Global policy on AIDS

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Food blockade for malaria parasite"Starving" the malaria parasite of haemoglobin could be a way of

treating malaria, since the parasite has only a limited capacity forde-novo synthesis or exogenous uptake of aminoacids and dependson the catabolisation of haemoglobin to provide the aminoacidsrequired for its development. In the parasite ingested haemoglobinis degraded in a proteolytic organelle called the digestive vacuole.Goldberg and colleagues had found that an early step in thebreakdown of haemoglobin in these vacuoles depended on theaction of an endogenous aspartic protease.1 The group have nowidentified the initial site of action of the enzyme-between residues33 Phe and 34 Leu at the hinge region of the haemoglobinmolecule.2 Cleavage here causes the molecule to unravel, whichexposes other sites to proteolysis by aspartic and other proteases.Goldberg and colleagues are now designing competitive inhibitorsfor the enzyme.

1. Goldberg DE, Slater AFG, Cerami A, Henderson OB. Hemoglobin degradation inthe malaria parasite Plasmodium falciparum; an ordered process in a uniqueorganelle. Proc Natl Acad Sci USA 1990; 87: 2931-35.

2. Goldberg DE, Slater AFG, Beauvis R, Chait B, Cerami A, Henderson GB.Hemoglobin degradation in the human malaria pathogen Plasmodium falciparum: acatabolic pathway initiated by a specific aspartic protease. J Exp Med 1991; 173:961-69.

Global policy on AIDSA new organisation, the Global AIDS Policy Coalition, has been

formed to collect information and provide independent analysis ofdata on AIDS and to strengthen policy making internationally. Thecoalition, founded by Dr Jonathan Mann and based at theInternational AIDS Center of Harvard University, aims to clarifyuncertainties in current AIDS/HIV policy; draw attention to newchallenges in AIDS/HIV prevention and care; and promoteattention to basic health and social issues. The coalition’s first

project will be to publish an annual report, AIDS in the World,which will bring together concise and up-to-date information onAIDS/HIV matters and epidemiological reviews. The first volumewill appear early in 1992.

The coalition’s address is: 8 Story Street, Cambridge, Massachusetts02138, USA (tel 617 495-0478, fax 617 495-2863).

Blood donor screening for hepatitis C

Routine testing in the UK of blood donations for antibody tohepatitis C virus started on Sept 1. For the Scottish National BloodTransfusion Service the tests will cost jl.2 million a year, andadditional funding has been allocated to cover this sum. InNorthern Ireland the costs will also be covered by central funds. InEngland and Wales, regional blood transfusion services will recovercosts through provider/purchaser arrangements. Second-

generation ELISAs are being used for screening.

In England Now

In the pharmacology department we all called her Mrs Mac. Shewas a solitary and rather taciturn old woman, and her normal habitatwas the animal house-a maze of dimly lit cellars. For upwards oftwenty years her life had been dominated by exclusive concern forthe regius professor and his researchers. The staff referred to him as"the chief ’, but Mrs Mac always called him "our chief ’.But there were red-letter days in her calendar. In June, when the

vivas were held in the pharmacy lab, Mrs Mac graced theproceedings in her Sunday best and brought her silver teapot andher precious china to do justice to the examiners’ tea. It was on oneof these occasions that Mrs Mac discovered she had forgotten tobring sugar. Although she had an imperfect sympathy for thelab-man, in the emergency she sought his help. He directed her

attention to an elegant glass jar, one of many standing in rows on theshelves of the pharmacy laboratory. It bore the inscription inabbreviated gothic, sacch.alb. The lab-man assured Mrs Mac thatthis was simply the latin for white sugar. Joyfully she seized the jarand emptied its contents into her sugar basin. What the lab-manmight have added was that among medical students practicalpharmacy did not rank as an exact science and excited only marginalinterest. Students who had taken from this jar an excess of sacch.alboften returned the surplus to any nearby bottle of white powder, andvice versa. Thus the sugar had become heavily contaminated withmany other white powders, including such delicacies as arseniousoxide and perchloride of mercury. The outcome of Mrs Mac’s hastyimprovisation was soon apparent: both examiners were seized withacute abdominal pain, nausea, and general distress. Mrs Mac washastily summoned. When she produced the jar labelled sacch.alb.,the diagnosis of poisoning was confirmed. The chief told me that hehad provoked vomiting digitally and his condition then graduallyimproved. "And the external examiner?", I inquired anxiously."My brother regius?", he replied, smiling indulgently. "Oh, hebolted to the hospital and had his stomach washed out-a timid littleman!"

* * *

"Come and have a look at this", said the senior partner, standingat the window. I looked over his shoulder and saw the object of hisconcern. The junior partner was standing at the edge of a largepuddle and gazing thoughtfully into space. He then stepped into thepuddle, stood for a moment, and then stepped back on to dry land.He subsequently repeated the process several times. Admittedly, ithad been a busy time in the practice, and we were all feeling a bitragged around the edges; but there is always something particularlyunnerving about being confronted with what appears to beincontrovertible evidence of psychiatric abnormality in a colleague.Eventually, curiosity got the better of me. Pushing open thewindow, I called to him, "What are you doing?" Curiosity gave wayto relief and hilarity as the story came out. "Trying to walk onwater", came the cheery reply. Apparently an elderly lady who hadnot visited the practice for years had come in that morning to makean appointment with a colleague who had shuffled off this mortalcoil some years ago. "I’m terribly sorry", said the receptionistgravely. "You may not have heard, but Dr X died three years ago."A puzzled look came over the patient’s face, followed by a stiffeningof the lips, and a glint of resolution in the eyes. "But I must seehim!", she snapped.

International Diary1991

A conference on Acute Aspects of Pressure Area Care is to takeplace in London on Sept 19-20: The Secretary, Tissue Viability Society,Odstock Hospital, Salisbury, Wiltshire SP2 8BJ, UK (0722-336262 ext2392).

A symposium on Growth Factors and Endometrial Function is totake place in London on Thursday, Oct 3: Symposium Secretary, RoyalPostgraduate Medical School, Institute of Obstetrics and Gynaecology,Queen Charlotte’s and Chelsea Hospital, Goldhawk Road, London W6OXG, UK (081-740 3904).

A meeting entitled Regulatory Peptides in the Lung-BasicMechanisms and Relevance to Disease is to be held in London on Oct7-8: Dr Duncan Rogers, Department of Thoracic Medicine, National Heartand Lung Institute, Royal Brompton Hospital, Dovehouse Street, LondonSW3 6LY, UK (071-352 8121 ext 3051).

A conference on Alcohol and Young People will be held in Edinburghon Tuesday, Oct 8: Dr Martin Plant, Alcohol Research Group, MorningsidePark, Edinburgh EH 10 5HF, UK.

A conference entitled On Course for the Future. Children’s HealthCare-Towards a Family Centred Service is to take place in London onMonday, Oct 28: National Association for the Welfare of Children inHospital, Conference Secretary, Argyle House, 29-31 Euston Road, LondonNWl 2SD, UK (071-833 2041).