Category: Ethics and Law

Categories : Ethics and Law Expert OpinionTags :

Gauteng Department of Health’s Non-payment Crisis Threatens Suppliers and Healthcare Stability

On By ModernMedia
Photo by Towfiqu barbhuiya on Unsplash

The South African Medical Technology Industry Association (SAMED) is raising the alarm over the Gauteng Department of Health’s ongoing failure to meet its financial obligations to medical technology suppliers – a crisis that now threatens business survival, jobs, and the stability of healthcare delivery across the province. 

The Gauteng Health Department currently owes SAMED member companies more than R700 million. Despite fulfilling their contractual commitments and continuing to supply essential medical products and services, many companies have been forced to carry this debt burden for months without payment. To remain operational, suppliers are relying on costly loans and overdrafts simply to sustain cash flow and pay their employees. 

SAMED Chairperson, Scott de Oliveira, notes that a recent member survey revealed several companies are on the brink of closure, with job losses imminent – even as South Africa prepares to host the G20 Summit, a global event intended to showcase Johannesburg and the country’s economic potential. 

“As the upcoming G20 Summit demonstrates, our government is capable of decisive action and resource mobilisation when it chooses to,” says de Oliveira. “What is deeply concerning in the medtech payment crisis is the Gauteng Department’s lack of urgency to engage with us.”  

Despite repeated formal requests from SAMED to meet with senior Gauteng Department of Health officials – including the Chief Financial Officer, Head of Department, and hospital Chief Executive Officers – no meaningful engagement has taken place. Meetings are frequently missed, and correspondence has gone unanswered. 

“This reflects a worrying lack of accountability, urgency, and leadership from decision-makers,” de Oliveira emphasises. 

The consequences of this inaction are far-reaching. The mounting financial strain on suppliers threatens not only the sustainability of small- and medium-sized enterprises but also the continuity of international subsidiaries that have invested in South Africa and are vital to the delivery of healthcare services. 

“Disruptions in the medical supply chain place patients and healthcare professionals at risk,” warns de Oliveira. “Delays or interruptions in the supply of essential equipment, consumables, and support services could have devastating effects on hospitals across Gauteng.” 

Several SAMED members have indicated that, unless the issue is urgently resolved, they will be forced to suspend supply to the Department, a decision that would further endanger patient care. 

SAMED calls on provincial and national leadership to take immediate, decisive action to clear the payment backlog and to implement a transparent, sustainable payment framework that ensures future compliance and stability. 

“It is irrational for government to champion economic growth and job creation through initiatives such as the MEDTECH Master Plan and the G20 Summit, while simultaneously eroding existing businesses and employment through maladministration,” concludes de Oliveira. “This crisis must be addressed urgently – to protect patients, preserve healthcare delivery, and rebuild trust between the public sector and its suppliers.” 

SAMED urges the media, public, and stakeholders to bring attention to this issue and hold the Gauteng Department of Health accountable. Public awareness and pressure are essential to compel action and safeguard the integrity of South Africa’s healthcare system.

Categories : Ethics and LawTags :

Casting Caution to Calderbank

On By ModernMedia

By Lisa Swaine, Partner at Webber Wentzel

The Supreme Court of Appeal (SCA) handed down its judgment on 16 October 2025 in the case of Itokolle-Clinix Private Hospital (Pty) Ltd v MNT obo DORM (863/2024) [2025] ZASCA 153. This judgment should serve as a caution for defendants when faced with a Calderbank offer.

The plaintiff, in the High Court, acting in her personal capacity and on behalf of her daughter (D), proved liability on the part of both Itokolle-Clinix Private Hospital (the Hospital) and a specialist obstetrician and gynaecologist, Dr Kofi Ofori Amanfo (Dr Ofori). The claim arose from her daughter being born with cerebral palsy. Both the Hospital and Dr Ofori were found by the High Court to have been negligent and that their negligence was the cause of the harm suffered by D and the plaintiff. The Hospital and Dr Ofori were found jointly and severally liable for 100% of the plaintiff’s proven damages.

A Calderbank offer is a ‘without prejudice’ offer made by a plaintiff to a defendant to save costs, and to rely on such an offer, once judgment is granted in the plaintiff’s favour, in support of claiming indemnifying or ‘punitive’ costs.

Its name comes from the English Court of Appeal’s judgment in the case of Calderbank v Calderbank [1975] 3 All ER 333 (EWCA), where it was held that there was no reason, in principle, why informal offers made outside the formal court rules could not be relied on.

Calderbank offers are approved and applied in our courts.

The High Court awarded costs on the High Court scale as between party and party to the plaintiff. The plaintiff applied to the High Court to have the costs order reconsidered, as she made a Calderbank offer before trial, indicating a willingness to settle if the defendants admitted liability for 85% of her proven damages. The offer was rejected, and the Hospital made two unacceptable counteroffers. The plaintiff therefore applied for an order awarding the plaintiff a portion of her costs up to a certain date as between party and party and the remaining costs, including those of the reconsideration application, as between attorney and own client.  The High Court ordered the Hospital and Dr Ofori to pay these costs sought.

The Hospital appealed against the judgment of the High Court and against the reconsidered order for costs.

The appeal was dismissed.

Why was the plaintiff successful on the issue of costs?

A Calderbank offer made by a plaintiff to settle a matter is recognised in the same way as a formal offer made by a defendant to settle a matter in terms of the court rules. A defendant, faced with a Calderbank offer, who fails to act reasonably in rejecting the offer, is at risk of being liable to indemnify a plaintiff in respect of all legal costs incurred, or pay more than the much reduced and limited party and party costs, from the date of the Calderbank offer.

A successful Calderbank offer is, however, not an automatic entitlement to recover more costs than those ordinarily recoverable. The plaintiff made a Calderbank offer to the Hospital and Dr Ofori that was more generous to them than the order made by the High Court. To succeed in recovering the attorney-and-own client costs claimed, the plaintiff had to prove that the defendants unreasonably rejected her Calderbank offer.

The factors considered by a court when deciding whether a defendant’s conduct was unreasonable depend on the facts of each case, and a consistently applied starting point is the public interest. It is in the public interest not to waste public resources on litigation that could be avoided by settlement.

On appeal, the Hospital argued that it was reasonable to reject the Calderbank offer. It submitted that its counteroffers of 20% and 50% liability, respectively, were reasonable.

In finding that the conduct of the Hospital was unreasonable, the High Court pointed to the extent of the information available to the Hospital at the time the Calderbank offer was made that, in the circumstances, ought to have alerted the Hospital to the high risk it was taking in continuing with its defence of the case.

In deciding whether to award attorney-and-own client costs, the High Court considered the plaintiff’s financial position in comparison to the Hospital’s, noting that an order for anything less would result in the capital amount awarded as damages being significantly eroded by the portion of the costs borne by the plaintiff. The High Court concluded that the costs order sought by the plaintiff was justified because its purpose was to ‘indemnify’ her in respect of costs unjustly incurred because of the unreasonable rejection of the Calderbank offer.

On appeal, the High Court was found to have exercised its discretion judicially in making the reconsidered order for costs and, as a result, there was no basis upon which to interfere with the High Court’s discretion.

As the cost implications of prolonged litigation have become exorbitant, the risk of paying ‘punitive’ costs should be a strong motivator for a defendant to properly assess its case and the risks inherent in defending it to trial, and give serious consideration to a Calderbank offer made, before forcing a plaintiff into unnecessary or protracted litigation.

Categories : Ethics and Law IT in HealthcareTags :

POPIA Compliance for Health Data: Navigating Special Personal Information Requirements in Healthcare

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By Wendy Tembedza, Partner at Webber Wentzel


Health data is one of the most valuable assets in modern healthcare, and the Protection of Personal Information Act, 2013 (POPIA) places strict requirements on its use.

Stakeholders in the healthcare sector understand the value of data in ensuring appropriate treatment for patients. With the proliferation of technologies such as artificial intelligence, which enable healthcare practitioners to derive valuable insights from the data they hold, the importance of managing data in a manner that ensures compliance with data protection laws must remain front of mind in all data processing activities.

This obligation is particularly acute given the volumes of data that evolving technologies allow healthcare institutions to collect and utilise. Importantly, when these larger datasets include special personal information, the obligation to process such information lawfully becomes even more significant. This is because POPIA regulates the processing of special personal information (which includes health and sex life information) more closely than it does other forms of personal information.

The implications of POPIA’s strict regulation of processing health and sex life information means that, where a responsible party is considering collecting such data, an assessment must be made before collection to ensure that the intended processing activities will be lawful under POPIA. Conducting such an assessment prior to collection is integral to establishing a lawful basis for processing from the outset, as all handling of health and sex life information must remain lawful throughout the processing lifecycle, from collection and use to deletion and destruction.

POPIA establishes, as a starting point, a prohibition on processing health and sex life information unless a justification exists. One general exception is where the data subject has granted consent for such processing. It is important to note that consent is specifically defined under POPIA as an informed, voluntary expression of will. Importantly, consent must be specific and cannot be overly generalised. Any reliance on consent must therefore meet these definitional requirements. Ensuring compliance with these requirements is increasingly pertinent where data is used for purposes that differ from the reason for which it was initially collected.

POPIA provides additional exemptions for processing special personal information. For health information, POPIA permits processing by medical professionals, healthcare institutions or facilities, or social services, where such role players are providing healthcare services. POPIA also provides an exemption that applies to insurance companies, medical schemes, medical scheme administrators, and managed healthcare organisations in certain circumstances.

While POPIA creates these categories of exemptions, it is important to note that even where a role player falls within an exemption, this does not eliminate the obligation on a responsible party to comply with POPIA’s eight conditions for lawful processing. Any responsible party relying on an exemption must still ensure that processing activities are ultimately lawful and consistent with the standards of care contemplated under POPIA.

The use of automated means to make decisions about data subjects using their health and sex life information must also be carried out lawfully and in compliance with POPIA. A data subject cannot be subject to a decision that has legal consequences for them, or that otherwise affects them to a substantial degree, where such a decision is based solely on automated decision-making using their personal information, except in limited instances.

Notably, POPIA specifically identifies health as an example of a decision that could have legal consequences or otherwise affect a data subject substantially. This highlights the importance of assessing all data processing activities, especially in sectors like healthcare, where there is growing reliance on technology to make diagnostic or treatment-related decisions.

The Information Regulator has recognised the importance of properly regulating the processing of health and sex life information in recently published Draft Regulations relating to the processing of such data by certain responsible parties. The Information Regulator notes that the primary purpose of these Draft Regulations is to assist responsible parties in implementing POPIA correctly and to provide better transparency to data subjects regarding their information.

The scope of application of the Draft Regulations includes insurance companies, medical schemes, medical scheme administrators, managed healthcare organisations and pension funds.

The Information Regulator’s move to regulate the processing of health and sex life information more closely underscores the importance of ensuring that all such processing activities are undertaken with an increased measure of care. Organisations must therefore assess their processing activities routinely to ensure ongoing compliance with POPIA. This is particularly important as healthcare-related technologies continue to advance, creating new and innovative ways to use data in patient treatment.

Healthcare stakeholders must ensure that use of such technologies comply with POPIA’s requirements and meet the standards established under the Act.

Categories : Ethics and LawTags :

EthiQal Invites You to an Ethics Webinar

On By ModernMedia

Date: 20th November

Time: 18h00 to 19h45

Link: https://webinar.ethiqal.co.za/

During this webinar, attendees will review the HPCSA Booklet 10: General Ethical Guidelines for Good Practice in Telehealth where the pertinent South Africa laws and basic principles around ethical practice for patient consultations and the accompanying administration will be explored. The webinar will offer insights into different types of telehealth and ethical guidelines with specific focus on the quality, security, and safety of patient records.

The audience will have an opportunity to listen and engage with clinical, legal, medical malpractice insurance, cybersecurity, and telehealth subject matter experts. During the webinar, a range of learning opportunities will be offered including short lectures, interactive case studies with a series of multiple choices questions, panel discussions, and audience Q&A.

This webinar will focus on specialist practices. Administrative staff working in these practices are welcome to join the discussion.

Click here to register for the webinar

Categories : Ethics and LawTags :

HealthTech: Navigating Legal Solutions for Africa’s Growing HealthTech Sector

On By ModernMedia
Photo by Kamil Switalski on Unsplash

HealthTech is transforming healthcare through AI, mobile applications, wearable devices, telemedicine, and big data analytics. While these advances offer enormous potential to improve patient outcomes and operational efficiency, they also raise complex legal and regulatory challenges – spanning intellectual property, data privacy, licensing, corporate governance, funding, taxation, and litigation.

Webber Wentzel’s Navigating HealthTech Legal Solutions highlights the firm’s extensive experience in helping innovators, investors, and healthcare providers across Africa address the legal and regulatory complexities of HealthTech. Mapping out the complexities at play across both the technology and the law, this resource brings together Webber Wentzel’s cross-practice teams to give clients a holistic perspective on opportunities, risks, and emerging trends in healthcare innovation.

“Our clients are leading the way in healthcare innovation, and they need legal partners who understand the sector end-to-end,” says Bernadette Versfeld, head of the Consumer sector. “This resource demonstrates how we help businesses navigate regulatory hurdles, adopt new technologies, structure investments effectively, and manage risk, all while enabling growth and innovation.”

Drawing on extensive experience working with healthcare companies, insurers, tech providers, investors, and regulators across Africa, the report provides insights into medical device licensing, HealthTech investment structuring, protecting personal health data, managing litigation risks, and compliance with South Africa’s National Health Insurance Act.

“As part of our ongoing commitment to supporting Africa’s healthcare sector, Webber Wentzel continues to advise on emerging trends, innovative technologies, and regulatory developments. By combining deep sector knowledge with cross-practice expertise, we help clients not just respond to change but shape it, empowering them to navigate the complex intersection of healthcare and technology,” adds Versfeld.

Access Navigating HealthTech Legal Solutions here.

Categories : Diet and Nutrition Ethics and LawTags :

Retracted: Widely-reported Trial on Apple Cider Vinegar and Weight Loss

On By ModernMedia

Journalists and others should no longer reference or use the study findings in future reporting

Photo by Kenny Eliason on Unsplash

BMJ Group has retracted research suggesting that small daily quantities of apple cider vinegar might help people who are overweight or obese to lose weight.

The small clinical trial was published in the open access journal BMJ Nutrition, Prevention & Health in March 2024 and its findings press released. The study findings generated widespread international attention at the time, and continue to be frequently referred to in media coverage.

The retraction was prompted by concerns raised about the quality of the work, including the approach to statistical analysis of the data; implausible statistical values; the reliability of the raw data; inadequate reporting of methods; and lack of prospective trial registration, which breaches BMJ Group’s editorial policy.

Initially, concerns were raised in critiques of the study, some of which were published as letters in the journal. But after review by BMJ Group’s content integrity team, the study was referred to statistical experts to evaluate its reliability.  This included attempts to replicate the results and examine the authenticity of the underlying data supplied by the authors.

It wasn’t possible for the statisticians to replicate the results and multiple analytical errors were identified. There were also irregularities in the data set, and their report, which is appended to the retraction notice, concluded that the data collected from each participant would require further independent scrutiny.

The authors said that the identified errors were honest mistakes, but they agree with the decision to retract the study.

Dr Helen Macdonald, Publication Ethics and Content Integrity Editor at BMJ Group, said: “Tempting though it is to alert readers to an ostensibly simple and apparently helpful weight loss aid, at present the results of the study are unreliable, and journalists and others should no longer reference or use the results of this study in any future reporting.”

She added: “This retraction reflects our strategic and proactive approach to investigating concerns raised about the content we publish. We act where necessary in the interests of openness and the importance of correcting the scientific record.

“While we deal with allegations as swiftly as possible, it’s very important that due process is followed. Investigations are often complex. This one involved detailed scrutiny of data and correspondence with researchers, institutions, and other experts, for example. Reaching a sound and fair and final decision can therefore take several months.”

Commenting on the decision to publish the study despite the lack of trial registration, Professor Martin Kohlmeier, editor in chief of BMJ Nutrition Prevention & Health, explained: “In hindsight, this was the wrong decision to make. But the authors come from a scientific environment that is underrepresented in nutritional research and the journal aims to prioritise high quality evidence, which usually comes from clinical trials.

“These are relatively unusual in nutritional research as they can be challenging to undertake because of the numbers of participants and time needed to obtain meaningful results.”

Source: The BMJ Group

Categories : Ethics and Law Substance UseTags :

INHSU 2025: Global Drug Policy and Harm Reduction Leaders Meet in Cape Town

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With drug use projected to rise 40% in Africa by 2030, a global conference will amplify pioneering policy responses and proven health interventions from across Africa and beyond.

14–17 October 2025 | Century City Conference Centre, Cape Town

By 2030, the number of people who use drugs in Africa is projected to rise by 40%, according to the United Nations Office on Drugs and Crime (UNODC). Without stronger drug policy and harm reduction responses, the region faces escalating rates of overdose, HIV, hepatitis C, and other harms.

The warning signs are already here: around 11% of the estimated 1.26 million people who inject drugs across sub-Saharan Africa are living with HIV and an estimated 15% currently have hepatitis C, a liver condition that can cause liver cancer and death.

New research also shows that more than 40% of people who inject drugs in sub-Saharan Africa have experienced a recent non-fatal overdose – more than double the global average of 18.5%.

“While the scale of the challenge is undeniable, pioneering efforts by a few African governments show what harm reduction leadership can look like,” says Angela McBride, Executive Director of the South African Network of People Who Use Drugs (SANPUD), INHSU board member, and co-convener of INHSU 2025. “Harm reduction means putting health and human rights before punishment – shifting away from criminalisation and towards evidence-based, rights-affirming policies.”

These evidence-based policies include decriminalising drug use, expanding needle and syringe programs (NSP) to provide sterile equipment to prevent the spread of blood-borne viruses, increasing access to opioid agonist therapy (OAT) – medication to treat opioid dependence and reduce cravings and withdrawal from opioids like heroin – and ensuring access to HIV and hepatitis B and C testing and treatment.

Africa responds to the crisis

Across the continent, examples of this leadership are starting to emerge – from new legislation in Kenya to large-scale service delivery in Mauritius.

  • In South Africa, the Central Drug Authority is implementing the National Drug Master Plan, acknowledging that the country’s drug crisis is worsening and calling for stronger cross-sector responses. The plan recognises harm reduction and OAT must be expanded if HIV and hepatitis C are to be contained. Ms Nandi Mayathula-Khoza, Chairperson of the Central Drug Authority, will be presenting on the new plan during the conference.
  • In Kenya, parliament is currently debating a Harm Reduction Bill. If passed, it would be a landmark move, embedding access to NSP, HIV-related healthcare services, and other evidence-based services into national law for the first time.
  • Finally, in Mauritius, government-backed harm reduction has already achieved coverage levels rarely seen in the region. More than half of people who inject drugs are receiving OAT, supported by a pioneering “social contracting” model that channels government funds directly to NGOs to deliver NSP and other services on the ground.

Learning both ways

These policy shifts will be a focus of INHSU 2025’s Policy Day, which will bring together decisionmakers from across Africa to debate and share reform strategies. The wider conference will then welcome more than 600 global experts – including researchers, clinicians, policymakers, and people with lived experience of drug use – to showcase African-led harm reduction successes alongside international innovations such as long-acting depot buprenorphine (LADB), a monthly treatment for opioid dependence, and community-led hepatitis C testing and treatment programs that are transforming outcomes worldwide.

“The evidence consistently shows that harm reduction works – what we need now is political will,” says Dr Andrew Scheibe, medical doctor and technical advisor with TB HIV Care in Cape Town, INHSU board member, and fellow co-convener of INHSU 2025. “Harm reduction reduces infections, prevents overdose, and connects people to healthcare, yet access across Africa remains the exception rather than the rule. INHSU 2025 will showcase how we can bridge that gap and deliver the services people urgently need.”

Funding, prisons, and women’s health

Beyond drug policy reform and harm reduction, the conference will focus on other areas with profound impacts on the lives of people who use drugs, including incarceration, gender specific health disparities, and shifts in funding.

Prisons and detention settings will feature prominently, with Professor Louisa Degenhardt (National Drug & Alcohol Research Centre, Australia) presenting a multistage systematic review on the global epidemiology of injecting drug use, HIV, viral hepatitis, and tuberculosis among people who are incarcerated.

Women face extreme stigmatisation and complex barriers to healthcare, especially during pregnancy. Women who use drugs will also be a core focus, with multiple presentations from speakers across Africa and globally. Neliswa Gogela (Groote Schuur Hospital/University of Cape Town, South Africa) will present on HIV and HCV Care for Women Who Use Drugs with other presentations from Tanzania and Kenya.Finally, Kennedy Kipkoech (University of Cape Town and University of Bristol, UK) will present new modelling on the potential impact of the suspension of US PEPFAR funding for OAT on HIV and hepatitis C transmission among people who inject drugs. PEPFAR has saved an estimated 26 million lives, prevented 7.8 million babies from being born with HIV, and supported millions of orphans and vulnerable children across sub-Saharan Africa (Lancet EClinicalMedicine, 2025).

“These issues go to the heart of what drives health inequities for people who use drugs,” says Emma Day, Executive Director of INHSU. “Incarceration increases risk of acquiring HCV, HIV and other infectious diseases. Women who use drugs are among the most stigmatised populations and gender responsive models are needed to appropriately support them. And without sustainable funding, harm reduction progress across Africa is at risk. INHSU 2025 is about confronting these systemic challenges head-on and building a stronger, more equitable response.”

View the full program here

Categories : Ethics and Law HIVTags :

Pharmacists Can Treat People with HIV, Appeal Court Rules

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“Legitimate and compelling public interests” to allow pharmacists to initiate antiretroviral treatment, says judge

By Tania Broughton

Pharmacists can initiate people with HIV on antiretroviral treatment, the Supreme Court of Appeal has ruled. Photo: GroundUp Staff

The Supreme Court of Appeal (SCA) has dismissed, with costs, an appeal by a doctor’s organisation, the IPA Foundation, aimed at stopping specially trained pharmacists from treating people with HIV and TB.

The IPA first took its dispute with the South African Pharmacy Council (SAPC) to the Gauteng High Court in Pretoria. In 2023, Judge Elmarie van der Schyff ruled in favour of the pharmacists, giving a judicial go-ahead for the council to introduce its Pharmacy-Initiated Management of Antiretroviral Treatment (PIMART) initiative.

However the IPA Foundation, intent on having the initiative set aside, took this ruling on appeal to the SCA. In that court, five judges this week ruled against it. The ruling came nearly 11 months after the case was heard, far more than the three months that judicial norms provide for when a judgment is reserved.

Read the judgment

Justice Tati Makgoka, writing for the court, said the initiative was created in response to a persistent rise in new HIV infection rates.

The SAPC, at the department’s request, deemed PIMART suitable for addressing this issue.

“As the high court correctly found, the SAPC evaluated the risks associated with pharmacists initiating first-line ART [antiretroviral treatment] and TPT [tuberculosis preventive therapy] as well as providing medicines for PrEP [Pre-Exposure Prophylaxis of HIV] and PEP [Post Exposure Prophylaxis of HIV], considering the risks when deciding to approve the PIMART training.

“The uncontested evidence presented by the SAPC demonstrates that the approved accreditation process for PIMART was rigorous and thorough,” Makgoka said.

In her previous judgment, Van Der Schyff had noted that a pilot project had emphasised the value of the initiative, which was in line with the World Health Organisation’s vision to promote widely accessible primary health care.

“The untapped value of pharmacists in fighting HIV was also emphasised by the efficient role pharmacies played in meeting health care needs and providing health care services during the Covid-19 pandemic,” she said.

“The need to widen access to first line ART and TPT therapy on a community level is not a figment of SAPC’s imagination but a dire need that is also evinced in other countries.”

The IPA Foundation had approached the Pretoria court, under the Promotion of Administrative Justice Act (PAJA), seeking to review and set aside the SAPC’s decision to implement PIMART.

IPA claimed that the SAPC had failed to give interested parties an adequate opportunity to comment before the initiative was implemented. It further contended that PIMART unjustifiably encroached on the domain of medical practitioners and was in conflict with legislation.

On appeal, the IPA persisted with these arguments.

Dealing with the background, Justice Makgoka said the SAPC had published a notice in the government gazette in March 2021 regarding the proposed adoption of PIMART, giving interested parties 60 days to comment. This resulted in government approval later that year.

It was only after this that the IPA submitted its comments and objections.

Following engagements, the IPA lodged the review application in the high court.

On the issue that the IPA and its members claimed they were not given sufficient notice of PIMART, because it was advertised in the government gazette during the Covid-19 pandemic – Makgoka said there was no suggestion that the pandemic had “paralysed the administrative functions” of the IPA.

Remarkably, the judge said, the IPA had not suggested that the notice did not come to its attention, finding that adequate notice had been given. Makgoka said that several other organisations had submitted comments during the prescribed period.

He said the IPA had also not challenged the validity of the Pharmacy Act, which specified publication in the gazette and in the absence of that, it was not open for it to say the publication was inadequate.

Makgoka said the IPA had introduced the issue of “rationality” only in its notice of appeal. However, the court had dealt with this because there was no prejudice to the SAPC.

In ruling on this issue, he said PIMART was a crucial intervention in the public interest, which had been devised by a group of medical experts.

“Through PIMART, the SAPC aimed to improve access to healthcare. Contrary to the IPA’s contentions, PIMART is an essential intervention in the fight against HIV/AIDS. Its introduction constitutes a rational legislative and practical measure with the competence of the SAPC as an organ of the state in enhancing access to healthcare for HIV treatment, in fulfilment of the state’s obligation under the Constitution,” Makgoka said.

“These are legitimate and compelling public interests.”

He said the IPA was wrong in believing that PIMART was a blanket licence for pharmacists to treat HIV patients.

“Its scope is limited and applies only to accredited pharmacists. It will not alter the scope of practice for medical practitioners. The fact is that medical practitioners do not have the exclusive rights to care for people living with HIV/AIDS. This is a collaborative effort involving various health professionals.”

The IPA had also submitted that pharmacists were not authorised to prescribe schedule 3, 4 and 5 medicines without a prescription.

However, the judge said, the Medicines Act carved out an exception to this with authorisation of the Director-General. It was through this that PIMART-accredited pharmacists could apply for permits to prescribe schedule 3 – 5 substances.

The appeal was dismissed with costs.

Certainly not all doctors oppose the idea of pharmacists initiating patients with HIV on treatment: the South African HIV Clinicians Society stated: “We look forward to supporting the rollout of PIMART which will further contribute to South Africa’s HIV response and progress towards the 2030 target of eliminating HIV as a public health concern.”

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Read the original article.

Categories : Ageing Ethics and LawTags :

Does Prior Incarceration Contribute to Poor Health Later in Life?

On By ModernMedia
Photo by Rodnae Productions on Pexels

A recent analysis reveals that older adults with prior incarceration report worse physical and mental health than their peers, even if they were incarcerated in the distant past. The findings are published in the Journal of the American Geriatrics Society.

Among the 1318 US adults aged 50 years and older who responded to the Family History of Incarceration Survey, 21% had been incarcerated. Formerly incarcerated older adults were more likely to be men, non-Hispanic Black or “other” race/ethnicity, meet criteria for disability, be unmarried, and have lower income and education compared with those never incarcerated.

After adjusting for potentially confounding factors like demographics and socioeconomics, prior incarceration was associated with an approximately 90% higher odds of reporting “fair” or “poor” physical health. Length of time since incarceration did not moderate the association, meaning that even those incarcerated more than 10 years ago had equally poor self-reported health. The association with mental health was explained in part by income and employment.

The findings suggest that clinicians could consider screening for incarceration history and connecting formerly incarcerated patients to services and organisations that serve this community.

“Mass incarceration began in 1973, so older adults have spent most of their adult lives in this era and millions have been incarcerated in the past. It is critical to understand how incarceration – even in the distant past – may affect the health of older adults and what we can do to improve their health,” said corresponding author Louisa W. Holaday, MD, MHS, of the Icahn School of Medicine at Mount Sinai.

Source: Wiley

Categories : Ethics and Law Obstetrics & GynaecologyTags :

Webber Wentzel Secures Landmark Constitutional Court Ruling Reforming South Africa’s Parental Leave Laws

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Photograph by Drew Hays on Unsplash

Webber Wentzel’s Pro Bono team represented Mr and Mrs van Wyk in a landmark case that has resulted in the Constitutional Court confirming that South Africa’s statutory four months of parental leave may be shared between both parents. The ruling marks a significant step toward gender equality in the workplace and family law.

The case challenged the unequal parental leave provisions under section 25 of the Basic Conditions of Employment Act (BCEA), which granted birthing mothers up to four months of maternity leave while limiting fathers to only 10 days.

Webber Wentzel argued that section 25 of the BCEA unfairly discriminated against fathers and placed an undue burden on birthing mothers by not allowing families to decide who should be the primary caregiver. The court agreed and criticised the 10-day leave for fathers by rejecting the cultural norms that reinforce gendered parenting roles as inconsistent with constitutional values.

The application was supported by the Commission for Gender Equality (CGE) and Sonke Gender Justice (Sonke). CGE advocated for equal parental leave for adoptive and surrogacy-commissioning parents, which the court partially granted. Sonke’s request for an equal 16-week leave for both parents was not granted.

The Constitutional Court, in a unanimous judgment delivered by the Honourable Justice Tshiqi, confirmed that sections 25, 25A, 25B and 25C of the BCEA, along with corresponding provisions of the Unemployment Insurance Fund Act (UIF Act), are unconstitutional. The Court held that these provisions violate the rights to equality and human dignity under sections 9 and 10 of the Constitution.

The Minister of Employment and Labour accepted that differentiation exists between birthing mothers and other categories of parents is automatically unfair as it is based on grounds specified in section 9(3) of the Constitution. Further, the Minister acknowledges that there is a need for reform in the current legislation pertaining to the parental leave regime contained in the BCEA.

As a result of the ruling in the Constitutional Court, the 4 months of maternal and the 10 days of parental leave will be combined into a total of 4 months and 10 days, which parents may now share as they choose. If no agreement is reached, the leave will be split equally. Where only one parent is employed, that parent will be entitled to the 4 consecutive months of parental leave.

The Constitutional Court also confirmed that the same parental leave provisions apply to adoptive parents and commissioning parents in a surrogacy arrangement.

The Constitutional Court has suspended the declaration of invalidity of the relevant BCEA and UIF Act provisions for a period of 36 months, to allow the legislature to remedy the necessary constitutional defects.  In the interim, the following principles will apply:

  • A single parent or a parent who is the only employed parent is entitled to four months’ consecutive parental leave.
  • Parents who are both employed may share the allocated parental leave of four months and 10 days between them, concurrently or consecutively.
  • An adoptive parent of a child younger than two years is entitled to four months’ consecutive parental leave.
  • If an adoption order is granted in respect of two parents, they may share the allocated parental leave of four months and 10 days between them, concurrently or consecutively.
  • A commissioning parent is entitled to four months’ consecutive parental leave.
  • Where there are two commissioning parents, they may share the allocated parental leave of four months and 10 days between them, concurrently or consecutively.

Employers are encouraged to review and, where necessary, update their leave policies and employment contracts to reflect the new parental leave framework.

“This judgment is a powerful affirmation of the constitutional rights to equality and dignity,” said Nkosinathi Thema, senior associate, Webber Wentzel. “It recognises that caregiving is not the exclusive responsibility of mothers and that both parents should have the freedom to decide how best to care for their child.”

The Webber Wentzel team comprised Ayanda Khumalo, Nkosinathi Thema and Lize-Mari Doubell. Counsel Nasreen Rajab-Budlender SC, Liam Minné and Sanan Mirzoyev appeared on a pro bono basis.

The judgment can be read here.

Ends…

Founded in 1868, Webber Wentzel is a leading full-service law firm providing clients with innovative solutions to their most complex legal and tax issues across Sub-Saharan Africa. With over 450 lawyers, their multi-disciplinary expertise is consistently ranked top tier in leading directories and awards, both in South Africa and on the African continent. Their collaborative alliance with Linklaters and their deep relationships with outstanding law firms across Africa provide clients with market-leading support wherever they do business.