News

December 27th 2009

Early this month we visited Uganda, to Lyantonde.

The trip produced two important firsts:

• the first training of African health workers in direct moxa techniques
• and the first treatment of a TB patient co-infected with HIV/AIDS

Both of these experiences have left a powerfully positive impression on us - and we hope to be back in Uganda as early as possible in 2010, next time to Kiswa Health Centre in Kampala to develop a more detailed investigation in collaboration with the sister in charge of the TB unit at the centre.

For more detail of this trip please click on the "Uganda" link (the bottom link on the panel on the left).

November 8th 2009

It’s been some time since our last posting, but it doesn’t mean for a second that we haven’t been busy. With our limited resources it’s a difficult matter balancing all the pressures inherent in this project whilst also keeping the wolf from the door. But we have interesting developments we think are worth sharing.

Two important connections on the continent of Africa have materialised which we are currently exploring. One is with the Pan African Acupuncture Project, which is an exciting organisation working in Uganda training local personnel in basic acupuncture techniques. The other is with the University of the Western Cape in South Africa. They have a faculty of Chinese Medicine and have expressed interest in developing a properly designed research study with us. Both of these initiatives complement each other.

Meanwhile, DOCSAVE, a German company which supplies materials relating to acupuncture and moxibistion across Europe, have been kind enough to offer us some support in terms of supply of materials for the fieldwork. This is massively welcome.

Back in the UK we are developing a modest investigation into changes in CD4 count in long-term HIV patients who already on Anti-RetroViral treatment but start a daily regime of direct moxa. This work is in collaboration with Freshwinds, a charity based in Birmingham UK which supports people with life-limiting illnesses including HIV/AIDS.

Over the last few months we have assiduously pursued every possible lead we have come across to help better inform our work. This has resulted in us pestering many of the great and good of acupuncture, both in Europe, in the US and in Japan. Finding the balance between being total pests and being quietly patient awaiting those anticipated words of wisdom has been a real challenge. To everyone who has been kind enough to respond to our pestering, we offer our eternal thanks.

The European Journal of Medicine is intending to publish the first part of a two part study we have prepared on the immune response from direct moxa. We hope this will appear in its next edition. What is exciting for us is that much of this has never appeared in English before. The second part (which is of course subject to EJOM’s final acceptance) will include some of our own conclusions as to how the mechanisms of direct moxa may work immunologically, particularly how they may be discretely and interconnectedly both dosage and point specific. These conclusions are still tentative, but they are drawn from the mass of papers which we’ve managed to collect on the subject, and  on our efforts to make sense of the often variable data and results that these papers contain. We hope that the publication of these papers will help support the idea that we have become simultaneously both authoritative and cautious explorers on the subject of the treatment of tuberculosis with moxa.

The realisation that the “tradition” of treating TB with moxa seems to have effectively actually died out with the practitioners who were still doing these treatments into the 1940’s has been a sobering one for us. It has also been one which we were reluctant to make. We have come to realise that the absence of living or working practitioners with actual experience treating this disease with moxa means that we have no alternative but to tread this path on our own in the sure knowledge that it has been trodden before, but less certain of its twist and turns than we had anticipated. One thing that we are surer of than ever, however, is that there is a certain urgent need for this path to be trodden.

May 24th 2009 

More ground work has been being done. We will have more news soon. We are currently commencing an active phase of fund-raising. In the meantime, we feel it right to publish the following:

Last weekend, a colleague observed that the figures quoted for any disease or catastrophe in Africa are always hyped up to generate aid, sometimes for the wrong reasons, and that we ought to bear this in mind. A few weeks ago, an esteemed member of an organisation involved in global health (who had kindly considered our project in the context of his own wealth of experience) queried the logic of our targetting Africa. Observations like these have not been that uncommon and give us pause for thought.

Last week we were sent an extraordinary recent WHO publication on Drug Resistant TB entitled "Airborne - a Journey into the Challenges and Solutions to stopping MDR and XDR-TB". The paper powerfully discusses treatment implementation in such diverse locations as the Philippines,Tajikistan and Lesotho. Importantly, it focuses on the urgent necessity of ramping up the mobilisation of both diagnostic and pharmaceutical resources to comprehensively fight TB globally. Within its pages there are some jaw-droppingly shocking observations from some important experts in the field, and we wish to quote them here. (We are fully aware that these individuals might well find some of our own ideas challenging and problematic from their biomedical perspectives, but we include their comments because they so powerfully highlight just how serious this problem is, and particularly how it is developing in Africa. We hope, therefore, that they might forgive us if their remarks are used in this particular arena since ultimately we share a common cause.)

Doctor Peter M Small is the Senior Program Officer for TB at the Bill and Melinda Gates Foundation. He writes: " We are combating a disease that kills someone every 20 seconds, with a 125-year-old diagnostic test that fails to diagnose half the number of cases, with an 85-year-old vaccine that does not protect adults and with 40-year-old drug regimens that you have to take for six months." 

Elsewhere he is quoted: "We are pitifully behind. To be honest, even our understanding of the epidemiology is severely limited. We don't actually know where the worst conditions are. Nor do we know whether in most places the situation is getting better or worse."

Doctor Hindi Satti is a Director of Partners in Health in Lesotho, possibly the best resourced country in Sub-Saharan Africa in the fight against TB: " We're finding higher rates of side effects among patients than anywhere else in the world - and we think it's due to co-infection."

Doctor Jim Yong Kim was a founder of Partners in Health, is a Professor of Medicine and Social Medicine at Harvard Medical School, is former Director of the WHO HIV/AIDS Department and is an expert on TB and a hero in the global war against AIDS. He writes chillingly: "It's not just one or two drugs. We need four or five immediately. People aren't sounding the alarm loud enough. Every time we look the problem is worse than we thought. Now it is  coming together with HIV in sub-Saharan Africa, and it could be the most frightening thing we are ever going to see."

Doctor Margaret Chan is the Director General of the World Health Organisation: " XDR-TB could take the world back to the era that predates antibiotics, with nothing in hand to guarantee treatment success."

For the last month we have been being scared by the media (and most probably by the pharmaceutical industry as well) by the spectre of a pandemic of swine flu. A far worse pandemic is very clearly already on the loose and has been for years - for some curious reason the media have found it so far relatively uninteresting, and the pharmas have found it too unprofitable to focus their energies and resouces upon. This is just too bad for those who are accused of over-hyping the problem to attract aid, it would seem. And even worse for those directly affected by this dual pandemic.

March 27th 2009

This week has seen "World TB Day" (March 24th, an anniversary of the day the TB bacillus was identified) come and go. Once again, it attracted little in the way of media attention.

A couple of reports emerged, however. The World Health Organisation revealed that rates of co-infection of TB with AIDS, particularly in Africa, have been "significantly" underestimated. A letter was also publlshed in the London Times, signed by twelve expertes on TB and infectious disease in the UK. It identified that the major agencies involved in the fight against TB are still facing "serious shortfalls" in funding. They called for world leaders attending the forthcoming G20 meeting to "fulfil urgently the promises they have made to avoid potential devastating effects"..

Stories of successful local campaigns in desperate circumstances do exist (google: Khayelitsha South Africa, TB, and MSF for instance) but they happen only with the help of dedication and resource. In Uganda, in contrast, the national referral hospital in Mulago is reported as currently suffering from a stock-out of anti-TB drugs. What this adds up to is that there have been no drugs suitable for treating kids with TB since December, and out-of-date drugs are currently being used for adults. If this is the case in a central hospital, we wonder what must be the state of medicine in more remote areas.

We received a response this week from a member of the WHO to some tentative contacts we'd made some months ago. In the context of the Uganda report, it makes for difficult reading: "It is difficult to envisage field testing moxa with and without first and second line medication - surely given the wealth of experience of using drugs for treatment of TB this cannot be ethically acceptable."

We have to ask - where is this "wealth" in Mulago, Uganda today? We know that what we are proposing is challenging - but surely it must be worth investigating in the clinical realty that exists.