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infection in AIDS patients. MAC is believed to be a major cause ofthe wasting syndrome that affects many AIDS patients. Criteria foreligibility for rifabutin under the Treatment IND (investigationalnew drug) protocol are a diagnosis of AIDS as defined by the USCenters for Disease Control, no history of MAC infection, and aCD4 cell count of200/u.l or less. Rifabutin is the 26th drug to receiveTreatment IND status since this programme was introduced in1987. It was granted this status on the basis of two large controlledclinical studies indicating that it may be effective in preventing ordelaying MAC infection in patients with impaired immunesystems. There is no evidence from these clinical studies that the

drug reduces or delays mortality. The most serious adverse effect ofrifabutin seems to be marrow depression. Other common side-effects include influenza-like symptoms, gastrointestinal disorders,and rash.

Food for thoughtFor those readers who have carnivorous inclinations, the latest

World Health Organisation (WHO) technical report on veterinarydrug residues in food! makes dyspeptic reading. Toxicological andsafety data about ten drugs used in animal medications or as aids toanimal production are reviewed. They include carazolol (a&bgr;-blocker given to prevent stress-induced sudden death in pigs),anthe1mintics, antimicrobials, and tranquillisers. Drugs givenimmediately before slaughter may lead to adverse effects amongconsumers-eg, carazolol in asthmatics. The report recommendsboth acceptable daily intakes and maximum residue levels for six ofthe ten drugs under review; insufficient data are available for adviceabout tranquillisers and tylosin, a macrolide antibiotic. The need forfurther toxicological studies (eg, on teratogenicity) is also outlined.Attention to improvements in pre-slaughter animal handlingshould diminish the need for drug treatment.

Illicit drug administration to animals was not covered in thereport, although this can produce important clinical sequelae .1,3WHO plans to convene the committee annually and it is to be hopedthat non-veterinary drugs given to increase muscle growth andweight gain will be included in their future deliberations.

I Jomt Food and Agriculture Organisation/World Health Organisation expertcommittee on food additives Evaluation of certain veterinary drug residues in food.Geneva: WHO, 1992.

2. Martmez-Navarro JF Food poisoning related to consumption of illicit p-agonist inliver Lancet 1990; 336: 1311.

3 Martinez-Frias ML, Cerreyo A, Rodriguez-PmIlla E, Urioste M. Methimazole inanimal feed and congenital aplasia cutis Lancet 1992; 339: 742-43.

More about tobacco control

The worldwide fight against tobacco gained impetus last monthwith the Australian Government’s announcement of a ban ontobacco advertising and all forms of promotion, includingsponsorship of sports. This ban follows that of New Zealand andCanada and is in stark contrast to the British Government’s refusalto consider such an action for 5-6 years. The Australian authorities’decision is welcome, but it carries several caveats-sponsorship forcricket is excluded from the ban until the end of 1995/96 season, andthere are exemptions for internationally televised events held inAustralia that would be in jeopardy if immediately covered by theban. The ban is otherwise all-encompassing; advertisements onbillboards, in cinemas, and on non-tobacco merchandise will beprohibited from July 1, 1993.The Australian initiative coincides with the launch of a new

journal: Tobacco Control. This venture from the BM] PublishingGroup is unusual in that it has an American editor and an Australiandeputy editor. The journal will report on tobacco use worldwide, itseffects on health, prevention and control, and the activities of thetobacco industry. The editor invites research papers on evaluationof prevention and cessation strategies, tobacco control policies andlegislation, epidemiology of tobacco use, and health effects.

Limitless boundaries

The first case of HIV-2 infection in a resident of Australia was

recently reported in a West African man living in Sydney who

probably contracted the virus in his country of origin. RoutineHIV-2 screening in New South Wales metropolitan bloodtransfusion centres will begin shortly. Concern about the spread ofHIV infection from the African continent is underlined by figuresfrom the World Health Organisation. Of over 1 million new cases ofHIV infection since April, 1991, one-half of these were in

sub-Saharan Africa. 90% of newly infected adults (who themselvesmake up 90% of new cases) have acquired their infection

heterosexually. Heterosexual transmission also accounts for a

substantial component of UK HIV disease. In the year from

March, 1991, to Feb, 1992, 181 (137% of the total) reported casesof AIDS were acquired heterosexually. This figure is a 36%increase on that reported from March, 1990, to Feb, 1991 (135 or10-1% of the total).

I. National centre in HIV epidemiology and clinical research. Australian HIVSurvecllarece Report 1992; 8 (suppl 1): January.

Media and mental health

The Matthew Trust, a mental health reform group with aparticular interest in mentally disordered patients or offenders, hasdrawn attention to the ways in which the media tend to portraypeople with mental illness and to deficiencies in the self-regulatorycode of practice of newspaper editors in the UK after the Calcuttreport that was commissioned as a result of public disquiet aboutoccasional excesses by some parts of the press.! The Trust pointsnot only to the frequent derogatory or prejudicial comments aboutpeople with mental illness in newspapers and on television but alsoto the inadequacy of provisions against intrusions of privacy. TheTrust claims that, even for patients or ex-patients in secure hospitalsor prisons, confidential information is often imparted to journalists(whether self-declared or working incognito), in defiance of normalstandards of professional confidentiality or common decency and,in some cases, in clear breach of the Official Secrets Act. The Trust

argues that the code of practice needs strengthening, and thatbroadcasting services should establish similar or strongerguidelines.

1. Matthew Trust. The media and the mentally disordered. 1992. Pp 29. /;26.50(including postage and packmg). ISBN 1-874362-00-9. (Available from MatthewTrust, PO Box 604, London SW6 3AG, UK).

MEDACT

Medical Action for Global Security was launched in the UK lastweek with a pledge to campaign against not only war but also allnon-military threats to our environment, such as poverty, hunger,over-population, environmental degradation, inter-ethnic conflict,and disease. The main function of MEDACT will be to serve as afocus for public education and debate about these issues. The neworganisation--created from the merger of the Medical Associationfor Prevention of War and the Medical Campaign Against NuclearWeapons-also plans to work closely with International Physiciansfor the Prevention of Nuclear War. Even in a post-cold-war world,many other, perhaps less obvious, areas of potential conflict stillexist. For instance, disagreement about rights to shared watersystems might be a cause of further international tension, especiallyin the Middle East and Africa; 155 of the world’s 214 first-orderriver systems are shared by two or more countries. Further detailscan be obtained from MEDACT, 601 Holloway Road, LondonN19 4DJ, UK.

International Diary

International symposium entitled Omega-3 Fatty Acids—Metabolism and Biological Effects is to be held in Oslo on Sept 15-19:Congress Secretariat, c/o Congress Conference, PO Box 7609 Skillebekk,N-0205 Oslo 2, Norway (47 2 56 19 30).

20th international congress of the World Federation of Hemophilia isto take place in Athens on Oct 12-17: Eva Veloudakis and Associates,Congress Organizers, 7 Platia Solomou, Psychico 154 52, Athens, Greece (tel01-64 74 781, fax 01-67 17 575).