A team of scientists from the University of the Sunshine Coast in Australia and around the world has developed a promising way to reduce the risks from biodegradable medical implants.
The implants are coated in bioactive peptides, which are small, naturally occurring protein fragments that can support health and wellbeing.
The new coating combines advanced metal processing with biomolecular science to improve compatibility with the body, reduce inflammation and boost antibacterial activity, enabling the implant to degrade safely as the bone heals.
Associate Professor Tianfang Wang said the technology could be most beneficial for orthopaedic implants such as plates, screws and pins used to repair fractures, as well as certain dental implants.
“Our ultimate goal is to create self-absorbing implants that support healing then naturally disappear once no longer needed. This would reduce the physical and emotional burden associated with implant removal, giving patients greater confidence and comfort in their recovery.
“It may also be suitable for cardiovascular stents or other devices where antibacterial protection and immune compatibility is essential in the critical early stages after implant,” he said.
Traditionally, metallic implants are made from stainless steel or titanium and remain permanently in the body or sometimes require surgical removal after healing, which can cause pain, anxiety, and added costs.
Magnesium alloys are among a new generation of degradable implant materials currently being developed based on naturally occurring trace elements in the body and designed to degrade naturally over time in unison with healing, so that they don’t require removal.
“While the magnesium alloys are biodegradable, these implants may still need to be removed if they degrade too rapidly, or cause infection,” said Professor Xiaosong Liu, the lead Chinese collaborator from the First People’s Hospital of Foshan.
“Degradable, biocompatible magnesium implants with built-in antibacterial activity could eliminate these issues, reducing patient distress, surgical risks, and healthcare costs while promoting more sustainable medical practices,” said AMM materials scientist Dr Hejie Li.
Associate Professor Damon Kent, leader of AMM, said the next step is to move the alloy to production for early pre-clinical trials, while exploring partnerships with biomedical companies to support the scale-up.
“We are also exploring use of the coatings on other suitable metals and 3D metal printing options. There are a lot of possibilities,” he said.
UniSC Deputy Vice-Chancellor (Research and Innovation) Professor Ross Young said the innovation was the latest in a growing body of world-class translational research and impact at the University, particularly in the health and medical space.
“Expert researchers at UniSC continue to deliver new insights into cancer, chronic diseases, mental wellbeing such as PTSD and youth mental health, healthy ageing, nutrition and sports science,” Professor Young said.
“Coupled with our commitment to introducing a Medical Program, UniSC is truly establishing its position on the world stage for its leadership and expertise in human health.”
#InsideTheBox is a column by Dr Andy Gray, a pharmaceutical sciences expert at the University of KwaZulu-Natal and Co-Director of the WHO Collaborating Centre on Pharmaceutical Policy and Evidence Based Practice. (Photo: Supplied)
8th May 2026 | Andy Gray
We can generally trust that the medicines we buy at pharmacies contain what they are supposed to and that they were manufactured according to good quality standards. In his latest column, Dr Andy Gray zooms in on the regulatory scaffolding that enables this trust.
One of the health-related Sustainable Development Goal targets is to achieve “universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”. The word “quality” appears twice in that target description, as a requirement for the healthcare services delivered, and as an essential element of the medicines and vaccines made available.
‘Quality cannot be tested into a product’
There is a truism in the pharmaceutical industry that quality cannot be tested into a product. Instead, quality is assured by the implementation of a pharmaceutical quality system, referred to as current Good Manufacturing Practice (cGMP).
The primary legal enablement is provided by the Medicines and Related Substances Act, 1965. Section 1(3) of the Act states: “In determining whether or not the registration or availability of a medicine is in the public interest, regard shall be had only to the safety, quality and therapeutic efficacy thereof in relation to its effect on the health of man or any animal, as the case may be.” Evidence for safety and therapeutic efficacy is provided by well-conducted clinical trials. There is a difference, however, between registered medicines and complementary medicines. The latter require a warning on their labels stating: “This unregistered medicine has not been evaluated by the SAHPRA for its quality, safety or intended use”. Complementary medicine manufacturers are being progressively brought in line with GMP.
Evidence of quality is not reliant only on retrospective data, on tests conducted on the medicines used in the clinical trials, and the design of the dosage form to be sold, but also on the means to ensure that every batch made will deliver the same results. By requiring that every manufacturer of a medicine is licensed by the South African Health Products Regulatory Authority (SAHPRA), the Authority can ensure compliance with GMP. The ultimate sanction for not meeting GMP standards is withdrawal of licensure and therefore an immediate stop to all manufacturing activities.
New guidelines
SAHPRA updated its GMP guidelines in April 2026. The guideline defines GMP as “a set of principles and procedures that, when followed, ensure that medicines and related substances are of high quality, safety and efficacy”, and as a “system that ensures medical products are consistently produced and controlled according to quality standards”. Echoing the truism, it states that GMP is “designed to minimise the risks involved in any pharmaceutical production that cannot be eliminated through testing the final product”.
GMP requires the manufacturer to provide detailed description of the systems to be implemented to document every step in the manufacturing process and the control measures in place to ensure quality. These step-by-step descriptions have to cover every component included in the medicine and its packaging, the premises and equipment used, as well as the training and accreditation of the staff involved in the production process. A risk-based approach is used, for example differentiating between sterile and non-sterile production processes. Quality control testing during the production process is critically important.
GMP places a lot of emphasis on the capability of key personnel, but also the way in which authority and responsibility is assigned, accepted and documented, and how each person fits into the management decision-making process. For example, SAHPRA’s GMP guidelines differentiate between the Head of Quality Control, who “should have the authority to establish, verify and implement all quality control procedures such as authority over quality decisions, oversight of testing and results, approval of quality control documentation, laboratory management, validation and method control”, and the Head of Quality Assurance, who “should be part of the decision-making process in all matters that affect the quality of products including development, laboratory, storage, distribution, vendors and third-party contractors”. All staff engaged in production have to be trained on the principles of GMP and the specific duties assigned to them. Continuing training is required, with documented training programmes, training records, and checks to confirm that procedures are being followed.
What if medicines are made outside of SA?
That all sounds straightforward, if the manufacturer is located in South Africa and can easily be accessed by a SAHPRA GMP inspector. However, the majority of medicines consumed in South Africa are imported, and even those that are made locally mostly rely on imported active pharmaceutical ingredients or drug substances.
Although there is provision for exceptions, medicines imported into South Africa have to be subjected to post-importation identification and assay (testing of what it contains) by a local, accredited laboratory, or samples have to be returned to the manufacturer or an overseas testing laboratory.
SAHPRA is a member of two key organisations that are advancing harmonisation of regulatory standards. The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) publishes extensive quality guidelines. ICH Q10, for instance, describes the requirements for a Pharmaceutical Quality System.
SAHPRA is also a member of the Pharmaceutical Inspection Co-operation Scheme (PIC/S), which aims to pursue the “development, implementation and maintenance of harmonised GMP standards and quality systems of inspectorates”. Apart from its work on harmonising GMP standards, PIC/S enables the training of GMP inspectors and the voluntary sharing of GMP inspection reports. PIC/S membership requires an assessment of a regulator’s inspectorate systems and procedures, so provides a quality check at that level. South African GMP adopted the PIC/S GMP guide in 2006, updating that status in 2017.
SAHPRA’s GMP inspectors are not confined to working only within the boundaries of the country. They also inspect pharmaceutical production plants in other countries and work together with the WHO prequalification programme to extend their reach. That said, even the best-resourced regulatory authorities are struggling to cover a globalised pharmaceutical industry, with many facilities located in China and India. A recent commentary in the New England Journal of Medicine pointed out how few foreign plants making generic medicines had been inspected by the Food and Drug Administration, and the problems they encountered when conducting inspections, calling for improved post-marketing surveillance.
The public, patients and health professionals can therefore make a reasonable assumption that medicines produced in a cGMP-compliant production facility meet the required quality standards. However, that is insufficient on its own. Mature regulators are also required to have effective post-marketing vigilance systems in place. Apart from adverse event reporting, these systems should also enable the reporting of quality problems with medicines.
Substandard or falsified medicines
Effective surveillance of the pharmaceutical market assists in the identification of substandard or falsified (SF) medicines. The necessary control measures also have to be in place to enable recalls and the destruction of identified SF medicines.
The WHO Global Benchmarking Tool (GBT) requires evidence that “Legal provisions and regulations authorize market surveillance and control activities which include product sampling from different points of the supply chain.” SAHPRA does not operate its own testing laboratory, but contracts with a WHO -prequalified facility at North-West University. Proactive sampling of medicines from all points in the distribution chain needs to be strengthened, as part of the National Action Plan to combat SF medicines.
Despite the existence of a Global Surveillance and Monitoring System for SF medical products (both medicines and devices), quantifying the scale of the problem remains challenging. Medical product alerts have been issued in every WHO region, affecting every type of medical product, not only generic medicines. They have been identified in countries with well-resourced, mature regulatory systems and in countries that lack such capacity. Nonetheless, transparent reporting of problems identified, corrective actions taken and regulatory interventions can help to build confidence that quality assurance systems are not only working, but are seen to be working. Quality should not have to be assumed without assurance that effective systems are in place and appropriately monitored.
*Dr Gray is a Senior Lecturer at the University of KwaZulu-Natal and Co-Director of the WHO Collaborating Centre on Pharmaceutical Policy and Evidence Based Practice. This is part of a series of columns he is writing for Spotlight.
Disclosure: Gray serves on three technical advisory committees at the South African Health Products Regulatory Authority.
Note: Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.
MS (multiple sclerosis) is the most common chronic neurological disease among young adults globally, with no drugs capable of repairing nerve damage caused by the destruction of the myelin sheath. A doctoral thesis opens up a new avenue by demonstrating the effectiveness of two different drug molecules in initiating the regrowth of a protective layer surrounding neurons.
Researchers have long sought ways to initiate remyelination, a process where the destroyed myelin sheath grows back and the neurons recover. However, all drug candidates trialled so far have failed. The problem is that, particularly in the later stages of MS, the disease creates in the central nervous system local tissue conditions that inhibit remyelination.
In the first approach, a drug molecule targets a stress mechanism intrinsic to brain cells. In areas damaged by MS, this stress response is constantly in overdrive, effectively preventing tissue-repairing cells from doing their job. When the mechanism was blocked using the new drug molecule, remyelination was significantly enhanced and accelerated in brain tissue with MS-like damage. The study was published in the Molecular Therapy journal in February.
The second approach focuses on scar tissue formed around affected areas, which serves as a physical barrier to neural regeneration. By affecting the composition of this scar tissue with the second drug molecule, this approach also succeeded in promoting neuronal recovery. An article focusing on this approach was published in the Neuropharmacology journal.
Surprisingly, these two drugs based on entirely different mechanisms led to very similar results: significant remyelination and reduced neuroinflammation in disease models, that is, animal and cell tests modelling the tissue pathology of MS.
First drug that boosts remyelination requires further research
For the time being, the results were achieved in laboratory animals and cell models. The more complex tissue conditions of human MS make it necessary to investigate the efficacy of the drug molecules in humans. One challenge for drugs targeting the brain is the blood-brain barrier, which blocks many substances from entering the brain. The researchers nevertheless demonstrated that both molecules effectively reach the central nervous system in laboratory animals.
“The goal is to enable the molecules we have developed to reach clinical trials, which could one day produce the first drugs that enhance remyelination in MS. In the meantime, our findings can help in investigating the pathogenic mechanisms of MS that inhibit remyelination,” Koppinen says.
The thesis is also available in electronic form through the Helda repository.
Lyra Southern Africa’s latest behavioural health data reveals a steady year‑on‑year rise in addictive behaviours among South African employees, reflecting how prolonged stress is reshaping the ways people cope, escape and self‑manage emotional pressure.
Drawn from a five‑year analysis of Employee Wellness Programme trends, the data shows total addictive behaviour cases increasing from 1.79 percent of all cases in 2021 to 2.85 percent in 2025. While this may appear modest when viewed only as a percentage point shift, it in fact represents close to 60 percent growth over the period. Clinicians caution that this scale of increase reflects a material change in coping patterns, unfolding alongside heightened financial, social and psychological strain.
“This is not about sudden spikes or isolated events,” says Dubekile Mugumbate, Business Intelligence and Consulting Manager at Lyra Southern Africa. “It’s about stress that has become part of everyday life, and the coping strategies people reach for when that stress doesn’t let up.”
Lyra’s clinicians note that addictive behaviours rarely appear in isolation. They are often intertwined with anxiety, burnout, relationship strain and overwhelming life pressure. In the current climate, marked by economic uncertainty, rising living costs and ongoing instability at both household and societal levels, more people are turning to behaviours that offer short‑term relief or distraction.
Alcohol remains the most prevalent addictive behaviour across all five years, showing consistent year‑on‑year growth. Alcohol‑related cases have nearly doubled over the period, rising from just over 1 percent of all cases in 2021 to slightly above 2 percent in 2025. Clinicians describe this as a familiar pattern in high‑stress environments, where alcohol becomes an accessible and socially acceptable form of escape from relentless pressure. “When pressure is constant, people reach for what’s available and what works quickly to ‘numb the pain’,” Mugumbate explains.
Drug‑related cases present a different picture. While still significant, drug use and misuse shows a gradual decline as a proportion of addictive behaviour cases over the same period. This does not signal reduced risk, but rather changing access and preference as people gravitate toward behaviours that feel easier to hide or justify in daily life.
Gambling shows one of the sharpest increases. Though starting from a low base, gambling‑related cases more than quadrupled in the data set between 2021 and 2025. Clinicians link this rise to the normalisation of online betting platforms, instant gratification mechanics and the false sense of control gambling can offer to people feeling powerless in other areas of their lives.
Pornography use and sex‑related addictions remain smaller categories overall, but they continue to surface consistently year after year. These behaviours are often framed by employees not as addiction at first, but as stress relief, boredom management or emotional escape. Over time, however, they frequently intersect with shame, relationship breakdown and emotional withdrawal.
Internet and social media addiction, while still representing a smaller proportion of cases, shows renewed growth in 2025 after earlier fluctuations. Lyra clinicians note that constant digital engagement offers immediate distraction, connection and numbing, particularly during periods of uncertainty, loneliness or emotional overload.
Generational insights reveal important differences in how addictive behaviours manifest. Gen Y continues to represent the largest share of cases across all five years. This group consistently accounts for around a third of addictive behaviour presentations, reflecting the compounded pressures of mid‑career responsibility, financial obligation, dependants and expectation overload. For many, escapist behaviours become a way to briefly step away from relentless demand.
“For many Gen Y employees, the load never really comes off,” says Mugumbate. “Escapist behaviours can become the only space where the system pauses, even briefly.”
Gen Z follows closely behind, with a notable dip and resurgence over the period. Clinicians working with younger employees describe a generation navigating early career insecurity, limited disposable income and high exposure to digital environments that reward compulsive engagement.
Gen X shows steady growth year on year, particularly in the later years of the data. Here, addictive behaviours often emerge alongside cumulative burnout, long‑term stress and emotional fatigue rather than risk‑taking alone.
Gen Alpha presentations remain small but concerning. Drug use and pornography are more pronounced within this group than might be expected, highlighting early exposure, digital accessibility and the role of unmonitored online spaces. Clinicians stress the importance of early intervention as these patterns form at younger ages.
Baby Boomers make up a small proportion of cases but tend to present later and with more entrenched patterns. When addictive behaviours do surface in this group, they often intersect with grief, retirement‑related identity loss, health challenges or financial anxiety.
Across all generations, the common thread is escapism. Each behaviour offers momentary relief from stress, whether through numbing, distraction, stimulation or perceived control. In a high‑stress environment, those short breaks can become coping habits, and habits can harden into dependency.
“The rise we’re seeing in addictive behaviours is closely linked to the sustained pressure South Africans have been living under for several years now,” says Mugumbate. “When stress becomes chronic, people don’t always look for long‑term solutions. They look for immediate relief, and that’s where these behaviours come in.”
She adds that organisations often underestimate how closely stress, mental health and addictive behaviours are connected in the workplace.
“Addictive behaviour is rarely about the behaviour alone it’s a signal that something deeper is going unmet. In the current environment, many employees feel overwhelmed, financially stretched and emotionally depleted. Employers who want to protect productivity and wellbeing need to understand that prevention, early support and open conversation are far more effective than waiting until patterns become entrenched.”
As economic pressure, uncertainty and emotional fatigue continue to define daily life for many South Africans, the data suggests that addictive behaviours will remain a growing risk where people are left to cope alone. Organisations that recognise these patterns and invest in accessible, stigma‑free support play a critical role in helping employees find healthier ways to manage the weight they are carrying.
Groundbreaking research from the University of Houston shows that a single low-dose atropine eye drop can produce daylong effects in managing myopia, or nearsightedness.
Professor of Optometry Lisa Ostrin and postdoctoral researcher Barsha Lal are reporting that even one drop in the eye of low-dose atropine (0.01%–0.1%) produces clear changes in pupil size and focusing ability that persist for at least 24 hours. Importantly, they also found that the drop shows no short-term structural effects on the eye, with only temporary changes in blood flow inside the retina.
Ostrin’s latest research is published in the journal Eye and Vision. It adds to a growing body of vision research from David Berntsen, Golden-Golden Professor of Optometry at the University of Houston, who is co-leading a clinical trial to delay the development of myopia in children by using the atropine drops.
Low concentration atropine is widely prescribed to slow myopia progression in children, yet its short-term retinal and choroidal effects remain incompletely understood. Ostrin’s new study evaluated short-term effects of a range of low atropine concentrations on the length of the eye, the blood vessels in the retina and the thickness of the retina and choroid, which sits just behind the retina. These are important measurements because longer eye length is associated with myopia and as it gets longer, the retina and choroid are stretched.
“These findings indicate that a single instillation of atropine does not alter axial length or retinal or choroidal thickness over 24 hours but may transiently affect superficial retinal perfusion in a time-dependent manner,” said Ostrin.
In the double-masked, randomised study, twenty healthy adults received a single instillation of either a placebo or atropine in the right eye during five separate sessions. Researchers then checked the eye structure, thickness, and length in the central retina both one-hour and 24-hours later.
“Characterising these short-term effects is important for a better understanding of the physiological responses to atropine in clinical and research settings,” said Ostrin who previously published research results of a study investigating the short-term effects of a range of low-dose atropine concentrations on the pupils of young adults. In that study, she found similar results with a single drop of atropine inducing significant changes in the pupils.
Together, the studies indicate that atropine induces early functional and vascular effects in the eye, in the absence of structural change.
“By linking objective ocular responses with subjective visual experience, this work advances our understanding of how atropine works and supports more precise, evidence-based, and individualised approaches to myopia management,” said Ostrin.
