Author: ModernMedia

Categories : Emergency Medicine Injury & TraumaLeave a comment

Whole Blood and Components Equally Effective in Prehospital Trauma Care

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Photo by Mat Napo on Unsplash

Giving whole blood or the component parts of blood are equally effective options for paramedics and emergency medical technicians to use in treating patients with severe, traumatic bleeding before arriving at the hospital, according to a large, nationwide trial directed by University of Pittsburgh and UPMC clinicians and scientists.  

The results, published in the New England Journal of Medicine, provide flexibility to prehospital emergency care providers and could increase the odds that traumatically injured patients receive blood as soon as possible.  

“Traumatic bleeding is the leading cause of trauma death and is the most time-sensitive injury a person could suffer æ more time sensitive than a stroke or heart attack,” said co-lead author Jason Sperry,  professor of surgery in Pitt’s School of Medicine, and chief of trauma surgery at UPMC. “But it is preventable – and that starts with giving blood back to the injured person before they even arrive at the hospital.”  

Donated blood is usually separated into parts – red cells, plasma and platelets – for storage and so the parts can be used individually as needed. When someone is bleeding, emergency clinicians will often give all or some of these parts to the patient at once. Giving either whole blood or its component parts had long been considered safe options. 

But which is better for treating severe bleeding: Giving never-separated whole blood or giving the components? The answer matters for blood bank and emergency care logistics.  

Sperry and fellow principal investigators Francis Guyette, professor of emergency medicine in Pitt’s School of Medicine, and Stephen Wisniewski, professor of epidemiology and associate vice chancellor for clinical trials coordination at Pitt, launched the “Type O Whole Blood and Assessment of Age During Prehospital Resuscitation (TOWAR) Trial” to find out.  

The multicentre trial, which ran from May 2022 to June 2025, enrolled and included 1020 severely bleeding patients who were transferred to a trauma centre by medical helicopter. The patients were randomised 2-to-1 to receive either whole blood or blood components.   

The research team found no statistically significant difference between the two study arms. In both cases about a fifth to a quarter of the patients died within 30 days, compared to a third of traumatically bleeding patients who do not receive blood before arriving at the hospital. 

“This is good news,” said co-lead author Guyette, who is also medical director of STAT MedEvac, which is directed by a consortium of UPMC hospitals and is the nation’s largest academic, nonprofit critical care transport group. “It means that emergency responders can use whatever form of blood is most accessible to them. In U.S. civilian emergencies that may be component blood because that is how most blood banks package it, but in military settings whole blood is often all that is available. We’ve shown that both are equally great options.” 

In March, a European group announced the results of a similar, slightly smaller trial conducted in England, also published in the New England Journal of Medicine. Like the Pittsburgh team, they also found that giving whole blood or blood components was equally effective. The clinician-researchers believe that the combined findings will be reflected in guidelines set by various societies that oversee trauma care, surgery and blood handling.  

Whole blood is good for 21 days after donation, so the clinician-scientists were also curious if patient outcomes were any different if they were given new blood or blood closer to the expiration date. They learned that it made no difference—outcomes were the same for patients receiving newer blood within 14 days of donation compared to those receiving older blood within seven days of expiration. 

“Our thoughtful approach to the study design allowed us to not only answer the important question of the efficacy of whole blood compared to component therapy, but also to evaluate the health impact of an important public health question, the age of whole blood,” said senior author Wisniewski, who is also codirector of the Epidemiology Data Center at Pitt’s School of Public Health. “Our trial provides reassurance by verifying current standards that support the use of whole blood units throughout their entire shelf life.” 

The team also noted that the findings wouldn’t have been possible without the generosity of blood donors, study participants agreeing to share their data and the hard work of emergency care providers.  

“We’re very grateful to everyone involved, particularly the paramedics, emergency medical technicians and flight nurses,” Guyette said. “We are hopeful that this study and future research will give them better tools to save lives.” 

Source: University of Pittsburgh

Categories : Lab Tests and ImagingTags : Leave a comment

New ‘Quantum Glass’ Improves X-ray Resolution with Less Radiation

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A glass screen that moulds to the patient could allow more comfortable mammograms

The inside of this memory card (left) is viewed in an X-ray image (right) captured with a new resolution-boosting glass screen. Credit: Adapted from ACS Energy Letters 2026, DOI: 10.1021/acsenergylett.6c00958

X-rays allow professionals to diagnose injuries or ailments and peer inside suitcases at the airport, along with a variety of other applications. A team reporting in ACS Energy Letters has improved the glass screen that “translates” between X-rays and visible light, creating an X-ray system that produces high-resolution images with less radiation – it even works underwater. The screen can be moulded into curved shapes, a feature that could one day lead to more comfortable mammograms. 

“Because our glass screens are highly efficient at converting X-rays into visible light, they can capture diagnostic images using less radiation.”

Osman Bakr. corresponding author of the paper

A screen made of glass, called a scintillator, catches X-rays that pass through an object and converts them into flashes of visible light, explains Osman Bakr, one of the paper’s corresponding authors. “The more efficient the scintillator is at this conversion, the clearer the final digital image becomes and the lower the dose of radiation required to create it,” he adds. 

To improve the efficiency of glass-based scintillators, Bakr, Mehmet Bayindir and colleagues combined nanoclusters of copper, iodine, and an organic ligand into the glass. Then they formed their new glass into screens and captured X-ray images of a memory card and a bug, revealing intricate details within. 

“By designing these materials from the bottom up, we’ve created a ‘quantum glass’ that occupies the perfect sweet spot between molecules and nanocrystals,” explains Bayindir. Bashir Hasanov, the first author of this study, adds that “this allows the screen to be as moldable as plastic while maintaining the high-performance imaging capabilities of a rigid crystal, opening a new frontier for three-dimensional X-ray diagnostics using curved surfaces.” 

The presence of water typically makes X-ray imaging extremely challenging. However, the new, highly efficient scintillator captured a very clear scan of a fish’s tail in water. In fact, the image was indistinguishable from an image taken in air. 

Another property of the new nanocluster glass is that when heated to 42 degrees Celsius, it becomes almost rubbery, allowing the researchers to form a curved screen. This could allow future researchers to create X-ray imaging systems that curve to fit a person’s anatomy – a major drawback of current mammography machines, which require breast tissue to be compressed between flat panels for a proper scan. 

“We hope to mitigate the physical discomfort of life-saving screenings like mammography, encouraging more consistent patient participation,” says Bakr. “Because our glass screens are highly efficient at converting X-rays into visible light, they can capture diagnostic images using less radiation.” The researchers anticipate that the advances in this work could pave the way for safer, more frequent screenings that can start earlier, helping to catch cancer at an earlier stage.

Source: EurekAlert!

Categories : AgeingTags : Leave a comment

Calcium and Vitamin D Supplements Offer Little to No Meaningful Benefit on Fracture and Fall Prevention

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Recommendations for calcium and vitamin D supplementation should be re-evaluated, suggest researchers

Photo by Kampus Production

Calcium, vitamin D, or combined supplements offer little to no clinically meaningful benefit on fracture and fall prevention in most older people, finds an in-depth review of the latest evidence published by The BMJ.

Almost a third of people aged 65 and older fall each year, often resulting in fractures, which are linked to pain, reduced quality of life, and the need for residential care. Preventing falls and fractures is therefore a global public health priority.

Several previous evidence reviews have found no reduction in fractures with either calcium or vitamin D supplements and results are inconsistent for combined use. The benefit of vitamin D on falls also remains unclear.

Yet despite this, many clinicians, guidelines, and regulatory agencies recommend vitamin D supplements (with or without calcium) for bone health, and prescriptions have increased substantially in recent years.

To address this uncertainty, researchers in Canada reviewed the results of 69 randomised controlled trials involving 153,902 adults that assessed the effect of calcium or vitamin D supplements – or a combination of both – on reducing the number of fractures and falls compared with placebo or no treatment.

The trials were of varying quality, but the researchers were able to assess their risk of bias and certainty of evidence using established tools.

After agreeing on clinically meaningful thresholds, the researchers found little to no effect for experiencing any fracture from use of calcium supplements (moderate certainty evidence from 11 trials; 9,067 participants), vitamin D supplements (high certainty evidence from 36 trials; 92 045 participants), or combined supplementation (high certainty evidence from 15 trials; 51 126 participants).

Calcium, vitamin D, or combined supplementation also appeared to have little to no effect on specific fractures, such as hip fractures, or falls, based largely on moderate to high certainty of evidence.

The researchers acknowledge that some analyses included a small number of trials and participants, so these findings should be interpreted with caution, and results may not apply to individuals with specific bone disorders or to those receiving drug treatment for osteoporosis.

However, the findings were consistent after further analyses to account for differences such as participant age, sex, history of fractures and falls, and average dietary calcium intake, supporting the strength of their conclusions.

As such, they say these findings “do not support routine supplementation with calcium or vitamin D, or combined supplementation to prevent fractures and falls” and they suggest clinicians, guideline panels, and regulatory agencies “should re-evaluate their general recommendations for calcium and vitamin D supplementation in light of current evidence.”

Evidence from rigorous and well-powered trials is needed to inform recommendations for supplementation in higher-risk groups, say researchers in a linked editorial.

In the meantime, they suggest that focus and funding should be redirected towards interventions that have been shown to offer meaningful prevention of falls and falls related injuries, such as balance and resistance exercise, and interventions that combine elements like exercise, hazard assessment or education, tailored to individual risk.

Source: The BMJ Group

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One‑week Radiotherapy Course Effective for Early‑stage Breast Cancer

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New UK research has found that a one-week course of post-surgery radiotherapy is just as safe and effective as the traditional three-week course for people with early-stage breast cancer. 

The FAST-Forward trial, led by Keele’s Professor Murray Brunt and sponsored by The Institute of Cancer Research, London, followed more than 4000 patients for a decade after their treatment.  

The 10-year results of this phase III randomised trial, funded by the National Institute for Health and Care Research (NIHR) and published in the Lancet Oncology, show that a shorter, five-day radiotherapy schedule provides the same level of cancer control as the traditional three-week treatment.  

These findings build on previous five-year results that have already driven a shift in clinical practice. Since 2020, it is estimated that tens of thousands of people in the UK have already benefited from the shorter course on the NHS. Researchers expect this approach will also reduce the burden on people undergoing treatment for breast cancer worldwide and expand access to life-saving radiotherapy.  

Breast cancer is one of the most common cancers globally, and radiotherapy plays a critical role in reducing the risk of recurrence after surgery. A shorter treatment course is not only more convenient for patients – it also reduces hospital visits and eases pressure on radiotherapy services, making treatment more accessible.  

The research team compared the traditional schedule of 15 treatments over three weeks with two shorter schedules that used five treatments over one week. The two shorter courses gave slightly different amounts of radiation to allow the research team to work out the best dose.   

After 10 years, cancer coming back in the treated breast was very low in all three groups: 3.6% for the standard three-week treatment, 2.9% with the one-week treatment with a slightly higher dose, 2.1% with the one-week treatment with a slightly lower dose.   

The lower dose one-week treatment had side effects that were very similar to the standard approach, with no increase in long-term breast or chest wall changes. Because of this, this dose and schedule are now the recommended option.  

Professor Murray Brunt, chief investigator of the FAST-Forward study and Professor of Clinical Oncology at Keele University, said: “These 10-year results provide definitive long-term evidence that one-week radiotherapy given at an appropriate dose to the breast is a safe, effective, and more practical option for people with breast cancer. 

“By reducing treatment from 15 sessions to just five, we can offer patients the same excellent cancer control with fewer hospital visits, less disruption to their daily life, and reduced pressure on healthcare services. This approach has already transformed practice in the UK and has the potential to improve access to life-saving treatment for people with cancer worldwide. 

“Hearing patients talk about how much it helps to only need one week of radiotherapy has been really encouraging for everyone involved.”  

Professor Judith Bliss, Professor of Clinical Trials at The Institute of Cancer Research, London, who co-led the trial, said: “The FAST-Forward trial is transforming cancer treatment by reducing standard breast radiotherapy from 3 weeks to just one week, without compromising effectiveness.  

“The streamlined schedule has made radiotherapy more accessible, particularly for people who find it difficult to attend hospital and those in lower-income countries.”  

“The FAST-Forward trial is part of a long-term programme of research into improving breast cancer radiotherapy at The Institute of Cancer Research (ICR).  

“These final 10-year results mark a significant milestone in breast cancer treatment and reinforce the growing shift toward more efficient radiotherapy approaches. The success of FAST-Forward has led to the ongoing NIHR-funded FAST-Forward Boost trial, which is investigating whether more extensive radiotherapy – including an additional ‘boost’ dose for some patients – can also safely be delivered in five days.  

Professor Anthony Gordon, Director for NIHR’s Health Technology Assessment (HTA) Programme, added: “The legacy of the FAST-Forward trial is clear to see, with thousands of women benefiting from shorter courses of radiotherapy and fewer hospital visits, helping the health and care sector to achieve more effective and efficient use of resources. The new 10-year results show the benefit of investing in high-quality, long-term research to improve the health and wealth of the nation.  

“NIHR’s research aims to tackle the most urgent health and social care challenges, targeting the areas of greatest need and where the most significant impact can be made. The findings from the FAST-Forward trial have already made a considerable difference to the treatment regimens that breast cancer patients undergo, making them more efficient, while at the same time, easing pressure on NHS services.”

Source: Keele University

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Can New Research on Malaria Enzymes Help Overcome Challenges to Treatment?

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Photo by Ekamelev on Unsplash

Research published in The FEBS Journal may help overcome challenges to the treatment of malaria – a tropical disease caused by infection of red blood cells with Plasmodium parasites, which are transmitted through infected mosquito bites. The research is based on a strategy that targets an enzyme specific to the parasite, Falcipain-2 (FP2), which is essential for parasite survival and growth within the host.

FP2 allows the parasite to digest human haemoglobin so that it can replicate inside red blood cells, which leads to severe malaria symptoms, including red blood cell destruction. Although FP2 is parasite-specific, it is highly similar to a class of human enzymes called cathepsins. This study therefore sought to determine the detailed structural and functional characterizations of FP2 so that it could be targeting without harming cathepsins.

Previously, the researchers identified that polyethylene glycol (PEG) can form stable interactions with FP2. In this latest study, they focused on how different PEG molecules bind to FP2 and its target, haemoglobin. Their computational analyses identified a binding region, or pocket, of a particular PEG called PEG400 with FP2. This pocket exhibits minimal conservation in human cathepsins. PEG400 was capable of binding FP2 and affecting its digestion of haemoglobin.

“The findings pave the way for designing and incorporating new small molecule inhibitors of FP2 activity, suggesting opportunities for selective antimalarial therapies with a cumulative benefit of reducing off-target specificity,” said corresponding author Sampa Biswas, PhD, who conducted this work while at the Saha Institute of Nuclear Physics, in India, and is currently at InBOL (Indian Barcode of Life) Health Care.

Source: Wiley

Categories : Cancer General InterestTags : Leave a comment

One Mother Beat Blood Cancer Against the Odds. Thousands of Others Are Still Searching for Their Chance.

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As a professional photographer and mother of two young children, Claire had always been busy, but the long hours and constant fatigue felt like an occupational hazard. She never imagined that exhaustion could signal something far more serious than a demanding schedule.

Then, in January 2024, it happened: Claire blacked out at her desk while editing videos. It was her body’s final, unmistakable warning. What followed was a hospital stay, a bone marrow biopsy, and a diagnosis that would change her life forever. Claire had been diagnosed with blood cancer, specifically Myelodysplastic Syndrome (MDS), a serious bone marrow condition that, without treatment, can be fatal.

She was just 30 years old. And she was far from alone. Blood cancer remains one of the top five causes of cancer death in South Africa. Despite being potentially curable, countless patients never find their matching donor in time. Claire was determined not to become another statistic.

A Road Full of Obstacles

Claire’s path to diagnosis was not straightforward. Doctors initially attributed her worsening symptoms to iron deficiency, leaving her untreated as her condition quietly progressed. By the time MDS was correctly identified, the only viable path forward was a stem cell transplant.

While awaiting a donor match, Claire endured bi-weekly injections to keep her body stable, a gruelling holding pattern as her family and medical team searched for hope. That hope came through DKMS Africa, which successfully identified a fully matched, unrelated donor for Claire.

The first transplant, using cells from that 100% unrelated matched donor, was performed with great hope. Unfortunately, it was not successful.

Claire’s medical team was not deterred. Turning to family, they proceeded with a haplo-identical transplant, a “half-match” procedure using stem cells donated by Claire’s brother. This second transplant was successful.

Why Every Match Still Matters

Claire’s outcome is cause for deep gratitude and genuine celebration. But her journey also carries an urgent message that must not be lost in the relief of her survival.

Haplo-identical transplants, where stem cells are donated by a family member who is only a partial genetic match rather than a full one, can offer a path forward when a fully matched donor cannot be found. However, this option is not available or ideal for everyone. Not all patients have a suitable family donor, and even when they do, the procedure carries greater medical complexity and risk than a fully matched stem cell transplant.

For most patients, a 100% match from an unrelated donor remains the gold standard: the safest and most effective option. Yet only around 30% of patients find a compatible donor within their own family, meaning the remaining 70% depend entirely on a stranger’s decision to join the registry. The more people who register as potential donors, the greater the chance that every patient in need will find their match.

The critical shortage of registered donors, particularly from diverse ethnic backgrounds, means that for many, the search ends without a match. Despite blood cancer being potentially curable, countless patients never find their matching donor in time.

Every name added to the registry is a potential lifeline for someone, somewhere, waiting for their match.

A Family Restored

Today, Claire is recovering. Her children have their mother. Her family, who stood beside her through diagnosis, uncertainty, and two transplants, now share in a renewed sense of hope and possibility.

Her story does not end with survival. It continues with a plea to every person who has considered registering as a stem cell donor and hasn’t yet done so. “Help save others like me. We need more people to register as potential stem cell donors. Your registration could mean the difference between life and death.”

Categories : Cardiovascular DiseaseTags : Leave a comment

Self-reported Family History Often Underestimates Relatives’ Heart Attacks

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Pexels Photo by Freestocksorg

A new study from Karolinska Institutet shows that people’s own reports of heart attacks in the family only partially correspond with register data. The findings suggest that heart attacks among relatives are often underreported, particularly for events occurring early in life.

Asking patients about cardiovascular disease in the family is common practice in both research and clinical risk assessment. But how reliable is this information? Researchers at Karolinska Institutet have investigated this by comparing self-reported family history with Swedish national registers. 

The study included just over 25 000 participants from the Swedish SCAPIS cohort. Participants were asked to state whether their parents or siblings had suffered a heart attack, and the information was then compared with diagnoses in the Patient and Cause of Death Registers.

The results, published in the European Journal of Epidemiology, show that the agreement between self-reported data and register data was only moderate. 

“Our findings show that data from questionnaires only capture part of the occurrence of heart attacks in families,” says Agnes Wahrenberg, researcher at the Department of Clinical Research and Education and resident physician at Södersjukhuset. The study forms part of her doctoral thesis.

For heart attacks in close relatives, the sensitivity was 57.6 per cent, meaning that many cases identified in the registers were not reported in the questionnaires. Misreporting was more common for cases of heart attack occurring early in life.

At the same time, the study highlights the unique opportunities that Swedish health registers offer for research into hereditary cardiovascular disease.

“These registers can be used to supplement and validate family history information in both large cohorts and future register studies,” says Per Svensson, associate professor at the same department and senior physician at Södersjukhuset.

Despite these limitations, the researchers emphasise that self-reported information remains valuable, as it is easy to obtain and can help identify individuals at increased risk in everyday clinical practice.

“It can be difficult to know exactly which diseases have occurred in relatives, particularly further back in time. The Swedish registers are a unique complement to studies on family history and cardiovascular disease, as they enable a more comprehensive assessment of disease in relatives”, says Agnes Wahrenberg.

Source: Karolinska Institutet

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Can Aerobic Exercise Lessen the Health Effects of Exposure to Nanoplastics?

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Photo by FLY:D on Unsplash

Using female zebrafish as a model, researchers have found that aerobic exercise may influence various connections in the body to lessen the damaging health impacts of environmental nanoplastics. In the study, which is published in The FASEB Journal, adult female zebrafish were exposed to polystyrene nanoplastics for 21 days, with or without moderate aerobic exercise.

“Once ingested, nanoplastics may cross epithelial barriers and accumulate in multiple organs, including the liver, heart, brain, and ovary, eliciting oxidative stress, inflammation, and endocrine disruption,” the authors wrote. “Among these targets, the ovary appears particularly susceptible, yet the mechanisms underlying nanoplastic-induced ovarian accumulation and toxicity remain poorly characterized.”

Exposure to nanoplastics alone caused significant ovarian accumulation of particle-like structures, elevated oxidative stress, increased follicular cell death, and disrupted reproductive hormones. It also induced anxiety‑ and depression-like behaviors in tank and shoaling tests, accompanied by elevated stress hormone levels. In contrast, concurrent aerobic exercise lessened these effects.

Investigators also found that aerobic exercise counteracted gut microbe imbalances caused by nanoplastics. Analyses linked these microbial shifts to enhanced fatty acid and tryptophan metabolism, which correlated with improved neuroendocrine health.

The findings indicate that aerobic exercise may mitigate nanoplastic-induced neuroendocrine dysfunction via gut–ovary–brain connections.

Source: Wiley

Categories : Cardiovascular DiseaseTags : Leave a comment

AFib Found to Cause Profound Changes in Both Atria

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Human heart. Credit: Scientific Animations CC4.0

New research findings from the University Medical Center Göttingen (UMG) show that both atria undergo profound changes in cases of persistent atrial fibrillation. Until now, the left atrium was considered the primary site of the disease. The results of the international study were published in the journal Cardiovascular Research.

Atrial fibrillation is the most common persistent heart rhythm disorder worldwide, and is caused by chaotic electrical activity in the atria. As a result, the heart beats irregularly and often too fast. Many patients suffer from palpitations, shortness of breath, reduced physical performance, or exhaustion. The so-called persistent form of atrial fibrillation is particularly problematic, as the arrhythmia no longer resolves on its own. Over time, this leads to structural and functional changes in the heart tissue. The condition significantly increases the risk of stroke, heart failure, and premature mortality. Until now, research and treatment have focused primarily on the left atrium and the pulmonary veins that drain into it, which are considered major triggers of atrial fibrillation. 

A research team at the University Medical Center Göttingen (UMG) investigated whether and to what extent the right atrium is also affected by long-term atrial fibrillation. The study shows that the right atrium also undergoes profound remodelling processes and increasingly resembles the left atrium. 

“The results suggest that persistent atrial fibrillation must be understood as a disease of both atria,” says Dr Aiste Liutkute, the study’s first author. “This could also explain why established therapies are often not permanently successful in cases of long-standing atrial fibrillation.” 

The Approach

The research team analysed tissue samples from the right and left atria of patients with persistent atrial fibrillation, which had been collected during heart surgery. Samples from non-transplanted donor hearts with no known cardiac arrhythmias served as the control group.

Using state-of-the-art mass spectrometry techniques, the scientists examined thousands of proteins simultaneously to identify disease-related changes in heart tissue. Mass spectrometry is a high-resolution analytical method that allows molecules to be precisely identified and quantified based on their mass. This makes it possible to determine which proteins are present in heart muscle cells and how their composition changes in the presence of disease. For the study, the researchers first created a comprehensive reference library of the human heart proteome. The proteome refers to the totality of all proteins in a tissue or cell. Proteins perform central functions in the body and provide insight into which biological processes are active in the cells. In addition to the proteome analyses, the team examined the scarring of heart tissue under a microscope, confirmed notable protein changes using biochemical methods, and identified blood markers that indicate stress on the heart.

The Results

The analyses show that, in cases of persistent atrial fibrillation, the right atrium exhibits pathological changes similar to those in the left atrium. In both atria, the researchers found increased tissue scarring, a breakdown of important heart muscle structures, and clear signs of cellular stress and remodeling processes. These changes impair normal electrical signal transmission in the heart and may contribute to the persistence of atrial fibrillation. At the same time, many of the molecular differences that normally exist between the right and left atria disappeared. For instance, the right atrium lost typical protein markers that normally characterize its specific function and increasingly took on features of the left atrium, including proteins associated with altered energy metabolism and structural remodeling of heart muscle cells.

Source: University Medical Center Göttingen

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South Africa’s Dangerous Mix of Fake Medicines and Bogus Doctors

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Photo by Rodion Kutsaiev on Unsplash

By Spotlight Editors

Fake and substandard medicines, along with bogus healthcare practitioners, pose a growing threat to patient safety in South Africa.

The sale of fake and substandard medicines is a significant threat to patient safety around the world. In South Africa, the main affected products are painkillers, antibiotics, weight-loss and sexual enhancement products, skin-lightening products, and some chronic medicines.

In pealing back the different layers of this problem, it is essential to get the definitions right.

  • Substandard products are those that do not meet quality standards and specifications.
  • Falsified products deliberately misrepresent their identity, composition or source.
  • Neither of these should be confused with generic medicines, which have the medicines regulator’s green light for being safe, effective, and of good quality.

People are often duped into purchasing substandard and falsified products, especially when the real thing is not available or too expensive. But, as Elna Schütz this week reports for Spotlight, there are also people who buy these medicines fully aware of the risks.

These unregulated medicines are mostly distributed through informal channels, unregulated outlets, online platforms, and cross-border smuggling networks. It is also possible that some substandard and falsified medicines have been infiltrated into otherwise reputable medicines distribution channels.

Data on the scale of the problem is scant, but there is agreement that the problem is substantial. The WHO estimates that around 1 in 10 medicines in low- and middle-income countries are substandard or falsified.

The South African Health Products Regulatory Authority (SAHPRA) is the main body responsible for regulating substandard and falsified medicines. It does this through post-market surveillance and inspections, a whistleblower reporting system, product recalls, and monitoring illegal advertising and online sales. A new National Action Plan and comments from the Minister of Health suggests there is some intent to step up these efforts.

What of regulated medicines?

In two separate columns for Spotlight, Dr Andy Gray looked at the broader issues of the quality of medicines and sanctions for non-compliance with medicines legislation.

The good news is that 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. As regulatory entities go in South Africa, SAHPRA is generally one of the better-functioning ones.

But, outdated legislation means that SAHPRA doesn’t have all the tools it needs to stamp out the sale of unauthorised medicines. For instance, it has limited powers in relation to advertising and marketing, cannot block a web site, and cannot issue infringement notices, or impose sanctions on entities or individuals whose actions potentially place the public at risk of harm.

Fake health professionals 

Falsified medicines are not the only misrepresentations that should concern us in the health sector. Spotlight recently reported that South Africa is also battling the problem of bogus health practitioners. The issue goes beyond people pretending to be doctors and can include physiotherapists, interns, or anyone else treating patients without being properly qualified or registered.

The misrepresentation may include using fraudulent certificates, using another practitioner’s registration, or still offering healthcare services while being suspended or erased from the register.

From early 2024 through late 2025, 66 bogus practitioners were caught and arrested, with the majority operating in the economic hubs of the Western Cape, Gauteng, and KwaZulu-Natal.

You can help curb these problems. Suspicious practitioners can be reported to the HPCSA, and suspicious products or sellers can be reported to SAHPRA. People are also advised to buy only from licensed and authorised pharmacies and checking if healthcare providers are registered.

And then there is fake news

In some areas, as with bogus health professionals and falsified medicines, the solution to misrepresentation is clearly to have legally empowered regulators with enough muscle to consistently enforce the law.

But when it comes to misinformation and disinformation – call it fake news if you will – the way forward is much less obvious. In recent years, we’ve seen a toxic mix of political polarisation, conspiracy theories, disinformation campaigns, and twisted social media algorithms – often fuelling a rejection of science and evidence-based policy-making. Beyond just our screens, these trends have unfortunately started to distort the real world, as we’ve seen at various critical health institutions in the United States.

In our view, regulators should have a role in preventing misinformation and disinformation about medicines. But how exactly to make such regulation work in an age of largely unaccountable social media networks is not at all clear.

What we think is clear, is that much of the solution to the problem of health misinformation and disinformation, is simply to keep creating its opposite, high-quality, rigorous, and evidence-based journalism.

This is the core of what we try to do at Spotlight. It is also why we have made our journalism subject to the South African Press Code, work hard to stick to our Editorial Policy and Style Guide, and why we urge you to hold us accountable when we get things wrong, as we will inevitably do from time to time.

Please always feel free to get in touch at Editors@SpotlightNSP.co.za.

Republished from Spotlight under a Creative Commons licence.

Read the original article.