HIV testing and monitoring down by a fifth after Trump aid cuts
Crucial testing and monitoring of vulnerable South African HIV patients has fallen by up to a fifth since Donald Trump cut aid to health workers and clinics, government data shows.
The testing to monitor blood virus levels has fallen by 17 per cent in young people, and by 21 per cent in pregnant women.
The data reported by Reuters also shows that testing in infants has fallen by a fifth and is one of the most concrete signs yet of the effect the aid cuts are having on the country with the highest number infected by HIV.
Aaron Motsoaledi, health minister, admitted the funding cuts had caused problems, but strongly denied suggestions the country's anti-HIV campaign was close to collapse.
He said: 'Under no circumstances will we allow this massive work conducted over more than a decade and a half to collapse and go up in smoke because of what President Trump has done.'
Modelling released in March has already predicted the cuts could trigger soaring rates of global HIV infections and millions of deaths.
There could be between 4.4m to 10.8m additional new HIV infections by the end of this decade in low-and-middle income countries according to the forecasts published in the Lancet journal.
Regular testing of HIV patients is considered vital for managing the long-running outbreak because it tells whether treatment is keeping the virus in check, and whether it is sufficiently suppressed to prevent it spreading to others.
Testing is particularly important in pregnant women who are at risk of passing on the infection during childbirth.
Public health experts warn that with less testing, fewer people who are at risk of transmitting the virus will be identified.
Missing a test can also indicate that a patient has dropped out of the system and may be missing treatment.
Trump froze many foreign aid programmes by executive order in the early days of his administration.
South Africa was doubly hit, as he also targeted aid to the country for allegedly discriminating against white people. He falsely said white land was being seized by the government.
South Africa did not rely on America for its anti-HIV drugs but did rely on the United States President's Emergency Plan for Aids Relief (PEPFAR) to pay 15,000 health workers.
These workers did HIV testing and counselling in hotspots and checked up on patients who had dropped off their medication.
'These are shocking figures, with profound implications for maternal and child health across the country,' said Francois Venter, executive director of the Ezintsha Research Centre in Johannesburg.
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The Guardian
21 minutes ago
- The Guardian
The grip secret: it could be the key to a long and healthy life – here's how to improve yours
Anyone who has ever dropped their phone in the toilet – and isn't that all of us? – knows something about the importance of a good strong grip. We come into the world ready to grasp anything placed in our hands, and if we are lucky we leave it the same way. In between, grip lets us cling to our parents, hold our lovers, rock our babies. The morning I wrote this, before I was even dressed, it enabled me to strap on my watch, lock the kids out of the bathroom, wash my hands, insert my contact lenses, strip, shower, brush my teeth, take my medicine and check my phone. A few hours later, as I hung upside down on some gymnastics rings, it stopped me slipping off and cracking my head on the floor. But you know what? This just scratches the surface. Not only does grip help you work, play and pull your trousers on in the morning; it offers an immediate insight into your health. To put it bluntly, the weaker your grip, the more likely you are to die early. Find that hard to swallow? A study of 140,000 adults in 17 countries found that a weak grip went hand in hand with a higher risk of heart attack and stroke, and was a better guide to 'all-cause mortality' than blood pressure. It is associated with osteoporosis, diabetes, rheumatoid arthritis, fall risk and obesity, as well as cognitive decline. Unsurprisingly, perhaps, it is also linked to age-related muscle loss, or sarcopenia. For all these reasons and more, doctors often use grip strength as a quick measure of a patient's health, including their ability to recover from surgery or live independently. 'It's a really easy thing to test,' says physiotherapist Sarah Milner. 'You don't need to hook someone up to a machine, you don't need to look at their muscle mass, you don't need to take their weight …' The only real drawback is that it focuses on upper-body strength, which is why patient assessments often combine a grip test with a sit-to-stand, which gauges lower-body strength. Grip strength reliably reflects 'total body strength, neuromuscular coordination and cardiovascular resilience', in the words of Delhi GP Ramit Singh Sambyal. He says that patients in their 50s with a surprisingly weak grip often report fatigue, slower recovery after minor illnesses and a higher percentage of body fat. Conversely, those with a stronger grip tend to have better functional fitness and recover more quickly. To be clear, no one is saying a weak grip will kill you directly, in the way that heart failure will. But it usually indicates problems far beyond your hands and wrists. We don't yet have the scientific studies to back this up, but it seems reasonable to assume that anything that improves it will also improve your overall health. It will certainly improve your quality of life. Some weakening of the grip is inevitable as we get older. 'From about 50, muscle mass and nerve function gradually decline,' says Samantha Shann, occupational therapist at Oak Tree Mobility and director of The OT Service. 'But staying active – particularly with meaningful and hands-on tasks – helps slow the process.' Actually, we should be talking about grips rather than grip. As well as crush grip, which lets us shake a hand or hold a dumbbell, we mostly rely on pinch grip (think of turning a key or holding a plate) and support grip (to carry something like shopping), though there are enough subcategories to make your head spin. The more precise types may need to be trained with more delicate exercises, but in general what strengthens one grip also benefits the others, by working the flexor muscles that clench our fingers and thumbs, and the extensor muscles that straighten them, as well as our wrists and forearms and sometimes our upper arms and shoulders, too. How do you know whether all this needs attention? Sometimes looking is enough. Lucy Joslin teaches calisthenics, which features a lot of dangling from rings or pull-up bars, and handstands, where often the only thing keeping you balanced is the way your hands grip and flex against the floor. Every class begins with exercises for the hands, wrists and shoulders – bending them, stretching them, putting weight on them, frequently in quite uncomfortable positions. 'I look at people's hands all day long,' she says. 'You can tell unconditioned hands from conditioned hands – the people who are in touch with their fingertips and the people who are not. And then they go to grip a pull-up bar and it's like their hands can't close properly. And as for hanging off the bar, which is something I take for granted … no. And it's not just because they don't have the strength in their shoulders.' Milner, meanwhile, says her job has given her 'monkey grip'. As a result, 'I like doing bar hangs. That for me, is like, 'Where's my grip strength at?' And I know that if I'm fatigued my bar hang is a piece of shit.' On a good day she can hang for 90-120 seconds. When she told me this, I thought I'd see how long I could manage. Thanks to almost a year of calisthenics I made it to 90 seconds – but the last 45 were pretty unpleasant. There are gentler ways of testing, though. 'You can do it by squeezing a tennis ball and seeing how long you can hold your tightest grip,' Milner suggests. Do that regularly and you'll be able to track whether your grip is improving or deteriorating. 'I encourage clients to notice how they manage everyday tasks,' says Shann. 'Can they open a tight jar, wring out a cloth or carry a kettle comfortably? These are all functional ways of assessing grip.' For a more formal measurement, you'll normally squeeze (all right, crush) a device known as a dynamometer. You can get one of these for less than £20, though it may not be as accurate as medical-grade equipment. 'Grip strength varies with age and gender,' says Shann, but broadly speaking here's how much force you should be able to exert: Age 18 to 25 Women 27-31kg, men 46-52kgAge 26 to 35 Women 26-30kg, men 44-50kgAge 36 to 45 Women 25-29kg, men 42-48kgAge 46 to 60 Women 20-28kg, men 35-47kgAge 61 to 75 Women 18-26kg, men 30-45kgOver 75 Women 16-20kg, men 25-40kg 'While everyone's baseline differs,' Shann says, 'these numbers can highlight the need for support or intervention. It could mean a person is at risk of frailty, especially if combined with fatigue or reduced mobility.' Remember what I said about accuracy? Naturally, I had to try a dynamometer myself. The first one I bought gave me a reading of 39.1kg, which as a 61-year-old I should have been happy with. It still felt a little low given how much time I spend hanging from things. So I got another and squeezed it all the way to 46.6kg. I'm not sure which reading is more realistic, but I know which is better for my ego. Still, to put both into proportion, the world-record squeeze is more than 170kg. But what can you do if you're not happy with your result? 'I often recommend turning everyday activities into opportunities for strengthening,' says Shann. 'Tasks like cooking, gardening or carrying laundry all challenge grip in a natural and functional way. Structured exercises can be added in when more support is needed, such as a tennis ball squeeze (hold for three seconds, release, and repeat 10 times per hand, daily) or a towel twist (roll a towel and twist it in opposite directions, for one or two minutes a few times a week). I usually tell clients they can expect to notice small improvements in four to six weeks if they're consistent.' And those little gadgets where you try to force two handles together with your hand, against the resistance of a spring? I've somehow accumulated five of them, rated all the way from 50lb (23kg) to 250lb (113kg). I can barely make that last one move. Forget them, says Milner. What originally attracted me to them – that it's so easy to crank out squeeze after squeeze after squeeze – is also what makes them dangerous. 'They're terrible,' she says. 'People start using them and they give themselves some form of tendinopathy [tendon damage] from overloading. That repetitive gripping is awful.' Better to take a less direct, more holistic approach. 'When it comes to strengthening,' she says, 'it's really important to talk not just about your hand and your forearm, but about the whole kinetic chain.' This is the physios' way of saying that everything is linked; no muscle is an island; the toe bone's connected to the foot bone … 'The shoulder and the scapula – the shoulder blade – are intrinsically linked to grip strength,' Milner says. 'So I would do things like full-body strength training or functional strength training.' Imagine you're in a push-up position, say. 'If you've got your hands on the floor, and you're weight-bearing with a flat palm, or you start doing different types of grip on the floor, you're already strengthening your palm muscles and your forearm muscles, and you're loading up the shoulder blade. And then you can play with taking one hand off the ground and doing shoulder taps, or doing down dogs or a high plank. 'That's going to strengthen your wrists and hand muscles, but it's also going to hit you higher up the chain. It will also train your proprioception, which is basically knowing where your wrists and finger joints are in space, as well as your elbow and shoulder. And that is massively linked to strength, because if you have no idea where anything is, you're going to really struggle to be strong in that area.' Train your grip, in other words, by training things that aren't obviously your grip. And throw away those squeezy things. Six ways to improve your grip, by physiotherapist Sarah Milner At home Push-ups These come in many variations, so if they seem intimidating, you can adjust the difficulty by changing the angle, the position of your hands and the distribution of your weight. Start standing with your hands on the wall for a simple push exercise and progress this to the classic horizontal version on the floor. You can make this more challenging by playing with the position of your hands (wider, more narrow) and where your weight goes through (fists, just fingertips). Wet towel wrings Soak a towel in water, then grip and twist it to wring it out. Use both hands, and twist in both directions to improve the strength of your forearm and hand flexor muscles. Pinch grip holds Find the heaviest book in your house and take it between your fingers and thumb in a classic 'pinch grip' position. See how long you can hold it. You can play with the position of your arm (by your side, out in front of your body, above your head) and how bent or straight your elbow joint is. In the gym Dead hangs Try to hold on to a bar as long as your grip will allow you. You can change your hand position to challenge different hand and forearm muscles (neutral, supinated or pronated). This is a great exercise that helps activate your shoulder muscles, which are so important for grip strength. (Confused about those hand positions? If you stand with your arms by your sides, thumbs facing forwards is neutral. Palms facing forwards is supinated. And palms facing back is pronated.) Barbell bent-over rows This is a great multi-muscle exercise; the heavier you go, the harder your arm muscles, shoulders, shoulder blades and core have to work. Make sure you progress the weight steadily, and get a professional to guide you if you're concerned about your form. You can use either a pronated or a supinated grip. Reverse kettlebell above-head shoulder press. Hold on to the handle of an upside-down kettlebell (the ball part should be at the top and handle at the bottom). Try to keep your wrist in a neutral position (and straight) as you complete a strict above-head shoulder press. Try to move slowly and avoid the kettle collapsing down. This will challenge all of your arm and hand muscles as well as improving joint control and stability through the shoulder, elbow and wrist.
Daily Mail
36 minutes ago
- Daily Mail
Man suffers 'infection' that affects us all - it was actually killer cancer that cost him his NOSE
A man whose GP said his breathing issues were due to a routine infection has now lost his entire nose to the real cause, a deadly form of cancer. William Brogan, 47, from Hamilton, South Lanarkshire now faces major surgery to restore his face after medics were forced to amputate his nose. The only initial symptom the former chef had was a sore nose—an ailment common to a variety of routine winter illnesses. But after almost a year of doctors trying to relieve Mr Brogan's illness with antibiotics, the real devastating cause was revealed to be the blood cancer lymphoma. Lymphoma is a cancer of the lymphatic system—a network of blood vessels and glands helps fight off infections— and which kills about 5,000 Britons per year. In Mr Brogan's case, the disease originated in part of the lymphatic system in his nose, but by the time it was diagnosed in January this year, it had also spread into his mouth. He claims doctors dismissed his worries about the ongoing nose pain and believes his cancer could have been caught earlier. 'I had been telling them for months and months that it was something more. You know your own body,' he said. 'The antibiotics were helping at first but when I asked for more help I had to wait for an appointment. It got worse in that time waiting. 'It took them over a year to get a biopsy and find it was cancer. 'They could have caught this nine months earlier before it travelled into my mouth. 'Now I've got a hole in my face and a triangle where they removed part of my nose.' After finally being diagnosed Mr Brogan had to undergo a marathon 20-hour operation to remove the cancer earlier this year. This sadly meant he had to have his nose as well as the upper gums of his mouth removed. While medics attempted to rebuild the gum with healthy tissue taken from under his arm, this unfortunately proved unsuccessful. This meant he needed another five-hour operation to remove the failed transplant, before another 12-hour surgery for another transplant to rebuild his upper mouth which did prove successful. He has since been undergoing radiotherapy—where powerful radiation is used in an attempt to kill cancer cells— before medics attempt to rebuild his nose. Mr Brogan said losing his nose, and the extreme change to his appearance this had brought, had taken a huge mental toll on him and he was now on medication to help. 'Diazepane, used to relieve symptoms of anxiety, is the thing that gives me the courage to go out,' he said. 'People say "there's that man with the hole in his face".' But he added he's hopeful for the future. He said specialist surgeons having looked at photos of him prior to the amputation to ensure they can make him a nose that matches his previous appearance. 'I'm hoping to have a skin graft to try and rebuild my face within the year,' he said. 'They've already taken a picture of my face, so they know what colour to make my nose. 'I can't thank the surgeons enough. They saved my life.' Family doctors most commonly prescribe antibiotics for nose pain in cases of sinusitis, an infection of the sinuses. While most sinusitis cases are triggered by viruses—for which antibiotics don't work—if infections persists for a long period, it can be a sign it's caused by a bacteria. In these circumstances a medic can prescribe antibiotics to help clear the infection. Studies suggest between one in 20 to one in six Britons get sinusitis each year, though many cases are mild and can be treated at home. As lymphoma can develop in any part of lymphatic system the symptoms patients experience can vary immensely. For example, some may develop swollen tonsils in the mouth, a lump in the tummy, or skin rashes depending exactly where the cancer is. However, the most common sign of the disease is a painless swelling in areas like the neck, armpit or groin. Other symptoms—reported by some patients—include night sweats, unexplained weight-loss, a high temperature, breathlessness and persistent itching all over the body. Approximately 13,500 cases of non-Hodgkin lymphoma—the more common version of the disease—are diagnosed in the UK each year, about 37 cases per day. About half (55 per cent) of patients will survive at least a decade after being diagnosed. One in 52 men and one in 71 women will develop non-Hodgkin lymphoma over the course of their life, according to charity Cancer Research UK. People in their 80s are the most likely to be diagnosed with non-Hodgkin lymphoma of any age group. While the rates of this cancer have increased by almost a third across all age groups since the 90s there has been a small decrease in recent years. What is lymphoma? Lymphoma is a cancer of the lymph nodes, which is the body's disease-fighting network. That network consists of the spleen, bone marrow, lymph nodes and thymus gland. There are various types of lymphoma, but two main ones: non-Hodgkin and Hodgkin. Both have much better prognoses than many types of cancer. WHAT IS HODGKIN LYMPHOMA? Hodgkin lymphoma is a type of cancer that starts in the white blood cells. It is named after Thomas Hodgkin, an English doctor who first identified the disease in 1832. It affects around 2,000 people each year in the UK, and 8,500 a year in the US. Hodgkin lymphoma is most common between the ages of 20 and 24, and 75 and 79. Five-year survival rates: The survival rates are much more favourable than most other cancers. Stage 1: 90% Stage 2: 90% Stage 3: 80% Stage 4: 65% Symptoms include: A painless swelling in the armpits, neck and groin Heavy night sweating Extreme weight loss Itching Shortness of breath Coughing Risk factors: Lowered immunity A family history of the condition Smokers Those who are overweight Treatment: Chemotherapy Radiotherapy Steroids Stem cell or bone marrow transplants WHAT IS NON-HODGKIN LYMPHOMA? Non-Hodgkin lymphoma can occur anywhere in the body but is usually first noticed in the lymph nodes around sufferers' necks. Non-Hodgkin lymphoma affects around 14,000 new people every year in the UK. In the US, more than 80,000 people are diagnosed annually. It is more common in males than females, and it is commonly diagnosed either in a patient's early 20s or after the age of 55. Five-year survival rates: Survival can vary widely with NHL. The general survival rate for five years is 70 percent, and the chance of living 10 years is approximately 60 percent. Symptoms include: Painless swellings in the neck, armpit or groin Heavy night sweating Unexplained weight loss of more than one-tenth of a person's body Itching Risk factors: Over 75 Have a weak immune system Suffer from coeliac disease Have a family history of the condition Have had other types of cancer Treatment: It depends on the number and locations of the body affected by Non-Hodgkin lymphoma. Therapy typically includes chemotherapy.
The Sun
39 minutes ago
- The Sun
Amber heat health alert extended as Met Office warns temperatures could hit 35C
A HOT weather health warning has been extended across most of England as temperatures are set to climb to 35C - in one of the hottest June days on record. Amber heat health alerts for Yorkshire and the Humber, East Midlands, West Midlands, East of England, London, South East and South West have been in place since June 26. 1 They were due to expire by 6pm on Tuesday, but the UK Health Security Agency (UKHSA) extended them until 9am on Wednesday morning. A yellow heat health alert has also been extended for the North West. Health heat alerts are issued by the UKHSA and Met Office when weather conditions are expected to have severe impacts across health and social care services. This could include a rise in deaths, particularly in people over 65 and those with existing health conditions, including respiratory and cardiovascular diseases. There are also concerns over an increase in demand on health and care services, and overheated hospitals and care homes. The alert - the second highest, behind red, on the UKHSA's system - means people should take precautions for their health while enjoying the hot weather, such as staying hydrated and stopping themselves from overheating. The main risks posed by a very hot weather are dehydration - from not drinking enough water - and overheating, which can make symptoms worse for people who already have problems with their heart of breathing. The Met predicted temperatures would top 30C across England, including in Manchester, Sheffield, Bristol and Cambridge. London and the South East of England are expected to sizzle under highs of 34C. The current hot weather is forecast to continue through Monday and Tuesday, with the potential for temperatures as high as 35C in some areas. Cheap hacks to stay cool this summer Dr Agostinho Sousa, head of extreme events and health protection at UKHSA, said: "The current spell of hot weather is forecast to continue until the middle of this week, with temperatures above 30C likely in most regions of England. "We are reminding everyone to take sensible precautions while enjoying the sun. "Remember that it is very important to check on friends, family and neighbours who are more vulnerable, as the temperatures we are likely to see over the next few days can result in serious health outcomes across the population, especially for older adults or those with pre-existing health conditions." Monday is set to be one of the hottest June days ever. How to stay safe in hot weather While many people enjoy warmer summer weather, hot weather can cause some people to become unwell through overheating (becoming uncomfortably hot), dehydration, heat exhaustion and heatstroke. Remember the following tips if you want to stay safe: Keep out of the sun at the hottest time of the day, between 11am and 3pm If you are going to do a physical activity (for example exercise or walking the dog), plan to do these during times of the day when it is cooler such as the morning or evening Keep your home cool by closing windows and curtains in rooms that face the sun If you do go outside, cover up with suitable clothing such as an appropriate hat and sunglasses, seek shade and apply sunscreen Drink plenty of fluids and limit your alcohol intake Check on family, friends and neighbours who may be at higher risk of becoming unwell, and if you are at higher risk, ask them to do the same for you Know the symptoms of heat exhaustion and heatstroke and what to do if you or someone else has them Heat exhaustion occurs when the body overheats and cannot cool down. Heat exhaustion does not usually need emergency medical attention if you cool down within 30 minutes. If you do not take action to cool down, heat exhaustion can lead to heatstroke. Common symptoms of heat exhaustion include: Tiredness Weakness Feeling faint Headache Muscle cramps Feeling or being sick Heavy sweating Intense thirst Heatstroke is where the body is no longer able to cool down and the body temperature becomes dangerously high. Common symptoms of heatstroke include: Heatstroke is a medical emergency. If you think someone has heatstroke you should dial 999 and then try to cool them down. Source: UK temperatures have only surpassed 34C on three different occasions since 1960. The hottest June day ever was 35.6C, recorded on June 28, 1976. It marks the second heatwave for parts of the UK this month, as temperatures topped 32C earlier in June. Heatwaves are becoming more frequent, with experts they can become "silent killers" due to their impact on health. Dr Friederike Otto, associate professor at Centre for Environmental Policy, Imperial College London, said: "Heat waves are called the silent killer, for a reason, every year thousands of people in Europe die due to extreme heat, particularly those that live in poorly insulated homes, on busy, polluted roads, and that already have health problems." The weather in the UK comes as a heatwave grips much of southern Europe. Professor Richard Allan, from the University of Reading, said the UK was on the edge of a "large dome of heat" over continental Europe which was driving the heat wave, while ocean temperatures were also up to 2C above average to the south-west of the UK and "hotter still in the western Mediterranean". "The ebb and flow of gigantic atmospheric waves have generated the stable, cloud-free conditions for heat to build up across western Europe," he said, but added that rising greenhouse gas levels due to human activities were making heat waves more intense. Temperatures have climbed above 40C in countries including Italy, Spain and Greece, with holiday destinations such as Rome, Milan and Naples under the highest heat alert, while Greece is on high wildfire alert. After Monday's hot conditions, the Met Office said a tropical night may also be on the cards, with temperatures not falling below 20C overnight in some places into Tuesday. But Northern England, Northern Ireland and Scotland face a cloudier, cooler day on Monday with some outbreaks of rain moving across Northern Ireland and western Scotland. Parts of south-east England could hit 35C on Tuesday before some fresher conditions move in from the west through the rest of the week, the Met Office said. Met Office Chief Meteorologist Paul Gundersen said: "Temperatures are rising further today with low 30C widely across England including places like Manchester, Sheffield, Bristol and Cambridge. "The highest temperature is expected to be 34C in London and the south east of England. "These high temperatures and humid conditions will be quite uncomfortable for those working outside as well as people leaving Glastonbury and attending the start of Wimbledon and other outdoor events. "Stay hydrated and try to keep out of the sun during the hottest part of the day," he advised. The signs of heat exhaustion - and when it becomes heatstroke Heat exhaustion does not usually need emergency medical help if you can cool down within 30 minutes. The signs include: Tiredness Dizziness Headache Feeling sick or being sick Excessive sweating and skin becoming pale and clammy or getting a heat rash, but a change in skin colour can be harder to see on brown and black skin Cramps in the arms, legs and stomach Fast breathing or heartbeat A high temperature Being very thirsty Weakness Diarrhoea HEATSTROKE is a medical emergency, so get inside and call 999 for an ambulance. Stay with the person, who may not be able to help themselves. Try to remove clothes if possible and lie the person down. Use a cool flannel and sponge them down and use a fan to try and help them lose heat by evaporation. If they are conscious and able, try to encourage them to drink. If they lose consciousness, put them into the recovery position while you wait for an ambulance. The NHS says to call 999 for signs of heatstroke that include: Still being unwell after 30 minutes of resting in a cool place, being cooled and drinking fluids A very high temperature Hot skin that's not sweating and might look red (this can be harder to see on brown and black skin) A fast heartbeat Fast breathing or shortness of breath Confusion and lack of coordination A seizure or fit Loss of consciousness
