Tag: 12/8/26

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Opinion Piece: Medical Aid Cover is Changing – Are South Africans Prepared for the Gaps?

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Photo by Alex Green on Unsplash

By James White, Director: Sales and Marketing at Turnberry Management Risk Solutions

Medical aid remains essential for accessing private healthcare in South Africa, but it is no longer safe to assume it will cover the full cost of treatment. In 2026, industry regulators recommended that scheme contribution increases be capped at around 6-7% (CPI plus 3%), roughly in line with inflation, yet several major schemes have raised contributions well beyond that, with healthcare cost inflation broadly running at 9 – 11% against consumer inflation of about 3%. Medical aid options have also introduced growing numbers of co-payments, sub-limits, penalties and benefit restrictions. As a result, the role of gap cover has changed. What was once seen as an optional extra has become a critical safeguard against medical expense shortfalls, and it is now imperative that advisers and clients understand where medical aid cover may fall short and how those risks can be managed.

Healthcare cover is not what it used to be

The biggest change over the past decade is that medical aid has become far more complex. In the past, it was fairly simple to understand, and many routine healthcare costs were covered. Today, most day-to-day expenses are paid from medical savings or out of a client’s own pocket, and members must weigh up co-payments, sub-limits, designated service providers, network restrictions and benefit limits, all of which affect what a scheme will ultimately pay. At the same time, healthcare costs have continued to climb, and specialists often charge well above scheme rates. This means that having medical aid and being fully financially protected are no longer the same thing.

Every registered medical scheme is still required to cover Prescribed Minimum Benefits (PMBs) in full, a defined list of around 270 conditions, the Chronic Disease List, and emergency care, regardless of a member’s savings or threshold status. But PMBs are a floor, not a ceiling: outside of them, members are far more exposed than many realise.

Despite this, many people still believe they are adequately protected, without fully understanding the limitations of their medical aid. The reality often only becomes apparent when they need treatment. A claim subject to a co-payment, a specialist charging above the scheme rate, or a treatment subject to benefit limits can result in significant and unanticipated out-of-pocket costs.

Advice needs to evolve with the healthcare system

As the healthcare landscape has changed, the role of the adviser has changed with it. Recommending a medical aid option is no longer enough. Advisers also need to help clients understand how that option works, what it covers, where medical expense shortfalls may still arise, and how concepts such as co-payments, penalties, and designated service providers could affect them.

Advice also needs to be more personalised than in the past. Medical scheme options differ significantly, and the right level of cover depends on a client’s healthcare needs, affordability and family circumstances. A younger family with children, for example, may require very different cover from someone approaching retirement, even if both belong to the same medical scheme.

It’s also worth noting that gap cover itself isn’t unlimited. Under the Demarcation Regulations, gap cover claims are capped at an aggregate annual limit per beneficiary, a figure adjusted each year for inflation. Most claims fall comfortably within it, but very large shortfalls can still exceed the cap, which is one more reason the underlying medical aid plan needs to be right in the first place, not just the gap cover sitting on top of it.

This advice is no longer a once-off conversation either. Medical scheme benefits change, family circumstances shift over time, and healthcare needs evolve. Regular reviews help ensure that both medical aid and gap cover continue to provide the level of protection clients need.

A critical part of healthcare planning

The healthcare system has changed significantly over the past decade, and the way advisers approach healthcare cover needs to change with it. Medical aid remains essential, but it no longer provides the level of protection many people still expect. As a result, gap cover has evolved from an optional extra to a core part of protecting against medical expense shortfalls. Helping clients understand how their medical aid works, where shortfalls may arise, and how gap cover can address them has become an important part of modern healthcare advice.

As medical aid benefits, healthcare costs, and client needs continue to change, regular reviews are essential. By ensuring cover continues to reflect a client’s circumstances, and by explaining potential shortfalls before they arise, advisers can help clients make informed decisions and avoid unexpected medical expenses. Clients should speak to their broker or financial adviser regularly, to make sure their medical aid and gap cover continue to meet their healthcare needs.

Turnberry Management Risk Solutions (Pty) Ltd is an authorised Financial Services Provider (FSP no. 36571). Underwritten by Lombard Insurance Company, an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.

Categories : DermatologyTags : Leave a comment

Does Eczema Increase the Risk of Developing Shingles?

On By ModernMedia
Atopic dermatitis in a young patient. Source: NIH

An analysis in JDDG: Journal der Deutschen Dermatologischen Gesellschaft found that people with eczema (also known as atopic dermatitis) face an elevated risk of developing shingles (or herpes zoster).

Eczema is a chronic inflammatory skin condition, while shingles presents as a painful rash when the virus that causes chicken pox reactivates in the nervous system, particularly later in life or in immunosuppressed individuals.

When researchers analysed 1997–2023 primary care information pertaining to 113 426 267 people listed in a UK database, they found that individuals with eczema had a 28% higher risk of developing shingles after adjusting for other influencing factors such as age, sex, comorbidities, cigarette smoking, and alcohol use. Use of immunosuppressant medications had a minimal effect on shingles risk. Also, shingles risk increased with the severity of eczema.

Mechanistically, an altered skin immune response in people with eczema may put them at risk of developing shingles.

“These findings may inform vaccination guidelines,” the authors wrote.

Source: Wiley

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What the Dead Can Teach the Living – UP Professor Explores the Wider Impact of Forensic Pathology

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Prof Ryan Blumenthal, senior forensic pathologist at the University of Pretoria, delivered his inaugural professorial address, exploring how forensic pathology helps advance justice, public health and prevention.

Every day, forensic pathologists are called upon to answer one of society’s most difficult questions: how did this person die?

For Professor Ryan Blumenthal, a senior forensic pathologist in the University of Pretoria’s (UP) Department of Forensic Medicine, that question has always led to another: What can this death teach us about protecting the living?

Reflecting on three decades of forensic practice, Prof Blumenthal’s inaugural professorial address explored how forensic pathology extends beyond determining the cause of death. As this address, titled ‘The Dead Teach the Living: Advancing Forensic Pathology for Justice, Prevention, and Public Health’, took place during National Science Month in July, Prof Blumenthal highlighted the vital role that science plays in advancing justice, protecting public health and improving society.

Drawing on his career as a forensic pathologist, researcher, educator, science communicator and lifelong student driven by an insatiable curiosity, his address examined how lessons learnt during autopsies have influenced courts, healthcare, public policy and scientific understanding. Prof Blumenthal explained that forensic pathology is a discipline that strengthens justice, informs public health, guides prevention strategies and generates evidence that can help prevent future deaths.

“Our work lies at the intersection of medicine, science, law, and public engagement, driven by a simple belief: the dead have much to teach the living,” he said. “Whether investigating deaths, advancing forensic pathology, researching lightning injuries, teaching students or communicating science to the public, our mission has always been to pursue the truth, serve justice and leave the profession stronger than we found it.”

Prof Blumenthal is recognised internationally for his contributions to forensic pathology. He has published extensively on electrocution, lightning injuries, suicide and the pathology of trauma, contributed chapters to nine international textbooks, and is an NRF C2-rated scientist.

His work has also reached audiences well beyond academia through bestselling books, documentaries and public engagement initiatives that have helped make forensic science more accessible. His book Autopsy – Life in the trenches with a forensic pathologist from Africa (Jonathan Ball Publishers), launched in August 2020, became a non-fiction bestseller in South Africa. It has since been translated into Afrikaans and Russian. His latest book, Trace (Tafelberg Publishers), was launched in April 2026 and explores real forensic case studies, demonstrating how autopsies can help create a better world by advancing science, justice and public health.

Research with impact beyond the courtroom

While forensic pathology is often associated with criminal investigations, Prof Blumenthal’s research highlights its much broader contribution to society. He argues that forensic pathologists could also be regarded as public health pathologists, as autopsies do more than determine the cause of death; they identify preventable risks, guide public health measures, improve safety and help prevent future deaths.

One of his research focus areas is suicide; he has studied forensic data from Pretoria to examine how suicide patterns have changed over 30 years.

A study of 1,820 possible and probable suicide cases in Pretoria between 2015 and 2021 found that the year after the start of the COVID-19 pandemic, recorded the highest number of suicides during the study period. Suicide cases increased from 9.74% to 13.32% of all medico-legal admissions. The study identified important shifts in demographic patterns and methods of suicide, providing evidence to inform mental health policy and suicide prevention strategies in South Africa.

Another area of Prof Blumenthal’s internationally recognised expertise is lightning and electrical injuries. His research has advanced the understanding of the pathology and epidemiology of lightning injuries, explained how lightning causes injury and death, identified patterns unique to South Africa, and informed practical guidance for forensic practitioners, clinicians and emergency responders.

“I have devoted my career to understanding one of the deadliest forces of nature – lightning – transforming this phenomenon into forensic knowledge. It really is science in service of society.”

His work has also helped establish the fields of lightning medicine (keraunomedicine) and lightning pathology (keraunopathology) as recognised interdisciplinary areas of research spanning forensic science, engineering, clinical medicine and disaster medicine.

His research has also advanced the field of electropathology through studies of electrocution, strengthening forensic investigations by improving approaches to death scene investigations and autopsies involving electrical fatalities. By integrating the study of natural and man-made electrical injuries, his work has helped shape international reference texts used by forensic practitioners around the world.

During his address, Prof Blumenthal also highlighted research into toxicology, exploring how forensic investigations help interpret deaths involving substances such as methanol, fentanyl and ethanol.

He also spoke about his research into weapons and how forensic pathology helps explain the effects of different weapons on the human body. “Our research into weapons reminds us that the distinction between lethal and nonlethal is often misleading. From full-metal jacket mild steel core ammunition with its unpredictable wounding potential to so-called less-than-lethal weapons that can still prove fatal, our work as forensic pathologists reveals the gap between design intent and biological reality,” he said.

The future of forensic pathology

Prof Blumenthal described how advances in forensic radiology, molecular autopsy, toxicology, artificial intelligence, robotics and digital innovation are creating new opportunities to improve the accuracy, efficiency and safety of forensic investigations. He emphasised that these technological advances must be accompanied by stronger, more streamlined forensic systems, effective leadership, sound policy development and sustained investment if they are to benefit countries facing high burdens of trauma and violence.

He also highlighted the growing role of technology in forensic pathology. One example is the use of agile quadruped robots to assist with forensic death scene investigations in hazardous environments. His recent interdisciplinary research showed how these robots could help investigators safely document scenes and collect evidence while reducing risks to personnel, offering a glimpse into the future of forensic practice.

Prof Blumenthal concluded by outlining a vision for a more modern, resilient and technologically enabled forensic pathology service that delivers better justice, strengthens public health and serves all South Africans.

Watch Prof Blumenthal’s inaugural address here.

Provided by University of Pretoria


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From Outer Space to Clinical Trial: A New Drug for Blood Cancer

On By ModernMedia

ADAR1 inhibitor researched in outer space holds promise for AML and myelofibrosis now – and possibly cancers like glioblastoma multiforme in the future

A member of the lab of Catriona Jamieson, MD, PhD, prepares a vial of investigational new drug rebecsinib ahead of the launch of Axiom 4 in July 2025. The drug – which inhibits the gene ADAR1, implicated in the growth of more than 20 cancers – is now available via clinical trial at UC San Diego for patients 18 years of age and older who have secondary acute myeloid leukaemia (AML) that has either recurred or not responded to treatment, or higher-risk myelofibrosis.

A clinical trial of rebecsinib – a first-in-class investigational drug that inhibits the ADAR1 gene involved in the proliferation of more than 20 cancers – is underway at UC San Diego.

The first patient was treated July 6, according to principal investigator James Mangan, MD, PhD, professor of medicine at UC San Diego School of Medicine and a haematologist and oncologist at UC San Diego Health. He called the drug “promising.”

“This trial has great science behind it,” Mangan said. “It uses a totally novel mechanism and really is for patients who have a desperate, unmet need.”

The Phase 1 clinical trial, sponsored by Aspera Biomedicines, is open to adults 18 years of age and older who have secondary acute myeloid leukaemia (AML) that has either recurred or not responded to treatment. It’s also open to patients with higher-risk myelofibrosis. Both are rare blood cancers for which few treatment options exist initially – and no good options if they return.

For AML and myelofibrosis patients, the rebecsinib clinical trial means hope, Mangan said: “If this works, it’s a good option for those who don’t otherwise have targeted agents available to them.”

UC San Diego Sanford Stem Cell Institute Director Catriona Jamieson, MD, PhD, a haematologist and researcher who discovered the drug, said she is “thrilled to take it from bench – and a bench on the International Space Station (ISS), no less – to the bedside of patients who need it most.”

“Rebecsinib shows all the promise in the world not only to halt the progression of multiple cancers, but to shrink them, as well as prevent their spread to multiple sites in the body,” she added.

One of the First Drugs Tested in Space

The U.S. Food and Drug Administration green-lit rebecsinib for clinical trial in March of last year, making it the first and only ADAR1 inhibitor with an investigational new drug application.

It’s one of the very first drugs studied in the cosmos. Jamieson, who is also a professor of medicine at UC San Diego School of Medicine and chief of its Division of Regenerative Medicine, has sent multiple research payloads to the ISS, testing the drug on various types of highly lethal cancers with ADAR1 involvement like ovarian cancer, metastatic breast cancer, AML and glioblastoma multiforme – experiments made possible by millions in grants from NASA’s In-Space Production Applications program.

In fact, in the summer of 2024, Jamieson received the prestigious ISS National Laboratory Compelling Results Award in Biology and Medicine for her discovery that the drug blocks the activation of ADAR1 in cancer – in space.

“Seeing Dr Jamieson’s cancer stem cell research launch on SpaceX CRS-34 – mere weeks before the first patient received rebecsinib in clinical trial – was nothing short of extraordinary,” said donor Rebecca Moores, whose funding of Jamieson’s lab made possible the drug’s development. “Hope is literally on the horizon for patients with blood cancer – and, hopefully, soon, those with other types of cancer as well.”

Scientists are still learning about the distinctive properties of space that threaten human health, including microgravity and galactic cosmic radiation. Such conditions create a uniquely stressful environment that mimics an accelerated version of aging and disease progression on Earth. Depending on the experiment, one month in microgravity can give researchers a preview of a few years, if not more than a decade, of maturation on Earth. This allows them to quickly see how a patient’s cells might age or how a medical condition like cancer might manifest in extended time. It also gives them a quick preview of how a drug might work long-term on a patient’s cells, whether a tumour or a miniature organ created from stem cells.

The landmark NASA Twins Study of 2015-2016 found that space can affect the immune system, gut bacteria, body weight, serum metabolites, immune system, gene expression and cognition of astronauts, among other health factors. Jameison’s research found that space also activates ADAR1, which, in turn, produces ADAR1p150, a protein that promotes tumor growth by hiding cancer from the immune system.

“Space gives Dr Jamieson a tremendous chance to see a lot of changes in stem cell DNA in a short period of time,” Mangan said.

Rebecsinib, he added, could be “a therapeutic mechanism to restore stem cell function after space travel” for astronauts. “If that’s true, it could also be very applicable to an analogous situation that occurs not in a two-week space journey, but over the course of 60 years of life as a human being, over which we accumulate similar stresses to, and mutations in, stem cells.”

‘Every Patient Needs Hope’

Rebecsinib’s June clinical trial launch is only the beginning. The trial may eventually expand to other ADAR1-involved cancers, including lymphoma, glioblastoma multiforme and metastatic breast cancer.

Among those hopeful for the impact of rebecsinib is patient advocate Andrew Schorr, 75, who has lived with myelofibrosis and chronic lymphocytic leukemia (CLL), another blood cancer, for decades.

His myelofibrosis is relatively stable at the moment, he said. If that were to change, however, rebecsinib “might be another option – and I would be grateful.”

Schorr is no stranger to clinical trials. He has participated in two over the years – one for CLL and another for deep vein thrombosis – and has covered many over his career as a medical journalist.

“Every patient needs hope for what could be their next treatment, because these drugs peter out,” he said. “Cancer finds a way around them. They’re not as effective over time, as your disease progresses. You’re always left wondering what the next option is. The fact that there could be a next option gives me a lot of hope.”

Source: University of California San Diego

Categories : Paediatrics Respiratory DiseasesTags : Leave a comment

Early Flu Antiviral Reduces ICU Admissions in Hospitalised Children

On By ModernMedia

Sudy finds early treatment was associated with a 31% lower likelihood of ICU admission

Photo by Andrea Piacquadio on Unsplash

A new US study finds antiviral treatment is linked to fewer intensive care unit (ICU) admissions and shorter hospital stays for children hospitalised with influenza. The study, published in JAMA Pediatrics and led by experts at the University of Colorado Anschutz, is one of the most comprehensive real-world evaluations of antiviral treatment in paediatric influenza to date.

The research found that children who received early treatment with antiviral treatment, in this case oseltamivir, were 31% less likely to be admitted to an ICU and had shorter hospital stays than those who did not receive the antiviral.

The findings come as use of antiviral medications among hospitalised children with influenza has declined despite national guidelines recommending treatment for suspected or confirmed cases.

“After one of the most severe influenza seasons in the past two decades, these findings reinforce the importance of treating children with influenza who are hospitalised. Our findings show that oseltamivir treatment can decrease the risk of needing critical care, even if started beyond the first two days of the start of the illness,” said the paper’s senior author Suchitra Rao, MD, professor in the department of paediatrics at the University of Colorado Anschutz School of Medicine and infectious disease specialist at Children’s Hospital Colorado.

One of the largest and most rigorous real-world evaluations

The researchers looked at data from more than 7000 paediatric hospitalisations captured through a FluSurv-NET, a CDC-supported surveillance network that captures laboratory-confirmed influenza hospitalisations. The data spanned 13 states and eight influenza seasons.

Unlike many earlier observational studies, this research accounted for when symptoms began and when antiviral treatment started, providing stronger real-world evidence on the effectiveness of oseltamivir in hospitalised children.

“Earlier studies were often missing key information about when children became sick or whether they started antiviral treatment before being hospitalised, making it harder to evaluate the medication’s effectiveness. By capturing those details and using advanced statistical methods, we were able to produce stronger real-world evidence to inform the care of children hospitalised with influenza,” adds Rao.

The findings reinforce current national recommendations that children hospitalised with suspected or confirmed influenza receive an antiviral medication as soon as possible.

Source: University of Colorado Anschutz