Govt to distribute free flu medicine through clinics

The government will provide the antiviral drug oselamivir to patients with influenza-like symptoms free of charge at private clinics around the country.

Meanwhile, foreign firms, embassies and international organisations will be allowed to stockpile oseltamivir for their emergency use against the pandemic of type-A (H1N1) flu.
The handout of free medicine is aimed at preventing more fatalities of people infected by the virus, which has already killed 71 people as of yesterday. Seven people are in intensive care units.
Over 800,000 tablets of oselamivir will be handed out to medical clinics by mid-August, Public Health Minister Witthaya Kaewparadai said yesterday.
"These clinics should not charge patients for oseltamivir as the government will foot the bill," he said.
Having concluded that some healthy persons died from the flu because they were not treated with the drug or were given it too late, the government is now encouraging doctors and clinics to dispense the medicine as soon as patients show serious flu symptoms.
Clinics that get the state-sponsored drug are also required to collect detailed information about their patients and use a referral system so that patients can be transferred to appropriate hospitals.
Initially, each clinic will get 50 tablets of oselamivir.
Medical Registration Division's director Dr Tara Chinakarn said only 8,700 of 17,000 clinics nationwide and 2,000 clinics in Bangkok are competent to dispense the antiviral drug to patients with flu-like symptoms.
Regarding the move to allow foreign organisations to bring in anti-flu drugs, the Public Health Ministry said local units of the World Health Organisation and the International Red Cross and Red Crescent, for example, are not required to register with the Food and Drug Administration (FDA) to import medicines at this time.
The FDA said each foreign organisation may import antiviral drugs for 20-30 per cent of their local employees. The drugs can be stored at a hospital and will be prescribed only by doctors.
In a related development, a 16-year-old girl who is two-months pregnant suffered a miscarriage after being infected with the type-A (H1N1) virus.
The Health Ministry is now drafting guidelines for physicians to provide special care for pregnant women who are admitted to hospital.
Dr Tawee Chotepitayasunon, head of the Public Health Ministry's influenza team, said the guidelines would be released next week.
However, he advised pregnant women to seek medical help immediately after developing flu-like symptoms, which include fever above 38.5 Celsius.
The Department of Mental Health said public panic over swine flu had lessened.
"We found that people in Bangkok had a better understanding than those living upcountry. That's a good sign in terms of communication [about the disease]," department director Dr Chatree Banchuen said.

The NAtion

About 1,800 policemen to keep peace at red-shirt rally this evening

Metropolitan Police Bureau will deploy about 1,800 anti-riot forces to keep peace for the red-shirt rally scheduled for this evening at Sanam Luang, MPB commissioner Lt General Worapong Chewpreecha said on Friday.About 600 policemen will be on the grounds while the remaining forces will act as reinforcement if needed, he said.

The Nation

Cambodia, Vietnam to step up inspectorate cooperation

Increased cooperation between the government inspectorates of Vietnam and Cambodia would help the latter upgrade its system from central to local levels, said a Cambodian official.
This would in turn contribute to the successful implementation of the second phase of Cambodia’s 2006- 2010 economic development strategy, Minister of National Assembly-Senate Relations and Inspection Sam Kim Suor said while receiving a delegation led by Vietnamese Inspectorate General headed by Vice Inspector General Nguyen Van San in Phnom Penh Wednesday.
The Cambodian minister spoke highly of the practical assistance that the Vietnamese Inspectorate General has given to its Cambodian counterpart, especially in human resources training.
Both parties briefed each other on the political and economic situation in their respective nations, exchanged information on the role inspectors play in helping the government deal with complaints from citizens, and discussed measures to enhance bilateral cooperation between both countries’ inspectorates.

Source: VOV

Malaria: Artemisinin resistance continues developing in western Cambodia

Artemisinin, the "basis of the most effective" malaria treatment recommended by the WHO, took nearly twice as long to clear malaria parasites in patients in western Cambodia than it did in patients in northwestern Thailand, according to a New England Journal of Medicine study, which shows the "drugs are losing their power against the disease in Cambodia," Bloomberg reports (Bennett, 7/30).For the study, researchers at the Wellcome Trust-Mahidol University Oxford Tropical Medicine Research Program "compared the effects of artemisinin drugs in 40 malaria patients in western Cambodia and 40 patients in northwestern Thailand. On average, the patients in Thailand were clear of malaria parasites within 48 hours, compared to 84 hours for the Cambodian patients," according to HealthDay News/U.S. News & World Report (7/29).
"We do not see 100 percent resistance, but the parasite is much less susceptible to artemisinin than we are used to. If used in combination with other drugs we can still cure malaria but it takes a few days longer," Arjen Dondorp, the leader of the study, said, the Telegraph reports (Leach, 7/30).
For decades, scientists have known that the area near Cambodia’s border with Thailand, "is a breeding ground for drug-resistant malaria," according to Nature News (Sanderson, 7/29). Chloroquine "started to fail there in the 1950s and 1960s, before becoming ineffective elsewhere, according to the study. The WHO ... is coordinating efforts to prevent artemisinin-resistant malaria from spreading to Africa, which has 90 percent of the world’s cases of the disease," Bloomberg writes (7/30). In an accompanying NEJM editorial, PATH's Carlos Campbell, who was not involved the study, writes "that the results leave no question that there is artemisinin resistance in western Cambodia," according to ScienceNow (Vogel, 7/29).
In a separate study published in the same issue of NEJM, scientists used "chloroquine to protect people while gradually exposing them to malaria parasites and letting immunity develop," according to the AP/Washington Post. "The results were astounding: Everyone in the vaccine group acquired immunity to malaria; everyone in a non-vaccinated comparison group did not, and developed malaria when exposed to the parasites later," the AP/Washington Post writes.
"The study was done in a lab at Radboud University in Nijmegen, the Netherlands, and was funded by two foundations and a French government grant," according to the news service. While, a "vaccine that uses modified live parasites just entered human testing," this particular study "was only a small proof-of-principle test, and its approach is not practical on a large scale similar," according to AP/Washington Post (Marchione, 7/30).

TYPE A(H1N1) - All flu patients must seek attention within two days

The Public Health Ministry yesterday advised people, even people with no underlying conditions, to seek medical help within two days of developing flu-like symptoms.

Meanwhile, a 57-year-old physician at Chiang Mai University's Faculty of Medicine succumbed to the flu, becoming the first victim in the healthcare industry, provincial health chief Dr Wattana Kanjanakamonsaid.
Wattana suspected that the unnamed doctor might have caught the infection from a patient.
Meanwhile, the ministry reported that a total of 24 people with no underlying diseases had died of the type-A (H1N1) influenza so far. The other 41 fatalities involved patients with chronic health problems. As of yesterday, the number of confirmed flu cases were 8,877.
Most of the deaths were caused by patients waiting six or more days before seeking medical attention, which meant that they did not respond well to the antiviral oselatmivir, said Dr Paijit Warachit, the health ministry's deputy permanent secretary.
People with no chronic diseases should wait no more than two days before seeking medical treatment, while those with chronic disease should head to the nearest hospital as soon as they develop flu-like symptoms, he warned.
Patients with severe flu symptoms need to consume oseltamivir within 48 to 72 hours after being infected in order to cut down the chances of developing severe pneumonia, which can be fatal, he said.
Ramathibodhi Hospital's Dr Sayomporn Sirinavin said the antiviral showed best results if taken within 48 hours. However, he said, it was not necessary to dispense the antiviral to patients with mild symptoms because they could develop a resistance to the drug.
Next month, the Government Pharmaceutical Organisation (GPO) will start producing 20 million tablets of the antiviral to help fight the outbreak, and decided last week to increase its stock of oseltamivir from 15 million to 55 million doses.
GPO director Dr Vithit Attavijjakul said it would take no more than 24 hours to deliver the drug in urban areas and 48 hours for rural areas. GPO is also reserving 50,000 oseltamivir tablets for its regional offices in Chiang Mai, Udon Thani and Hat Yai to distribute to 18 provinces.
GPO has also reserved 50,000 courses of the zanamivir, imported from Australia, for patients resistant to oseltamivir. The World Health Organisation reported that type-A (H1N1) cases resistant to oseltamivir have been found in Canada, Denmark, Japan and Hong Kong. So far, nobody has shown resistance to the antiviral in Thailand.

Source: The Nation

Resistance to Malaria Drug Reported in Cambodia

Malaria parasites in western Cambodia have become resistant to artemisinin-based drugs, a development that could put millions of lives at risk, researchers say.
Artemisinin-based drugs are the first-line treatment for malaria, which kills more than a million people a year, mainly children and pregnant women. Artemisinin causes fewer side effects than other anti-malaria drugs and, until recently, malaria parasites had no resistance against it, according to information in a news release from The Wellcome Trust.
In a new study, researchers at the Wellcome Trust-Mahidol University Oxford Tropical Medicine Research Program, based in Bangkok, compared the effects of artemisinin drugs in 40 malaria patients in western Cambodia and 40 patients in northwestern Thailand. On average, the patients in Thailand were clear of malaria parasites within 48 hours, compared to 84 hours for the Cambodian patients.
"Our study suggests that malaria parasites in Cambodia are less susceptible to artemisinin than those in Thailand," lead author Dr. Arjen Dondorp said in the news release. "This means that it takes longer to kill the parasites. Artemisinin should clear the parasites at an early stage, preventing them further maturing and reproducing. When the drug's action is impaired, it becomes more difficult to eliminate the parasites from the body."
The study appears in the July 30 issue of the New England Journal of Medicine.
"Artemisinins are essential weapons in our war against malaria," study co-author Nick White said in the news release. "If they become ineffective, we have no immediate replacement. The consequences could be devastating. Elimination of malaria will not be possible and millions of lives could be lost."

Source: Yahoo News

Germany injects over $1 mln to Cambodia, Laos for fighting against hunger

Fearing with the continued impact by global economic crisis, the government of Germany has provided another 1.3 million euros (approximately 1.8 million U.S. dollars) to Cambodia and Laos to fight against hunger. In a statement released Wednesday, German embassy in Phnom Penh said of the above total amount, one million euro was destined for Cambodia which is expected to help assist about one million Cambodians in 2009. It said the fund was donated through the United Nations agency, World Food Program for its operation in this country. The fund will help improve immediate food security and nutritional status of the Cambodian people while enhancing social stability through interventions in three priority areas: education, health and nutrition, and disaster risk reduction. In April, the U.N. Office in Cambodia issued a statement saying the country's positive trends of its economy will be slowdown after it has enjoyed over decade of increase. And less demand from foreign markets and reducing of foreign direct investment have forced a mass of people losing their jobs, such as in garment and construction sectors. The U.N. data also indicated some 80 percent of Cambodians are living in rural areas, and where many poor families depend upon migrant remittances as their major source of income. It is, then, citing fear that Cambodia's rural poor might adopt "unhealthy" coping measures such as reducing their number of meals per day or eating less-nutritious foods, and cutting back on health services. Safety nets in health, education, food, and work can help break the poverty cycle, it added in the statement. According to the World Food Program, Cambodia might need 76.3 million U.S. dollars for three years project in curbing with people in crisis. It said the project that began in January 2008 and which is due to last until the end of 2010 has, so far, received 33 million U.S. dollars or bout 43 percent of its appeal, and that Germany has donated 2.3 million U.S. dollars or 3.1 percent of the total donated fund.

Source: Xinhua

Cambodia's Crackdown Stirs Concerns About Legal System

A heightened crackdown on journalists and opposition activists in recent weeks by Cambodia's leaders has provoked new concern that the government is engaging in widespread abuse of the nation's legal system to muzzle its detractors.
Newspaper editor Hang Chakra is serving a one-year sentence in Phnom Penh's notorious Prey Sar prison for articles that alleged corruption among government officials. Opposition activist Moeung Sonn, who heads the Khmer Civilization Foundation, fled the country last month after being given a two-year sentence because government officials feared unrest when he questioned whether a new lighting system would damage the revered Angkor Wat temple. Last week, a court heard charges against Ho Vann, a member of parliament from the opposition Sam Rainsy Party who is accused of slandering 22 generals by questioning their academic qualifications.
And on Friday, a court is to hand down its verdict in a case against Mu Sochua, another opposition member of parliament, who is accused of defaming Cambodia's authoritarian prime minister, Hun Sen.
"I'm sure I will be found guilty, unless there is some magic in the air, and I don't feel that it is," Mu Sochua said in a telephone interview.
The cases have caused growing concern among human rights activists about Cambodia's legal system, which has long been accused of political bias.
"The Cambodian government is imposing its most serious crackdown on freedom of expression in recent years," Brad Adams, the Asia director for Human Rights Watch, said in a statement last week.
The case against Mu Sochua, a mother of three and former minister for women and veterans affairs, has brought the concern to a head because she is the first person to challenge Hun Sen so openly.
In a lawsuit, she accused Hun Sen of calling her "strong leg" -- a term considered derogatory in Khmer culture -- in a speech in early April. When he declined to apologize, she called a news conference and declared that his comment was an insult to all Cambodian women. That provoked a countersuit from Hun Sen. The courts have thrown out her lawsuit, but Hun Sen's is ongoing.
"If he allowed Mu Sochua to challenge him, other people might go down the same path. It is to make sure a second person won't try the same thing in the future," said Son Chhay, another outspoken opposition member of parliament.
Mu Sochua is fighting her legal battle alone. Her attorney withdrew last month after he came under government pressure, provoking a protest from the Office of the United Nations High Commissioner for Human Rights.
"The government kept on slamming him with more and more penalties, and he was facing the end of his career," Mu Sochua said. "I am not going to put another lawyer through that torture."
If convicted, she is likely to face a fine of about $2,500. But, more important, she could lose the right to sit in parliament, and that could be Hun Sen's intent, analysts said.
His ruling Cambodian People's Party won 90 of 123 seats in parliament in elections last year, but analysts said Hun Sen could be using the courts to get rid of the opposition.
"He wants to put them out of business," said David Chandler, a history professor at Monash University in Australia. "The whole concept of pluralism hasn't got any roots in Cambodia. The opposition is almost, by definition, disloyal."
Son Chhay said the recent crackdown is a symptom of a government that is failing to address some of the pressing issues facing the country, including corruption, land seizures and economic stagnation.
"Although they control the institutions, they can't allow activists or the opposition to spread the issues -- that could bring disaster. Like many dictatorial regimes in the region, because they are unable to solve the problems, they resort to all measures to control the people and shut them up," Son Chhay said.
The government also is looking to pass a law that would limit demonstrations to 200 people and require permission from authorities.
In the early 1990s, the international community invested about $1.5 billion in a U.N. effort to restore civil government to a country that Hun Sen, a former member of the Khmer Rouge, had run since 1985.
The opposition fears that he is destroying fragile institutions that have taken years to build.
"What is really detrimental to Cambodia as a whole is that because he wants to make a point as a man, he is destroying so much we have invested in nation-building," Mu Sochua said. "It is not me on trial, but the judiciary of Cambodia."

Source: The Washinton Post