Give child pneumonia the attention it deserves

Diana E Wangari, CNS Special Correspondent
When most people are asked about lung health and infectious diseases, the first condition that probably comes to mind is TB. This is expected as, for decades, TB was regarded as a major killer and it showed no discrimination in choosing its victims, infecting children, women and men; rich and poor alike. Neither was it restrictive in its area of destruction—it could attack different organs--from the lungs to the bones. The fight against TB had to be mounted and the campaigns had to be aggressive to match the evolution of a disease that is seemingly outsmarting all efforts to control by appearing in newer avatars of drug resistant TB.

Preparing frontline health workers for community-led change

Nenet L Ortega, CNS Special Correspondent
Photo credit: Nenet L Ortega/CNS
If care for people affected by TB is going to be truly patient-centred, TB services will have to be demand driven and communities will need to be actively involved in the planning and implementation of care. A genuine patient centred TB service rests upon the readiness of its providers, the facility, the TB patients themselves and the whole community. Ideally, services in a TB facility should be rendered by trained health practitioners like the doctors, nurses and other allied health workers.

Tuberculosis does not recognize borders

Shobha Shukla, Citizen News Service - CNS
It is time indeed high time to recognize that globally we have today a 1 billion mobile population, (232 million international and 740 million internal migrants) comprising workers, refugees, asylum seekers, and those forced by climate change to move to other regions. The migration process is fraught with risk factors for TB exposure, infection, transmission and poor outcomes due to social determinants of poverty, substance abuse, and migrant unfriendly health services in receiving countries, making migrants a key affected population for TB.

Alarm rings to contain drug-resistant TB

Shobha Shukla, Citizen News Service - CNS
Retrograde policies and practices and critical gaps in care for multidrug-resistant tuberculosis (MDR-TB) are fuelling a worldwide public health crisis, according to a new report, ‘Out of Step’, released today by Médecins Sans Frontières (MSF) at the 45th Union World Conference on Lung Health at Barcelona.

Embarrassment of riches in HIV prevention response?

Dr Mitchell Warren, AVAC
"There are risks and costs to action. But they are far less than the long-range risks of comfortable inaction" - insightful words of former US President JF Kennedy come in mind while listening to respected HIV prevention research advocate, Dr Mitchell Warren, who is the Executive Director of AVAC - Global Advocacy for HIV Prevention. Considerable improvements have happened in HIV responses but a lot remains undone. With research taking place in HIV science, lot of credible evidence is stacking up on not just basic sciences, but also socio-behavioural and operational aspects of rolling out what we know works. Despite loads of evidence, some policies and practices are not evidence-based and impede HIV responses on the ground.

TB-Diabetes: the looming co-epidemic

Carolyn Kavita Tauro, CNS Special Correspondent
Dr A Harries (L), Dr A Kapur (R)
On the opening day of the 45th Union World Conference on Lung Health, “The Looming Co-epidemic of TB Diabetes: A Call to Action” was launched to highlight a serious public health threat. This report promotes an international policy framework for action and lays out a research agenda to fill knowledge gaps on the topic of the co-epidemic of TB-diabetes. The purpose of the report is to highlight to various stakeholders like country policymakers, government officials, health care managers, clinicians, patients and patient groups and activists about the serious public health risk that is present between tuberculosis (TB) and diabetes.

TB-Diabetes: "An issue relevant all over"

Babs Verblackt, CNS Special Correspondent
The international action against the looming co-epidemic of diabetes and TB should speed up, avoiding a slow response like the one that had happened to the other co-epidemic of TB and HIV years ago. Dr. Anil Kapur, member of the Board of Directors  of the World Diabetes Foundation, explains why - and elaborates on the double burden of diabetes and TB in an exclusive interview with Citizen News Service (CNS).

Meaningful community participation to end TB

Nenet L Ortega, CNS Special Correspondent
Photo credit: Nenet Ortega/CNS
The theme for this year’s  45th Union World Conference on Lung Health, taking place in Barcelona, Spain, is focused on community driven solutions to address health challenges of the next generation. According to Jose Luis Castro, the Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union), the conference  calls on everyone to  explore  the need of generating  health solutions that would address  health challenges  involving the different  stakeholders, policy makers and, most especially, the  people in the communities being served.

Regular HIV prevention counselling reduces risk of infection

Dr Wipas Wimonsate at HIVR4P
"Foundation of HIV prevention is infact HIV testing" said Dr Anthony Fauci of National Institutes of Health at the opening plenary (via video link) of the HIV Research for Prevention (HIVR4P). But mobilizing people to go for voluntary and repeated counselling and testing for HIV has indeed been a challenge. It is even a steeper challenge to mobilize key populations such as men who have sex with men (MSM) to go for HIV testing repeatedly.

Call to action to halt the looming TB-diabetes co-epidemic

Babs Verblackt, CNS Special Correspondent
Dr Anthony Harries, The Union (L),
Dr Anil Kapur, WDF (R)
It is time to act and no time to waste. That is the urgent message of the report "The Looming Co-epidemic of TB-Diabetes: A Call to Action" launched jointly by the International Union Against Tuberculosis and Lung Disease (The Union) and the World Diabetes Foundation (WDF) at the opening day of the 45th Union World Conference on Lung Health in Barcelona. The report warns against the brewing storm of diabetes and tuberculosis (TB) that is no longer confined to the teacup.

Tackling the Challenges of TB-Diabetes co-infection

Eranga Isaac, CNS Correspondent, Nigeria
TB is an infectious disease caused by the Mycobacterium TB. While it typically affects the lungs, it can affect virtually any part of the body. TB spreads from person to person through the air when someone sick with the disease coughs, sneezes or spits. Another person needs only to inhale a few of these germs in order to become infected. Key symptoms include cough, fever, night sweats, and weight loss, which can sometimes occur over many months.

Bold and audacious steps needed for TB control

Diana E Wangari, CNS Special Correspondent
Photo credit: Diana Wangari/CNS
When the Indian Minister of Health and Family Welfare Dr. Harsh Vardhan made a speech at the WHO Global Tuberculosis Symposium held just prior to  the 45th Union World Conference on Lung Health in Barcelona, he was greeted with a roaring applause. I could not help but wonder whether it was in recognition for the inspirational speech just delivered or it was an appreciative gesture for a step long overdue.

WHO launches new guidelines on management of latent TB infection

Shobha Shukla, Citizen News Service - CNS
For the first time, the World Health Organization (WHO) has issued guidelines on testing, treating and managing latent TB infection (LTBI) in individuals with high risk of developing the disease. These guidelines were launched today at the Global TB Symposium just before the start of the 45th Union World Conference on Lung Health in Barcelona.

No single HIV prevention method can end AIDS: Combination prevention is key

As HIV prevention needs and contexts vary, it is important to expand the range of effective prevention options that people can use. Archbishop Desmond Tutu said in a video link at the first-ever international conference on all HIV-related biomedical prevention research, that “No single method of prevention can end this epidemic on its own." That is why conferences on microbicides and vaccines merged to provide one single global platform to deliberate on a spectrum of biomedical prevention research for HIV. HIV Research for Prevention (HIVR4P) is being held in Cape Town, South Africa.

Health Experts Call For International Action Against Diabetes And TB

Owen Nyaka, CNS Correspondent, Malawi
 The International Union Against Tuberculosis and Lung Disease (The Union) and the World Diabetes Foundation recently released a report at the 45th Union World Conference on Lung Health in Barcelona calling for international action against the looming co-epidemic of diabetes and TB.

Nepal gearing to protect public health from tobacco industry interference

There is a direct and irreconcilable conflict of interest between tobacco industry and public health policy. This conflict of interest is also enshrined in the preamble of the Article 5.3 of the global tobacco treaty (formally called WHO Framework Convention on Tobacco Control). The WHO Director-General Dr Margaret Chan had said at a recent meeting in Moscow: "Giving any tobacco company a place at the negotiation table [of global tobacco treaty] is akin to appointing a committee of foxes to take care of your chickens."

No longer business as usual: Out of the box solutions needed to end TB

Shobha Shukla, Citizen News Service - CNS 
In May 2014, the World Health Assembly approved the WHO's new post-2015 global TB strategy and targets for tuberculosis, which aims to achieve the targets for 2035-- 95% decline in TB deaths and 90% decline in TB incidence rate compared with 2015--less than 10 TB cases per 100, 000 population, and the elimination of catastrophic costs for TB-affected households. It is a 20 years approach but also includes the expectation to have by 2025 new revolutionary tools like shorter and better regimens for TB and MDR-TB.

VIP visits proving catastrophic for this slum

Dr Sandeep Pandey, Magsaysay Awardee and CNS Columnist
[Video of burning slum] Some 160 families live in a slum opposite the ‘Bhavishya Nidhi Bhawan’ office in Vibhuti Khand, Gomti Nagar, Lucknow. The consist of mostly a scheduled caste community which makes stone items and a muslim community which makes traditional Indian percussion instrument ‘dholak’. In 2009 the Governor was supposed to come and inaugurate the Human Rights Commission office located nearby. So that the poor did not come in the way of Governor, the slum was bulldozed by Lucknow Development Authority. When the Governor’s office came to know about this they felt it would be too embarrassing for the Governor to go and inaugurate the Human Rights Commission after such a human rights violation act had taken place. The Governor never came.

Cerebral Abscess can damage Brain Functions

Chhatra Karki, CNS Correspondent, Nepal
Are you suffering from an ear-abscess? Be careful if you have not undergone treatment for a long time. Delay in treatment can cause the pus from the abscess to spread all over the head and result in a cerebral abscess. Heart problems can further compound the risks.

The torment of common citizens

Dr Sandeep Pandey, Magsaysay Awardee and CNS Columnist
Shanti devi is a stone cutter belonging to scheduled caste community. She lives in a village called Meerpur Sudihamau of Barabanki district. She was visiting her brother Gabbar in Lucknow in June 2014 with her entire family. Gabbar lives in a slum opposite Bhavishya Nidhi Bhawan and Seema Shashastra Bal campus in Vibhuti Khand, Gomti Nagar, Lucknow. On the night of 3rd-4th June, 2014 at 1 am her husband Vinod went out to urinate by the side of road. A speeding car came and hit him. It dragged his for a while and then fled the scene of accident. Vinod was taken to KGMU Trauma centre but could not be saved.

Transforming Women’s Lives Through Radio and TV

Swapna Majumdar, CNS Special Correspondent
Photo Credit: Swapna Majumdar
In 2008, in De Mugogo, an impoverished village in the Democratic Republic of Congo (DRC), voices of women were heard for the first time on a community radio-- Radio Bubusa FM was the first community radio set up by women in DRC’s South Kivu province. The radio station, exclusively for rural women, shared information on health, violence against women, HIV/AIDS, and food security with a community that had never before listened to a radio.

Towards tobacco control…Better Late Than Never

Photo Credit: Carolyn Kavita
Carolyn Kavita Tauro, CNS Correspondent, India
For those who have been fighting for tobacco control, Wednesday the 15th of October was a step ahead when the Health Minister of India announced that, come 1st April 2015, graphic and text warnings (which reflect the adverse effects of smoking and are meant to act as a deterrent to the buyers) will cover up to 85% of space on both sides of cigarette packs and other tobacco products. 60% space will be devoted to pictorial warnings while 25% will be covered by textual warnings. 

Diabetes And TB: Double Trouble

Chhatra Karki, CNS Correspondent, Nepal
TB has established its strong foothold as an epidemic, especially in the low and middle income countries, and diabetes is adding fuel to the fire. World Health Organization (WHO)  identifies about 8.6 million cases of TB annually. At the same time, around 382 million people in the world live with diabetes. This cannot be good!

WHO cautions: "Do not let fox guard chickens"

[Audio podcast] This the first time ever when global tobacco treaty negotiations are taking place in Russian Federation. While sharing an internal tobacco industry document that is now in public domain, Dr Margaret Chan, Director General of the World Health Organization (WHO) said: “One record shows that there was an internal discussion whether the [tobacco] industry should consider children as part of its market. I remember very well one reply which I would like to quote: ‘they have got lips, we want them’. They [tobacco industries] just want market share, they could not care less whether they are killing children or not.”

Strong tobacco taxation policy adopted despite industry interference

Allies of tobacco industry had tried to persuade government delegations before the global tobacco treaty negotiations began in Moscow earlier this week. But governments who have ratified the global tobacco treaty voted for public health and not corporate interests. Dr Margaret Chan, Director General of the World Health Organization (WHO) said at the opening of Sixth Session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control (FCTC): “In a brazen move, the tobacco industry brought its agenda and its voice here to the heart of tobacco control. [On Sunday 12th October,] at the International Tax and Investment Centre, whose board of directors include several tobacco companies, had convened parties and observers to discuss tobacco tax and price policies without fully disclosing their vested interests.”

Tuberculosis and Diabetes -Lessons From The Past

Alice Tembe, CNS Correspondent, Swaziland
As the world mobilizes for the world’s largest global conference on lung health issues in Barcelona –the 45th Union World Conference on Lung Health organized by The International Union against Tuberculosis and Lung Disease (The Union) from October 28 through November 1, 2014, it is essential to learn from our past as new research evidence surfaces. Since the advent of HIV in the 1980s and 1990s, TB was seen as a number one opportunistic infection accounting for the highest number of deaths among people living with HIV (PLHIV) in Swaziland, noted by the then Executive Director of the National Emergency Response Council on HIV-AIDS, Dr Von Vissel.

Programmatic Management of MDR-TB by Private Health Sector in the Philippines

Nenet Ortega, CNS Correspondent, Philippines
Several Asian countries, including Philippines, come in the bracket of 22 high TB burden countries in the world. The Department of Health of Philippines, implements the National Tuberculosis Control Programme (NTP) through its health offices and units of 81 provinces and 1,634 municipal and city governments.  Direct services are provided mainly at the primary health centres that utilize the Directly Observed Treatment Short Course (DOTS) strategy to treat TB.

Will diabetes add the last straw on the burdened back of TB?

Shobha Shukla, Citizen News Service - CNS
According to a new Series about TB and diabetes, published in The Lancet Diabetes and Endocrinology, the rapid increase in rates of type-2 diabetes, especially in low- and middle-income countries where TB is endemic, could thwart global efforts to control and eliminate TB. Currently there are 8.6 million cases of TB annually and the worldwide population of people living with diabetes is 382 million.

Do doctors engage patients? Consumers central to evidence-informed healthcare

Shobha Shukla and Bobby Ramakant, CNS
Dr Kay Dickersin,
Director US Cochrane Center
Who decides the questions health scientists research upon to find reliable answers? Do the patients decide or other consumers, or the doctors, or the policy makers, or other stakeholders make a call? How important is the consumer voice in decision-making on the research tables? "There is one famous example, when doctors and patients of rheumatoid arthritis came together. Doctors had assumed pain to be a major research outcome that patients were interested in. When they engaged the patients in their discussions doctors were very surprised because what was most important to the patients is that they felt tired all the time. It had not occurred to doctors that feeling tired is something they should be studying. It is very important that people interact and we learn a lot about what we have not been measuring because of the assumptions" said Dr Kay Dickersin, Director, Center for Clinical Trials, John Hopkins Bloomberg School of Public Health and Director of the US Cochrane Center.

Evidence shows we can prevent obesity in children: E Waters, Anne Anderson Awardee 2014

Shobha Shukla and Bobby Ramakant, CNS
Prof Elizabeth Waters
Anne Anderson Awardee 2014
Researchers have demonstrated that childhood obesity prevention programmes have a positive health impact on body mass index (BMI - a measure of body fat based upon height and weight). So policies and practices should take this evidence into consideration to nip alarming rates of childhood obesity. Professor Elizabeth Waters, Jack Brockhoff Chair of Public Health in University of Melbourne, did this game-changing systematic review on childhood obesity prevention with her colleagues, which is the most downloaded review in The Cochrane Library. Prof Waters was also awarded the prestigious Anne Anderson Award for 2014 at 22nd Cochrane Colloquium in Hyderabad, India.

Humid houses pose health hazards

Babs Verblackt, CNS Correspondent
Indoor air quality concerns more than just the fumes and smoke in the house. Dampness and mould pose health risks too, especially for people living with asthma. Researchers warn that people's living habits and the new energy efficient technology used to revamp old houses might actually give indoor damp and mould more room to rise. The need for adequate heating, ventilation and home maintenance remains crucial for ones lung health.

Modi's economic policy at loggerheads with Gandhi's vision

Dr Rahul Pandey and Dr Sandeep Pandey, CNS Columnist
Mahatma Gandhi’s birth anniversary is an opportune time to assess Prime Minister (PM) Narendra Modi’s major policy thrusts on the economic front. His policy contrasts both with Gandhi’s vision and with what is needed to develop long term capabilities in India’s workforce and economic infrastructure. In a nutshell Modi’s economic policy is an accelerated version of that of former PM Manmohan Singh and his United Progressive Alliance (UPA) government.

Those who 'own little, live on little' carry highest burden of climate change

Photo credit: Alina Saba
Shobha Shukla, CNS Columnist
Climate change seems to be the new food for thought for world leaders to chew upon. Recently 122 heads of state gathered in New York City for the UN Climate Summit, organised by UN Secretary General Ban Ki Moon, aimed to mobilize action to prevent looming climate disasters and garner political will for a new climate change treaty by the end of 2015.

Connect researchers and policy makers for maximising evidence-informed public health gains

Bobby Ramakant and Shobha Shukla, CNS
Dr Taryn Young
When scientists produce evidence that a public health intervention works (or not works), why does it takes years of delay to implement these learnings into programmes on the ground? Dr Taryn Young, Director, Centre for Evidence-Based Health Care at Stellenbosch University, South Africa, said to Citizen News Service (CNS) at the 22nd Cochrane Colloquium in Hyderabad, India: "We see a gap between the evidence being ready and actually being implemented. Because whole evidence-informed policy making and practice takes some time as there are many other factors, costing, feasibility, acceptability, politics, etc."