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An international health organization has reported that it has suspended more than $150 million in grants to Uganda because of serious mismanagement. Officials of the agency, the Global Fund to Fight AIDS, Tuberculosis and Malaria, said Wednesday that they had taken the action to warn Uganda and other countries that they needed to manage the fund's grants properly. The fund had awarded Uganda $201 million in five grants and had already paid out $45.4 million of that. Two grants were made to help fight AIDS and two for malaria. The fifth grant was for tuberculosis control. Some started in 2003, and some this year. Payment will resume 'as soon as Uganda comes up with a proper plan to rectify the issues of mismanagement,' said Jon Liden, a spokesman for the fund. It has given Uganda until Oct. 24 to improve management of the grants

Dr. Chan, 58, who is both affable and media-savvy, first drew public attention when, as director of the Hong Kong department of health, she boldly directed the territory's response to two major disease outbreaks that threatened the world's health and economy. In 1997, she ordered 1.4 million chickens and ducks slaughtered to control the first cases of the A(H5N1) strain of avian influenza. In 2003, she led the investigation of SARS, a new virus that emerged in China. Indeed, Dr. Chan faced such complaints after the first cases of A(H5N1) avian influenza appeared in Hong Kong in 1997. No vaccine was effective against the strain. But the virus was susceptible to a drug, amantadine, and Dr. Chan authorized the equivalent of US$1.3- million to buy a large supply of it in case a large outbreak occurred. Black & White Photo: Peter Parks, AFP, Getty Images / A woman cleans at a Hong Kong poultry market in an effort to combat the spread of a deadly strain of avian flu.; Black & White Photo: Carol T. Powers / the New York Times / Dr. [Margaret Chan] was instrumental in containing the virus when it struck in 2003. Chan is now the World Health Organization's chief of pandemic influenza

Payment will resume ''as soon as Uganda comes up with a proper plan to rectify the issues of mismanagement,'' said Jon Liden, a spokesman for the fund. It has given Uganda until Oct. 24 to improve management of the grants. Uganda's grants from the fund are unusual in that they are managed by the finance minister, not the health minister as in most other recipient countries, Mr. Liden said. Uganda has been cited as a model for reducing the transmission rates of H.I.V., the virus that causes AIDS. Mr. Liden said people ''should not confuse Uganda's record in fighting AIDS with the mismanagement of funds by a small group of individuals.''

The Swiss pharmaceutical company Roche agreed to donate millions of doses of an antiviral drug to help prevent or slow transmission of the avian influenza virus if it begins to spread among humans, the World Health Organization said

L'Equipe reproduced what it said were the results of the laboratory's tests, with sample number, and the forms with the same number and [Lance Armstrong]'s name. L'Equipe, which said it had conducted ''a long, painstaking and rigorous investigation,'' reproduced what it said were EPO tests on frozen urine samples taken from riders during the 1999 Tour. In a drug test, for example, they may compare a suspect sample of stored blood with one that contains no drugs. Six samples that the paper said were taken from Armstrong proved positive for the ''indisputable'' use of EPO, the paper said. It added that six other samples from riders who were not identified had also proved positive. ''It cannot be regarded as a positive test in the strict regulatory sense,'' the newspaper said, doubting that French sanctions could result. Some spectators were focused on accusations against Lance Armstrong during the ninth and final stage of the Tour of Germany yesterday in Bonn. (Photo by Gero Beloer/European Pressphoto Agency)(pg. D1); Lance Armstrong in Paris in 1999. A French newspaper has accused him of cheating during that year's Tour. (Photo by Patrick Kovarick/Agence France-Presse)(pg. D2)

Herpes simplex, the virus that causes neonatal herpes, rarely leads to serious medical problems in adults. But in newborns, it can produce ugly skin blisters and fever that can progress to damage the brain permanently and cause complications in the heart and liver. The serious forms of the disease can also occur in the absence of skin blisters. Most neonatal cases are caused by herpes simplex virus Type 2, which causes the largest proportion of genital herpes cases. But an increasing proportion of genital herpes is due to herpes simplex Type 1 (cold sores) that can be transmitted by oral sex, Dr. [H. Hunter Handsfield] said. Dr. John M. Douglas Jr. who directs the division of sexually transmitted disease prevention at the C.D.C., said he welcomed the article as a way to promote discussion of an important issue concerning a complication of herpes, which is believed to be the most common sexually transmitted disease in this country

The enzyme 11beta-hydroxysteroid dehydrogenase (HSD) type 1 converts inactive cortisone into active cortisol in cells, thereby raising the effective glucocorticoid (GC) tone above serum levels. We report that pharmacologic inhibition of 11beta-HSD1 has a therapeutic effect in mouse models of metabolic syndrome. Administration of a selective, potent 11beta-HSD1 inhibitor lowered body weight, insulin, fasting glucose, triglycerides, and cholesterol in diet-induced obese mice and lowered fasting glucose, insulin, glucagon, triglycerides, and free fatty acids, as well as improved glucose tolerance, in a mouse model of type 2 diabetes. Most importantly, inhibition of 11beta-HSD1 slowed plaque progression in a murine model of atherosclerosis, the key clinical sequela of metabolic syndrome. Mice with a targeted deletion of apolipoprotein E exhibited 84% less accumulation of aortic total cholesterol, as well as lower serum cholesterol and triglycerides, when treated with an 11beta-HSD1 inhibitor. These data provide the first evidence that pharmacologic inhibition of intracellular GC activation can effectively treat atherosclerosis, the key clinical consequence of metabolic syndrome, in addition to its salutary effect on multiple aspects of the metabolic syndrome itself.

Historically, influenza pandemics have struck unpredictably. The last three were in 1968, 1957 and 1918 to 1919. To Dr. [David Chan], pandemic influenza is a global political and medical problem that requires an international solution. What complicates the task is that the same influenza experts who say that a pandemic will surely come also say they do not know when, what strain of virus will cause it or how many people it will sicken and kill. Indeed, Dr. Chan faced such complaints after the first cases of A(H5N1) avian influenza appeared in Hong Kong in 1997. No vaccine was effective against the strain. But the virus was susceptible to a drug, amantadine, and Dr. Chan authorized the equivalent of $1.3 million to buy a large supply of it in case a large outbreak occurred. None of it had to be used. During the SARS outbreak, Dr. Chan was a daily figure on Hong Kong television. The driver, who had also stopped at the light, recognized Dr. Chan and knew from news reports that the W.H.O. wanted her to go to Geneva to work on environmental health. Rolling down his window, he said, ''It's one chance in a lifetime, and think of what you will do for Hong Kong and for China.''