Blockchain technology is also revolutionizing supply chains in the pharmaceutical industry, in the process, helping track fake medicines. 



From genomics to robotics, technology is truly revolutionizing
the healthcare sector. And while it’s easy to become consumed by exciting,
futuristic trends like artificial intelligence (AI) diagnosis, digitized
patient records and 3D-printed medical tools, technology is also transforming
the pharmaceutical industry. How medication is prescribed, dispensed and
administered is big business with McKinsey predicting the value of Africa’s
pharmaceutical industry to be $65 billion in 2020.



But fake drugs are an ongoing and complex issue – they can
cause death, have unknown side-effects, fail to treat illnesses, and sometimes
even add to the spread of disease. According to World Health Organization (WHO)
statistics, 42% of detected cases of falsified (or substandard) pharmaceuticals
occur in Africa – reports estimate that between 72,000 and 169,000 children die
each year from pneumonia because of counterfeit antibiotics while fake malaria
drugs cause an additional 64,000 –158,000 deaths every year in sub-Saharan
Africa. Both antimalarials and antibiotics sit among the most commonly-reported
counterfeited drugs.



“Fake medicine distribution is rampant because business
processes are siloed between the various industry stakeholders, which puts the
industry at risk of fraud,” explains Heidi Patmore, a marketing consultant
specializing in technology that’s changing consumer behavior. 



“One solution to this would be cross-company process
automation which could easily be enabled by a blockchain data interchange. This
creates an open information system that all players can use to verify the
authenticity of medication because it can track and trace it from when it’s
manufactured to when it is dispensed to the patient.”



Companies such as IBM and SAP are working on blockchain
solutions to weed out Africa’s counterfeit medication network. When medicine is
returned to pharmaceutical manufacturers, for example, it is often re-sold
instead of being destroyed. How can a small local pharmacy ensure what is
returned is authentic? SAP are working with their existing client base – Merck,
GSK, Ingelheim, McKesson and others – on a blockchain project to verify that
any returned drugs are original. 



IBM Research’s solution for Africa (currently in development
in Haifa, Israel) includes a mobile interface and permissioned blockchain
backend that enables each certified and authorized party in the network to
initiate action, finish their transaction, and track its progress. 



“It also includes the monitoring of temperature to ensure
compliance with the proper conditions for transportation and asset transfer,”
adds Inna Skarbovsky, a blockchain architect from IBM Research – Haifa.
“Blockchain ensures full provenance for each medicine package, uniquely
identified with a barcode or a serial number. This makes it possible for all
authorized parties to track the drugs through the entire supply chain and the
drugs’ life-cycle.”



This also allows significant cost reductions by eliminating each participant’s need to manage a separate system for traceability of its components. “It also improves procedural efficiency for change-of-hands, make it much harder for counterfeit drugs to be introduced into the supply chain and to be distributed to end-users,” says Skarbovsky.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="768" height="1024" src="https://www.forbesafrica.com/wp-content/uploads/2020/01/IMG_20190927_124217-1-768x1024.jpg" alt="" class="wp-image-42537"/><figcaption> Towett Ngetich, CEO of Uthabiti Health, a Kenya-based pharmaceutical company </figcaption></figure>



Towett Ngetich is the CEO of Uthabiti Health, a Kenya-based pharmaceutical company that has implemented blockchain to bring transparency and accountability back to a country where statistics show that 30% of medicines sold are counterfeit. Uthabiti, which means ‘verify’ in Swahili, was started after Ngetich’s first-hand experience with the effects of fake health products: “Back in university, a significant number of students fell victim to unplanned pregnancies and unsafe abortions. With deep research, it was uncovered that there had been a supply of fake contraceptives and backstreet abortion pills into the student market,” explains Ngetich. More findings showed the presence of fake antibiotics, antiretrovirals (ARVs) and non-communicable diseases (NCD) medicines in the Kenyan pharmaceutical supply chain. 



“Pharmaceutical science is the center of healthcare – one
mistake in any drug composition or formulation has the risk of endangering a
significant number of people. The need to access safe, affordable and quality
health products in its simplest form means life and death in diagnosed health complications.
Blockchain gives patients the ability to track and trace products using
attached IDs – it also gives Uthabiti Health the ability to know where all our
health products sit within each supply chain,” he says. Uthabiti Health
procures medicines from different pharmaceutical manufacturers. Once received,
they go to an internal laboratory for quality testing and are then labeled with
the product’s safety lab report – attached in their codes is a unique
blockchain ID. The medicines are then passed on to their partnering retail
points, ensuring that the medicines dispensed to patients can be verified with
something as simple as a text message. 



“This brings in consumers in safe-proofing the supply chain
of pharmaceuticals,” adds Ngetich. 



The proliferation of fake drugs throughout Africa is complex
– on average, medicine changes 30 hands before reaching the destined pharmacy –
but blockchain technology has great potential to help stop counterfeit medicine
distribution because it brings traceability and trackability to the entire
pharmaceutical supply chain, ensuring the immutability of information.&nbsp; 



<h4 class="wp-block-heading">Blockchain ethics?</h4>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="709" height="1024" src="https://www.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-709x1024.jpg" alt="" class="wp-image-42533" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-709x1024.jpg 709w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-300x433.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-600x867.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-208x300.jpg 208w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-768x1110.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC-1063x1536.jpg 1063w, https://cms.forbesafrica.com/wp-content/uploads/2020/01/CandicedC.jpg 1329w" sizes="(max-width: 709px) 100vw, 709px" /><figcaption>Candice De Carvalho</figcaption></figure>



While blockchain is still a relatively niche technology, it is slowly changing how organizations operate. Blockchain promises better security and transparency, but not necessarily for the customer, in the case of drug allocation: “Where blockchain technology could likely increase efficiency and simultaneously decrease the abuse of medicines, customers benefit. The pharmaceutical and related industries are unique however, in that the ‘consumer’ is also a patient – a vulnerable group with special needs and rights,” explains Candice De Carvalho, the founder of Easy Ethics CPD.



Although overall transparency in the supply chain increases
through the use of blockchain, and this confers patient benefits, these must be
weighed against patient privacy and confidentiality.&nbsp; 



“With emerging technologies more freely available, we’ve
observed an interesting shift in patient behavior, where data privacy is
regarded less as an absolute by patients, in favor of a kind of sliding scale,
where privacy itself is a currency that purchases medical benefits along the
way,” adds De Carvalho. “Patients, for the right benefits, are perhaps more willing
to part with some privacy privileges.”



De Carvalho questions the genuine knowledge that patients
have of any exposure they experience through their use of novel medical device
or systems innovations. The key drivers for the business are not necessarily
unified with the total needs of the patient. However, the more the technology
owners protect and balance the patient’s need for confidentiality and consent,
the more they will ultimately see business benefit.&nbsp; 



“In the context of a doctor-patient relationship, the doctor has a positive duty to enhance patient understanding so that the patient enjoys a truly informed consent. Does this then mean that technology providers are now responsible in the same way that medical health workers are?” she ends.



-Tiana Cline

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Cure For Counterfeit Drugs?

After cancer had spread throughout her body, and death was inevitable, Patricia Ferguson decided she wanted to be in control of it. So, she went on a hunger strike.
“She had always said she would rather take an overdose than become a burden,” says her son, Sean Davison.
Having flown from Cape Town, South Africa, to Dunedin, New Zealand, to be with his mother during her final days in 2006, Davison was confronted with a horrific scenario and a decision that is hard to comprehend.
Unable to move her limbs, Ferguson was bedridden. Bruises and bed sores covered her body and her flesh was starting to rot. She wished her pain would end and no longer wanted to be a burden on her loved ones. She had starved herself for more than a month but her body refused to give in.
Finally, she pleaded for her son to give her a lethal dose of morphine pills that she had saved up over days. Witnessing her suffering for weeks, Davison sorrowfully agreed to help his mother.
“My instinct was to keep her alive. But I realized that this was what she wanted, and if I didn’t help her she would have suffered a lot more,” he says.
He crushed the pills, mixed them in a glass of water, and handed it to his mother. After about an hour she peacefully fell asleep.
Davison says this was an act of compassion; New Zealand authorities said it was a crime. He was arrested and later sentenced to five months house arrest.
Helping his mother die seemed to split society. Although many sympathized with Davison – including Archbishop Desmond Tutu, who wrote a letter that helped prevent him spending time behind bars – others were appalled by his actions. While being kept as a prisoner in his mother’s house, Davison received two death threats.
In 2010, while awaiting his trial, Davison, now the Head of the Forensic DNA Laboratory at the University of the Western Cape, founded Dignity SA. It is an organization that is fighting to legalize assisted dying in South Africa.
“My mother would never have gone on that ill-fated hunger strike if she knew she had the option of an assisted death,” Davison wrote in a column in December last year.
But, just like he faced resistance in New Zealand, Davison has detractors in South Africa. Dr Albu van Eeden is the CEO of Doctors For Life, a group of doctors that campaigns against controversial issues, such as euthanasia, abortion and homosexuality. He claims suicide is an infectious disease.
“The concept of suicide contagion is a very well established principle in psychology and psychiatry,” he says.
Suicide contagion is defined as the exposure to suicide or suicidal behaviors from family, friends, or media, and can result in an increase in suicidal behavior. Van Eeden believes that 99.9% of suffering can be effectively treated with medicine.
“It’s just erroneous now when we have the most effective pain treatment in the history of the world, now suddenly there is a need for assisted suicide,” he says.
Assisted suicide is when a doctor provides the medication and/or information for a terminally-ill patient to end their own life, while euthanasia involves a doctor administering the medication. Today, euthanasia is legal in the Netherlands, Belgium, Colombia, and Luxembourg. Assisted suicide is legal in Switzerland, Germany, Japan, Canada, and in the US states of Washington, Oregon, Colorado, Vermont, Montana, and California.
In South Africa, assisted dying is illegal but some are trying to change that in courts and Parliament. The most recent case is that of the well-known advocate Robin Stransham-Ford, who insisted his cancer and kidney failure infringed on his constitutional right to dignity. In 2015, on the day Stransham-Ford succumbed to the cancer‚ the High Court ruled that a doctor could help him end his life. Numerous organizations, including the Department of Justice, the Department of Health, and Doctors For Life, asked the Supreme Court of Appeal to review this. In December 2016, the decision was overturned.
Aubrey Magerman, Attorney and Director at Magerman Attorneys, feels that assisted dying should be legalized; he says it is still a crime in South Africa.
“We’re back at square one, where we would be criminally culpable to assist someone in ending their life,” he says.
Magerman believes everyone should have a constitutional right to a dignified life and a dignified death.
“I have had my own grandparents pass away out in the rural Northern Cape under terrible circumstances, with no assistance, and in horrible pain, and being unrecognizable for weeks on end. It is terribly traumatizing for anybody. I wish, when it come to my time [to die], I will have the opportunity [to undergo assisted suicide].”
Magerman refers to the popular MP Mario Oriani-Ambrosini, who had stage-four lung cancer.
“One day he couldn’t take the pain anymore and he killed himself. His family found him with his brain and blood splattered all over the bedroom walls and on the bedding. So, I don’t think the State should tell us how to die,” he says.
Despite this, Van Eeden says assisted dying can have consequences beyond easing a person’s suffering.
“Once you allow it you are stretching man’s tendency to stretch the limit or the borders which makes the slippery slope happen,” he says.
“In Canada, they now want to make it possible for people who are asking for euthanasia to donate their organs. Suicide was originally only meant for terminal illness, for people with unbearable suffering, until they said ‘on what basis is physical suffering worse than mental suffering?’ So then they said ‘ok, we’ll allow it for mental suffering as well’.”
“So now you find a person can go to their doctor and say ‘I’m depressed, I’m worthless’. Maybe he’s a disabled person or an old person, and he says I don’t mean anything for anybody, I’m a burden to society, to my children, I think I’m in the way. I want to rather commit suicide and please you’re the doctor, you must do it for me. Now they can say to him, ‘You know what? Your life is worthless but it can have purpose, you can give your organs for donation&#8230; And this just shows you what a monster suicide becomes.”
Van Eeden is also worried about the regulation of the laws.
“Holland was not able to keep its regulations. Firstly, they said there would be a waiting time, and two or three doctors must agree with the decision, but all these things went out the door. Initially, it was only for patients above the age of 18, now it’s changed so that children above the age of 12 years old can ask for euthanasia without the consent of parents. The limits are constantly being stretched,” he says.
Magerman agrees that regulation is vital if assisted dying laws are introduced.
“What is required here is for the State to step in. It should be up to Parliament, which is the body charged with making legislation. It is not something that can be regulated in the courts.
“It creates absolute uncertainty. It is simply for Parliament to say we will for now on regulate assisted suicide or euthanasia and the parameters of that will be set.”
But Van Eeden has concern that State regulation opens the door for laws to be abused.
“It will always be cheaper to take a life than to treat a person and try and help him. So there’s a very strong financial incentive to any government once you start allowing assisted suicide.”
It’s a complex issue with many legal, ethical and religious variables to consider. Those against assisted dying say that it goes against the sanctity of life that is stressed by most religions.
One iconic religious leader defies this. Archbishop Desmond Tutu, in October 2016, said he would like to have the option of assisted dying.
“I have prepared for my death and have made it clear that I do not wish to be kept alive at all costs. I hope I am treated with compassion and allowed to pass on to the next phase of life’s journey in the manner of my choice,” he wrote in the Washington Post.
“For those suffering unbearably and coming to the end of their lives, merely knowing that an assisted death is open to them can provide immeasurable comfort,” he added.
In 1998, South Africa’s President Nelson Mandela asked the Law Reform Commission to look into assisted dying.
The commission decided that assisted dying should be legalized, even writing a draft bill. Despite this, it was never debated in Parliament, and continues to gather dust.
In 2014, Tutu lambasted the way Mandela was used as a political prop days before his death, calling it ‘disgraceful’.
“My friend was no longer himself. It was an affront to Madiba’s dignity,” wrote Tutu, who is often referred to as South Africa’s moral conscience.
Would assisted dying legislation have allowed Mandela to die with more dignity? It’s impossible to answer definitively, but a sobering thought nonetheless.

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Mercy Or Monster?

Kitted out in worker boots, hard hats and blue overalls, Iman Mkwanzi and Nene Mboweni are demolishing stereotypes. The owners of Mkweni Groundworks – a construction company specializing in general building, road signage, landscape and horticulture – are glass ceiling-crashers.
Mkwanzi and Mboweni began looking at different avenues for a new business, and discovered a trend – women were thriving in construction.
Inspired by them  making their mark in a male-dominated sector, they decided to get their hands dirty.
“We actually wanted to be in worker boots. We weren’t really fazed by project management, we felt like we needed to change the dynamic a bit and get in there…From the beginning, we’ve had funny reactions,” says Mboweni.
“You’ve got to be street smart – working from the ground upwards. If you know what the dynamic is at the bottom, understanding the dynamic at the top is easier. We’re trying to bring a fresh new mentality into it because there’s huge problems in this industry and enterprises have dominated and monopolized a space. The bigger enterprises grow, you lose contact with the ground but we’re in touch with it,” says Mkwanzi.
Mboweni studies medicine and runs a baking business, Nnüa; Mkwanzi works as a model and has just completed her degree in medical microbiology. For the duo, every day is labor intensive. Their new venture often involves breaking down glass walls and stereotypes.
“It’s male-dominated but if you’re assertive as a woman, you’re just as powerful,” says Mboweni.
“I’ve had stereotypes thrown at me my entire life. I’ve never cared and I’m not going to start caring about other people’s negative opinions – that just brings you down. We’re going to focus on the positive,” says Mkwanzi.
Constructing buildings and building careers – Mboweni and Mkwanzi are on their way up.

IMG_1784

Wearing Multiple Hats

It is 2015, the deadline for the WHO Millennium Development Goal 5 (MDG5) to reduce 1990s’ maternal mortality by 75%. On May 23, the world will observe United Nations International Day to end obstetric fistula (a breakdown of the birth canal caused by obstructed labour, leaving women incontinent, infection-prone and ostracized). 2015 is also the deadline for WHO MDG4 to reduce 1990s’ under-five child mortality by two-thirds.
A London-educated obstetrician gynaecologist and fetal medicine specialist, I’ve just returned to South Africa after 14 years. I’m delighted to be joining the WITS Maternal and Fetal Medicine Centre at Morningside Mediclinic in Sandton in Johannesburg and with the extra day I’ll spend every week as an Honorary Consultant at Chris Baragwanath Hospital in Soweto.
As a Ugandan-Rwandan, I also return as a sub-Saharan African, fully aware that sub-Saharan Africa made the slowest progress (under 20%) in reducing maternal mortality, that its share of the world’s maternal deaths actually grew from 42% in 1990 to 62% in 2013, and that the projection is it will fail to meet the MDG5 target. I’m also aware that nearly three million women and girls, mostly sub-Saharan African, live with obstetric fistula. Sub-Saharan Africa also has the highest under-five child mortality – 16 times that of developed countries, with more of the 6.6 million child deaths (44% in 2012 compared to 37% in 1990) occurring in the newborn period, clearly linked to a deficit in safe maternity care.
<img loading="lazy" decoding="async" class="size-medium wp-image-30046 alignleft" src="http://www.forbesafrica.com/app/uploads/2017/05/Opinion-Olivia-Barigye-200x300.jpg" alt="" width="200" height="300" srcset="https://cms.forbesafrica.com/wp-content/uploads/2017/05/Opinion-Olivia-Barigye-200x300.jpg 200w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/Opinion-Olivia-Barigye-300x450.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/Opinion-Olivia-Barigye.jpg 555w" sizes="(max-width: 200px) 100vw, 200px" />
Coming from a UK system, my conscience is heavy. I have worked within clinical governance frameworks where maternity health workers manage obstetric emergencies in multidisciplinary teams, have unrestricted access to updated evidence-based protocols, emergency drugs, blood products and broad spectrum antibiotics and are regularly appraised and supported through enforced emergency drills and continuous professional development. In sub-Saharan Africa, there will be an isolated traditional birth attendant dealing with a post-partum haemorrhage on her own, an unknown expectant mother walking in labor to get help, and I can remember the midwife I met traveling through rural Uganda in 2013 who, when I asked about clinical audit in her unit, responded saying “we are too demoralized by what we face everyday to be dealing with audits”.
However, against the bleak backdrop of sub-Saharan Africa’s high maternal and under-five child mortalities, I’m hopeful. The speed of mobile phone penetration in sub-Saharan Africa over the last decade, faster than anywhere else in the world, points to Africa’s potential. In 2007, mobile subscriptions were already three times faster than in Europe, and in 2009, there were 10 times as many mobile phones as fixed-lines, Kenya being a shining example.
Aside from clear evidence that GDP increases with mobile phone penetration in developing countries, the possibilities are countless.
Relevant to me are the growing number of mHealth projects. Programs and applications that provide real-time intelligence, monitoring and response to disease outbreaks (Nigeria’s ‘EOCs’), provide remote diagnoses (Botswana’s ‘Kgonafalo’), prompt patients to take their medication (South Africa’s ‘Cell-Life’), and prevent drug counterfeiting (Ghana’s ‘mPedigree’). I’m excited by the mHealth projects in maternal health – Nigeria’s ‘mCBS’, South Africa’s ‘MAMA’ and Uganda’s mobile electronic fetal heart monitor ‘Winsenga’.
I owe something to the 800 women and 25,000 children under five who die every year, from preventable causes.
The United Nations has called for accelerated interventions and prioritization in maternal and child health and we await political will, sound strategies and adequate resources. I’ve decided I must take advantage of the great strides Africa is taking in mobile infrastructure and have taken to mHealth, developing a mobile App targeted at safer childbirth as most maternal deaths are due to complications occurring around pregnancy.
Mismanaged labour is also a direct cause of obstetric fistula and newborn deaths. The App will prompt community birth attendants on timely assessments during labour and detect deviation from normality for both mother and fetus. These remote assessments will be electronically visible through a real-time location-based platform for skilled obstetricians and midwives.
Pre-existing medical conditions are another cause of maternal death. The App will therefore in the first instance, perform a risk-assessment to guide on the safest venue for delivery. Patient data and outcomes will be captured into an electronic system to facilitate audit and accuracy of maternal mortality estimates for central monitoring.
I can’t be a bystander as Africa goes through this historic boom in technology while women are evicted from our world simply because they are deprived the safe experience of childbirth. I have to do this because my heart is heavy knowing that with every hour, 33 women die in childbirth from preventable causes. Investing in maternal health will not only improve a mother’s health and her family’s, but will increase women’s numbers in the workforce and promote the economic wellbeing of their countries. I have to do this because women hold up half the sky.

Mobile Apps  For Maternal Health?

For thousands of years, humans have ground plants and animals to cure the sick. It was a time long before bread mould could also cure a headache. But these days, the tinctures and potions of old have taken a back seat to contemporary medicine.
Not so for complementary medicines in South Africa, an industry that is now worth $750 million, according to Peter Kreft, CEO of CoMED Health, who own brands Bioter Health and Natura, some of South Africa’s largest manufacturers of complementary medicine.
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This growth has now been stinted thanks to new regulations released by the South African government’s health regulators, the Medicines Control Council (MCC), since November 2013. The laws could mean as much as 50-60% of the industry having to take their cures off the shelves, says Kreft.
The MCC’s statement reads: “It has come to the attention of the National Department of Health that an increased number of so-called complementary medicines are being sold in the country which may pose significant risks to the South African public. For this reason the Minister of Health has called for the registration of these complementary medicines by amending the Medicines and Related Substances Act, 1965 (Act 101 of 1965) on 15 November 2013 making it a requirement for the MCC to evaluate and pronounce on the safety, quality and efficacy of these medicines.”
The MCC issued a deadline of February 15 for complementary medicines to place disclaimers on their products, as part of the first phase of the MCC’s revision process. This relabeling, according to Kreft, is not only costly to the industry but leaves very little room to market a product’s uses. The disclaimer will have to read that the product in question is yet to be evaluated by the MCC, and is not intended to diagnose, treat, cure or prevent any disease.
“I think like most other companies, we’d be in trouble, because it would affect 20 percent to 30 percent of our turnover. And if you take 20 percent to 30 percent of our top line and look at the infrastructure that we need to keep going here – and we do our absolute best to be compliant with regards to regulatory requirements – we will no longer be able to do this and probably be faced with either amalgamating with others that could bring up the additional turnover and hence also a bottom line, or closing our doors which I would be very loath to do,” says Kreft.
For Danny Pillay, President of the Homeopathic Alliance of South Africa and a practising homeopathic doctor in Sandton, Johannesburg, the regulations are a much needed remedy.
“When you have someone committing to a safe manufacture process and then all of a sudden you have someone producing their goods in their backyard and selling it as a supplement, or a product.  That is endangering the public… The reality is there are far too many unregistered persons that are illegally practising and sometimes some quarters of industry provide the products,” says Pillay.
Pillay explains that the medicines claiming to be Schedule 2 or 3 drugs will be most affected. These are high-risk, prescription-only drugs that claim to treat cardiac, diabetic or dietary related conditions. Schedule 0 drugs (low risk, over-the-counter drugs which form the majority of complementary medicines) have less stringent requirements than higher risk drugs.
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“Because products were not registered as medicines previously, there has not been enough drive or need to provide medical proof. We are not talking randomized trials all the time but we need empirical proof showing that there are studies that see the value of these medicines… There is now some burden on the manufacturer when they make a claim on a drug that has a higher risk,” says Pillay.
The cost of regulated medicine may be hard for customers and manufacturers to swallow. What once cost manufacturers $190 to register a product, now costs $470 and as much as $1,300 for some products. This excludes the costs for providing clinical proof of a drug’s efficacy and safety.
In the meantime, customers may have to wait months or even years for their embargoed products, while the MCC re-evaluates and registers the backlog of thousands of drugs.
When FORBES AFRICA inquired into the dangers of professionals acting illegally and the dangers of illegal drugs on the market with the Allied Health Professions Council of South Africa (AHPCSA), the statutory health body established to control all allied health professions, its response was in support of the MCC.
“In the view of the AHPCSA, complementary medicines, while generally safer than conventional medicine, can and do have potential for harm and adverse effects and therefore the AHPCSA has welcomed the regulation. The AHPCSA rejects the concept that a medicine is safe simply because it is ‘natural’. It should be noted that those AHPCSA professions that administer, dispense, or compound and dispense complementary medicines also complete a course in pharmacology so as to be in a position to understand conventional medicines, in particular the question of possible drug-interactions between complementary medicines and conventional medicines, both of which may exert physiological effects.”
There are critics who also believe the regulations infringe on a consumer’s rights and freedom of choice.
“[The MCC is ] free to advise, they are free to encourage, they are free to guide, they are free to say they don’t think homeopathic or complementary or traditional medicines work, but they are not free to interfere with the rights of consumers to decide for themselves. And I think this is where there’s a real breakdown of the paradigm in trust,” says Leon Louw, CEO of the Free Market Foundation.
Meanwhile the future of complementary medicine in South Africa hangs on a knife-edge. For the moment it’s still sick in bed waiting to see if it will rise with a healthy new body or missing some of its limbs.
&nbsp;
By date of print, the MCC were unavailable for comment.

Pills, Placebos and Profits

It’s February 2014. The New Year is already distant. The overcrowded yoga studio is thinning out as the New Year’s resolutions fade. I like more space but I don’t like what it means in terms of women letting go of their resolve to take better care of themselves this year.
Sometimes I draw a Wheel of Life with clients and ask them to place descriptors on the spokes for the different roles in their lives. They generally easily combine their professional and personal selves: executive, mother, spouse, member of professional body, MBA student, extended family member, board director, church committee and so on. I ask them to rate, from one to 10, how important each role is – marking the spoke with a colored pen. Using a second color, they rate the effort they dedicate to each role. With the third colored pen they rate their level of satisfaction. Together we consider the alignment and discord, and the changes that are needed.
There’s often one role missing. My clients stare at their wheel, puzzled. “What about the role of self-care?”  I ask rhetorically. Without self-care every other role may be jeopardized. It is extraordinary how many people relegate and neglect self-care. Steven Covey’s concept of being “properly selfish” needs more advocacy. I admire the women I’ve had the privilege to work with for over a decade but I often fear for them. They are outstanding achievers but at what cost to their long-term selves?
Whilst this column was named Headspace, I aspire to work with clients on the connectivity between our headspace, emotions, body fitness and energy. I’m increasingly respectful of the power of breath. It seems like the simplest thing – breathing. We’ve done it since the day we were born. Yet breathing consciously can contribute to our ability to create different choices and outcomes for ourselves.
As CEO of the Land Bank my medical check-up revealed high blood pressure and the blood analysis indicated high levels of cortisol – another indicator of stress. I spent 10 years on chronic medication. Then I read that one of the beneficial effects of meditation is improved blood pressure. My meditation breathing has been one of my best investments and I’ve had four drug-free years.
“So how have things gone since our last session?” The client gives me an update and the very recall of the events spark a panic attack. I’m able to draw on my training on breathing for relaxation to assist my client to recalibrate and regain their equilibrium. Another client is battling with insomnia – again certain breathing exercises can induce sleep and act as an effective alternative to slipping pills and their possible side effects.
My favorite easy breathing tool is one that I often teach clients, both individuals and teams, to use when they need to interrupt a burst of anger that might otherwise lead to behavior they will later regret. It’s aptly named S.T.O.P.
Imagine the traffic light. STOP. On red, take a breath – breathe in for the count of four. On amber, observe and hold your breath for the count of four. Then proceed to green, breathe out for the count of four and repeat. Focusing on the breathing breaks the anger burst in the way that a fuse breaks the electrical circuit when there’s danger of overload.
Another conscious breathing practice includes movement. Perhaps you’ve seen people doing Tai Chi, which resembles slow-motion ballet. Chi or Qi (Mandarin for breath) embodies the concept of vitality and life-force. While western medicine works with two body networks:  blood veins and the nervous system, the Chinese work with a third network, that of meridians. When meridian flows are blocked people experience fatigue in spite of clocking up hours of sleep or cardio training. It’s worth considering learning the body-breathing exercises that stimulate Qi.
I hope I’ve made you curious on two counts. Firstly, to consider what your wheel of life look likes. And secondly, the role that breathing plays in an expanded concept of fitness. Remember that leadership roles are stressful and self-care is paramount.

S.T.O.P.

It was a contract scribbled on a paper napkin that catapulted Barcelona’s footballer, Lionel Messi, to international stardom. History almost repeated itself when Ashley Uys signed a contract on a train to Frankfurt.
Ashley Uys and Andrew Smith*, his previous business partner, were on their way to Frankfurt airport to catch their plane home to South Africa after signing a deal with a German company. As the train rattled to the airport, Smith turned to Uys with what seemed to be a sweet deal. For Uys it turned into a rotten headache.
It had been a long journey to the railway car.
In 2006, Uys, a biotechnologist scientist, was working from the University of the Western Cape’s laboratories in South Africa, trying to run his own operation.
Two years later Smith, a businessman based in the United Kingdom, approached the Cape Town-based scientist with an interest in the type of work and research Uys was doing and a suggestion of starting a joint venture.
Smith knew of a German company that had been struggling for nearly two years to find a test developed for long-term alcohol consumption. The joint venture would develop a test that can detect alcohol consumption in urine. The German company wanted to sell the product to rehabilitation clinics.
Uys flew to Germany and within three days he had developed a prototype and it worked. It was a world first.
“I was like, ‘My word! My first big development,’” says Uys.
Smith and Uys had struck a deal in the German town of Gottingen and were on a train to Frankfurt to catch a flight to South Africa. Smith then proposed they go 50/50 on the test and split the profits.
“I said ‘We can’t go 50/50 on this test because my organization develops test kits. Our joint venture is a vehicle for drug testing services. Your company does hair testing. So obviously this component of work is my company,’” says Uys.
He proposed to Smith that he gets shares as he introduced Uys to the German company. Smith said he’d give him R6 million ($580,000) and suggested he set up his own operation, which Uys was in the process of doing.
“I said yes and signed with this guy. I finally got the break. I was over the moon. After all this hard work, after waiting a year for sales, all the studies and research, sacrifices and stress, lack of resources and money —I had finally made it,” says Uys.
A year later, Uys had still not received the R6 million ($580,000). He called Smith and asked for his money because he didn’t want to raise investment or lose equity to set up his operation.
“He told me there was no date on the contract and he can give the capital whenever he wanted,” remembers Uys.
Smith threatened to sue Uys if he went ahead with the product. The Germans phoned Uys saying they wanted him in their country to work on the product, while they negotiated with Smith on his behalf.
Uys went to Germany. Smith sued him and the court battles began. But the court favoured Smith and he won with costs. It, however, didn’t end there.
Smith didn’t know how to make the test after numerous trials, so the court ordered Uys to hand over his books to help Smith to develop the product.
“Even with the formulation, it is important to have the know-how. He struggled for a year. He eventually blackmailed me and said ‘I’m going to tarnish your name now’. He put the judgment on his website and actually paid ad words so it would appear on the first page if you Googled my name. He was trying to burn my name,” says Uys.
A few years later, Smith failed with the product. He showed up last year and settled for 2.5% for two years, short of the 50% he had proposed two years before.
“That was really nice for me because it showed who the culprit was and it was reported in a newspaper and people could see I was not a crook. I just made a big mistake by signing a contract. I was then being sued for my own product,” he says.
Now, after lying dormant for two years because of the legal disputes, Uys says they will continue with developments of the prototype. It could make him a fortune.
“I’m very happy I went through this experience. It was a learning curve. I was only 25 or 26 at the time and still naïve and excited. So I’ve learnt a lot from this court case and I’m really happy that it happened without damaging my reputation,” says Uys.
In 2010, he started Medical Diagnostech, developing around 1.5 million kits per year for HIV, pregnancy and ovulation or fertility tests. He employs around 20 people, three of whom are family.
The 30-year-old has made most of his money from the R4, three-step Malaria test kit, which has sold almost 600,000 units this year.
“We’re listing with the World Health Organization. They accepted us in their round five testing to become the preferred supplier. We also got accreditation now to operate on a global scale.”
Uys grew up in the Cape Flats, a neighborhood notorious for gang violence and drug abuse, in a country where most of the people live below the poverty line. Few can afford drug tests which often cost around $6 a piece.
Uys created the Oculus ID range, software that can test for drugs and impairment. He also developed the smartphone application, OculusMobi, and the OculusPro unit. They are used for facial recognition and to test for impairment. OculusLaw, a portable professional camera, takes a picture of the eye. If the eye does not react to the flash, the person could be on drugs. Drugs such as crystal meth and cocaine can enlarge the pupil, while heroin makes them smaller.
Uys is a man changing the world, one medical kit at a time, and has a current potential revenue of up to $12 million. But for now, the small company turns over around $500,000  a year.
He may not have received that $600,000 from Smith, but his reputation as a scientist remained intact and appears destined to make his fortune through his innovative projects.
It’s been a long journey since the train to Frankfurt and now Uys appears to be on track.
*Andrew Smith is not his real name

A Sweet Deal Turned Sour

One person’s passion can change the fate of humanity for good. Add a dose of personal tragedy to the mix, and you get a fascinating case study in the drive to change healthcare in Africa’s second-largest and fastest-growing economy.
<div id="attachment_175" style="width: 484px" class="wp-caption alignleft"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-175" class="size-large wp-image-175" src="/wp-content/uploads/2017/04/1-2-731x1024.jpg" alt="" width="474" height="664" />Ola OrekunrinWelcome to the world of Ola Orekunrin, medical doctor, helicopter pilot, author, medical research fellow, fan of Hannibal Lecter movies and one of Nigeria’s trailblazing entrepreneurs.</div>
Orekunrin, 25, is among the brightest of a new breed of young and visionary entrepreneurs in sub-Saharan Africa. Furthermore, she is an African who has made her name in Europe and is now bringing home that experience to the continent to create wealth and jobs. She saw an opportunity in helping everyone from oil companies to factories airlift injured workers to distant hospitals after accidents.
Nigerians have been talking about an air ambulance system for the country since the early 1960s. No-one had taken up the idea, until Orekunrin stepped in two years ago.
“I’m very passionate about healthcare in Nigeria and I really do believe I was born to practise medicine,” she says.
How has she achieved so much at such a young age? A healthy measure of humility may be one reason.
“I’m the most clumsy, disorganized, eccentric person ever…honestly,” she says defensively.
The trauma and emergency specialist is poised to change the face of medical practice on the continent with Flying Doctors Nigeria Limited—West Africa’s first medical emergency evacuation service. She studied air ambulance services in India and elsewhere in Africa, before founding Flying Doctors with £200,000 ($313,000). The money came from the liquidation of her assets, including her life savings, fast car and London apartment. Private investors matched the money.
Today, she employs 25 professionals and the firm is poised for speedy growth, considering the retinue of current and prospective clients in the financial services, petroleum and public sectors.
“Our main clients are from the oil and gas industry and manufacturing firms. I definitely think patronage from these sectors is set to grow,” she says.
The service that Flying Doctors provides fills a gaping hole in quality healthcare in the world’s sixth-largest crude oil producer. Often distances between factories, remote oil industry installations and hospitals can be more than 100 kilometers. For this reason alone, Orekunrin is optimistic about more business coming from Nigerian and international corporates. She also expects increased business from the public sector and state governments, as most do not have organised disaster management systems.
“Tragedy led me to entrepreneurship,” she says. “I believe that perhaps my sister, who died when she was just 12 years old, may have lived if this sort of service was available in Nigeria at the time. I feel the need to make a difference and prevent it happening to someone else. So my main childhood motivation for becoming a doctor was because my sister was ill when I was growing up and I had very positive experiences with doctors and nurses. My mother wasn’t keen on me taking up flying, my other interest, so I went to medical school. My inner-rebellious child started learning to fly as soon as I left medical school. I love flying now, nearly as much as medicine!”
<img loading="lazy" decoding="async" class="alignleft size-large wp-image-174" src="/wp-content/uploads/2017/04/1-28-1024x731.jpg" alt="" width="474" height="338" />
Born in London and raised in a working-class foster home in Lowestoft, a little fishing town in the East of England, she enrolled for a medical degree at the University of York and qualified at 21—one of the youngest ever to take the doctor’s Hippocratic Oath in Britain.
Barely out of medical school, she jetted off to Japan for medical research work and then China, where she had “one of the most invaluable experiences”, in addition to picking up Japanese and a liking for sushi.
“My proficiency in Japanese meant nothing to people in China,” she told FORBES AFRICA. “After growing up in England, Asia was an interesting shock to my system, but my experience there has greatly influenced my work ethic and attitude to life.”
Now Orekunrin lives in Lagos, West Africa’s commercial hub and Africa’s fastest growing city with a current population of 19 million.
“It’s hard enough practising medicine in Nigeria, and I’ve seen that people tend to wonder why I am doing what I am doing now. I am getting used to the positive prejudice,” she quips.
“Starting a business like this has been much harder than I thought. It was a lot of hard work, with a lot of discouragement. There were a number of points when I thought it would never happen. It took an enormous amount of dedication, focus and sacrifice. But the number of lives we save each year makes it all worth it. I would do it all again in a heartbeat.”
Flying Doctors received its initial technical support from the UK’s East Anglian Air Ambulance Service. A portion of operating profits is ploughed into the Flying Doctors Foundation, which funds public healthcare projects in Nigeria. She won’t disclose what the firm is currently worth, but the rapid response air ambulance service they provide has been hailed as one of the most important healthcare innovations in Nigeria this decade.
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Tag: Medicine

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