Jillian Gardner

HIV home testing - a problem or part of the solution?

The realisation of the NSP goals requires strategies that lead to a greater number of individuals getting tested. This article has one simple objective – to stimulate discussion and debate on the topic of HIV home testing, which the author postulates may be preferable to some people, largely because it enables individuals to perform some or all aspects of the test in locations chosen by them. In this way home testing has the benefit of potentially increasing the number of people who test, know their HIV status and consequently present for treatment. The article considers whether some of the reasons that are usually offered against this approach to counselling and testing are sufficiently justified in the South African context, and suggests that these reasons are not sufficiently justified and that this system of HIV testing could contribute towards achieving the goals set out in the country’s NSP.

Professionalism and the intimate examination - are chaperones the answer?

Complaints of sexual impropriety against healthcare practitioners are escalating. Professionalism in the practitioner-patient relationship and the role-based trust in health care do not allow crossing of sexual boundaries. Communication with patients is key to prevent erroneous allegations of sexual misconduct. The intimate examination is difficult to define. A chaperone present during an intimate examination protects the patient and practitioner and should be considered a risk reduction strategy in practice.

The 'war on drugs' has failed : is decriminalisation of drug use a solution to the problem in South Africa?

This article engages in the debate surrounding decriminalisation of drug use and whether this is a possible solution to the problem of drug use in South Africa – a question becoming more prevalent in global discussions about drug policy and its efficacy. We argue that two aspects must be addressed when evaluating a policy: its philosophical justification and its efficacy. We find that criminalising drugs may be justified by the public harm principle, but it does not effectively achieve the purpose of preventing and decreasing drug use and associated burdens. Thus, we argue that prohibition is a constitutional limitation, but does not necessarily achieve its purpose in the least repressive or most effective way. Finally, we suggest that a solution to the drug problem will have to address the health needs of the drug user and the context, particularly socio-economic, of drug use. Decriminalisation could theoretically do this by changing society’s perception of drug users, thus helping to promote a human rights-based, public health-orientated approach to the drug problem in South Africa.

Nanotechnology in medicine and healthcare: Possibilities, progress and problems

Nanotechnology or nanoscience covers the investigation, design, manipulation, precision placement, measurement, modelling or fabrication of matter, structures, devices and systems that exist at the nanoscale – essentially at the atomic and molecular size levels. Nanotechnology has the potential to change the way we address some of the worlds most critical development problems. In 2005, the United Nations (UN) Millennium Project’s Taskforce on Science, Technology and Innovation concluded that nanotechnology can contribute to the attainment of the Millennium Development Goals (MDGs), specifically, the goals to reduce child mortality, improve maternal mortality and combat HIV/AIDS, malaria and other diseases. Health, specifically improved primary healthcare, is one of six focus areas highlighted in South Africa’s National Nanotechnology Strategy (NNS), where nanotechnology can offer the most significant benefits for the country. Nanotechnology can revolutionise the practice of medicine and the delivery and accessibility of health care. However, despite the significant benefits of nanotechnology, there are problems that could prevent it from being widely accepted. The qualities that make nanotechnology so appealing are also those that give rise for concern. In particular, there are uncertainties about its potential impact on human health, the environment and societies in general, along with the concern that nanotechnology, much like genetic engineering or modification, is “messing” with the building blocks of nature and is therefore “unnatural” even unethical. This article considers these concerns and concludes that there is nothing intrinsically good or bad about nanotechnology, but that its acceptability will depend largely on how it used and introduced into society.