Truancy, as usual

I've noticed that a lot of people are finding me through looking for info on volunteering in Tanzania, if that's the stuff you're after you can find it here and here.

Sorry I haven't been posting very regularly recently, I've got loads of work to finish before heading back to East Africa in June. I'm taking Abby (my little sister) with me this summer... will be far more travelling than I did last summer - we plan to do a loop of Lake Victoria but I'm not sure if we can stomach the grueling day long bus journey from Mwanza to Kigali - so it might involve a bit of backtracking though Uganda. I'm going to spend a week in Mwanza and can't wait to see the kids again and catch up with the wonderful people I met there :) Then Abby and I are going of to gorrilla trek in Rwanda. Abby wants to be a primatologist so I'm hoping it'll be some inspiration for her! We will be darting around like mad - look forward to some real (and hopefully interesting) posts starting the end of next month.

Please don't tell me you're surprised

Today the Post's Shankar Vedantam reports that the pharmaceutical company which sponsors a drug trial is most likely to find their own drug works 'best'. Comparison of Schizophrenia Drugs Often Favors Firm Funding Study goes onto say:

...when psychiatrist John Davis analyzed every publicly available trial funded by the pharmaceutical industry pitting five new antipsychotic drugs against one another, nine in 10 showed that the best drug was the one made by the company funding the study."On the basis of these contrasting findings in head-to-head trials, it appears that whichever company sponsors the trial produces the better antipsychotic drug," Davis and others wrote in the American Journal of Psychiatry.

Such studies make up the bulk of the evidence that American doctors rely on to prescribe $10 billion worth of antipsychotic medications each year. Davis pointed out the potential biases in design and interpretation that produced such contradictory results. Other experts note that industry studies invariably seek to boost the image of expensive drugs that are still under patent. Moreover, they say, the trials are relatively brief and test drugs on patients with simpler problems than doctors typically encounter in daily practice.

By contrast, when the federal government recently compared a broader range of drugs in typical schizophrenia patients in a lengthy trial, two medications that stood out were cheaper drugs not under patent. The medication that worked best for patients with severe, intractable schizophrenia was clozapine, whose sales lag well behind every other drug in its class. And an earlier leg of the study found that the largely unused drug perphenazine had about the same risks and benefits as far more expensive competitors that are widely assumed to be safer.

US govt policy at work

AIDS prevention efforts are being undermined by spending restrictions in US foreign aid the Washington Post reports today. Despite years of evidence showing that tied aid is less effective than untied aid (Sachs, 2005), Bush's PEPFAR plan requires that a significant proportion of US funding must be spent on abstinence only prevention efforts. This means that in many cases struggling health systems have had to cut spending to more necessary areas in order to fulfill US demands.

Of the 15 "focus countries" -- 12 African countries, plus Haiti, Guyana and Vietnam -- nine reduced the amount of money for programs to prevent mother-to-child transmission of HIV in their 2006 budgets to meet the spending target for abstinence promotion.

In one, mother-to-child funding was cut from $1.4 million to $1 million, and in another it was reduced by $300,000, said GAO's David Gootnick, who oversaw the report.

In perhaps the largest adjustment, one country cut from $8 million to $4 million its spending on prevention services for couples in which one person has HIV infection and the other does not -- an extremely high-risk group -- as well as on sexually active youths and sex workers.

I graduated!

My aunt Meriel, my gran, me and my mum celebrating my MSc graduation :)

Last day in the Gambia

Maz and I with our wonderful taxi driver Pappe Jazz

Crossing the Gambia & Senegal

Sunrise on the Gambian River

Leaving the ferry on the farside of the river

Sunburned but smiling

We packed so much into the past few days that it's gone by in a total blur. On Sunday we walked round the Abuko nature reserve - before we walked in our taxi driver asked if we wanted him to drive round to the exit to pick us up or if we wanted to walk back to the entrance - we foolishly told him we were perfectly capapble fo walking back and set off. Gambia is really famous for the variety of birds here, and we saw some really beautiful ones, but were much more impressed by the massive crocodiles along the banks. At about the 33rd marker I started to feel a bit tired and asked our guide how much further the walk was - he laughed and said there were 107 markers till the end! We kept going and at about the 1/2 way point stopped at the animal rehab house, had a drink and snapped a few pics of the alarmingly close hyena family. The last 1/2 I walked fast to reach the end as soon as possible, and have never been so happy as to see our taxi driver waiting patiently for us. Maz and I jumped in and were happy to be off when we were told the Nigerian president was about to pass and we couldn't leave until he had done so... about 20 minutes later a parade of cars filed past and we were finally on our way.

We met up with the Gambian family of one of Maz'z coworkers on Sunday evening and they have been taking brilliant care of us - guiding us to places we never would have found on our own, explaining the country from a locals point of view and even feeding us a wonderful Gambian dinner of fish, plassus and rice last night. They live so far away from where we are staying on the coast that it took a couple of hours by gellah-gellah to get back last night, but it was a much more relaxing trip than the dalla-dallas of Tanzania (for a start everyone had their own seat!).

Today I decided to take a break from all the hectic site-seeing to spend some time on the beach and am decidedly pink as a result!

Future football stars

Children in the Gambia

The family that made us feel welcome in the Gambia

Just as close as they appear

Gambia Maybe Time

Hello from hot and sunny Kotu Beach, the Gambia. Maz and I left the absolutely freezing streets of London yesterday morning thinking it wouldn't be possible to survive in temperatures any colder and spent the evening walking a long the beach barefoot. The cold that I had when I left England has almost dissappeared with the warm weather.

We had heard quite a lot about sex tourism here before we came (as has just about everyone it seems!), though watching the middle age women with boys 1/2 their age is a sight that can only really be seen to be believed. Thanks to this wonderful practice, we've found it completely impossible to walk anywhere unaccompanied by 'bumsters' who seem harmless but are rather irritating. This morning we went to the markets in Serrekundu (the largest city in the Gambia) and spent an hour or so walking round with a constant companion telling us "relax and take it easy, I'm not hassling you," If that is so, I dread to think what hassling is!

Now that we've missed the peak sun hours, we'll spent the afternoon lounging on the beach and relaxing :)

The Western Sahara by air

Some good news in the new year?

Today Justin Gillis wrote that a Once-a-Day AIDS Pill Could Be Ready Soon in the Washington Post. This is, ofcourse, good news. Having to take only one pill a day means treatment regimens are easier to maintain, patients won't get as sick and drug resistant strains are less likely to develop. Though "[t]he pill won't be ideal for women of child-bearing age, since it may cause birth defects." The group most affected by HIV/AIDS worldwide, won't be able to use this new drug. The eternal cynic in me noticed this sentence:

"With nearly two dozen AIDS drugs on the market, with many more on the way, and with the patients taking them expecting to live out normal life spans, companies say devising convenient regimens has become a make-or-break problem."

and it made me wonder: isn't this the perfect market for drug companies? I know it's been said before, but an ever-increasing population forced to maintain drug regimens for their entire natural life, it all seems too perfect. What incentive do pharmaceutical companies have to develop a cure for AIDS? No matter how hard we try to treat the rapidly multiplying numbers of people affected by HIV/AIDS in developing countries, until there is a cure the poorest will continue to have far higher HIV infection and AIDS mortality rates.

The Post also reports that the NIH Halts International AIDS Study testing whether breaks from anti-retroviral drugs had an effect on drug effectiveness. Unsurprisingly, the trial "showed that patients had twice the risk of dying or developing clinical AIDS if they took breaks from the drug cocktails, called highly active antiretroviral therapy." This has major implications for donor agencies funding treatment in developing countries. While there are now several programmes offering developing countries assistance for ART (anti-retroviral treatment) that are expected to increase their investment in the coming years, it is crucial that these programmes don't, as all too often happens, have their funding cut in future budgets. Pressure must be kept up to ensure that the Global Fund, the WHO's 3*5, and other AIDS treatment programmes are maintained as even short breaks in treatment can increase the development of drug resistant HIV strains, cause earlier AIDS onset and more illness for those with HIV/AIDS.