Author: ModernMedia

Categories : Ageing Medical IndustryTags :

Case Study: Allmed and Tafta

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Empowering Dignified Elder Care Through Compliant, Compassionate Staffing Solutions

Photo by Matthias Zomer on Pexels

For nearly seven decades, The Association for The Aged (Tafta) has been a cornerstone of care for senior persons in Durban and surrounding communities. Its services include assisted living, frail care, home-based care, meal delivery, and essential social work and advocacy programmes, all designed to support the dignity and well-being of older persons.

Delivering this level of care consistently requires the right professional healthcare staff and strong administrative support across Tafta’s multiple facilities.

The challenge: ensuring compliance and consistency
Recruiting and managing trained Caregivers across several care units can be complex, particularly when strict compliance and accreditation standards must be met. Tafta needed a partner who could supply qualified staff while supporting operational efficiency and upholding care standards. Allmed, a specialist medical personnel solutions provider, with proven experience in healthcare staffing and administration, emerged as the ideal solution.

“At the time we were reviewing our contracts, we considered Allmed as one of the service providers to tender,” explains Yoshina Kistensamy, Divisional Manager: Operations of Tafta.

The requirements were clear: the partner needed to ensure all staff were fully compliant and accredited, while also providing responsive after-contract support. Financial flexibility was equally critical, enabling staffing to scale up or down according to operational realities without penalty.

Allmed provides layered support, with trained professionals backed by clinical facilitators, ensuring both quality care and peace of mind for residents’ families. This support is delivered across three key areas:

  • Strategic staffing: Ensures every facility has adequate, skilled personnel and optimises workforce allocation to meet varying needs.
  • Compliance oversight: Monitors adherence to healthcare standards, reducing risk and ensuring safe, consistent care practices.
  • Hands-on engagement: Provides practical support to staff and enhances day-to-day operations.

By combining these three areas, Allmed enables Tafta to operate efficiently while maintaining a strong focus on the quality and dignity of resident care.

The impact: lifting the burden, prioritising care
The partnership has given Tafta the space to focus on its core mission: providing compassionate care. By outsourcing much of its care staff, Tafta has transferred complex HR responsibilities, including training coordination, on-site supervision, and disciplinary processes, directly to Allmed.

Allmed provides layered support, with trained professionals backed by clinical facilitators, ensuring both quality care and peace of mind for residents’ families. This support is delivered across three key areas:

  • Strategic staffing: Ensures every facility has adequate, skilled personnel and optimises workforce allocation to meet varying needs.
  • Compliance oversight: Monitors adherence to healthcare standards, reducing risk and ensuring safe, consistent care practices.
  • Hands-on engagement: Provides practical support to staff and enhances day-to-day operations.

By combining these three areas, Allmed enables Tafta to operate efficiently while maintaining a strong focus on the quality and dignity of resident care.

The impact: lifting the burden, prioritising care
The partnership has given Tafta the space to focus on its core mission: providing compassionate care. By outsourcing much of its care staff, Tafta has transferred complex HR responsibilities, including training coordination, on-site supervision, and disciplinary processes, directly to Allmed.

“For us, the primary benefit lies in ensuring that our care staff remain fully compliant with all required accreditations and registrations, which supports our commitment to delivering quality care through trained professionals,” says Kistensamy. “In addition, Allmed manages the HR processes, supplementary training, and ongoing supervision for this team, allowing us to focus on expanding and strengthening care and support services for our residents and the broader eThekwini community.”

Allmed’s support goes beyond typical service agreements. They work alongside Tafta’s management and care teams. “Whether it’s a quick phone call, a WhatsApp message, or an on-site visit, Allmed is always available,” Kistensamy adds. “Knowing they are just a message away provides enormous peace of mind.”

Forging a partnership that goes above and beyond
Tafta values the partnership for more than staffing consistency. At the organisation’s annual Sports Day for older persons, Allmed has donated essential items, provided an on-site nurse, and actively participated alongside staff and residents. “It’s not just about supplying caregivers – Allmed consistently shows up and supports our programmes,” says Kistensamy.

Allmed also contributes to Tafta’s fundraising and public-relations events, including the International Day of Care and Support, golf days, resident Christmas lunches, and donor gala dinners. Their willingness to engage with staff, residents, and fellow care partners reinforces Tafta’s values and demonstrates that effective healthcare partnerships are built on the seamless alignment of the organisation, its beneficiaries, and its supporters.

Flexible solutions for non-profit needs
Agility has been a cornerstone of the Allmed–Tafta partnership. When budget pressures arose, Allmed offered alternative staffing rates without compromising service quality.

“They understand our sector and our challenges, and they work with us to make sure our residents are always cared for,” says Kistensamy. Three elements define the success of this collaboration:

  1. Exceptional customer service: proactive support and responsiveness beyond contractual obligations.
  2. Flexible staffing solutions: ability to scale services up or down based on resident needs and operational realities.
  3. Qualified, supported staff: ongoing training, supervision, and guidance ensure consistent, high-quality care.

Through this partnership, Tafta can prioritise its core mission: ensuring every resident receives compassionate, dignified care. With Allmed providing expert staffing and compliance support, the organisation can operate smoothly while maintaining high-quality care standards.

Categories : Implants and ProsthesesTags :

‘It’s a great sign’: Innovative Cochlear Implant Trial Expands Earlier than Expected

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The new cochlear implant is implanted invisibly under the skin, unlike this standard design. Photo by Brett Sayles

A highly sought-after clinical trial testing completely under-the-skin cochlear implants is expanding earlier than expected. Promising preliminary results showed no serious adverse events or unexpected device effects.

The Medical University of South Carolina, which has one of the larger cochlear implant programmes in the country, is one of several sites in the United States taking part in the Acclaim study. Three patients were implanted in the first wave of the trial and have been using their devices for at least six months. Now, MUSC has the chance to enrol more.

“New patients are coming this week, and we’re going to resume device placement as soon as possible. We have people flying in from all over the country to be part of the trial as well as South Carolinians,” said Teddy McRackan, MD He’s medical director of the MUSC Health Cochlear Implant Program.

Some participants are traveling to Charleston to get the experimental implants because slots in the 56-person national trial are limited, and they like the idea of cochlear implants without external parts.

The Acclaim implants would be the first such devices to hit the market if they obtain approval from the Food and Drug Administration. McRackan said they use the body’s natural hearing bone movements to detect sound instead of the external microphones used in traditional cochlear implants.

“The trial has made it clear that hidden cochlear implants appeal to a lot of people,” said audiologist Elizabeth Camposeo, AuD. She’s assistant director of the MUSC Health Cochlear Implant Program.

“Seeing our patients going through this trial just feels like such a massive opportunity. I didn’t know how hard we were struggling to overcome the physical stigma of visible implants. There were many patients we screened for the trial who we could help with a traditional implant but who did not want any part of it. These people are profoundly hearing impaired, like 10 out of 10 terrible hearing, and they absolutely would not consider a traditional implant.”

They have plenty of company. Just 5% of adults in the United States who could hear better with traditional cochlear implants have them, according to the American Cochlear Implant Alliance.

To measure the Acclaim implants’ effectiveness, participants will check in for testing at one month, three months, six months, one year and two years after their implants are activated. Implantation requires surgery and then one month for healing before doctors turn on the devices.

Once the implants are activated, Camposeo said researchers will start analysing data about how much sound they detect and how well patients understand speech. “Similar to when you have your eyes checked, how close are you to 20/20 vision, we check sound detection. More importantly, we test speech understanding. We play a word. You repeat it back. We play a sentence. You repeat it back in both quiet and noise, because the world is a noisy place.”

A noisy place, and a place where potentially groundbreaking devices can be developed quickly, McRackan said. “I don’t think anybody thought two years ago that the Acclaim device would be at this point now. I think it’s kind of amazing how fast things are progressing.”

Source: Medical University of Southern Carolina

Categories : Environmental Effects NeurologyTags :

Five Ways Microplastics May Harm the Brain

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A new study highlights five ways microplastics can trigger inflammation and damage in the brain.

Photo by FLY:D on Unsplash

Microplastics could be fuelling neurodegenerative diseases like Alzheimer’s and Parkinson’s, with a new study highlighting five ways microplastics can trigger inflammation and damage in the brain.

More than 57 million people live with dementia, and cases of Alzheimer’s and Parkinson’s are projected to rise sharply. The possibility that microplastics could aggravate or accelerate these brain diseases is a major public health concern.

Pharmaceutical scientist Associate Professor Kamal Dua, from the University of Technology Sydney, said it is estimated that adults are consuming 250 grams of microplastics every year – enough to cover a dinner plate.

“We ingest microplastics from a wide range of sources including contaminated seafood, salt, processed foods, tea bags, plastic chopping boards, drinks in plastic bottles and food grown in contaminated soil, as well as plastic fibres from carpets, dust and synthetic clothing.”

“Common plastics include polyethylene, polypropylene, polystyrene and polyethylene terephthalate or PET. The majority of these microplastics are cleared from our bodies, however studies show they do accumulate in our organs, including our brains.”

The systematic review, recently published in Molecular and Cellular Biochemistry, was an international collaboration led by researchers from the University of Technology Sydney and Auburn University in the US.

The researchers highlighted five main pathways through which microplastics can cause harm to the brain, including triggering immune cell activity, generating oxidative stress, disrupting the blood–brain barrier, impairing mitochondria and damaging neurons.

“Microplastics actually weaken the blood–brain barrier, making it leaky. Once that happens, immune cells and inflammatory molecules are activated, which then causes even more damage to the barrier’s cells,” said Associate Professor Dua.

“The body treats microplastics as foreign intruders, which prompts the brain’s immune cells to attack them. When the brain is stressed by factors like toxins or environmental pollutants this also causes oxidative stress,” he said.

Microplastics cause oxidative stress in two main ways: they increase the amount of “reactive oxygen species” or unstable molecules that can damage cells, and they weaken the body’s antioxidant systems, which normally help keep those molecules in check.

“Microplastics also interfere with the way mitochondria produce energy, reducing the supply of ATP, or adenosine triphosphate, which is the fuel cells need to function. This energy shortfall weakens neuron activity and can ultimately damage brain cells,” said Associate Professor Dua.

“All these pathways interact with each other to increase damage in the brain.”

The paper also explores specific ways in which microplastics could contribute to Alzheimer’s, including triggering increased buildup of beta-amyloid and tau; and in Parkinson’s through aggregation of α-Synuclein and damage to dopaminergic neurons.

First author UTS Master of Pharmacy student Alexander Chi Wang Siu is a currently working in the lab of Professor Murali Dhanasekaran at Auburn University, in collaboration with Associate Professor Dua, Dr Keshav Raj Paudel and Distinguished Professor Brian Oliver from UTS, to better understand how microplastics affect brain cell function. 

Previous UTS research has examined how microplastics are inhaled and where they are deposited in the lungs. Dr Paudel, a visiting scholar in the UTS Faculty of Engineering, is also currently investigating the impact of microplastic inhalation on lung health.

While evidence suggests microplastics could worsen diseases like Alzheimer’s and Parkinson’s, the authors emphasise that more research is needed to prove a direct link. However, they recommend taking steps to reduce microplastic exposure.

“We need to change our habits and use less plastic. Steer clear of plastic containers and plastic cutting boards, don’t use the dryer, choose natural fibres instead of synthetic ones and eat less processed and packaged foods,” said Dr Paudel.

The researchers hope the current findings will help shape environmental policies to cut plastic production, improve waste management and reduce long-term public health risks posed by this ubiquitous environmental pollutant.

Source: University of Technology Sydney

Categories : Cancer DermatologyTags :

Lower Doses of Immunotherapy for Skin Cancer Give Better Results

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According to a new study, lower doses of approved immunotherapy for malignant melanoma can give better results against tumours, while reducing side effects. This is reported by researchers at Karolinska Institutet in the Journal of the National Cancer Institute.

“The results are highly interesting in oncology, as we show that a lower dose of an immunotherapy drug, in addition to causing significantly fewer side effects, actually gives better results against tumours and longer survival,” says last author Hildur Helgadottir, a researcher at the Department of Oncology-Pathology at Karolinska Institutet, who led the study.

The traditional dose of nivolumab and ipilimumab is the one that is approved and established. Due to the extensive side effects, Sweden has increasingly begun to use a treatment regimen with a lower dose of ipilimumab, which is both gentler and cheaper. Ipilimumab is the most expensive part of this immunotherapy and causes the most side effects.

“In Sweden, we have greater freedom to choose doses for patients, while in many other countries, due to reimbursement policies, they are restricted by the doses approved by the drug authorities,” says Hildur Helgadottir.

Lower dose is more effective

The study included nearly 400 patients with advanced, inoperable malignant melanoma, the most serious form of skin cancer. The study shows that the regimen with the lower dose of ipilimumab is more effective, with a higher proportion of patients responding to treatment, 49%, compared to the traditional dose, 37%.

Progression-free survival, the time the patient lives without the disease worsening, was a median of nine months for the lower dose, compared to three months for the traditional dose. Overall survival was also longer, 42 months compared to 14 months.

Serious side effects were seen in 31% of patients in the low-dose group, compared to 51% in the traditional group.

“The new immunotherapies are very valuable and effective, but at the same time they can cause serious side effects that are sometimes life-threatening or chronic. Our results suggest that this lower dosage may enable more patients to continue the treatment for a longer time, which is likely to contribute to the improved results and longer survival,” says Hildur Helgadottir.

There were some differences between the two treatment groups, but even after adjusting for several factors such as age and tumour stage, the better outcome for the lower dose of ipilimumab remained. The study is a retrospective observational study and therefore it is not possible to definitively establish a causal relationship.

Source: Karolinska Institutet

Categories : PaediatricsTags :

Use of Social Media Linked to ADHD-like Symptoms in Kids

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Increased ADHD-related symptoms in children were linked to social media use, but not video games and television

Photo by Emily Wade on Unsplash

Children who spend a significant amount of time on social media tend to experience a gradual decline in their ability to concentrate. This is according to a comprehensive study from Karolinska Institutet, published in Pediatrics Open Science, where researchers followed more than 8000 children from around age 10 through age 14.

The use of screens and digital media has risen sharply in the past 15 years, coinciding with an increase in ADHD diagnoses in Sweden and elsewhere. Researchers at Karolinska Institutet in Sweden and Oregon Health & Science University in the USA have now investigated a possible link between screen habits and ADHD-related symptoms.

The study followed 8324 children aged 9–10 in the USA for four years, with the children reporting how much time they spent on social media, watching TV/videos and playing video games, and their parents assessing their levels of attention and hyperactivity/impulsiveness. 

Social media stands out

Children who spent a significant amount of time on social media platforms, such as Instagram, Snapchat, TikTok, Facebook, Twitter or Messenger, gradually developed inattention symptoms; there was no such association, however, for watching television or playing video games.

“Our study suggests that it is specifically social media that affects children’s ability to concentrate,” says Torkel Klingberg, professor of cognitive neuroscience at the Department of Neuroscience, Karolinska Institutet. “Social media entails constant distractions in the form of messages and notifications, and the mere thought of whether a message has arrived can act as a mental distraction. This affects the ability to stay focused and could explain the association.”

Significance at population level

The association was not influenced by socioeconomic background or a genetic predisposition towards ADHD. Additionally, children who already had symptoms of inattentiveness did not start to use social media more, which suggests that the association leads from use to symptoms and not vice versa.

The researchers found no increase in hyperactive/impulsive behaviour. The effect on concentration was small at the individual level. At a population level, however, it could have a significant impact.

“Greater consumption of social media might explain part of the increase we’re seeing in ADHD diagnoses, even if ADHD is also associated with hyperactivity, which didn’t increase in our study,” says Professor Klingberg.

Well-informed decisions

The researchers stress that the results do not imply that all children who use social media develop concentration difficulties, but there is reason to discuss age limits and platform design. In the study, the average time spent on social media rose from approximately 30 minutes a day for 9-year-olds to 2.5 hours for 13-year-olds, despite the fact that many platforms set their minimum age requirement at 13. 

“We hope that our findings will help parents and policymakers make well-informed decisions on healthy digital consumption that support children’s cognitive development,” says the study’s first author Samson Nivins, postdoctoral researcher at the Department of Women’s and Children’s Health, Karolinska Institutet.

The researchers now plan to follow the children after the age of 14 to see if this association holds. 

Source: Karolinska Institutet

Categories : CancerTags :

Tough Enough to Save a Life? SA Athletes Challenge Men to Register as Stem Cell Donors

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Jaco Pretorius was inspired by his best friend’s life being saved by a stem cell transplant.

With South African men having a 20-50% higher incidence rate of blood cancers than women, sports icons Jaco Pretorius, Seabelo Senatla, and Temba Bavuma are leveraging their platforms to challenge more men to join the stem cell registry and help rewrite the odds for patients in need.

The challenge confronts a widespread public disconnect from the issue. “Many people seem to be disinterested, until one of their own is diagnosed,” notes Senatla. “People tend to be nonchalant when things don’t pertain to them; they have this attitude of ‘not my problem’.”

Pretorius agrees that a lack of awareness is a major hurdle. “My experience is that people are not aware of the great need in our country and the simplicity of the process. But we’ve seen so many times how sport has the power to unite South Africa. When athletes from different backgrounds set an example, I believe people will follow, and together we can make a real difference.”

His advocacy is rooted in his own firsthand experience. Motivated to register after his best friend’s life was saved by a transplant, he was later called upon to donate. He hopes sharing his story will dismantle common fears. “The perception is that it is a painful procedure which carries personal risk. My experience was the complete opposite.”

A concern Bavuma often hears about is the time commitment, especially for those with demanding jobs or family responsibilities. “But if you do get the call to donate, those few days potentially add years, even decades, to someone else’s life. That’s a trade any of us should be willing to make.”

Tackling a common myth, Senatla says, “One of the biggest myths I’ve had to debunk is people having the notion that since stem cells are taken from them, they’ll be left with fewer stem cells. The body of a healthy person is constantly producing stem cells. You’re not in danger of having too little if you donate some to someone.”

For him, the motivation to act is deeply personal. “I grew up in an environment in which I was made to understand that your gifts are not only for you. Other people must benefit as well. That’s what’s in practice here.”

Addressing men who might be hesitant, Senatla points out that they aren’t losing anything by registering. “Rather, they’re affording someone who is ill a second chance at life.”

Bavuma challenges the passive mindset. “In cricket, you can’t field, thinking someone else will take the catch. The same goes for this. Too many people assume there are enough donors already, or that someone else will register.”

Pretorius adds, “I would encourage other people to immediately take action. The process is pain-free, professional, non-invasive, and there are no financial implications – only your time and commitment.”

The outcome of his simple act was profound. “I received communication from the stem cell recipient that the transplant was successful, and the person is healthy and well. That was one of the best feelings – to know that through such a simple action, someone else’s life was saved.”

Palesa Mokomele, Head of Community Engagement and Communications at DKMS Africa, highlights the impact of these role models. “While men currently make up the majority of registered donors in South Africa, the overall pool of donors is critically low compared to the national need. Having respected public figures like Jaco, Seabelo, and Temba lead this conversation is invaluable. When men see other men stepping up, it directly challenges hesitation, shifts perceptions, and ultimately helps save lives.”

Senatla offers a reminder of our shared humanity. “You’re never too important to help, and you should help because you can. Being in a position to help is an absolute privilege.”

“This isn’t a spectator sport; everyone who can help needs to get in the game,” concludes Bavuma.

South Africans aged 17 to 55 who are in good health can register as potential stem cell donors. The process is simple and starts with an online registration and a cheek swab.

Register today at https://www.dkms-africa.org/save-lives.

Categories : Cardiovascular Disease Obstetrics & GynaecologyTags :

Planned Birth at Term Reduces Pre-eclampsia in Those at High Risk

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Planned birth at term reduces the incidence of pre-eclampsia in women at high risk of the condition, without increasing emergency Caesarean or neonatal unit admission, according to new trial results.

Photo by SHVETS production

The PREVENT-PE trial, led by researchers from King’s College London and King’s College Hospital NHS Foundation Trust, is the first to find that a strategy of screening for pre-eclampsia risk at 36 weeks of pregnancy, and then offering planned early term delivery according to the mother’s risk, can reduce the incidence of subsequent pre-eclampsia by 30%, compared with usual care.

The trial, funded by the Fetal Medicine Foundation (FMF), also found that the intervention did not increase the rates of birth by emergency Caesarean or neonatal care needs, and there was no evidence of other harms to mother or baby.

The findings were published today in The Lancet.

Pre-eclampsia is high blood pressure that develops during pregnancy, most commonly at term gestational age. Pre-eclampsia affects 2-8% of pregnancies worldwide and can be life-threatening – there are around 46,000 maternal deaths due to pre-eclampsia each year and around 500,000 foetal or newborn deaths.1

Pre-eclampsia usually develops after 20 weeks of pregnancy, or soon after the baby is born. While aspirin can be taken to significantly reduce the risk of developing pre-eclampsia before 37 weeks of pregnancy, there are no treatments available to reduce risk at term (37-42 weeks).

Building on findings from an earlier data analysis, the PREVENT-PE trial recruited over 8,000 women from King’s College Hospital and Medway NHS Foundation Trusts. Women were randomly allocated into one of two groups: the intervention group (risk assessment for pre-eclampsia, followed by planned early term delivery according to risk) and the control group (usual care at term).

Pre-eclampsia risk was assessed using a model developed by the FMF, which combines maternal demographics and history, with blood pressure, and specific markers in the blood.

Those at high risk of developing pre-eclampsia at term were offered planned birth at 37, 38, 39 or 40 weeks of pregnancy. Women considered to be at low risk received usual care, according to their hospital protocols and UK standards of care.

A 30% reduction in term pre-eclampsia, from 5.6% to 3.9%, is very important. It represents an even greater reduction in the number of pre-eclampsia cases than we can achieve for preterm pre-eclampsia with aspirin.Professor Kypros Nicolaides, founder and chairman of the Fetal Medicine Foundation, and senior author of the paper

This trial took place in busy NHS maternity units serving a highly diverse population, and often socially deprived communities where the burden of pre-eclampsia is greatest. The high level of participation and adherence shows that a personalised, risk-based approach is acceptable, practical, and aligns with what women want from their care. Achieving a 30% reduction in term pre-eclampsia, without increasing emergency Caesarean birth or neonatal admissions, represents a meaningful and reassuring improvement for women, babies, and maternity services.Dr Argyro Syngelaki, Reader in Maternal-Fetal Medicine at King’s College London and co-lead author of the paper

We will soon report on the health economic implications of the trial, as well as the experiences of women and staff who participated, to provide policy-makers with the information that they need to implement the trial intervention within the NHS.Professor Laura A. Magee, Professor of Women’s Health at King’s College London and co-author of the paper

Read the full paper in The Lancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01207-3/fulltext

References:

  1. World Health Organization (2025). Pre-eclampsia. Available at: https://www.who.int/news-room/fact-sheets/detail/pre-eclampsia (2 July 2025)

Source: King’s College London

Categories : GastrointestinalTags :

New Insights on Gut Microbes that Prevent Formation of Cancer-causing Compounds

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Gut Microbiome. Credit Darryl Leja National Human Genome Research Institute National Institutes Of Health

Nitrogen metabolism of gut bacteria can provide health benefits. Specifically, gut microbes metabolise dietary nitrates and nitrites and prevent the formation of cancer-causing compounds called nitrosamines. New research published in The FEBS Journal sheds light on these processes and pinpoints which types of bacteria are most important.

Investigators found that Escherichia coli – and to a lesser extent, species of the genera Lactobacillus, Bacteroides and Phocaeicola – can efficiently metabolise different forms of nitrogen, thus preventing carcinogenic nitrosamine formation. They also demonstrated that this bacterial processing is critical to enable microorganisms to survive and colonise the intestinal tract, likely preventing harmful changes in the composition of the gut microbiota.

The findings highlight the importance of the gut microbiota in preventing the formation of harmful nitrogen metabolites, potentially decreasing the risk of certain cancers. The study also illustrates how the microbiota facilitates crosstalk between our diet and the gut, thus having important implications for both health and disease.

“The discovery that specific gut bacteria rapidly metabolise nitrite suggests a protective mechanism through which the microbiota contributes to the maintenance of intestinal and systemic health,” said corresponding author Prof Uwe Deppenmeier, of the University of Bonn, in Germany.

Source: Wiley

Categories : Healthcare Politics and Regulations Metabolic DisordersTags :

Patients Left Vulnerable as Diabetes Supplies Dwindle

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Photo by isens usa on Unsplash

By Joan van Dyk

Getting to grips with rising diabetes rates is arguably one of the most urgent tasks for South Africa’s public healthcare system, but the setbacks keep coming. While some communities are facing shortages of blood sugar meters and insulin pens, a smaller wave of insulin vial shortages is now on the horizon.

In August, activist Eksoda Mazibuko was sure that years of community organising had finally yielded tangible results for people with diabetes in Hluvukani, a town in Mpumalanga.

The 35-year-old had just received R50 000 from Good Morning Angels, Jacaranda FM’s community upliftment project. It was more than enough for him to buy blood sugar meters and test strips for the fifty-person support group he runs at Tintswalo Hospital in Acornhoek, where stock had run out.

When the body can’t make or use insulin – the hormone that keeps blood sugar in check – people have to watch their levels, so they know how to eat and medicate themselves. It’s a process held together by medicines and an ecosystem of tools ⁠such as meters, strips, pens, lancets, needles, syringes, which unravels when one part is missing. Over time, poorly controlled blood sugar causes cumulative damage to one’s body that can result in severe complications such as amputation, blindness, kidney damage, and stroke.

Most people who take pills to treat diabetes need monitoring from time to time, but for the majority of those who are on insulin treatment, it is essential. People with diabetes who are taking insulin must check their blood sugar levels multiple times a day. To do this, they need glucometers – devices that measure the sugar levels in a drop of blood. But access to glucometers is a challenge. Spotlight previously reported that not everyone who needs these home testing devices is given one and those who do receive them rarely get enough test strips and lances to enable proper monitoring of their blood sugar levels.

Without tests and test strips, people in Hluvukani had no way of knowing how to adjust their insulin. Injecting the wrong amount could in extreme cases result in someone going into a coma or dying.

Mazibuko himself, who was diagnosed in 2003 and has always needed insulin, knows how terrifying it can be when monitoring tools are out of reach.

When the devices and test strips finally arrived, he shared a celebratory photo on social media. Excited messages streamed in on WhatsApp, but among them was an upsetting note from a government pharmacist: “You should have asked me before you ordered.”

Unbeknownst to the hospital staff that helped Mazibuko choose the device, the national government’s supplier would be changing, as it does every three years or so when a new tender is awarded. That means state pharmacies would soon stock a different kind of test strip.

Glucometers generally can’t interpret test strips from a different brand or model, so the glucometers that he’d already started to hand out would soon be useless.

“They were already open so I couldn’t send them back. After I worked so hard to get those machines for my community members,” said Mazibuko. “It was heartbreaking.”

According to a report from the Clinton Health Access Initiative, in poorer countries companies make most of their profit on the test strips rather than the glucometers used to read the strips. Spotlight understands that some companies go as far as giving away the devices to lock people into using their specific test strips. According to Cathy Haldane, who leads the non-communicable diseases team at FIND (a global diagnostics alliance), there have been some efforts toward encouraging universal interoperability of test strips, but these efforts haven’t gathered much steam.

Why diabetes is still a national guessing game

South Africa is one of the few countries that buys blood glucose meters and test strips en masse, but there are still lots of people who are treated with insulin who don’t have access to them.

One reason for this is that the national health department buys machines and strips for the public sector but it’s up to provinces to manage stock at pharmacies and clinics, explains Haldane.

A lack of good quality diabetes data could be making harder for health department staff to predict how much they’ll need, she says. Unlike the country’s digital HIV & TB tracking system, there’s no centralised database for diabetes and other chronic diseases such as high blood pressure and cancer. As Spotlight previously reported in-depth, there is a serious lack of reliable diabetes data for South Africa. Haldane says, “that’s how people on insulin treatment who should get a machine and monthly test strips end up going without”.

Not having reliable data leaves national planners, doctors and nurses in the dark about how many people need blood sugar monitors, where the system is failing and how the country is faring against targets outlined in the health department’s action plan for chronic diseases, which lapses in 2027. The plan states that by 2027, the health department wants at least 50% of people receiving care for diabetes to have their blood sugar under control. The available data though, all from pockets of academic research, suggests that we are falling far short of this target.

The diabetes data that is available paints a harrowing picture.

According to a StatsSA report on non-communicable diseases, diabetes was the leading underlying cause of death for women and second biggest underlying cause of death for men in 2018. While other reports suggest that diabetes is lower on the list of top killers, it clearly does claim many lives in the country. The International Diabetes Federation estimates that about half of people with diabetes in South Africa haven’t been diagnosed.

If trends continue, 2018 research suggests the treatment, management and complications of type two diabetes could cost the government as much as R35-billion by 2030.

In rural KZN, insulin pen stockouts persist

Meanwhile, more than 700 kilometers from Hluvukani, in KwaZulu-Natal’s rural King Cetshwayo district, some healthcare staff are using their own money to help keep diabetes services going.

Indira Govender, a doctor affiliated with the Rural Doctors Association of South Africa (Rudasa) who works in the area, says clinic managers are often the ones buying new batteries for blood sugar meters used in the facility and by patients.

The devices use the coin-like batteries also used in some watches, which aren’t easy to find in far flung areas.

Govender worries about the patients on insulin who still have to use a glass vial and syringe to inject themselves. “Not everybody has a fridge to store the insulin in. People struggle to draw up the right amount of insulin, sometimes because they can’t see well,” says Govender.

South Africa ran out of pens in 2024 when the health department’s longtime supplier, Novo Nordisk, stopped manufacturing pens prefilled with the cheapest form of insulin. The news came as global demand surged for one of Novo Nordisk’s long-acting diabetes medicines, semaglutide, because it was shown to also be effective for weight loss. Semaglutide is also provided in pens rather than vials.

In a 2024 letter to Novo Nordisk’s chief executive officer, MSF demanded that the pharma giant either ensure continued supply of the cheapest insulin pens in South Africa or that it offer a newer kind of pen at $1 each. That’s the amount that MSF’s research found would cover production costs, a fair profit margin and an allowance for tax.

The newer pens are filled with a form of insulin that takes effect faster and lasts for longer than previous versions. Novo Nordisk signed a deal in May in which it commits to providing these pens to South Africa until 2027. The department was charged just under $4 (around R75) per pen.

At the government clinic where Govender works in KwaZulu-Natal, however, insulin pens have reportedly not returned to pharmacy shelves.

“We haven’t had pens here since at least 2024,” says Govender.

The KwaZulu-Natal health department did not respond to Spotlight’s queries about the delivery delays.

Local consequences of global disruptions

While some communities are still waiting for insulin pens, a smaller wave of vial shortages is on its way for South Africa, according to an October circular.

Novo Nordisk told the health department to expect six to eight week delays in the delivery of short-acting, medium-acting and longer-acting insulin sold in 10ml vials. The department did not respond to Spotlight’s queries, but the circular listed four alternative prefilled pens that are available and expects stock to stabilise by January 2026.

One of the listed alternatives, Novo Nordisk’s NovoMix30, is also on a list of insulin pens and vials that will be discontinued in 2026, according to a directive issued by the health ministry in New Zealand.

No such directive has been issued by South Africa’s health department. Candice Sehoma, advocacy advisor for MSF Access in Southern Africa, says she would be surprised if the country avoids it.

It’s part of a concerning pattern of shortages of essential medicines worldwide, she says.

“We’re seeing more and more companies deprioritising insulin and discontinuing affordable medicines,” says Sehoma.

When there’s insulin but no food

While his stock of test strips lasts, Mazibuko takes them along when he visits members of his support group in Hluvukani.

They could technically find matching strips in the private sector, but they’re likely to be too expensive. A 2024 study found that for someone earning South Africa’s minimum wage, a single blood-sugar test in the private sector costs more than an hour of work, and a month of basic diabetes supplies can swallow three full days’ wages.

Many of the people on Mazibuko’s route are facing far more serious problems than the loss of glucometers. Those who aren’t working are often not taking their medication well either, Mazibuko says. “They don’t have food so they skip breakfast and also skip their insulin because they’re scared.”

Injecting insulin on an empty stomach can cause a sudden blood sugar crash that could lead to dizziness, confusion or a seizure.

Mazibuko is working on a skills programme to help these people make a living that might also protect them from lapses in basic supplies at government health facilities, which he claims happens often.

“Sometimes you go to the clinic, they tell you that they’ve run out of insulin, or they tell you to buy your own needles and syringes. You will have to do that with borrowed money,” says Mazibuko.

The Mpumalanga health department also did not respond to Spotlight’s requests for comment.

Republished from Spotlight under a Creative Commons licence.

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Is Caffeine Actually Getting an Unfair Rap in Atrial Fibrillation?

On By ModernMedia
Photo by Porapak Apichodilok on Pexels

Caffeine may have been unfairly portrayed as the villain in some heart rhythm disorders, according to a new study published in the Journal of the American Medical Association.

Longstanding medical advice has held that patients with atrial fibrillation (AF) should cut back on their caffeine intake – or eliminate it entirely – to improve their condition. Wong et al. conducted an investigation into the relationship between regular caffeinated coffee consumption and the recurrence of atrial fibrillation (AF) or atrial flutter.

The DECAF randomised clinical trial, conducted across five international centres, enrolled 200 patients with persistent AF who were successfully cardioverted and then randomised to either consume caffeinated coffee (averaging one cup daily) or abstain from coffee and caffeine for six months. But contrary to expectations, the caffeine group actually saw an improvement in symptoms.

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