RURAL DOCTORS TO VET ITEMS ON PURCHASE LIST

       The Public Health Ministry plans to have the Rural Doctors Society officially investigate its planned procurement of medical devices under the Thai Khemkhaeng budget.
       "We will let the society's representatives sit in on a committee to oversee and investigate the procurement," the ministry's Permanent Secretary Dr Paijit Warachit said yesterday.
       He was speaking after the Rural Doctors Society revealed many items listed in the procurement plan were overpriced. These items included UV fans and biochemistry blood test devices.
       The society's chairman Dr Kriangsak Watcharanukulkiet said some items were in fact not necessary at all.
       "For example, not all tambon hospitals need a one-tonne truck. Some of these hospitals have just a few staff members. They won't be able to find a driver. In addition, maintenance and petrol costs could put them in trouble," Kriangsak said.
       He also pointed out that many manufacturers were willing to give free biochemistry blood test devices worth Bt3million to state hospitals as long as the facilities agreed to buy solutions from them.
       Kriangsak said his society did not seek to shoot down the procurement plan.
       "But we are calling for a review because there is clearly a way to save the budget," he said.
       Health Professional Association chairman Paisal Bangchuad added that many advanced medical devices from the planned procurement would be useless at tambon hospitals.
       "Most staff members at the tambon hospitals are not doctors. We cannot administer advanced equipment," he said.
       He said the tambon hospitals wanted devices that could be shared with health volunteers.
       "We hope the ministry will prepare some budget for each hospital to buy what is necessary for its operations. For example, some hospitals may want boats, not pickups," he said.
       Paijit said he had instructed provincial public-health chiefs to suspend the procurement of controversial items. "I am going to appoint a deputy permanent secretary to oversee the overall procurement too," he said.
       Public Health Minister Witthaya Kaewparadai said a committee tasked with investigating the budget use for the procurement of medical devices would comprise six to seven members.
       "In this committee will be representatives from provincial hospitals, community hospitals and the Rural Doctors Society," he added.

SEARCH FOR A WONDER VACCINE

       "To successfully develop a vaccine takes a very long time,a huge budget and a long-running procedure ... Vaccine development is not always done for commercial purposes. So we researchers desperately need strong support from all partiesinvolved PUNNEE PITISUTTITHUM
       Ajourney of a thousand miles all begins with a single step, and so does the journey of Punnee Pitisuttithum."The development of an HIV/Aids vaccine is like a hurdle race. There are a number of barriers that we researchers must jump across. And in this race, to reach the finish line is not a piece of cake," said Punnee, head of the Department of Clinical Tropical Medicine, Mahidol University.
       For more than 10 years, the 52-year-old researcher has been devoting her time and energy working on HIV/Aids vaccine trials. Her job is to test preventive serums over and over to see whether any of them can work against the particular HIV strain found in Thailand. After a considerable amount of trial and error,the effort Punnee along with her team invested eventually paid off when the result of the HIV/Aids vaccine trial recently carried out was announced.
       The result of the trial shows that the vaccine has 31.2 percent efficacy in preventing HIV/Aids infection.In other words, it appears to be able to reduce the chance of catching the virus by around one-third in tested volunteers. Yet it cannot lower the level of virus in the blood in infected cases.
       But even though the effectiveness of the new vaccine is yet to reach the 50 percent efficacy rate needed to apply for a vaccine licence, and that the vaccine seems to not be powerful enough, the result can still be considered an important scientific breakthrough. The experimental project, according to Punnee, does indeed give new hope in the HIV/Aids vaccine research field and at the same time paves the way for the development of more successful anti-HIV drugs in the future.
       "During the past five to six years, apart from testing the HIV/Aids vaccine, we [research team]have also been working to empower the community through vaccine trials. We have raised awareness and created a better understanding regarding the importance of HIV/Aids prevention. Volunteers that took part in the trial along with other people in the community have become a part of the project and have begun to have a sense of belonging. We have created networks among volunteers and established a volunteer club. At the same time, we have also trained our staff so that they meet international standards.'
       "This way, we have improved our research infrastructure, boosted capacity building and prepared groundwork for future studies which, to me, is as important as the trial itself," commented Punnee,who is also chief of the Clinical Infectious Diseases Research Unit.
       Graduated from the Lady Hardinge Medical College,Delhi, India, Punnee has been working with the Vaccine Trial Centre, a clinical facility founded within Mahidol University's Department of Tropical Medicine, for more than 20 years. Her main responsibility is to examine the safety and efficacy of vaccines sent from vaccine manufacturing companies in other countries and to also check, analyse and confirm whether they are safe to use in Thailand. So far she has experience in clinical vaccine trials for cholera,polio and cervical cancer.
       According to the professor, the HIV/Aids vaccine trials in Thailand first started in 1994, after the spread of the epidemic in the early 1990s. At that time, a team of researchers only attempted to use one vaccine that could stimulate just one arm of the immune system. Unfortunately, it failed.
       "In the trial we conducted earlier, we used an HIV/Aids vaccine called Aidsvax, which could create antiviral immunity only in human blood. But it didn't succeed. The vaccine was not able to prevent the HIV/Aids infection. So we came up with a new regimen.This time we created immunity for both human blood and human cells," recalled Punnee of how the recent HIV/Aids vaccine trial was initiated.
       The vaccine clinical trial, referred to as RV 144,was carried out under the concept of "prime-boost"combination, the scientist explained. Simply speaking,RV 144 tested two vaccines. The first, Alvac HIV or the "prime", enabled the body to make immune defences to target cells invaded by the virus before the infection could spread out of control. The second,Aidsvax B/E or the "boost", stimulated the production of immunity in the blood. The vaccine combination,Punnee remarked, was based on HIV strains that commonly circulate in Thailand.
       Alvac HIV was developed by Sanofi Pasteur, the vaccine division of French-based drug manufacturer Sanofi-Aventis, while Aidsvax B/E was originally developed by Genetec Inc and is now licenced to Global Solutions for Infectious Diseases.
       The trial, Punnee went on, was designed primarily to test the ability of the vaccine formula to prevent HIV/Aids infection, as well as its ability to reduce the amount of viral load of those who became infected.
       RV 144 involved 16,402 HIV-negative male and female volunteers aged 18 to 30. Having lived in Rayong and Chon Buri province, these heterosexual Thai candidates were at average risk of contracting the HIV/Aids.
       All participating candidates were divided into two groups: one group received the prime-boost vaccine regimen and the other was administered placebos.Vaccines were injected into volunteers over the course of six months. After that, the test subjects were required to have a follow-up blood test once every six months for the next three years.
       Prior to their participation in the trial, all candidates were notified of and consented to the potential risks associated with receiving the experimental vaccine combination. Throughout the study period, they also received counselling on HIV/Aids prevention.
       RV 144 began in October 2003. In total, it took about six years for the trial to be fully completed.And this, according to Punnee, was the first successful prime-boost vaccine trial in the world, which signifies that the development of a safe and effective vaccine against one of the world's most dangerous pandemics is still possible.
       Involving such a large number of volunteers being tested, RV 144 was also Thailand's first communitybased and the world's largest HIV/Aids vaccine trial ever conducted, added the professor.
       "Right now there are approximately 600,000 Thai people living with HIV/Aids infection. And each year there are about 16,000 new cases of HIV/Aids infection reported in Thailand. The vaccine will therefore be like the light at the end of the tunnel for the world population," said the researcher.
       As the HIV/Aids vaccines were manufactured in Western countries, the next question is:"Then why was the vaccine trial performed here in Thailand?"
       "Testing a vaccine in countries other than the particular one that will use the vaccine is ethically wrong," Punnee explained."If we, for example, want to use the HIV/Aids vaccine in Thailand, it is critical that we test it here to see whether it works with the particular strain that spreads here. And it's the same with this [RV 144] trial. If other countries wish to use this vaccine regimen, they have to test and further develop it in their respective countries, too."
       "Admittedly, Thailand itself is not yet capable of creating such vaccines. And we have absolutely no idea as to when we will be ready to do so. But carrying out the trial and having the HIV/Aids vaccines tested here in Thailand will enable our country to have negotiating power in terms of the vaccine price to be sold here. With our participation in the trial run, Thais will have vaccines that are cheaper and more affordable," she added.
       The future of vaccine development in Thailand,according to the vaccine analyst, looks quite promising.Since the Avian influenza outbreak several years ago, Thailand has been on alert and started building and improving the country's potential in producing vaccines to shelter its people from illnesses. The Ministry of Public Health is now therefore working actively on its plan to set up a plant to manufacture vaccines both for use and for study. One of the country's most significant threats is, however, the lack of scientists who are capable of developing knowledge and expertise needed for vaccine production.
       "Thailand has come a long way from where it first began in terms of vaccine research and development.During the past 20 years, our vaccine clinical trials have met international standards. Even so, we still have quite a long way to go because to successfully develop a vaccine takes a very long time, a huge budget and a very long-running procedure. Successful laboratory research, for instance, does not necessarily mean that the vaccine will work well for everybody.More studies are essential to ensure that the vaccine will be safe to use.
       "Vaccine development is no easy task. And it is not always done for commercial purposes. So we researchers desperately need strong support from all parties involved," Punnee noted.
       Now that the result of the RV 144 HIV/Aids vaccine trial has been disclosed, Punnee and her team are well aware that a lot more work, studies and challenges lay ahead.
       Yet the researcher considers the recent vaccine trial as the first step towards success. She fully hopes that a safe and highly effective HIV/Aids vaccine will one day be accessible to people not just in Thailand but also around the globe.
       "The ultimate goal of all vaccines is to function as a preventive measure against a specific disease prior to a person being infected. So my highest hope for the HIV/Aids vaccine is that some day in the future the young generation will be eligible to receive the vaccine, especially before their first sexual experience.In the meantime, we researchers have a lot of work to do. And the result of our previous trial will be a stepping stone to our path towards developing a successful vaccine."

CONNECTIONS CREATE GROWTH FOR THAI OPTICAL

       By some measures, Thai Optical Group, a listed lens manufacturer, may look like any other original equipment manufacturer. But its special relationship with major retailers of glasses in Thailand and the UK tells a different story.
       According to Thai Optical Group (TOG) chairman Sawang Pracharktam, the company is expecting a "jump in business" in the next three years. This is because a 25-per-cent stake in TOG was bought last year by Specsavers, the biggest optical retailer in UK, and Specsavers is planning to increase its number of stores around the world from 1,500 to 2,000 over the next few years. The expansion is likely to demand more lenses from TOG.
       When Specsavers bought the stake in TOG, it also revealed plans to increase its lens purchases from TOG from 30 per cent of its needs at present to 50 per cent.
       Sawang said the increase would take time and Specsavers had already sent its experts to help TOG to improve its production lines and efficiency, in order to meet the firm's pricing and volume targets.
       Specsavers bought the controlling stake in TOG because it wanted to ensure that it wouldn't be bought by other companies, he said. TOG remains one of a handful of independent lens manufacturers that have survived competition and takeovers in the world market.
       TOG reported flat growth in sales revenue in the first half of this year, although profit rose by 14.67 per cent to Bt74.5 million. The firm suffered an 11-per-cent slide in sales and profit during the second quarter because political unrest in April led to the cancellation of small orders requiring a short delivery time of four days.
       Due to advancements in technology, and in order to reduce their costs, some retailers of glasses in developed countries have begun ordering prescribed lenses for individual customers from cheaper foreign sources like TOG.
       "We can ship them back the lenses, complete with the frame, within four days of the order being placed - the same lead time they would get if they ordered from a local laboratory," he said.
       TOG's laboratory now supplies several thousand pairs of glasses per day to individual customers in France, Germany, Australia and the Netherlands, through local retailers.
       Sawang said the firm had no plans yet to provide direct services to individual customers in foreign countries, because such a move might not be ethical.
       TOG still relies on original-equipment manufacturing for 80 per cent of its revenue, with the rest coming from its own brand.
       Sawang said distribution channels had increased in recent years. As an independent manufacturer, TOG can sell its lenses to brand owners, other manufacturers, independent laboratories and chain stores, as well as selling its own brand lenses through some of the same channels.
       The group's major strategy over the next few years will include building its own sales channels, enabling it to reach customers in potentially rich markets such as Vietnam, Singapore and Malaysia, where it plans to establish lens laboratories next year.
       TOG will reap benefits from its special relationship with Better Vision, one of Thailand's largest retailers of glasses, which has already opened 12 retail shops in Malaysia and 13 in Singapore, he said. Better Vision, or Hor Waen in Thai, is run by the same family that formed TOG.
       In Thailand, TOG sells its lenses through its exclusive distributor Nam Sin Thai, also run by the Pracharktam family, which resells the lenses to Better Vision.
       Sawang said a financial adviser was studying a possible merger between Better Vision and TOG.
       TOG is expected to grow by 8 per cent this year, down from 15 per cent, which has been its annual target for many years. Nevertheless, the firm is aiming to increase its sales revenue and net profit to more than Bt2.5 billion and Bt300 million, respectively, in 2014, he said.
       Last year, it booked a net profit of Bt143.38 million from revenue of Bt1.52 billion.

Vaccine results confuse scientists

       Experts agree that a vaccine is the onlyway to conquer Aids,but the virus mutates unbelievably fast, can hide from the immune system and attacks the very cells sent to battle it.
       More than 25 years into the Aids pandemic, scientists finally have a vaccine that protects some people - but instead of celebrating, they are going back to the drawing board.
       The vaccine - a combination of two older vaccines - only lowered the infection rate by about a third after three years among 16,000 ordinary Thai volunteers.
       Vaccines need to be at least 50% effective,and usually 70 to 80% effective, to be useful.
       Worse, no one knows why it worked."Additional studies are clearly needed to understand how this vaccine regimen reduced the risk of HIV infection," said Dr Eric Schoomaker, surgeon-general of the US Army, which helped pay for the study.
       Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, said:"We need to bring the best minds together and map the way forward."
       The vaccine is a combination of SanofiPasteur's ALVAC canarypox/HIV vaccine,which includes synthetic versions of three HIV genes, and the failed HIV vaccine AidsVax, made by a San Francisco firm called VaxGen and now owned by the nonprofit Global Solutions for Infectious Diseases.
       "It is likely that significant efforts will be needed to fully understand the study results and to appreciate how they will inform the next steps to develop and deliver a safe and effective HIV vaccine," said Dr Peter Kim,president of Merck Research Laboratories.Merck's first Aids vaccine failed in 2007.
       "I am not sure this will encourage com-panies to immediately jump in," said Mitchell Warren of the non-profit Aids Vaccine Advocacy Coalition."What we hear from pharma and from small biotechs is that they are fascinated by an Aids vaccine but as a business proposition, it is too risky."
       The Thai trial may help them re-evaluate,Mr Warren said. But first, some scientific direction is necessary."What is needed there is more in-depth analysis, to extend these findings, doing both clinical [human] and preclinical [animal)]studies to find out why it is working and how we can make it better,"said Jim Tartaglia, vice president of research and development at Sanofi. Companies and non-profits along with governments have been working to make a vaccine against the human immunodeficiency virus that causes Acquired Immune Deficiency Syndrome.The fatal and incurable virus has killed 25 million people and infects 33 million now.
       Experts agree that a vaccine is the only way to conquer it, but the virus mutates unbelievably fast, can hide from the immune system and attacks the very cells sent to battle it. To work, any HIV vaccine would have to activate both arms of the immune system - the antibodies that home in on invaders such as viruses to neutralise them,and the T-cells that recognise and destroy viruses. This vaccine did not appear to generate much of either response, and yet prevented infection 30% of the time.
       Even more confusing, among the 51 people who were vaccinated but were infected anyway, the virus thrived just as well as it did among unvaccinated HIV patients. Researchers would not have expected that they would have expected the vaccine to at least make the infection less serious, as influenza vaccines do, for example. Dr Fauci wonders if the vaccines stimulated some component of the immune system that has been overlooked.
       Dr Donald Francis, a former government vaccine expert who helped develop AidsVax and who helped found Global Solutions for Infectious Diseases, said his team would be developing smaller studies to answer some of these questions."We have a limited amount of vaccine now," Dr Francis said.
       The findings do offer renewed hope for finding a better vaccine.
       "There are now six approaches that look better than Merck's vaccine in the best of the animal models," said Dr Seth Berkley,head of the International AidsVaccine Initiative, which funds studies.
       IAVI believes the rewards could be substantial - not just stopping the worst pandemic of our times, but financially."At its peak, an HIV vaccine could represent 5% to 13% of the total global vaccine market,"IAVI estimates. At $2 a dose for the developing world and $100 in richer countries, IAVI estimated companies might bring in $1.6 billion to $3.8 billion a year with an HIV vaccine. Yet the private sector accounts for just 10% of all Aids vaccine research and development funding.

SAMITIVEJ HOSPITAL JOINS PROGRAMME WITH PDA TO HELP PROVINCIAL PATIENTS

       Samitivej Hospital recently joined Mechai Viravaidya's Population and Community Development Associations programme to improve living conditions of the rural poor in Nakhon Ratchasima and other north easteen provinces.
       The hospital is encouraging customers to donate new and used toys to children under the toy-sharing programme in Buri Ram.
       It also recently made a Btl-million donation to develop Nuangpluang Village in Nakhon Ratchasima with a commitment to fund the project annually.
       To Samitivej CEO and managing director Raymond Chong, the longterm corporate-social-responsibility (CSR) projects are aimed at creating opportunities for their medical staffto serve people in rural areas, as well.
       "I would like our staff always to come to the village to educate people about health and guide children on planning for a career," he said.
       "We don't want to do only a one-off charity event and then depart. We intend to strengthen the bond with villagers in many regards. Nuangpluang will be the first village Samitivej will develop as a community".
       The hospital's CSR project for Nakhon Ratchasima is called Healthy Community.
       "It sets out to assist villagers by improving their health and developing career skills and overall living conditions," Chong said.
       The PDA, founded and chaired by Mechai, will run the project for the hospital.
       Mechai is well known for his family-planning efforts decades ago. The campaign earned him the nickname "Mr Condom".
       Chong said the Btl-million allocated for Nongpluang would be used as a community fund for villagers seeking employment opportunities. It will also be used to pay for scholarships.
       For the toy-sharing project, Chong said big boxes had been set up at its three hospital-on Sukhumvit and Srinakarin roads in Bangkok and in Chon Buri's Sri Racha district-tostore donated toys.
       In only one month 2,000 items have been donated, demonstrating the public's willingness to bring happiness to provincial children.
       The toys are meant as rewards for desserving children who have performed some sort of public duty, such as growing saplings, replaning trees or collecting garbage.
       Mechai, whose family has been a loyal patron of Samitivej Hospital for four generations, initiated the toy project in Buri Ram afew months ago.
       Tanatat Puttasuwan, director of CSR at the PDA, said the aim of the toy-sharing project was to foster a spirit of philanthropy among youngsters.
       Children wishing to borrow the toys must perform a good deed, such as some sort of activity that promotes recycling and green projects.
       "There is a real danger of children becoming too self-centred and failing to show regard for others," he said. "The toy-sharing programme should help instil sense of compassion and empathy for others who are less fortunate," Tanatat said.
       In only one month, 2,000 items have been donated, demonstrating the public's willingness to bring happiness to provincial children.

BGH unit taps sports medicine

       Bangkok Hospital Group is rebranding its bone and joint treatment unit in both the domestic and overseas markets, hoping to cash in on expected high demand when the economy rebounds.
       The rebranding will focus on promoting the advanced technology available for treatment and surgery, said Dr Pornthep Mamanee, chief of sports medicine,knee and shoulder surgery at the affiliate of SET-listed Bangkok Dusit Medical Services Plc (BGH).
       "The department is focusing on developing human resources in this sector to serve the huge demand from local and overseas patients. We will conduct training programmes for technicians and physicians from this year onward," he said."Qualified personnel with the knowledge of new treatments are still far below the actual demand in the market."
       New technologies such as robotic surgery and arthroscopy using imaging equipment are minimally invasive and shorten recovery times. Dr Pornthep said treatment times for some conditions were just one or two days compared with more than five days previously.
       The department expects the number of patients for the services will rise by 10-15% from 450 last year,70% of whom are foreigners.
       Bangkok Hospital opened its bone and joint centre seven years ago and attracted just 20 patients in the first year, but new technology in recent years has encouraged more people to seek treatment.
       "Thailand will be another hub for sports medicine within the next few years and we need to accelerate human resource development for this sector in line with other health-care businesses,"said Dr Pornthep.
       Only a few state medical schools offer training courses in new technology related to the sector. They include Siriraj Hospital, Chulalongkorn Hospital and Ramathibodi Hospital.
       Bangkok Hospital Group, the country's largest private hospital operator, this year has also upgraded and rebranded some other specialty units including neurology, in a bid to raise public awareness during the economic downturn.

Hospital graft claims denied

       Doctors can choose to buy own supplies
       The government has not ordered state hospitals to buy specific supplies as part of the Thai Kem Kaeng national development spending project, Public Health Minister Witthaya Kaewparadai says.
       About 86.6 billion baht has been allocated for medical facilities under the Thailand: Investing from Strength to Strength scheme.
       Rural doctors claim the project calls for the purchase of medical equipment at inflated prices and local hospitals are not being invited to participate in the procurement.
       However, Mr Witthaya said yesterday that provincial public health authorities and hospital directors had full authority over the choice of medical supplies and could order the supplies that would meet the demands of their patients.
       He denied central authorities had intervened in the procurement process at local hospitals.
       Of the 86.68 billion baht allocated to the Public Health Ministry,60% will go towards putting up public health buildings and the rest towards medical equipment.
       Mr Witthaya said the Public Health Ministry had stepped up measures to ensure the spending was transparent.
       Special working groups would follow all aspects of the project's implementation.
       Khamron Chaisiri, director of the Thai
       Kem Kaeng office, said the ministry had set up a committee to supervise procurement and coordinate the process with hospital directors and public health doctors at the provincial level.
       The ministry, through the committee, will assign experts on procurement, laws and construction to work with provincial authorities,and will field regional inspectors to monitor the spending.
       As part of the public health improvement project,2,151 state clinics will be upgraded to tambon-based hospitals.Each facility will receive 1.35 million baht for the development, with 500,000 baht to go towards construction and 855,000 baht towards medical supplies.
       Local health authorities have come up with 46 items for procurement. They include dentistry units, electrocardiographs, foetal heart rate detectors, massage beds, sonographers and outdoor audio systems.
       However,Pongthep Wongwatcharapaibul, secretary-general of the Rural Doctor Foundation, yesterday said the government was also offering what hospitals did not want, such as UV sanitisers. He also said supplies listed for purchase under the project were overpriced.
       Dr Pongthep said a UV sanitiser was quoted at 40,000 baht but its market price was only 6,000 baht. A respirator was quoted at 1.2 million baht but a hospital had bought one for 500,000 baht. Hospital representatives were not given a say on the choice of medical supplies. A probe was needed into the way the scheme was being run.

Fearless volunteers

       Rayong residents say they took part in the HIV vaccine trial because it will be useful for the world
       The world has 16,402 Rayong residents to thank for their dedication in volunteering for the globe's largest HIV vaccine trial conducted in Thailand six years ago.
       "This is our ray of hope: to keep younger generations from contracting HIV. That's why I decided to join the trial," says 32yearold gardener Aree Khamphonrat, after hearing the trial result which shows it is now possible to produce a powerful prevention against the viral killer.
       The result was announced by the Public Health Ministry on Thursday.
       The Phase III vaccine study was launched in 2003 and involved 16,402 noninfected volunteers aged between 18 and 30, the age group at average risk of contracting HIV. Half of them received the primeboost vaccine combination and the other half received a placebo.
       Modest results
       The trial's final result shows that the experimental vaccine is 31.2percent effective in reducing the risk of infection. It failed to reduce or kill the HIV virus in the blood of infected persons.
       The result, though modest, is a light at the end of the tunnel for scientists around the world.
       6 vaccinations in 3 years
       Aree received six vaccinations in the past three years. She socialised like any other normal person, and occasionally went to a healthcare centre for a routine check.
       "I was excited when the healthcare staff told us about the bloodtest results," she said.
       Aree was reported to be in good health and there were no signs of any chronic illness. "They told me to use a condom when I had sex, but during the trial I had no sex and my test result was negative."
       No worries
       Even though there were reports of two volunteers dying, she said she did not worry about the adverse side effects of the vaccine.
       Thirtythreeyearold freelance worker Tanad Yommaha also had no fears of being a volunteer as he thought the project would be useful to the rest of the world.
       "[During the trial] I went about life like any other normal person because I believed that the vaccine was safe enough to prevent me from becoming infected with HIV," he said.
       Aree and Tanad do not know whether they received the vaccine or a placebo. They are waiting for their individual results, which are to come in next month.

PUBLIC HEALTH MINISTRY TO SET UP PROBE PANEL ON SPENDING

       Moves are afoot to siphon funds from Bt9-bn budget: doctors foundation
       Public Health Minister Witthaya Kaewparadai is preparing to set up a fact-finding panel to inspect the ministry's budget spending, following corruption allegations from the Rural Doctors Foundation.
       Witthaya reacted after the foundation claimed yesterday preparations had been made to massively siphon funds from the Bt9.29-billion allocated to the Public Health Ministry under the Thai Khemkhaeng (Invest for Strength) stimulus project.
       "The panel will be set up as soon as possible. I will invite Kriangsak Wacharanukulkiart, head of the Rural Doctors Society to join the panel because he is impartial and has a wide network of doctors in rural areas. He can help us find the truth from his network," Witthaya said.
       He will hold a meeting today to discuss setting up of the panel after his meeting with nationwide provincial public health officials.
       Dr Pongthep Wongwatcharapaibul, secretary-general of the Rural Doctors Foundation, alleged that certain politicians had made preparations to buy unneeded equipment for public hospitals around the country at inflated prices.
       And reference prices for procurements of public hospitals under the project have also been inflated so that the budget could be siphoned from, Pongthep alleged.
       "I will ask provincial public health officials about the budget request and require them to inspect unnecessary budget spending or too high prices of medical tools. Hospitals should buy what they need," said Witthaya.
       The TKK programme is the second stimulus package with a total budget of Bt1.56 trillion.
       The Bt9.29 billion allocation for procurements under the projects of the Public Health Ministry has been approved by the Cabinet.
       Pongthep said the details of the allocation showed irregularities.
       For example, the Cabinet approved the procurement of items not requested by public hospitals,citing
       UV disinfecting machines as an example.
       He said the Cabinet approved the project to buy the UV disinfecting machines for public hospitals nationwide at the price of Bt40,000 per each unit. The overall value of the procurement would be over Bt300 million although the machines were not needed, he said.
       He claimed the machines could be normally bought for Bt6,000 per unit.
       The Cabinet also approved the procurement of respiratory systems at Bt1.2 million per unit, while some hospitals had bought the systems for only Bt500,000 per unit, Pongthep said.
       He added that the Cabinet also approved the construction of living quarters for hospital staff at the rate of Bt9.6 million per a building, while some hospital bid for the construction early this year for only Bt6 million per building.
       "I've checked with hospitals and found that some local politicians met them and asked them to list what they wanted at inflated prices," Pongthep said.
       "This project lacked transparency from the beginning because hospitals were not asked what should or should not be procured and how much the items should be bought for."
       He said compiling of the items to be purchased under the TKK programme was made while the new permanent secretary and director-generals were about to be appointed so "some who want career advancement did it for the politicians".
       Pongthep said Prime Minister Abhisit Vejjajiva should appoint Doctor Banlu Siripanich, a former senior Public Health Ministry official, to investigate the alleged irregularities.
       Pongthep said Banlu should find out who initiated the purchase of UV machines and who compiled the inflated list of reference prices.
       He said the Banlu committee, if appointed, should amend the list of reference prices and should remove unnecessary items from the procurements to save the budget for buying what
       is really needed.
       Banlu once headed a panel, which investigated alleged massive corruption of the procurements of the Public Health Ministry, resulting in the conviction of then public health minister Rakkiart Sukthana, who is now serving his jail term.
       Pongthep said the current case would be similar to the Rakkiart case except the public health minister is now a Democrat Party member. Rakkiart was then a minister in the Social Action Party.

BLASTED TO BEAUTY

       When working women decide they need to do something about their complexion, not everyone's ready for Botox, lasers or chemical peels. For most, the simpler, gentler investment for their hard-earned money is skin moisturisers, night creams and serums.
       You could have counted me in with that group, but then along came Turbo Bright.
       A young dermatologist at Romrawin clinic in Bangkok explained that the key to this natural treatment is fast-moving micro-droplets of saline sprayed at high pressure directly onto the skin surface.
       Vitamin C or nutritious serums can be introduced to the stream, forced by the jet of current past the outer layers and deep into the epidermis.
       It's high-powered but non-abrasive, and certainly effective-microdermabrasion and mesotheraphy without the needles.
       "It can be used in combination with laser treatment, and leaves you feeling relaxed, with completely rejuvenated skin," the specialist said.
       In the treatment room, I lay down and tucked my hair in a cap as cotton buds were inserted in my ears. I was ready to experience the magic. An easthetician explained that the first step is cleansing, followed by the Turbo Bright.
       The high-velocity jet can be loud, but that means it's hard at work peeling away the superficial layers of the skin to allow deeper penetration for the vitamins.
       Next, the hand-held Turbo Bright device is moved around the face to encourage lymphatic drainage from the neck and side of the face.
       Then it's time to boost skin brightness. The lovely aesthetician carefully moved the device to every facial feature in turn, from forehead to cheek, nose and above the lip and chin, without missing a micro-spot.
       The spray is kept close to the skin but never touches the surface.
       The last step involves spraying on Vitamin C to encourage new cell growth.
       The fluid stream feels powerful without ever giving you the worry that damage is being done. The jet pressure is just right to shear away dead skin, leaving no red-ness afterwards.
       Honestly, it feels a little like going through a car wash, but after an hour I was truly relaxed. I felt I'd been to a spa rather than a dermatologist' clinic. The immediate result was nothing short of stark cleanliness and a visible glow.
       For more information, see www.Romrawin.com or call (02) 655 7511.

354,000 Thais got HIV in past 25 years

       The total number of infections is 354,000, and 94,800 patients have died from the sexually transmitted disease from 1984 to August this year, said Suphan Srithamma, the Public Health Ministry spokesman.
       Most of those infected, or 63%, are aged between 25-39.
       This year alone, 1,980 people have become HIV-positive.
       The ministry's HIV/Aids update came two days after the Disease Control Department disclosed the result of an HIV vaccine trial carried out in Thailand.
       The results of the trial show the vaccine has 31.2% effectiveness in preventing HIV/Aids infections.
       Dr Suphan said the HIV infection rate among male sex workers,12.21%, continues to rise.
       Infection rates in the other groups surveyed are falling or have recorded little change, according to the ministry's latest study on HIV infections, conducted last year.
       Among female sex workers, those who worked at a brothel tended to have a significantly lower infection rate than those working independently and secretly, said the doctor.
       That has raised concerns over the risk of HIV transmission from informal female sex workers to male clients and their wives, said Dr Suphan. More condom use campaigns are needed to help curb infections, he said.
       The HIV infection rate among alien workers, fishermen, and drug users was 1.24%,2.5% and 48.15% respectively, a small change on the previous year.

Govt looks at delaying order for flu vaccine

       Thai health authorities are considering shelving plans to order an added 3 million flu vaccine doses to cover priority groups because of global production shortages.
       Deputy permanent secretary for public health Paijit Warachit yesterday said the order for the 3 million doses against the pandemic influenza might have to be put on hold.
       "It's not easy to order millions of vaccine doses at this time as there are only about 500 million doses available worldwide, compared to a global population of 6 billion," Dr Paijit said.
       Dr Paijit will assume office as the new public health permanent secretary on Oct 1.
       He also said it was essential to consider other factors such as the research and development of a local nasal-spray type vaccine and to take into account the outcome of vaccine donation pledges to developing countries.
       The subcommittee on immunisation practice, which advises the government on vaccine matters, last week recommended that front-line healthcare workers, pregnant women and people with obesity problems or developmental disability and chronic diseases about 5 million people - should be the first to receive vaccines.
       He said they were the top priority in regard to type-A (H1N1) flu because they belong to high-risk groups.
       The recommendation is aimed at reducing the number of deaths in the country based on the fatality figures released by the Bureau of Epidemiology.
       Dr Paijit said the type-A (H1N1) flu has put 10,000 people in hospital ever y day.
       However, only 2 million doses of inactivated vaccine will be available from the manufacturer, Sanofi Pasteur,in December and January.
       Dr Paijit said provincial health officials have been instructed to closel y monitor and control the spread of the H1N1 virus in schools, factories,temples and prisons as cases of local human-to-human transmission have been reported nationwide.
       The flu situation in the North and Northeast could get worse in coming months as the weather changes from the rainy season to the cool season, Dr Paijit said.
       An estimated 5 million people in Thailand have already contracted the H1N1 virus after the first case was reported in late April, he said.
       This group amounted to only 8% of the total population and would not help slow the virus transmission rate,Bureau of Epidemiology director Pasakorn Akrasevi said.

PUBLIC URGED TO KEEP WASHING THEIR HANDS

       The Public Health Ministry yesterday urged people to be vigilant in frequently washing their hands and wearing face masks when they are in public areas, in a bid to slow down the second wave of the type-A (H1N1) influenza virus expected to re-emerge from next month until January.
       The move comes after the ministry learned that people nationwide have been ignoring personal hygiene in flu prevention - such as eating well cooked food, not sharing spoons, frequently washing hands, and using face masks.
       "We know that good personal hygiene among individuals is the key preventive tool against the pandemic. But nowadays, because people are not taking precautions, a second wave of the pandemic is certain," he said.
       The Public Health Ministry yesterday announced that seven more people - five men and two women- had succumbed to the new flu virus during the past seven days, bringing the total deaths to 160.
       Most of fatalities were reported in six provinces including Si Sa Ket with two deaths, followed by Khon Kaen, Phetchabun, Songkhla, Phitsanulok, and Sukhothai, each with one.
       The ministry estimated over 5 million people have been infected with the new flu virus during the past four months since the outbreak hit Thailand.
       " We need collaboration from members of the public to prevent a second wave," Witthaya added.
       The Department of Medical Science's National Influenza Centre has conducted a study of 2,011 samples collected from patients with flu-like illness admitted to nine hospitals across country from January 1 to July 31. It found 44 per cent had been infected with the new type-A (H1N1), virus while the remainder were infected with seasonal flu.
       However, the number of patients with the new flu virus admitted to hospital had dropped from 10,000 cases per day to 8,000.
       The coming end of the rainy season and the beginning of winter season's cool weather could cause the disease to spread more easily, Witthaya said. Provincial public health offices nationwide should strictly implement preventive measures against the new flu virus pandemic.
       The ministry's deputy public health minister, Dr Paijit Warachit said people with chronic disease should seek medical treatment at hospital immediately if they develop high fever, while others are advised to go to hospital on the second day after a high fever develops.
       To boost public immunity against the new flu infection, Paijit said the government had ordered two million doses of inactivated vaccine. The first lot of 1 million doses will arrive in Thailand in December, while the second lot will be despatched in January next year.Medical workers, pregnant women, and patients with chronic disease will be the first to receive vaccination.
       Meanwhile, the Government Pharmaceutical Organisation (GPO) had decided to delay the first phase of clinical trials of a vaccine against a new strain of type A (H1N1) influenza from September 24 to October 6 after tests with guinea pigs found one had an infection in its lungs. Results of the new tests will be released in two weeks. Vaccine trials with 24 human volunteers have been delayed.
       Meantime, GPO has produced a third lot of the vaccine against the new flu virus and stored it.

Courses to detect Cardiac defects early

       Starting next month, nurses and health workers at government hospitals and clinics across the country will be given training to help them detect cardiac problems in new-born babies - to help reduce high fatality rates.
       There are now 7,000-8,000 babies with congenital heart-related problems, or around 0.8-1.0 of the annual birth rate in Thailand.
       Without early detection and surgery before the babies are a year old, 20 per cent of them could die or suffer chronic heart diseases, the Cardiac Children Foundation of Thailand said yesterday.
       Foundation chairman Prof Bunchob Pongpanit said of those born with heart-related problems, 5 per cent of symptoms were curable while the remaining 95 per cent faced a risk of dying or having life-long defects. Therefore, early detection of symptoms and treatment was crucial to limit further complications.
       The first courses in the training programme, funded jointly by the National Health Security Office and a charity fund on behalf of late Princess Mother, would begin next month until all selected personnel across the country complete the courses.
       Training will include class lectures and basic practice at local health facilities. And a network of trained personnel will be built up to extend the task further.

HEALTH MINISTRY TO CLOSELY WATCH PURCHASE OF EXPENSIVE DEVICES

       Public Health Minister Witthaya Kaewparadai yesterday instructed top level health officials to watch closely the buying of expensive medical devices under the government's Thai Khemkhaeng (Invest for Strength )budget.
       "I will set up proactive measures to prevent corruption. If there is any corruption, I will kill it," he said.
       On Monday, he received complaints of a ministry letter ordering provincial public health offices to instruct rural hospital directors to purchase medical devices - the "UV fan" which kills micro bacteria in hospitals - at Bt 40,000 per each. The cost of the UV fan in the market ranges from Bt 20,000 to Bt40,000.
       Rural Doctor Society's chairperson, Dr Kriangsak Watcharanukulkiet said he had received complaints from several rural hospitals over the ministry's letter ordering purchase of the UV fan from a private manufacturer.
       The letter attached the name of a UV fan manufacturer and recommended to rural hospitals the price of Bt 40,000.
       Kriangsak said hospitals in Maha Sarakham, Nakhon Ratchasima, Khon Khaen and Songkhla were told to purchase 56, 58, 20, and 16 UV fans, respectively.
       " Of course, some hospitals need to purchase this medical device - but why is there only one supplier's name attached to the ministry's letter? The ministry said it was displaying the UV fan's details for rural hospitals so they can make their own decision about whether to buy it or not," he said.
       "We will keep a close eye on this issue as we don't want low level public health officials becoming an instrument for politicians to exploit over the Thai Khemkhaeng (TKK) project ," he added.
       Witthaya explained that under the TKK project, the government has allocated Bt86 billion to the Public Health Ministry which will budget Bt 45million to provincial public health offices across country to buy UV fans.
       He said he had ordered senior health officials to investigate allegations the ministry may have also set price specifications for respirators under the TKK budget.
       Dr Paijit Warachit will be the key man to investigate this complaint when he takes over as the ministry's permanent secretary.
       He said he has allowed hospital directors across the country to make their own decisions on whether or not to buy the respirators under this project. If there is any scandal over price setting, the hospital director must take responsibility for it.
       "So far, I have not established any ministry committee setting [price] specifications for the respirator," he said.
       When asked about complaints about an adviser who might be involved in the suspect ministry UV fan purchase order, Witthaya said some advisers are physicians and may have interest conflicts with someone else.
       " Don't look at them with a pessimistic view," he said.
       Witthaya has asked health officials who may have information to contact him and he would scrutinise the issue with utmost transparency.

HI-TECH HEALTH PLAN WITHOUT A FRAMEWORK?

       To make Thailand into a country where people can expect equality in receiving high-quality health and medical services no matter where they seek them, the country needs a distinguished national e-health policy as a frame-woke for its investment in healthcare technology.
       So says Boonchai Kijsanayoti, health-informatics officer at the Public Heath Ministry.
       Moreover, he says the country's health and medical systems need a national e-health governance body as well as additional investment in healthcare-related information and communications technology(ICT).
       At present, Thailand's annual information-technology(IT) expenses for the healthcare industry amount to 3-6 per cent of gross domestic product(GDP), whereas the United States spends 15 per cent of its GDP per year on healthcare-related IT investments.
       The World Health Organisation(WHO) says e-health means the use of information and communications technology(ICT) to improve the quality of healthcare, the overall health of the population and the efficiency of the healthcare system.
       Boonchai said the establishment of an e-health system required a development model, and there were three main elements involved: foundation policy and strategy - such as governance, fixing of policy, funding and infrastructure; enabling policy and strategy - such as citizen protection, equality and interoperability; and e-Health applications - such as public health services, knowledge services and providers of service.
       Meanwhile, the Public Health Ministry has rolled out the second phase of the National Health Information System, covering the three years between 2010 and 2012. The plan aims to improve healthcare services by providing a health information system at 11,160 healthcare points of service throughout the country.
       Under the plan, there are four stages of implementation. First is the establishment of the infrastructure and net works for the new system, connecting healthcare service facilities with the Internet and establishing health data centres at provincial health offices. It will also connect central health-information offices with provincial health data centres and develop health-information security systems.
       Second, the ministry will develop both the infrastructure for a Health Information Exchange and national standards for minimal health-data sets, health-information messaging standards, health-information privacy and security standards and health-terminology standards.
       The third stage will involved the implementation of telemedicine services using an Internet connection(Web technology) to provide teleconsultations between primary care providers and secondary care providers in provincial of district hospital. It will enable 252 provincial or district hospitals around the country to serve 1,500 sub-district health-promotion hospitals.
       The fourth stage will be the implementation of a health television system with the aim of providing health-education broadcasting and health-threat alerts from the minstry's central office facilities across country.
       The government has allocated Bt2.97 billion to roll out the plan over the next three years.
       Additionally, the ministry is working on the second phase of the National Health Standard Data Set, concerning standards for clinical data. It has been working with the National Electronics and Computer Technology Centre and the National Health Security Office, Boonchai said.
       He said the ministry was also continuing work on the first phase of National Health Standard Data Set, which was due to end this year. The work involes harmonising reimbursement data sets of three health-insurance schemes: social security insurance, national health security insurance and civil service medical benefits, as well as decreasing the reporting workloads of health-service providers.
       "We will continue to work on the development of national standare codes, including medical disease classifications, drug codes, the Thailand drug code, the health facilities code and the laboratory code," Boonchai said.

Carer jailed for sex attack

       A carer at a former children's home was jailed for two years yesterday for sexually attacking teenage girls, the Press Association reported.
       Gordon Wateridge, nicknamed "the Perv" by his victims, carried out the attacks in the 1970s at the Haut de la Garenne children's home in Jersey.
       The 78-year-old, described as a "persistent sexual bully" during his trial last month, was found guilty of eight charges of indecent assault and one charge of assault at Jersey's Royal Court.
       Youngsters sent to the home were vulnerable and suffered from a variety of problems. But Wateridge, then in his 40s, failed in his obligation to look after them, the court heard.
       He would grope girls' breasts, kiss them on the neck and, in one instance,forced his hand inside a victim's underwear.
       Wateridge, who was born in Croydon,south London, was the first person to be charged in connection with a historic child abuse investigation on the island.
       One victim repeatedly broke down in tears in court as she recalled how Wateridge would regularly lean out and grab her and other girls as they walked past the home's snooker table.
       The woman, who was taken into the home after her father unexpectedly died,said Wateridge would push her on to the snooker table and grope her breasts and inner thighs.
       "It wasn't right ... I was a girl of 13 or 14, he was a big man, I would be shouting at him to stop," she said.
       Passing sentence yesterday, Judge Christopher Pitchers said:"What he did was rightly described in the trial as sexual bullying." It was true, he added, that the acts carried out by Wateridge were at the "lower end" of the sentencing guidelines.
       He said:"They were vulnerable because they were children and because they were placed in the home without the support of a loving family. They were entitled to expect care, love and kindness but in fact they received sexual bullying and unkindness."

Illegal stimulant upgraded to type-1 drug

       The Food and Drug Administration has reclassified the illicit stimulant dimethylamphetamine a type-1 drug in an effort to arrest its growing popularity.
       The stimulant is related to methamphetamine but has a reduced effect.
       The addictive drug was previously classified a type-2 drug, which carried a jail sentence of up to 20 years under the Narcotics Act for anyone caught smuggling it. The smuggling of type-1 drugs carries the death penalty.
       The FDA has upgraded the classification of dimethylamphetamine to match methamphetamine, mainly due to the increase in smuggling of the drug.
       The suggestion to elevate its classification to type-1 was made by the Office of the Narcotics Control Board, FDA secretary-general Pipat Yingseree said.
       "We have to keep seeking ways to stamp out new trends in the smuggling of drugs," he said.
       "Drug dealers were switching from trading in methamphetamine to dimethylamphetamine mainly because of the lenient penalties."
       Mr Pipat said the drug's mild effect,compared with methamphetamine, also enabled dealers to sell more.
       Public Health Minister Witthaya Kaewparadai has approved a ministerial regulation classifying dimethylamphetamine as a type-1 drug.
       Its enforcement is expected to take effect within 180 days after its publication in the Royal Gazette, he said.
       Kobkul Chantavaro, an adviser to the ONCB, said traces of dimethylamphetamine have occasionally been found in ice, or crystal methamphetamine.

LOCAL TEAM MAKES VACCINE FOR SPASMS

       KKU academic says success rate is 100% on some symptoms
       After two decades of research, a Khon Kaen University academic has produced medication created with extracts of botulinum toxin that can be used to treat muscle spasms.
       Prof Dr Sutthiphan Jitphimolmas said his work was based on relevant studies conducted in many countries and that medications extracted from botulinum toxin were already available in Europe at high prices.
       "The research team has produced vaccines that are effective and, at prices as low as Bt3,000, easily affordable for Thai patients," he added.
       Citing studies and research under his supervision, vaccines and medications can treat various kinds of muscle spasms, especially those on the face, eyelids, the back, migraine, heavy sweating and crossed eyes, said Sutthiphan, who is also dean of KKU's Faculty of Medicine.
       "The success rate of treatment on these symptoms is 100 per cent," he added.
       Patients given vaccines or medication via injections on affected muscles experience a drop of frequency of spasms within two weeks. The treatment takes about three months in severe cases.
       "Of the 700 patients vaccinated or medicated, 90 per cent are on their way to recovery while 80 per cent have fully recovered," he added.
       Sutthiphan said extensive research was underway on botulinum toxin in other countries for other uses such as cosmetic treatment for wrinkles or to reduce physical irritation during intercourse. Other symptoms that can possibly be cured with botulinum toxinbased medications include difficulty in urination, tension in the vocal cords and the treatment of congenitally distorted feet.
       Botulinum toxin is a neurotoxic protein produced by the bacterium Clostridium botulinum that was discovered more than 200 years ago. It is the most toxic substance known to mankind, but can be used in very small doses to treat muscle spasms.
       Outbreaks caused by botulinum toxin are not frequent in Thailand, with the most recent reported in 2006 in Nan, when more than 200 people became sick after eating food made of bamboo shoots. Canned foods and sausages that are not properly produced are the most common sources of contamination.

Poor "have no access" to vaccine

       Top of the agenda for the World Health Organisation's (WHO)Western Pacific meeting this week will be how to combat the H1N1 flu pandemic in developing nations.
       There are growing fears that poorer countries will not get enough vaccines,despite a pledge last week by the US and eight other nations to make 10% of their flu vaccine supply available to others in need.
       "The developing world will have no access to vaccines for the time being.There are some donations but it is not enough," said Lo Wing-lok, a member of Hong Kong's government scientific committee on emerging diseases.
       "It is very much a matter of equity and the WHO must look at any way to address this."
       Developing countries such as the Philippines are not only unable to produce the vaccine for the H1N1 flu virus but their people are more vulnerable to infection because of poverty, crowded living conditions and lack of healthcare.
       While the Americas still have the highest death toll from the virus, cases are expected to increase.
       In the Western Pacific there are about a million people living in poor conditions without access to healthcare, making them particularly vulnerable, WHO regional director Shin Young-soo said yesterday, on the eve of the WHO meetings in Hong Kong.
       "Hopefully many countries including China and the United States are soon going to vaccinate their own people but that is not the case for many developing countries and it is something we are worried about," he said.
       The WHO and the UN are working on raising a billion dollars to help buy vaccines for countries that need help,he added.
       Mr Shin said some experts estimate that 20% to 30% of the Western Pacific region will eventually be affected by the virus. So far Australia has the highest H1N1 flu death toll in the region, with about 171 deaths, according to the WHO.
       The organisation warned last week that production of vaccines will fall substantially short of the amount needed to protect the global population.
       The WHO put the number of deaths worldwide from the virus at 3,486, up 281 from the previous week.
       Despite new evidence that only one dose of the vaccines currently being tested will be enough for most people,a WHO spokesman said output next year will be "substantially less" than the annual 4.9 billion doses production forecast. The US, Australia, Brazil, UK, France,Italy, New Zealand, Norway and Switzerland have said they will make donations to nations without vaccines.

Top medical award goes to Thai teacher

       A Thai medical science teacher has won an Association for Medical Education in Europe award.
       Paphan Musikawat, a medical science teacher at Maharaj Hospital in Nakhon Si Thammarat, won the Amee award in recognition of her assessment of medical science students under the hospital's project to produce doctors for rural people.
       Dr Paphan was among a group of medical science educators who attended the annual Amee conference where the award was presented. The conference was held in Malaga, Spain, from August 29 to Sept 2.
       There were five award categories: curriculum planning, assessment, teaching and learning, student issues and research in medical education. There were 450 entries for the awards, seven from Thailand.
       Dr Paphan has been granted Amee membership and issued with free copies of Medical Teacher , an international journal of education in the health sciences,for one year.
       Amee is a worldwide organisation with members in 90 countries on five continents. Members include educators, researchers, administrators, curriculum developers, assessors and students in medicine and healthcare professions.
       It organises an annual conference and delivers courses on teaching, assessment and research skills for teachers in medicine and healthcare professions.

CHINESE PRODUCTS "UP TO STANDARDS"

       China's manufacturers of medical products claim to have upgraded their goods in order to overcome a negative image of offering low-quality products, and to enable them to compete with rival manufacturers around the world.
       Many of them joined last week's Fourth Medical Fair Thailand 2009. Among about 250 exhibitors at the fair, about 55 were from China, the highest number from any participating country.
       Danny Gao, sales manager of Shenzhen Creative Industry, which makes a wide range of patient-monitoring equipment and home-care products, said that some medical products manufactured by Chinese firms in the past might have had lower quality than those of their foreign rivals.
       However, they have now improved their product quality in a bid to export to the world's markets.
       His company, for example, has developed its medical equipment over the past nine years and its products are now distributed both within China and overseas, to markets such as the United States, European countries, South Africa and South America.
       Over recent years his company has been earning 70 per cent of its income from within China and the rest from exports. However, this year, revenue from the domestic market has fallen to 60 per cent of the total and 40 per cent has come from exports.
       "We would like to expand our world markets, which are much bigger than our domestic market. Exporting to world markets such the US and Europe would guarantee that Chinese medical products, like those of our company, have high quality," he said.
       Shenzhen Creative Industry's products have been approved by the US Food and Drug Administration, Gao said.
       Hollye Chen, marketing director of Reach Surgical, a manufacturer of medical staplers, said she believed that medical products made by Chinese manufacturers were these days of the same quality as those produced in other countries. However, Chinese firms could manufacture at lower prices because some of their costs, such as overhead expenses, were much lower than those of overseas companies.
       "Medical technology is something that every country can learn. I can say that Chinese people have the same talent as the Americans, for example. But our production costs are much lower, depending on the competitive situation and regions. So, I can't say for how much less Chinese companies can produce medical equipment," Chen said.
       Reach Surgical has been operating for four years. Its exhibit at the Medical Fair Thailand was its first foray into international markets.
       "I've heard that the healthcare business in Thailand is growing and the government supports the industry to become a medical hub for the region. So, there is a big opportunity for us to expand our business to this kingdom," she said.
       The company is also looking for other export destinations in Asia, as well as in the US, Europe and South America.
       Kris Su, international sales manager for Guoteng Science and Technology Development, one of China's leading manufacturers of patient monitors, said the medical products of some Chinese companies had low quality because fierce competition forced them to cut costs in order to set the lowest prices.
       However, some manufacturers maintain a focus on manufacturing high quality products in a bid to compete with overseas firms. So, customers - both end users and hospitals - have to study the products on the market very carefully before deciding to purchase or place orders.
       China has many manufacturers of patient monitors. However, his company exports its products to 60 countries and 75 per cent of its revenue last year came from export sales, he said.

PHYSICIAN BAGS AMEE AWARD

       Dr Paphan Musikkawatr, a physician at Maharaj Nakhon Si Thammarat Hospital, has won a prestigious award from the Association for Medical Education of Europe Conference for her outstanding research to improve the curriculum for medical students.
       "This award will lift the standard of the Thai medical curriculum to be recognised at the international level," Dr Prat Boonyawongvirot, permanent secretary of the Public Health Ministry, said yesterday.
       Prat, who led a delegation of 16 medical professors to the meeting in Malaga, Spain early this month, said the ministry had submitted seven research papers to the academic competition held during the conference.
       The competition committee had selected only one outstanding study conducted by Paphan to receive the AMEE's Patil Award for her excellent work in curriculum assessment.
       Paphan's research was on "the implementing portfolios in an objectivebased curriculum at the Maharaj Nakhon Si Thammarat Hospital's Medical Education Centre.
       Her work focused on the evaluation of medical students' learning under the project to boost the number of rural doctors.
       Paphan will receive a certificate, AMEE membership and a year's subscription to a medical curriculum journal as her prizes.
       The AMEE is the largest conference for medical professors around the world to discuss medical curriculum development. This year it attracted over 2,300 medical professors from 81 countries.

FRESH WAVE OF SWINE FLU INFECTS THOUSANDS IN MEXICO

       Mexico was hit with 1,341 new swine flu cases since Monday, bringing the total to 26,338 ahead of the usual autumn flu season, health officials said yesterday.
       The Health Ministry said one more person died from the A(H1N1) virus between Monday and Thursday, bringing the death toll to 218 in the country where the virus first emerged in April before becoming a pandemic. In late August, Health Minister Jose Angel Cordova estimated nearly one million people could be infected by the virus during the winter, out of a total population of 100 million in Mexico.
       The official global flu death toll has reached 3,486, up 281 from a week ago, according to the World Health Organisation (WHO), which has reported 296,471 known cases of infection. That number is seenas far below actual figures as some countries lack systematic analysis.
       The UN agency said the Americas region still has the highest death toll, at 2,625. The Asia-Pacific region reported 620 official fatalities, while Europe recorded at least 140 deaths.
       In the Middle East, 61 people succumbed to the virus while in Africa, 40 people have died from it.
       The WHO on Friday warned that the production of swine flu vaccines will fall "substantially" short of the amount needed to protect the global population.
       "Current supplies of pandemic vaccine are inadequate for a world population in which virtually everyone is susceptible to infection by a new and readily contagious virus," WHO director general Margaret Chan said.
       Despite new evidence that only one dose of the vaccines currently being tested will be enough for most people, WHO spokesman Gregory Hartl said output next year will be "sub-stantially less" than the 4.9 billion doeses annual production forecast.
       Some 25 pharmaceutical laboratories working on vaccines have indicated that weekly production is lower than 94 million doses, he said.
       In May, the WHO had forecast a weekly output of 94.3 million doses if full scale vaccine production was launched.
       But pharmaceutical companies have in recent weeks slashed their production expectations due to poorer than expected yields from the so-called "seed virus" strians developed by WHO-approved laboratories.
       Amid growing fears that poorer nations will not get enough vaccines, the United States led nine countries which on Thursday pledged to make 10 per cent of their swine flu vaccine supply available to other nations in need.
       The UN health agency's chief applauded the move the United States, Australia, Brazil, Britain, France, Italy, New Zealand, Norway and Switzerland.

       Mexico Health Minister Jose Angel Cordova estimated nearly 1 million people could be infected.

Human trials of flu jab delayed again

       Human trials of the Thai-made type-A (H1N1) influenza vaccine have been delayed for the second time after the World Health Organisation recommended the Thai team conduct more studies on the trial jab's safety.
       Vichai Chokewiwat, the Government Pharmaceutical Organisation (GPO)chairman, said the WHO viewed that Thai scientists were new to the production of live-attenuated vaccine, so the country should take careful steps in producing a vaccine.
       The WHO's recommendation came after the Thai team detected an abscess in a rat injected with its trial H1N1 vaccine earlier this month.
       Although the WHO experts concluded that the abscess had nothing to do with the trial vaccine, they recommended more studies be done before Thailand goes ahead with human trials.
       "So we decided to postpone the vaccine testing on humans for 10 more days. The trials will begin on Oct 5," Dr Vichai said after the meeting of a committee on vaccine trials on humans which he chaired yesterday.
       The human testing was originally scheduled for Sept 21, but was later postponed to Sept 24 and then Oct 5.
       "Yes, we are worried that Thailand's H1N1 vaccine development project is not going as smoothly as expected, but we have come this far and we won't give up," said Dr Vichai.
       In the meantime, the GPO would recruit volunteers for vaccine trials.
       The GPO planned to conduct vaccine tests on 24 volunteers, but only seven were on the list as most of the applicants did not meet the testing requirements.
       In another development, the subcommittee on immunisation practices,a body that counsels the government on vaccine matters, yesterday proposed a priority list of H1N1 vaccine recipients.
       The advisory panel would next week submit the list to the Public Health Ministry for review and then help state and local health departments plan for a vaccination campaign as soon as the previously-ordered 2 million vaccines arrive around December and January.
       Under the list, health care workers,pregnant women and those with obesity problems will be among people first in line to receive the vaccine, followed by those with chronic diseases and developmental disabilities, totalling 5 million,who are at the highest risk of complications from the new flu strain.
       Somchai Chakrabhandu, Disease Control Department chief, said the recommendation is based on the number of fatalities reported by the Bureau of Epidemiology.
       The type-A H1N1 flu has caused over 10,000 hospitalisations and 153 deaths in 56 provinces as of Sept 16. Most of them were among these risk groups,except for the healthcare workers.
       Charung Muangchana, director of the national vaccine committee, said an estimated 400,000 healthcare workers are listed to receive the vaccine first because they are on the front lines in providing services at hospitals.

City hospitals to unify patient record-keeping

       By the end of this year, patients who already have records with one hospital can be admitted to other hospitals in the 17-hospital Electronic Medical Record (EMR) network without having to re-register, offering customers a hasslefree registration process, according to Dr Chatree Duangnet, Chief Executive Officer of Bangkok Hospital Medical Centre.
       Based at Bangkok Hospital, the new single patient EMR systemwill manage and interconnect the database to other hospitals in the network, offering patients a one-stop registration service,along with quicker and more convenient services.
       Veerasak Kritsanapraphan, the Bangkok Hospital Group's Chief Information Executive, added that the IT development projects with IBM solutions on the UNIX system greatly benefit both patients and doctors.
       "Imagine Bangkok Hospital customers who may travel to Phuket but unfortunately have an accident. They can be admitted to Bangkok Hospital Phuket without wasting time going through the registration process while the doctors can instantly track a patient's medical history from the system."
       In the next phase, the system will add more services by providing 'whatif' analysis setting parameters for each patient and offering suggestions for doctors to make decisions faster.
       Dr Chatree added that in terms of security, the system has to verify that only authorised persons can gain access to patients' data and meet security at international standard.
       "If you are one of our customers,while laying down in the roomwatching a program and then doctor comes, it is possible for the doctor to retrieve the patient's record to show up on the TV and can discuss the progress with the patient.
       "In the long term, the hospital may open connections to other public hospitals. However, such a system has the challenge of standardising data by creating a unique patient ID number no matter which hospital they are at. In order to map medical records between hospitals it is easiest to integrate in our group first," Dr Chatree said.
       Attracting more medical tourists
       According to Veerasak, the single patient EMR also helps hospitals in the Bangkok Hospital Group to attract more overseas patients through hospital partner alliances in Europe and the Middle East when patients are referred here.
       The foreign hospitals can request to monitor and update the status of their patients via the online system.
       In line with the improved efficiency in patient records and tracking, the Bangkok Hospital Group will also upgrade its financial and business management system with IBM Cognos solution, to connect hospital data and analyse statistics to help executives make precise investment decisions.
       In the healthcare business, there are many unexpected factors that may affect its business. This solution helps to prepare business plans with 'what-if' modelling capabilities such as scenarios in closed airports or in pandemic situations.
       "With these two important projects we are able to offer an effective treatment analysis faster than before, and with more convenient services. The systematic and integrated data system will be of great benefit for medical research,paving the way for the Bangkok Hospital Group to set a new standard of Smarter Healthcare in Thailand."
       Build IT R&D in healthcare
       Dr Chatree added that even during the economic downturn, the hospital still continued investing in IT and established a new IT company called Greenline Synergy to centralise all IT teams in each hospital under one company.
       Each company has to allocate a minimum budget of 1.5 percent from its revenue worth 20 billion baht to IT.
       "We sees IT like oxygen for our business to create with advanced technology not only for treatment but also for infrastructure no matter wireless or mobile computing and caring service," Dr Chatree said.
       Acting as general manager for Greenline, Veerasak said that the new company will recruit more staff this year and there are also plans to increase capital register from 30 million baht to give stronger bargaining when negotiating with vendors.
       Moreover, the company has allocated a number of staff in research and development for Radio Frequency Identification or RFID to enhance patients'safety and potential to use in babymother first phase.
       "There are a lot of technological issues to consider especially when it operates it should not have any affect or interfere with medical equipment. If the company is successful it will roll out through the entire group. Within the next couple of years, the company plans to sell the solution to other hospitals outside the Bangkok Hospital Group.
       "When centralising IT, we experience a lot of savings starting in standardising technology and acquiring hardware and software. With the power of bargaining,it can reduce rental PC costs from 1,500 baht per unit to 500 baht. While we can replicate the solution to roll-out in the network before selling to make more money a as profitable business,"Veerasak said.

IMPACT OF RECESSION ON FIRMS NOT UNFORM

       A look at the expansion plans of two Thai companies demonstrates the varying effects that the recession has had in the Kingdom.
       Better Vision Group, operator of the Hawman chain of optical-goods shops, has been forced to scale back its investment plans, said managing director Pakee Pracharktam.
       The perception of eyeglasses as a necessity for those with vision problems is still largely limited to the Kingdom's large urban areas, Pakee said. Much like books and computers, rural Thais still do not perceive glasses as a necessity, he said. This reality has made the recession particularly difficult for the firm.
       "We opened five or six Hawwan shops in 2007 in line with the rapid expansion of hypermarkets. However, several of these stores, especially those in rural towns, did not see good sales," Pakee said. The company has more than 80 stores at shopping malls and hypermarket branches nationwide.
       After it started experiencing cash-flow problems last year, the compaby decided to delay new investments to focus on existing branches, Pakee said.
       The company has shut down several shops that showed little promise, including outlets in Ratchaburi and Prachin Buri, and some smaller outlets in Bangkok.
       "We have tried to improve the performance of our stores by launching more promotions and staff-development initiatives," said Pakee.
       Under the adjusted-growth plan, the company will only open two or three new stores per year, he said.
       "We will evaluate all investment possibilities, however," he said.
       Pakee said 2009 had brought many negatives, including the continuing of the political unrest from last year and the deadly type A (H1N1) influenza otubreak.
       In stark contrast to the Hawwan chain's experience, Nitipon Group, a leading beauty-clinic operator, is going full steam ahead with its growth plans, setting its sights on the upcountry market, said managing director Nitipon Chaisakulchai.
       "Our Nitipon clinics already cover all prime locations in Bangkok. What we want to do next is to expand the retail network upcountry," he said.
       "We currently operate 37 Nitipon clinics, seven of which were opened in the first half of this year. We see great opportunities to expand our network in the provinces," Nitipon said.
       The expansion of Central Plaza shopping malls into the Northeast, especially in Khon Kaen and Udon Thani, would create new business opportunities for retail tenants in Bangkok-including Nitipon-that want to open upcountry outlets, he said.
       Unlike other businesses, Nitipon said, beauty clinics had proven to be "recession-proof."
       "Amid the economic slowdown, we have not seen any significant drop in demand for beauty clinics' services. Beauty clinics are a part of Thai consumers' lifestyles today, and Thais are still highly concerned about their appearance," Nitipon said.
       The company recently launched several clinics under a new brand, Retouch Laser Centre by Nitipon Clinic. Retouch Laser Centres have opened at The Mall Bangkapi, Future Park Rangsit, Seacon Square and Fashion Island.

Hematopoietic Stem Cell Transplantation for patients at Wattanosoth Hospital

       Hematopoeitic stem cell transplantation is a complex medical treatment program that can cure many otherwise incurable blood or bone marrow diseases, beta-thalassemias, lymphomas, and certain cancers, both in adults and children. This treatment approach backed by specialised tertiary care has been accepted worldwide as one of modern medicine's amazing curative methods. Through an affiliation with the Barbara Ann Karmanos Cancer Institute in the USA. Wattanosoth Hospital is now able to commence transplants that comply with the standard treatment regimen.
       Our hematopoietic stem cell transplantation unit is established on the 6th floor of Wattanasoth Hospital, part of the renowned Bangkok Hospital Medical Center. This two=bed unit is equipped with highly-efficient clean rooms and other related facilities and has a capacity of 10-15 stem cell transplantations a year. Our physicians and nursing staff have previous experience in performing over 120 transplants and attending patients intensively. The most common and most successful conditions that have been treated with this procedure are thalassemias, multiple myelomas, lymphomas, aplastic anermia, and leukemias. The source of the hematopoietic stem cells used is derived from bone marrow, peripheral blood or umbilical cord blood collectre and preserved after a baby is born. The treatment procedures are most commonly called Bone Marrow Transplatation(BMT), Peripheral Blood Stem Cell Transplantation, and Umbilical Cord Bolld Transplantation, respectively.
       For certain blood diseases such as beta-thalassemia, patients will need to have suitable HLA-matched healthy donors, possibly their own brothers/sisters or unrelated volunteers. We will test the blood of the patient and the potential donor for typing and matching and cooperate in circumstances where it is necessary to search for an appropriate unrelated donor.
       Allogeneic stem cell transplatation where a healty person donates cells to a sick person is so sophisticated scheme of therapy and integration of medical sciences and technology. We offer well-organised comprehensive treatment program for particular group of patients who fulfil indications for undergoing transplantations. Our stem cell transplant physicians wil discuss, explain and answer the patient's and/or parents' questions regarding this effective and informed curative therapy in detail.
       Our stem cell transplant physicians comprise the BMT Conference which discusses and plans treatments for each BMT patient. Full explanations, family education and support information is provided to BMT patients and their families and all questions are answered regarding this effective and informed curative therapy.
       BANGKOK HOSPITAL Tel.1719

Obama lays down law on health care

       President Barack Obama told Congress on Wednesday to end its political bickering and move quickly on a broad healthcare overhaul that would dramatically transform the US health system and insurance market.
       In a sometimes emotional speech,Mr Obama said lawmakers were closer than ever to enacting healthcare reform and spelled out proposals to improve conditions for those with insurance and expand the choices for 46 million uninsured Americans, including a controversial government-run "public option". He also rebuked critics, accusing them of substituting scare tactics for honest debate by pushing false ideas like the charge that "death panels"would decide treatment for the elderly.
       "I will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it," he told a joint session of Congress and a national TV audience."If you misrepresent what's in the plan,we will call you out."
       Democrats, who have struggled for decades to enact healthcare reforms,gave Mr Obama frequent standing ovations while Republicans murmured unhappily at times and held aloft copies of a Republican-sponsored healthcare bill. Republican Congressman Joe Wilson shouted "you lie" when Mr Obama said his plan would not insure illegal immigrants.
       Republicans also laughed loudly when Mr Obama said "there remain some significant details to be ironed out". Mr Obama hoped the speech would rejuvenate his flagging push for an overhaul of the $2.5 trillion healthcare system and reclaim control of a debate that has bogged down in Congress amid rising public scepticism.
       He said the overhaul would cut costs,improve care and regulate insurers to help protect consumers while expanding coverage. He repeated his pledge that the proposal, which would cost $900 billion over 10 years, would not increase the budget deficit.
       As promised, he spelled out the concepts he wanted in any final bill passed by Congress, including affordable coverage for all Americans and creation of an insurance exchange where individuals and small businesses could shop for policies. He reiterated his support for a government-run insurance plan - the so-called public option - that has drawn strong opposition from cr-
       tics who say it would harm insurance companies and amount to a government takeover of the industry.
       But he was clear that the lack of a public option in any final bill would not be a deal-breaker, and he promised to entertain Republican ideas to foster more competition and reduce costs.
       "The public option is only a means to that end - and we should remain open to other ideas,"he said. In the Senate, months of bipartisan Finance Committee talks by the so-called "Gang of Six" negotiators moved into the final stages earlier in the day as the panel's Democratic chairman, Max Baucus, said it was time to proceed with or without Republicans.
       Mr Baucus said he would push ahead with a bill next week modelled after proposals he distributed recently to members. That plan would levy a fee on insurers to help pay for coverage but would not include a governmentrun option, which he said "cannot pass the Senate". Mr Baucus' plan would tax insurance firms on their most expensive policies and offer tax credits to individuals and families to help offset the cost of premiums.