NHSD motions

Finally got the time to link =). The pros and cons are IMHO... feel free to comment, or even better, write something about the motions. Any news on the selection outcomes?

NHSD 2007

Theme: 21st Century Medicine: Making us better?

1. THW give the government the go-ahead in eKesihatan. (eventually revoked/put on hold)

• Pro: Accountability, Road Safety, Outsourcing.
  
• Cons: Monopoly, Cost-efficiency, Political will, Ethical issues, *A total waste of time? / counterproposal

2. THW stand behind hybrid-embryonic cloning.(*Christ! First, understand what the heck is cloning here.)

• Pro: Scientific breakthrough, Medical benefits - eg infertility, Regulations of use
  
• Cons: Playing God, Ethical issues, Abuse, Protection for the Privileged
  

3. THBT the private sector should do more to support the healthcare service in Malaysia.

4. THW make medical insurance compulsory for all.

5. THBT the Malaysian Government is not paying enough attention to the healthcare sector.

6. THW stand behind a National Healthcare Plan.

7. THW urge the Malaysian Government to play a larger role in women's healthcare.

8. THBT only pharmacists has the right to dispense drugs.

9. THW only honor the words of the terminally ill patient for euthanasia.

10. THW make passing an aptitude and communication test compulsory for all medical student before progressing to their clinical years.

11. THW make organ donation compulsory for all brain dead patients.

12. THBT medical schools should do away with the current PBL based medical curriculum.

13. THBT that medical services provided in-flight by a doctor should be absolutely free.

14. THBT the US child health insurance program should be implemented in Malaysia.

15. THBT athletes suffering from Androgen Insensitivity Syndrome should be excluded from the Gender Testing regulations.

16. THBT the government should make it compulsory for the private sector to offer the option of the 5 years maternity leave.

Tagging the forgetful

This article about tagging forgetful people (Alzheimer's) with chips that store personal info. I'm sure everyone knew about the angkasawan and the debate on space exploration, so i thought I may interest you with something else. Read on!

We've tagged you

Sub Head: Uproar flares in the United States over Alzheimer's tags.

Byline: By CELESTE BIEVER

IT looks deceptively familiar. The patient rolls up his sleeve, the doctor sticks a needle into his arm, and soon it's all over.

But this is no routine vaccination. Instead, the patient has been injected with a fleck of silicon that will uniquely identify him when zapped with radio waves.

Now, nearly three years after their use was approved by the US Food and Drug Administration, implantable radio frequency identification (RFID) chips are the focus of a new controversy.

The battle lines are being drawn in a quiet corner of West Palm Beach, Florida. On May 12, some 30 protesters held an inter-faith prayer vigil outside Alzheimer's Community Care, a day-care facility for people with dementia.

At issue is the facility's plan to implant 200 patients with microchips manufactured and donated by VeriChip of nearby Delray Beach. When scanned, the chip reveals a unique ID number, which when entered into a password-protected database gives access to medical information about its owner.

If the plan goes ahead, it will be the first time the technology has been tried on a group of people with a specific mental impairment. The forgetfulness that comes with Alzheimer's can make it impossible for people with the condition to pass on vital information when faced with a medical emergency, which is why advocates are keen to make use of RFID chips with this group.

"If for whatever reason – an automobile accident or hurricane – the person becomes separated from their loved one, they are totally, totally helpless. They can't share what medically is wrong with them," says Mary Barnes of Alzheimer's Community Care. "This could be a safety net."

Privacy advocates say that it is precisely this helplessness that makes the proposed use of the tags unacceptable. "This is a community that is not in a position to give fully informed consent or to say no," says Katherine Albrecht, of CASPIAN, a Florida-based consumer rights organisation. "The nature of the disease is that they can't fully understand."

Albrecht likens "the violent and invasive act" of implanting a chip in someone who does not have the ability to consent to the act of rape. Others agree with the sentiment, if not the comparison. "This is by definition a way of doing something that denies a person control," says Lee Tien, of the Electronic Frontier Foundation, San Francisco, California. "If that doesn't strike at the heart of human dignity, I don't know what does."

He and Albrecht would rather see a chip implanted in a bracelet.

Barnes says a bracelet would not be nearly as useful. People might remove it if it got uncomfortable, especially those with Alzheimer's, who might not understand why they should wear it.

Bracelets could also label people as mentally ill, whereas an implanted chip is much less obvious, says Rick Rader, of the Orange Grove Center, Chattanooga, Tennessee.

The centre, which cares for children with Down's syndrome, cerebral palsy and autism, was in the media spotlight two years ago when it considered using VeriChip's device in a similar study on its patients, a plan that has since been put on the back burner.

At the time, there was an outcry from those who saw an implantable RFID as reminiscent of the "mark of the beast", as described in the book of Revelation. As explained on Albrecht's Web site, the Bible states that people who take the mark of the beast – a mark on the right hand or the forehead that contains a number or a name that is required for buying and selling – will receive a "grievous sore" as well as the "wrath of God", while those who refuse will be rewarded.

It is something Albrecht, a Christian, takes seriously. "I don't think anyone is arguing that the VeriChip implant in its current incarnation would meet that definition," she says. "But the concern for many people is that this would be a necessary precursor to getting to that point and therefore probably should be objected to." – New Scientist Magazine/Premium Health News Services/TMSI

Pix: Injecting microchips into patients with Alzheimer's disease or other types of dementia would violate their rights, some say.

Some news excerpts: click links to read

Dear all,

Selamat Hari Raya, and happy holidays! I am also stuck in the Raya mood, and the most exciting event that happened in Malaysia was the Angkasawan blast-off to space. "We have lift-off!". Nina has sent me her take on the AIDS debate, I'll post it online next week. So, just a quick summary on what's interesting (that I know of):

1.'Legalise drugs' report supported (BBC)

North Wales Police Authority has backed a review of drug laws after its chief constable urged legalisation.
Richard Brunstrom asked the authority to back his calls to scrap current laws, legalise most drugs and bring in a new system to control them. While it agreed to support the report - to go to the Home Secretary as part of UK-wide consultation, it stopped short of calling to scrap current laws. A senior police officers' body called legalisation "a counsel of despair".

2. Genetic testing, Discrimination and Privacy (Council for Responsible Genetics)
The Genome Project has sparked a huge debate on its repercussions on the society. One of the most important issue was the abuse of genetic information and accompanying discrimination. Surf this site for more information.
3. Sensationalism in journalism - Yellow Journalism (Wikipedia)
Where do we draw the line?

4. Space tourism and Space exploration
The next frontier vs a total waste of time (and money)

That's all folks for this week :).
WW

The transplant debate

Weekly highlights - and links to reports/commentaries
1. Heart transplant - MAS
2. Myanmar's violence to silence- there
3. Methadone programme for drug addicts -MAS
4. Deporting and banning Bangladeshi immigrants - MAS
5. Jena Six - USA
*This is not new, but interesting: racial tensions still deeply ingrained in parts of the US.*
6. I hate sports pages... so anything in sports please let us know.

I'm sure all of us had debated organ transplants and organ donations one way or another. Be it the idea of who gets the transplant, the black market and organ "selling", or the rights to organs.

The recent case where Tee Hui Yee, a 14-year-old living on a mechanical heart for about one year, gets not one, but two heart transplants within the span of 1 week. The donor's picture was in the frontpage of nearly every newspaper in town. We celebrated the generosity of the young man, who was killed in the accident. I wonder what happened to the general rule that donors aren't supposed to reveal their identities.

That sparked an idea of a motion: THBT transplant patients can have a second chance.

Do give your supporting or dissenting arguments in the comment box below, or if you have problems with the motion, do shout-out! =)

Cheers, WW

A nuke-free world?

Source: International Herald Tribune

It's time to junk nuclear weapons

Sometimes I wonder if superpowers like the US wanted world peace. Without the "dictators" in the Middle East needing weapons, or Gaza's troops needing tonnes of bullets everyday, they can kiss a big chunk of their revenue goodbye. I may be cynical, but hey, this is a debate ;).

Should the United States aim to achieve a world free of all nuclear weapons? In one sense, the question is trivial - nuclear disarmament has been a stated aim of the United States since the dawn of the nuclear age. And the United States also committed to working toward this end when it signed the nuclear Non-Proliferation Treaty in 1968.

But in another sense, the question is fundamental. Although successive administrations (at least until the current one) have mouthed the words affirming this objective, few have actually made this commitment an organizing principle of their nuclear weapons policies. That may be about to change. Earlier this week, Senator Barack Obama pledged that as president he would say: "America seeks a world in which there are no nuclear weapons." Former Senator John Edwards has also pledged to lead an international effort to eliminate nuclear weapons, as has Governor Bill Richardson of New Mexico.

And it isn't just presidential candidates who are talking about a nuclear-free world. So are former statesmen like Henry Kissinger, George Shultz, Bill Perry, and Sam Nunn. Writing in The Wall Street Journal last January, they urged that the United States set the goal of a world free of nuclear weapons, and proposed specific actions to that end.

Nearly 20 years after the Cold War ended, the time has come to make a concerted effort to verifiably rid the world of all nuclear weapons. The United States must start by recognizing that the threats it confronts have changed and so, consequently, has the role and purpose of our nuclear weapons. During the Cold War we worried about the possibility, however small, of a disarming bolt-out-of-the-blue attack on our nuclear forces. That is no longer a realistic possibility. We also confronted a superior conventional foe in Europe and elsewhere that we sought to deter by threatening nuclear escalation. Today, our overwhelming conventional forces can defeat any nation, anywhere on earth.

Tomorrow's nuclear threats are different. They are that unstable regimes or, worse, nihilistic terrorists get their hands on a bomb and use it. This threat is becoming more real as nuclear technology and materials spread around the world. The first order of business must be to ensure that all the nuclear weapons and materials in Russia and elsewhere are safe and secure. While recognizing the threat of loose nukes and materials, this administration has done far too little to make sure this happens. The next administration must do better.

The second order of business, though, is to reduce the salience of nuclear weapons in order to ease the road to their elimination. The only reason the United States should maintain nuclear weapons is because others have them. There cannot be another purpose. We don't need them to deter a non-nuclear attack on ourselves or our allies; our conventional forces can deal with those contingencies. We certainly don't need them to attack some far-away or deeply buried targets, because there isn't a target whose destruction is worth breaking the 62-year-old taboo against using a single nuclear weapon.

Given this limited role for nuclear weapons, there is much that the United States can do to lift the dark nuclear shadow over the world. It can sharply reduce its nuclear stockpile to 1,000 weapons or less, if Russia agrees to go down to the same level. It can eliminate tactical nuclear weapons to underscore that it understands that a nuclear weapon is a nuclear weapon, no matter its size, yield, range, or mode of delivery. It can agree never to produce highly enriched uranium and plutonium for weapons purposes, and accept the need for intrusive verification if other states agree to end such production as well. It can commit never again to test a nuclear device, and ratify the Comprehensive Test Ban Treaty.

If the United States were to do all these things, it would make clear, to our citizens and the world, that it is serious about tackling the nuclear danger. It would reestablish the nation as the leader of the global nuclear nonproliferation movement. Above all, it would make the world a much safer place.

Ivo Daalder is a senior fellow at the Brookings Institution. John Holum led the Arms Control and Disarmament Agency in the Clinton administration. This article appeared first in The Boston Globe.

Matter on AIDS

AIDS in Malaysia

Malaysia is home to the fifth fastest growing AIDS epidemic in the East Asia and Pacific region with its current rate of HIV infections doubling every three years.

Between the first detected case in 1986 and 2006, 76,389* people have been infected with HIV while 9,155* have died of AIDS. These statistics suggest that an average of 17 people test positive for the virus each day.

Malaysia's epidemic is largely dominated by injecting drug users who make up about 73% of total cases. There is concern however that heterosexual transmission is on the rise. The proportion of women reported with HIV has increased dramatically in the last decade from 4% of new cases in 1995 to 15% of new cases in 2006. Surveys show that in 2006, more housewives tested HIV-positive than sex workers. At the same time, the percentage of babies born with

HIV has also increased from 0.2% in 1991 to 1.4% in 2006.

As in most parts of the world, young people in Malaysia account for an increasing number of HIV infections every year. December 2006 statistics from the Ministry of Health reveal that 36% of infections are amongst people aged between 13 to 29 years old. It is likely that people infected with HIV before the age of 30 were infected in their twenties and sometimes even during their teens.

Gender inequity, stigma, discrimination, silence, denial and ignorance fuel the epidemic in Malaysia.

* Source: Ministry of Health, Malaysia

another related article, but in larger scope:

How widespread is the HIV/AIDS epidemic?

The HIV/AIDS epidemic is an unprecedented challenge to humanity. HIV/AIDS was once concentrated primarily in sub-Saharan Africa, but the epidemic knows no borders. It has spread to every region in the world and affects people regardless of age, gender, wealth, geography or sexual orientation. HIV/AIDS is now the fourth-biggest cause of death worldwide.

Concentrated Epidemics

In many countries, HIV is still considered 'low' or 'concentrated, ' confined mainly within groups at especially high risk, such as men who have sex with men, people who inject drugs and sex workers. An epidemic is considered 'concentrated' when less than one per cent of the general population but more than five per cent of any 'high risk' group are HIV-positive.

Generalized Epidemics

In sub-Saharan Africa, parts of Asia, Central America and the Caribbean, HIV has become a 'generalized' epidemic that is not contained within any section of the population. An epidemic is considered 'generalized' when more than one per cent of the general population carries the virus.

Sub-Saharan Africa

Nine out of ten children with HIV or AIDS are African. Sub-Saharan Africa is the worst affected region in the world. With just 11 per cent of the global population, the region is home to three-quarters of all people living with HIV and AIDS. Some 30 million people are carry the virus, and is AIDS the leading cause of death on the continent. One in ten people between the ages of 15 and 49 are HIV-positive in 12 countries. The majority of new infections occur among young people aged 15 to 24, especially among girls.

In Botswana, South Africa and Zimbabwe, it is estimated that more than 60 per cent of boys currently aged 15 can expect to become HIV-positive. In parts of southern Africa, more than 30 per cent of pregnant women are HIV-positive. Nine out of 10 children with HIV or AIDS are African.

Asia

In Asia, an estimated 7.2 million people are believed to be HIV-positive. Concentrated epidemics among injecting drug users and sex workers have crossed over into the general population in Cambodia, Myanmar and Thailand, resulting in generalized epidemics. In Indonesia, Nepal and Viet Nam, infection rates are exploding among those two high-risk groups, of whom the majority are under the age of 25. In China, home to a fifth of the world's population, concentrated epidemics have emerged in several provinces and HIV is moving so rapidly that many fear the country is on the verge of a generalized epidemic. India is home to the world's second-largest HIV-positive population.

Central and Eastern Europe and Central Asia

Central and Eastern Europe and Central Asia have the fastest-growing epidemic in the world. Around 1 million people aged 15 to 49 were living with HIV/AIDS in 2001, and the number is growing by 250,000 people a year. The epidemic is concentrated among addicted injecting drug users, but it is now spreading to a wider population of occasional injecting drug users and their sexual partners, most of whom are young. In the Russian Federation, there were 3,008 reported new HIV infections among injecting drug users aged 10 to 19 in 1999. By 2000, that number had more than tripled to 9,612.

The Caribbean and Latin America

About 1.9 million adults and children now live with HIV and AIDS, and the epidemic is in danger of spreading rapidly and widely. The Caribbean, with a 2.3 per cent prevalence rate among 15¡V49 year olds, is the most affected region after sub-Saharan Africa. Unsafe sex among men who have sex with men appears to be rife across the entire region; a large proportion of these men also have sex with women. Prevalence levels are highest in The Bahamas, Guyana and Haiti. Most new infections are being reported among young women aged 15-24.

Middle East and North Africa

In the Middle East and North Africa, more than half a million people are living with HIV/AIDS. Available data point to increasing HIV prevalence rates, with about 83,000 new infections in 2002. Significant outbreaks among injecting drug users have occurred in about half the countries in the region, notably in North Africa and in the Islamic Republic of Iran.

High-income countries

Approximately 76,000 people became HIV-positive in high-income countries in 2002, and 23,000 died of AIDS. About 1.6 million people now live positively with the virus, in large part thanks to anti-retroviral drugs that have made remarkable headway in holding back the development of AIDS symptoms. Unfortunately, the advancement in treatment comes with an underestimation of the risk and gravity of HIV/AIDS. Infections are on the rise again apparently because many people view HIV/AIDS as a treatable disease and are therefore not taking precautions to prevent contracting it.

source: http://www.unicef. org/aids/ index_epidemic. html

HIV status to tie the knot

Note: this is an exemplary effort from reno, :) I hope I could maintain this site with contributions from all of you.

28^th Sept 2007 (Fri)

BP training for NHSD

In front of KTSN PBSM, 20000

THW make it compulsory for future spouses to disclose their AIDS status

OG: Matthew, Reno

OO: Izzati, Nina

CG: J, Hafizah

CO: Prisca, Pravita

Adjudicators:

Chair- Bernard

Panel- Wen Nee, Stella

PM:

The problem is basically about the rise of AIDS cases in Malaysia due to unawareness of HIV status. Unawareness of spouse’s HIV status, if the spouse is HIV positive, it is more likely that he/she may be infected, including their offspring. It’s unfairness in marriage.

Mechanism:

• Premarriage counseling is conducted on future couples and HIV test is advised and make compulsory
• Medical result regarding HIV test must be presented during marriage legalization in marriage registrar
• If one/both of the couple is HIV positive, an agreement doc should be signed to make sure another half is well informed of this
• Check and balance: regular HIV test for an interval of approximately 5 years

*Medical confidentiality and practitioners of the test should be mentioned

1^st point from the PM: Duty of state (on the societal health)

It is duty of state to make sure that the HIV status of their spouse is being well informed to each other. We want to create a healthy society and increase AIDS awareness in this country, especially in this particular case of marriage.

Leader of Opp:

Rebuttals:

• On Duty of State - Right of choice whether to disclose the HIV status or not, because the positive or negative HIV is going to cause a big impact on their relationship.
• On Registrar - Feasibility is being question on free HIV test and bribery in marriage registrar (human nature is being brought up)
• On trust - It is up to the HIV positive partner to choose appropriate time to disclose his/her HIV status, because we believe in love is built on trust

1^st point from OO: Negative implication of the proposal (Freedom of Choice)

Discussed on the levels of human’s right of making choice and impact of tourism? of M’sia (*not much elaborated because running out of time)

* Adjudicator note: right to privacy is going to be a better point brought upon by Leader of Opp

=> I would love to listen to the argument on HIV status and tourism

DPM:

Rebuttals:

• On Freedom of Choice - Right to choice are less likely to be prioritized since it’s jeopardizing another human’s right of information/ fairness/ and even life of another half (even whole family, if including offspring) of the marriage.
• On trust and integrity - Bribery cases are insignificant enough to be ignored. Persons elected for the marriage registrar is elite and bound to rules, religion (since this case setup is in M’sia), and regulation.
• On feasibility - More people will attend to HIV test after this proposal is implemented, thus create AIDS awareness among Malaysians, which is out objective
• Tourism - Impact of tourism is not likely because the HIV status is only known by 3 parties: the patient, their spouse, and marriage registrar

2^nd point from OG: Fairness of the marriage

• Discussed in two levels: marriage partner and their children

Deputy Leader of Opp:

Rebuttals:

• Why the govt want to target only on disclosure of HIV status in marriage, why don’t target on other things that make more contribution to the HIV population in M’sia? e.g. IVDU (intravenous drug usage)

* 0.3% of M’sian are HIV positive

*60% are caused by IVUD

(it is outdated data; more recent data should be sought)

** please note that the National Health and Morbidity Survey 2006 (once in 10 years) has been released by the MOH lately.I've been trying to get it but to no avail, can anyone with access (doctors and medical line people alike) help? (ww) - would be helpful for debate on health - and politics in healthcare

CG:

Extension: Trickle down effects of the proposal

• Stigma removal from society which will further create societal acceptance on this case

*stigma is a good point but not well explained
- stigma always include fear, evasiveness and partial knowledge about an issue.
- revealing HIV status sends out a message that -
1. HIV is a disease, like cancer, like the common flu
2. The fact that it has no cure shouldn't create fear, because unlike SARS/EBOLA/even cancer, HIV is not genetic or highly communicable- (doctors would tell you that even healthy lifestyle may not prevent you from a strong inheritance of cancer), and conscious effort (condoms, abstinence) can prevent it.
*A bit of technical knowledge here - HIV is a Biosafety Level 3 virus, a step below Biosafety Level 4 bacteria, Tuberculosis (TB). If migrant workers are required to undergo check for TB, why not HIV in spouses?
3. HIV exposure will tell people that yes, it is deadly, but there are thousands of ways people can contract HIV - not necessarily promiscuity. And if the spouse can't take it, maybe they shouldn't be in the same bed together anyway. => better than getting a divorce later with HIV eh?

CO:

• *Inconsistency because the member of Opp gave me the feeling that HIV is really a serious thing in M’sia, but the whip came out and even said AIDS is just a small matter in this country
• Rebuttals are mainly discussing about love, trust, and how disclosure of the HIV status will destroy a marriage. *Better elaboration about it is up to the HIV patient to choose time to tell their partner. It can be countered by saying procrastinating and lazy nature of human. However, it was not brought up by the CG whip

Extension: Impact on the marriage

** I think so…’cause I hardly catch the points being discussed…I knew only trust and love is being discussed throughout in the closing half of the debate. The CO also mentioned about the positive impact if the patient is given the choice to choose their appropriate time to disclose their HIV status.

p/s:

* indicates comment from adjudicators

** is my personal think about the debate

** the whole debate was not carried out well because of the environmental situations. (We actually had people screaming around us during the debate…they got their crazy own activities lah…) Few new people from KTSN is also being exposed what the hell is BP style. Everyone has presented well.

A selection for NHSD in KTSN will be conducted next week…be ready for the battle!

By

Reno

29 September 2007

It’s late in night…just finished watching Ultraviolet with other guys…sleepy… :)