The Indian Express (Delhi Edition)
Stepping up to the plate
A Pakistani province starts taking food safety seriously
could help the situation. It has developed a small silicone ring designed to be inserted into the vagina, from where, for the next three months, it releases steady doses of dapivirine and levonorgestrel. The first of those is an anti-hiv drug. The second is a contraceptive.
IPM’S device builds on a previous model that contains only dapivirine.
Two big clinical trials of that device concluded in 2016 and showed it could reduce the risk of catching HIV by about a third. That may not sound particularly impressive. But Zeda Rosenberg, IPM’S founder, says this number almost certainly represents only a floor on the treatment’s effectiveness. “We know from the trial results that not all the women used the ring consistently,” she says. Those that did will, she thinks, have enjoyed substantially better protection.
Combining an anti-hiv drug with a contraceptive may give women a reason to use the product more faithfully.
Dr Rosenberg points out that in societies that expect women to be demure or chaste, those who take steps to protect themselves from HIV can often face stigma, since others may assume they are engaging in risky behaviour. But no such stigma applies to contraception. In any case, the ring is small and unobtrusive enough that women canwearitwithouttheirpartners’knowledge.
The first trial is designed only to demonstrate that the ring is safe, and will be conducted in America.
Later tests will check how well it works, though the fact that the dapivirine-only ring has already passed similar tests should speed that process. IPM hopes to have the first batch of dual-purpose rings ready for shipping by 2020. If there is demand, it might even offer the rings for sale in the rich world, in the hope that the cash so generated could cross-subsidise production for poor countries where the need is greatest. SOMETHING CATCHES the eye on Anarkali Food Street in Lahore, the capital of Punjab province. Bakers are pulling nan bread out of a tandoor oven, just as they did when the 200year-old bazaar was founded. One detail, however, is strikingly contemporary: synthetic paper hairnets, in a vivid shade of green. “We are worried about the food inspector,” explains Muhammad Aslam, as he wraps dough around a stone.
Thefearedscrutineersbelongtothepunjab Foodauthority(pfa),thefirstagencyofitskind inpakistan.foundedin2011,ithasitsworkcut out: some restaurants use rancid cooking oil, keep raw chicken on the floor or try to pass off donkey as beef. Such a scandal is the state of hygiene in Pakistan’s restaurants that television shows about crime often feature exposés of particularly abhorrent eateries, using jerky footage from hand-held cameras.
The PFA’S new chief, Noorul Amin Mengal, says it cannot hope to keep tabs on all Punjab’s food outlets. On April 17th he proposed that restaurant customers conduct their own food inspections, using a smartphone app produced by the PFA. But restaurants will be hostile to such intrusion: most of them do not welcome visitors to their kitchens. Your correspondent asked to enter several in Lahore, in both down-at-heel establishments and ritzy ones, and was barred each time.
Pakistan’sgovernment,however,iskeenon foodinspections.inthepasttwomonthsithas approvedanexpansionofthepfa’soperations from cities to rural areas, and signed off on the creationofequivalentagenciesintheprovince of Sindh and in Islamabad, the capital.
A fomer PFA official, Ayesha Mumtaz, made it wildly popular. In just over a year at the agency, she ordered almost 3,000 restaurants to close until they had made improvements, and arrested close to 400 people for selling dodgy fare. She transformed the food culture of Lahore, says Yasmin Khan, a restaurant-owner. Lookalikes of the so-called “fearless lady” used to send the kebab-hawkers on Anarkali Food Street running for cover.
Mrs Mumtaz has 61,000 fans on Facebook; the central-government minister responsible for food safety has barely 4,000. But she made enemies in the food business and among politicians connected with it. She was removed from her post in October, after allegations of corruption involving her driver surfaced. Since then, Lahoris say, there has been a lull in inspections.
The fear Mrs Mumtaz inspired still keeps some food-sellers on their toes. “If Ayesha Mumtaz wasn’t so strict, I wouldn’t be wearing this glove,” says a cupcake-salesman who had not realised that she had been replaced. But as temperatures rise and inspections wane, others are already abandoning their bothersome hygienic garb.