo ze-HPV 6 no-11 zingabanga izinsumpa zezitho zokuzala kanti ezinye izinhlobo eziyingozi ephezulu, kubandakanya izinhlobo 16 no-18, zingabanga umdlavuza. Umgomo wokulwa nezinhlobo ezimbili ezibanga umdlavuza ze-HPV manje sewukhona.

Indlela kuphela yokuthola i-HPV ukuthi kuhlolwe, isibonelo ngokwenza i-Pap smear noma ukuhlola kwe-HPV. Njengoba kushiwo ngenhla, abantu bangatheleleka futhi bangazi nokwazi, ngakho-ke ukuhlola kubalulekile. Okwamanje, abesifazane baseNingizimu Afrika banama-Pap smear amathathu amahhala ohlelweni lwezempilo lomphakathi ngesikhathi sokuphila kwabo, kusukela eminyakeni engama-30. Ukuhlola lokhu kubheka amaseli

Kungenzeka ube nomdlavuza womlomo wesibeletho uma unalokhu: Ukopha emva kocansi

Ubuhlungu ezansi nesisu

Ukuncipha komzimba okungachazeki

Okuphuma esithweni sowesifazane sangasese okungajwayelekile

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angajwayelekile emlonyeni wesibeletho angahle abe yingozi. Umdlavuza womlomo wesibeletho ukhula kancane, ngakho ukuhlola ngokuvamile akunasidingo. Kodwa kwabesifazane abaphila ne-HIV, umdlavuza womlomo wesibeletho unodlame kakhulu, ngakho uma une-HIV kufanele wenze i-Pap smear, ngisho ngabe

ungaphansi kweminyaka engama-30 yobudala.

Kufanele wenzeni uma uba nezimpawu zesifo: Uma ukhathazekile ngomdlavuza womlomo wesibeletho bona udokotela wakho noma unesi ngokushesha. Kufanele bakwenze ukuhlola kwe-Pap smear, okuyingxenye yokuhlolwa kwempilo yowesifazane. Udokotela noma usista ohlengayo bazohlola umlomo wesibeletho ukuhlola izimpawu zomdlavuza. Akufanele kube buhlungu futhi kuthatha imizuzu kuphela. Imiphumela uzoyithola emasontweni ambalwa alandelayo. Kuya ngemiphumela, kungenzeka kudingeke ukuthi ubuyele kokunye ukuhlolwa ezinyangeni ezimbalwa kamuva, noma ungadinga ukwelashwa. Umdlavuza womlomo wesibeletho ungelashwa ngokuhlinzwa kususwe umdlavuza noma ngomuthi noma ngokwelashwa kokushiswa ngemisebe yokukhanya. Abanye besifazane bangelashwa

umdlavuza wabo.

Kubalulekile ukuthola izinsizakalo zezempilo ngaphambi kokuba izimpawu zivele noma zibe zimbi kakhulu. Kwabesifazane abacishe babe yi-80,000 e-Afrika ababa nomdlavuza womlomo wesibeletho njalo ngonyaka, abaningi bafuna ukunakekelwa kokwelashwa isikhathi sesihambe kakhulu futhi seyiqhubekile, sekuyisifo esingelapheki ngesikhathi

ufika emtholampilo. Khumbula: unelungelo lempilo!

Imithombo: Batra, P. and E. Shuh Treatment Action Campaign Policy Position Paper on HPV and Cervical Cancer Prevention in South Africa Unpublished (2009); Denny, L. Burden and natural history of cervical cancer in Africa Conference abstract; Denny, L. HPV and cervical disease in HIV infected women Conference abstract: Padian, N. and A. Van de Straten, G. Rmjee, et al. Diaphragm and lubricant gel for prevention of HIV acquisition in southern African women: a randomized controlled trial The Lancet 370 (2007); Winer, R.L. and J.P. Hughes, F. Qinghua, et al. Condom use and the risk of genital human papillomavirus infection in young women The New England Journal of Medicine 354 (2006).

Cervical cancer is a preventable and often curable disease. It can be prevented through vaccination and

Khumbula: Umdlavuza womlomo wesibeletho ungavimbeleka noma welashwe uma utholakele kusemasishane. Ungephuzi, yenza i-Pap smear namhlanje!

Yini i-pap smear?

Uzivikela kanjani: Yenza i-Pap smear. Lokhu kuhlola okulula kuzothola izigaba zokuqala

zomdlavuza wesibeletho ukuze welashwe.

Njalo sebenzisa ikhondomu futhi uyisebenzise ngendlela efanele ukuze lingaphumi noma lidabuke. Ukusebenzisa ikhondomu uqhubeke kunciphisa ingozi yesifo se-HPV. Amadayaframu kanye nokokuthambisa akusiyo indlela efanele yokuvimbela isifo.

Sebenzisa okokuvikela amazinyo uma wenza ucansi lomlomo.

Beka umkhawulo enambeni yabalingani oya nabo ocansini.

Yima ubike ukuhlukunyezwa ngokocansi kwanoma yiluhpi uhlobo.

Yazi isimo sakho se-HIV. Abesifazane abane-HIV basengozini kakhulu kumdlavuza womlomo wesibeletho.

Yeka ukubhema. Ukubhema kwandisa amathuba akho okuba nomdlavuza.

Buza ngomgomo we-HPV. Lo mjovo ungavikela abesifazane abancane namantombazane egciwaneni le-HPV elibanga umdlavuza womlomo wesibeletho. Umjovo womgomo usebenza kahle kakhulu uma unikezwe ngaphambi kokuqala ukuya ocansini. Okwamanje ukhona kuphela ezingxenyeni ezizimele.

Unesi noma udokotela bazoqoqa isampula lethishu emlonyeni wesibeletho sakho bese belithumela liyohlolwa. Kufanele uthole imiphumela emasontweni ambalwa. akubuhlungu, kuthatha imizuzu embalwa kuphela futhi kungasindisa impilo yakho!

i-athikili ibukezwe nguSolwazi Lynette Denny, eNyuvesi yaseKapa kanye noNgcweti Omkhulu e-Groote Schuur Hospital.

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ovimbela

Umgomo we-HPV ungakwazi ukuvimbela ukufika kuma-70% ezimo zomdlavuza zomlomo wesibeletho e-sub-Saharan Africa, lapho obulala khona abesifazane abaningi kunanoma yiluphi olunye uhlobo lomdlavuza. Uma umgomo ungasindisa izimpilo eziningi, kungani ungekho ohlelweni lwezempilo lomphakathi?

Ngu-milie Shuh

Umdlavuza womlomo wesibeletho uyavimbeleka futhi kaningi isifo eselaphekayo. Ungavimbeleka ngokugoma noma ngezinhlelo zokuhlunga futhi uyelapheka uma usheshe watholakala futhi walawulwa ngendlela efanele. ENingizimu Afrika abesifazane abayi-7,000 ababa nomdlavuza womlomo wesibeletho njalo ngonyaka. Izinkulungwane zifa ngoba lo mdlavuza awutholakali masinyane ngokwanele kanye/noma welashwe ngokufanele. Lokhu kuyiqiniso ikakhulukazi kwabesifazane abampofu kanye nalabo abaphila ezindaweni ezisemakhaya, njengoba ukufi nyelela ezinsizakalweni zezempilo kungaba nzima ngezinkinga

Umgomoumdlavuzawomlomowesibeletho

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Isithombe umusa we- The Bigger Picture / Panos.

zezithuthi, izindleko kanye nokungabi nalwazi ngesifo. Ingxenye embi kakhulu, ukuthi lo mdlavuza kaningi uphazamisa abesifazane abaphakathi kweminyaka yobudala engama-35 nama-55 (masinyane kwabesifazane abaphila ne-HIV), uma bebalulekile

ekusimameni komphakathi nomnotho emindenini yabo.

Kufanele sifake ingcindezi ku-GlaxoSmithKline (GSK)

ne-Merck Sharp & Dohme (MSD) ukuthi behlise amanani

entengo emigomo yabo yomdlavuza womlomo wesibeletho.

Imigomo emibili emisha (Gardasil and Cervarix) yokuvimbela umdlavuza womlomo wesibeletho kwabesifazane baseNingizimu Afrika iyatholakala. Okwamanje unikezelwa kuphela ezingxenyeni ezizimele. Izinkampani ezenza imithi zingabiza amanani entengo aphezulu ngemigomo emisha njengalena ngenxa yamalungelo emithetho yokuvikela. Le mithetho yenzelwe ukuqinisekisa ukuthi izinkampani zingayibuyisa imali eziyitshale ekwenzeni nasekwakheni umuthi. Kodwa kunokugxekwa kokuthi izinkampani zenza imali eningi kunaleyo eziyitshalile.

Okunye futhi, amazwe afana neNingizimu Afrika kucatshangwa ukuthi acebile kakhulu ukuthi akwazi ukuxhasa umgomo ngokusebenzisa amaqembu afana ne-GAVI (i- Global Alliance for Vaccines and Immunisation). Lokhu kusho ukuthi uhulumeni waseNingizimu Afrika kufanele akhokhe inani lentengo eliphezulu

uma befuna ukuthi umgomo ube khona engxenyeni kahulumeni. Kus