Growing pains: Born in an atmosphere of limitless freedom, the internet has grown into a wild beast without much controls. But this attitude may prove dangerous in a sensitive area like health. Hence, 20 leading websites providing health related information have got together to chart out a 14 point list of ethical principals which internet health service providers must follow. The consortium calls itself Hi-Ethics for Health Internet Ethics and has been spearheaded by Drkoop.com which was founded by the previous American Surgeon General. The areas under discussion are providing up-to-date information, giving patients control over how much of their medical information can be used or stored, transparency regarding support from the pharmaceutical industry or conflicting interests, etc. They propose that a Hi-Ethics logo be used by websites which conform to basic standards. Other consumer agencies have also setup sites like the internet fraud watch (eBMJ 20 May 2000).

Dr. Jekyll and Mr. Hyde: Since the early 1990’s certain areas of South America have witnessed a curious phenomenon. Soldiers are providing basic health services in the villages of Bolivia. It started in 1982 when a nutrition project found that children who were brought up by both parents were healthier than those brought up by mothers alone. The father of these children had received compulsory military training where basics of health and hygiene had been taught to them. What is commendable is that the Ministry of Defense and the Ministry of Public Health subsequently joined hands to begin the novel health program "Centinela de la Salud" with the support of the Pan American Health Organization, UNICEF, and the United Nations Population Fund. Army conscripts are taught health concepts in imaginative ways using terms like the enemy for viruses, army for white cells, guns for drugs, etc. When they are integrated back into society many of them become community health workers. It appears the powers that be have realized that men have better things to fight than other men (The Lancet interactive 10 June 2000).

Greeks bearing gifts?: The brunt of the HIV epidemic is being borne by the poorest of the poor in Africa, who cannot hope for anti- retroviral drugs in their wildest dreams. Now in an apparently magnanimous gesture 5 major multinational drug companies have agreed to slash drug prices of anti-HIV drugs. In India, Glaxo has agreed to reduce the price of the fixed dose combination of Zidovudine and Lamivudine from Rs 710/- per tablet to Rs 88/-. Simultaneously President Clinton has announced that trade restrictions will no longer be enforced in Sub Saharan Africa if they prorcure drugs at cheaper prices. Normally according to the World Trade Organization’s Intellectual Properties Act, drugs whose patents are held by multinationals cannot be produced by cheaper methods locally. Cynics are still suspicious of this benevolence of hard nosed businessmen and feel that it may just concentrate the powers among a few drug companies (eBMJ 20 May 2000, The Times of India 23 May 2000).

Is the WHO getting too chummy with infant food manufacturers? Several consultants who recently attended the joint meeting of the WHO and the UNICEF are certainly convinced they are. The WHO currently recommends a vague 4-6 months age for introduction of comple-mentary feeds. But there is a growing feeling that it may be delayed till 6 months. According to allegations attempts to discuss this issue were curtailed and papers and references to this were censored. Though 20 consultants signed a paper saying that there was enough evidence to discuss this issue at present it was conveniently ignored. Breastfeeding has become a favorite controversy of pediatricians (eBMJ 20 May 2000).

Gouri Rao Passi,
Consulant,
Department of Pediatrics,
Choithram Hospital and Research Center,
Indore 452 001, India.
Email: [email protected]