Vitamin A supplements reduces child mortality by over 20 per cent

Vitamin A supplements reduces child mortality by over 20 per cent

The vitamin A supplementation of infants and children can potentially reduce child mortality by over 20 per cent, said Howard B. Schiffer, founder and President of Vitamin Angels in an interactive
community health literacy programme organized hardly 25 kilometers away from the state council house of Uttar Pradesh in India. I wonder if the policy makers in the state parliament were aware that a cost-effective intervention like vitamin A supplementation can reduce child mortality by over 20 per cent!

The state of Uttar Pradesh qualifies for this vitamin A supplementation programme because of chronic malnutrition, high vitamin A deficiency prevalence, and high rates of infant and child mortality, informed Howard.

Vitamin A deficiency does its worst damage during childhood and is a major contributor to child mortality and illness. The most commonly known effect of vitamin A deficiency is blindness. Less well known is that vitamin A is also essential for functioning of the immune system. “Even before blindness occurs, vitamin A-deficient children are at risk of dying from infectious diseases such as measles, diarrhea and malaria” said Arulmony Thangaswamy, the President of Believers Church.

However when the Vitamin Angels began this initiative to save lives more than a decade ago, particularly of young children, they weren’t aware of the impact of this intervention – they knew the significance of providing vitamin A supplementation but the global mandate came only last year at the Copenhagen Consensus.

At the Copenhagen Consensus 2008, more than 50 economists have worked to find the best solutions to ten of the world’s biggest challenges. During the last week of May 2008, an expert panel of 8 top economists, including five Nobel Laureates, sat down to assess the research. Combating malnutrition among the 140 million children who are undernourished was ranked number one. Providing micronutrients for 80% of the 140 million children who lack essential vitamins would cost just USD 60 million per year, according to the analysis. More importantly, this action promises yearly benefits - in the form of better health, fewer deaths, increased future earnings, etc - of more than USD 1 billion. Each dollar has a return of USD 17 - making this an incredible investment for donor nations and organizations.

Vitamin Angels is committed to eradicating childhood blindness due to Vitamin A Deficiency (VAD) on the planet by the year 2020, which is referred to as Operation 20/20. Vitamin A is critical for vision, bone growth and normal bodily development, and plays an active role in supporting a child's immune system. Today, half of the children who go blind from Vitamin A deficiency die each year from opportunistic infections and otherwise non-life-threatening illnesses.

“In addition to the vitamin A, all the children will receive de-worming medicine to improve the absorption of the vitamin A and help combat intestinal parasites” informed Howard Schiffer. Delivering vitamin A capsules and de-worming tablets together makes sense for health reasons:
* Parasites will consume the vitamin A before the child can absorb it.
* Worm infections and vitamin A deficiency both have serious health repercussions for a growing child and cause infection and disease.

The evidence demonstrating how worm infections damage a child’s health is unambiguous: worm infections are associated with a significant loss of micronutrients. It can cause significant vitamin A mal-absorption, which can aggravate malnutrition and anemia rates and contribute to retarded growth. A child’s physical fitness and appetite are negatively affected and his/ her cognitive performance at school is compromised. The constant and life long immune activation due to worm infections reduces the body’s capacity to resist other infections. Therefore to complement the impact of these simple health interventions, vitamin Angels are providing vitamin A supplementation along with the de-worming tablets.

Jojo Mathews, from Believers Church in Lucknow where the health camp was organized, had contributed immensely in mobilizing people from the neighbouring communities to benefit from this health initiative. Many children were administered vitamin A and de-worming pills. Hundreds of people from neighbouring area were benefiting from this initiative. Hardly half-a kilometer away from this church which was catering to the health needs of the community, stands the majestic premises of a state-of-the-art super-speciality medical institute. This indeed poses a question whether our health programmes are meeting people’s need, and investing resources optimally?

Bobby Ramakant

Published in
Media for Freedom, Kathmandu, Nepal
Citizen News Service (CNS)
The Seoul Times, Seoul, South Korea
Bihar and Jharkhand News Service (BJNS)

Evidence is key in improving health responses during financial crisis

Evidence is key in improving health responses during financial crisis

The study of causes, distribution, spread and control of diseases in populations, epidemiology, is a fundamental science and an integral part of public health. Epidemiology has helped address old public health challenges and continues to be a tool to investigate new challenges by providing evidence required for sound public health action.

Efforts to strengthen epidemiology should remain a priority of Member States even when plagued by the challenge of climate change, an energy crisis or a global financial crisis.

"To address each of these challenges, what we need is the information or the evidence or data not only for developing of our strategies and policies, but also for advocacy," said Dr Samlee Plianbangchang, Regional Director of the World Health Organization (WHO) South-East Asia at the inauguration of a "Regional Meeting on Application of Epidemiological Principles for Public Health Action" in New Delhi.

The two-day meeting is aimed at formulating an agreed framework for action, both within WHO and in Member States. This would help to strengthen epidemiological capacities in the Region and to apply this know-how and skills to overcome current public health challenges such as those arising from the current financial downturn, climate change and from emergence of new pathogens.

"The main idea behind this meeting is to ascertain how we can together strengthen and focus our attention on the application of epidemiological concepts and principles in national health programme development and management of health problems," said Dr Jai P. Narain, Director, Communicable Diseases, WHO SEARO.

More than 50 eminent epidemiologists are attending this two-day regional meeting.

Published in
Bihar and Jharkhand News Service (BJNS)
Citizen News Service (CNS)
The Seoul Times, Seoul, South Korea

Mr RB Sreekumar - a tireless crusader for social justice

Mr RB Sreekumar - a tireless crusader for social justice

The Indian Administative Service (IAS) and the Indian Police Service (IPS) are considered among the crème-de-la-crème of the Indian bureaucratic arrangement. Despite all kinds of socio-political changes, people belonging to these services still have public respect and public faith towards them, though for many reasons, a kind of visible erosion is being perceived and there is a perception that the so-called Steel frame is no more of the same sterling quality it used to be.

Yet there are persons whose acts and whose deeds make one think twice before arriving at such a conclusion. The Gujarat incidents of 2002 threw up many such heroes whose tales of courage, conviction and dedication towards service have made it into the folklores. One such person is Mr RB Sreekumar, the then Additional Director General of Police, heading the Intelligence Department in Gujarat during those troubled times.

This is what Teesta Setalvad, a noted social activist, said about Mr Sreekumar during her acceptance speech of the Nani A Palkhivala Civil Liberties Award, 2006-

“But only one man has remained a stoic and principled dissenter until today, refusing to cave in even as weeks lapsed into months and months into years. This man that I dedicate today’s honour to. His only quality-- that many but his co-travellers have seen as a fault-- is that he refused to sit by and let the mass crimes planned at the highest level go unchallenged. He suffered for these acts by being denied due promotion to the post of Director General of Police, Gujarat, the highest post in his field that as a policeman and thrice Presidential Award winner for bravery, he would and should aspire to. Mr RB Sreekumar, Additional Director General of Police, the state of Gujarat, I salute you.”

While it is true that the person whose speech has been produced here has earned lots of controversies in her enthralling and eventful journey, having earned an equal number of admirers and detractors but when she praises Mr Sreekumar in no uncertain words doesn’t it fill the hearts of all the fellow IPS officers with pride? If this is not true valour and heroism, what else is?

Mr Sreekumar later compiled his experiences in a book named "The Diary of a Helpless Man" where he termed the State government as "cruelly communal" and its officers "sophisticated sycophants" but everyone knows that there is not much bravery and valour in writing books after retirement because the fear of persecution is much diluted. But what makes Mr Sreekumar stand out in the crowd is the fact that he refused to toe the line expected of him even during the service where he had to undergo through a Departmental enquiry and finally got his promotion only through the intervention of the Court. This 1971-cadre officer and a person holding Post-graduate degrees in three subjects got superceded in the aftermath of his depositions before the Nanavati panel.

An Article in 'The Hindu' dated Sunday, 4 March 2007 titled- "Sreekumar retires from service, but not his battles" portrays the turmoil he had to go through- "He, however, scored a victory of sorts with the Central Administrative Tribunal (CAT) ruling in his favour against the Government's "refusal" to grant him promotion. But the CAT order came only a few hours before 1971-batch IPS officer ended his innings in the State police cadre on February 28. Also, the order could not be implemented as a related case is still pending in the Supreme Court. His pension will not be cleared until the court order is received.” As per the report in Hindu, he was denied promotion on the ground that a charge sheet against him, related to the period he was Superintendent of Police (SP) in Kutch way back in 1987, was pending in court. The high court later found the order illegal and reinstated him as Director General of Police (DGP) on May 3, 2008, with retrospective effect from February 23, 2005. He now lives in Gandhinagar and is working actively for justice to the victims of Gujarat genocide.

Our due regards to this brave officer of the Indian Police Service.

Amitabh Thakur

(The author is a senior police officer serving as Superintendent of Police (Intelligence), and can be contacted on mobile phone: 94155-34526)

Right-to-Information (RTI) movement brewing in UP

Right-to-Information (RTI) movement brewing in UP

-RTI Service centres will be set up in UP.

-200 computer cells will be constituted aswell in various districts to provide assistance to people wanting to get information online.

-Govt staff will be trained to update and feed the websites providing information of various departments.

The Right to Information Act (RTI) may be in place but is it actually translating into answers for those seeking them under it? Most who have used the act respond with a resounding NO. But then all hope is not lost as a movement in UP is now brewing amongst the people in the state capital which plans to ask for information under the RTI Act and get it too.

People like Urvashi Sharma who is a house wife and a mother of two but she displays an amazing awareness of her rights as a citizen of India. Better still she prefers to call herself a social worker and RTI activist.

"I have seen my husband being harassed for no fault of his and being accussed of harbouring and instructing his dalit students to speard communalism. A a mountain of paper work to terminate him from his post of a lecturer has been initiated by the departments he was posted to and if it wasn't for the RTI Act he would have been forced to live with such grave accusations. We demanded transparency provided to citizens under the act and were able to counter all charges. But this would not have been possible had we not joined the people's movement for the right to information," she says as she prepares to attend a dharna being organised by a group of citizens she has joined up to campaingn for issues under the RTI Act.

The movement she talks of is a group of local citizens for whom it all began as a personal battle for their rights and transformed into a community movement called the Action Group For Right To Information (AGRI). Not only does the group spearhead the cause of many who have sought for information under the RTI Act but also is now coercing the state governments to expedite measures to facilitate quick redressals of the cases that come to the State information commission.

But that is easier said than done claim most RTI activists in Lucknow.

Explains Afjal Ansari, the Chief Co-ordinator, AGRI, "Since the concept is based on what we call the participatory democracy in which the common man becomes a major part of the governance as well, asking for information is usually seen as accusations of corruption and not responded to. A right reserved only for the legislatures, politicians and bureaucrats until until now. But the RTI Act now provides a direct reach of a citizen to any part of the entire set up of the government system to ask for answers of actions taken, what can be more empowering than that. Anyone who has been in authority until now and has been conditioned to refuse permission to access files related to departmental issues, will resist all to attempts enhance accountabilty and transparency. So challenges do arise and we have to take them into our stride. As changing an age old system does not happen overnight and corruption is one such system."

Adds Azhar Ahmed Ansari Convenor, AGRI,"What is lacking is the training of the clerks and babus who are to function as per instruction of Public Information Officers (PIOs). Most are not even aware of the basics points mentioned in the act. Thus delays occur when they don't respond to the applicant within the stipulated 30 days. Making matters worse is the fact that these delays are costing the state government a whopping 2-5 lakhs in terms of TA/DA per hearing as no less that 250 cases come every month and deferred time and again. The concerned departments have to depute officers to represent their case on every new date given. Its not worth it as the penalty of Rs 25000 is usually paid by the PIO from his salary if delay is proved in responding. While the babu and the clerks get away completely. This must change and accountabilty must be for all."

But will things change?

"Of course, previously there were people woes related to the railways, passport office and even land alottments were many, but after RTI Act came into being things have really changed. It will take time but sustained efforts will usher in the change we desire atleast that's what we plan to ensure through AGRI," avers Ansari.

A fact which is seconded by most RTI Activists who also rue harassment of the applicant to discourage any queries.

Says Urvashi Sharma,"Seeking Information under the RTI Act is interpreted by the heads of the department against which an RTI has been filed as being directly accused of corruption. So no co-operation is extended to the applicant, and they are harassed with FIRs filed against them as trouble makers. Some even have to face a lot of humiliation at the hands of clerks and babus which discourages the applicants from filing RTIs. This is one major challenge we have to face when it comes to making optimum use of the RTI Act. But we started forming a base of all such cases and will address them under Section 19/1 or Section 19/3 under the RTI Act."

In addition AGRI has managed to address many more issues related to the act at a recent conference organised in Lucknow. Not only was the seminar attended by Chief Secretary, Atul Kumar Gupta, Chief Information Commissioner, Government of India, Wajahat Habbiullah, Retd Justice Kamaleshwar Nath, President of Transparency International but some, decisions were also taken to help iron out problems faced by the common man when making use of the act.

Among those were an initiatives like making all deparmental information available online. As per the Information Commissioner, Central Information Commission, Wajahat Habibullah the emphasis will be more on providing information over 20 years old online. With the World Bank pitching in a impressive Rs 23 crores for the project, the websites with all such public information will be ready by April 2009.

An added plus says Manish Sisodia, RTI Activist in the city, is that "people can phone in through phone booths and get information from any department. The system is based on the lines of phone booths in Bihar. If this works in UP a lot of backlog of files seeking information under the RTI and unnecessary harassment of people can be cut down."

Amen to that!

Anjali Singh

(The author is a senior journalist based in Lucknow, India. Email:

Published in
Central Chronicle, Madhya Pradesh/ Chhatisgarh
Asian Tribune, Thailand/ Sri Lanka
The Seoul Times, Seoul, South Korea
Pakistan Christian Post, Karachi, Pakistan
Citizen News Service (CNS)
Media for Freedom, Kathmandu, Nepal
Bihar and Jharkhand News Service (BJNS)

Finally, anti-HIV microbicides research gives hope

Finally, anti-HIV microbicides research gives hope

The anti-HIV microbicides research has finally given a positive outcome - the microbicides gel PRO2000 under research showed 30% reduction of HIV transmission in the human clinical trials.

Women who were offered PRO2000 microbicide gel plus condoms had 30 per cent fewer HIV infections than those offered condoms only or condoms plus a placebo gel, according to the clinical trial results presented by the trial's Protocol Chair Dr Salim S Abdool Karim, PhD, University of KwaZulu-Natal in Durban, South Africa. Dr Karim presented the results at the 2009 Conference on Retroviruses and Opportunistic Infections (CROI). This multi-site clinical trial is known as HPTN 035, and tests two candidate microbicides (PRO2000 and Buffer Gel). It was conducted by the US National Institute of Health (NIH) funded Microbicides Trial Network (MTN) in South Africa, Malawi, Zambia, Zimbabwe and the US. The PRO2000 microbicide gel did show anti-HIV activityby reducing HIV risk among women by 30 per cent, however the other candidate microbicide tested in the same clinical trial - Buffer Gel microbicide - did not reduce HIV risk among women.

This news is particularly encouraging to health advocates because microbicides research had a series of disappointing news in the past decade with different microbicide-candidate-products under research showing no positive anti-HIV effect in human trials.

According to the World Health Organization (WHO), microbicides are compounds that can be topically applied inside the vagina or rectum to protect against sexually transmitted infections (STIs) including HIV. They can be formulated as gels, creams, films, or suppositories. Microbicides may or may not have spermicidal activity (contraceptive effect). At present, an effective microbicide is not available, and different candidate-microbicides are in various stages of research.

The Global Campaign for Microbicides (GCM), an advocacy organization that has been campaigning to expand women's HIV prevention options for over a decade, said in a press statement that not only these trials found that women who were offered PRO2000 gel plus condoms had 30 per cent fewer HIV infections but also the reported adherence to the gel was high at 81 per cent. In another analysis that accounted for the time that women did not use produce because they were pregnant, the study found PRO2000 to be 36% protective against HIV compared to the control arms.

"The results on PRO2000 are a ray of hope for women" observed Lori Heise, Director of the Global Campaign for Microbicides (GCM). "This is the first time that we have had human data actually showing that a vaginal gel can work to reduce infection. It's not a home run, but this "proof of concept" should invigorate the field"

Another effectiveness trial of PRO2000, conducted by the UK-funded Microbicide Development Programme (MDP), is currently in its final stages in South Africa, Tanzania, Uganda and Zambia. This trial - known as MDP 301 - has enrolled over 9,000 women, three times the number enrolled in HPTN 035.

“This second trial should help us refine our estimate of how effective PRO2000 actually is,” noted Dr. Samu Dube, GCM’s Africa Program Leader in the GCM press statement. “With three times the number of women, the MDP trial will yield an even more precise estimate of effectiveness. We will need such data before deciding whether it makes sense to move this product forward toward licensing and distribution.”

The development of microbicides is seen as a key to empowering women to protect themselves from HIV. Women are biologically more vulnerable to the transmission of STIs and many cultural and economic factors compound this vulnerability.

Millions of women live in societies that permit them no role in sexual decision-making, that condone male infidelity and assign the burden of shame and stigma associated with infectious diseases to women. Existing preventative strategies have largely failed to address this vulnerability, focusing on abstinence, mutual monogamy and male condom use, none of which are easily controlled by women.

Vaginal microbicides are also likely to fail until men understand and respect the need for women to protect themselves against HIV and other STIs. Not only do women need preventative options that they can choose to use freely but the gender inequalities that make it harder for women to insist on safer sex must be addressed alongside.

Bobby Ramakant

Mayawati ji, why did we get bulldozers instead of homes?

Mayawati ji, why did we get bulldozers instead of homes?

Anti-Dalit and Anti-poor action by a pro-dalit Government

On 19 February 2009, at the behest of Bahujan Samaj Party’s Satish Chandra Mishra, the local administration came into swing to brutally demolish the slums in Nadwa (daliganj), Lucknow . 216 poor people were rendered homeless despite of central government of India's and UP state government's promise to provide homes for the poor.

On 21 February 2009, in front of the state's legislative council (Vidhan Sabha), a massive dharna was held by those displaced and many people from the city participated to express their solidarity and concern on the houses of people getting demolished.

The authorities responded that under Gomti Action Plan to develop the banks of river Gomti, a private company has been contracted to do so. It is clear that the beneficiaries of this kind of 'development' will be private companies and the poor people will face bulldozers and displacement.

The activists of Asha Parivar and National Alliance of People's Movements (NAPM) vehemently opposed the ideology of this kind of anti-poor development.

Inspector General (IG) of Police (retired) SR Darapuri, Magsaysay Awardee (2002) Dr Sandeep Pandey, senior Narmada Bachao Andolan activist Arundhati Dhuru, Industrialist Naveen Tiwari, and many other citizens from Lucknow had participated in this dharna in the state capital of Lucknow.

The displaced people are questioning the state and central government policies of providing housing for the poor despite of which their houses were demolished brutally by bulldozers.

They are also questioning the insensitivity of officials to the plight of homeless poor people who without making any alternative arrangements of providing shelter to those displaced, went ahead with bulldozers to demolish the houses and belongings of the Nadwa slum residents.

At least two women, who were pregnant, had to face the ignominy of this demolition. Luckily one woman delivered twins at a hospital on 19 February 2009 despite of becoming homeless earlier on the same day, and the other, delivered a dead child on 21 February 2009.

The residents of Nadwa slums are mostly dalits and have been saving from their daily earnings to qualify for housing under Basic Services for Urban Poor (BSUP). But the local administration demolished the slums even when these alternative housing facilities are not yet ready to use.
A government official said that at least these BSUP houses will not be ready for next 4 months.

The representatives of those displaced also met the Mayor Dr Dinesh Sharma to demand alternative housing for themselves. Sources said that the situation in Lucknow is quite gruesome - there are about 1,500 families displaced due to river-bank 'development' and only 400 of those will get the houses being constructed under BSUP scheme.

The question for the state's Chief Minister Mayawati who is a celebrated saviour of Dalits is that despite of her promises, state government's promises and central government's promises, why were these people made homeless in such a brutal way (bulldozing their houses) when alternative housing facilities were not ready?

Also the reason which the authorities have given of a private company being contracted to 'develop' the river bank of Gomti is ironical - after all, whose 'development' is it? Of the rich and the mighty who got the fat contracts to 'develop' river banks, or the poor people who were displaced due to this kind of 'development'?

A spoonful of sugar can help fight Malaria

A spoonful of sugar can help fight Malaria

One teaspoon of moistened sugar placed underneath the tongue of sick hypoglycaemic children – a simple solution to a serious problem.

Nearly 800,000 children die every year from malaria. In Africa, malaria combined with hypoglycaemia causes many of these children to die before they get to a health care facility, where they could access life saving intravenous treatment. A clinical trial conducted in Mali, with the support of Antenna Technologies, suggests that placing a spoonful of sugar under the child's tongue can be effective, and moreover much simpler than glucose.

Despite recent progress in the prevention and treatment of malaria, this tropical disease still affects more than 250 million people and kills nearly one million each year. With 85 to 90% of deaths occurring among children, it is the most vulnerable who pay the biggest price of the disease. The majority of these victims are under five years old and live in remote areas, mainly in Africa.

Children with hypoglycaemia, that is almost 20% of children with severe malaria, are three to four times more likely to die from the disease. Standard practice is to give an intravenous infusion of glucose, but this is often only accessible too late since it is administered at hard to reach health facilities. A clinical trial was carried out in Mali, in Sikasso Hospital, by the Department of Paediatrics and with the support of the Swiss International Cooperation and the Antenna Technologies team. This trial has identified a new method to correct hypoglycaemia and raise blood glucose. Results from this study have been published in the Malaria Journal.

By placing a teaspoon of sugar moistened with a few drops of water under the tongue of the child, even a child already in a state of coma, blood glucose levels were raised, providing what appears to be a simple first aid treatment. This easy treatment can be given by non professionals at home and during transportation to health centers, buying precious time, and saving many lives.

Proposed a long time ago by, among others, the French paediatrician Hubert Barennes, this simple method has not yet been applied due to a lack of trials. Trials have now been carried out. The bold action has been going against the idea prevalent among medics, to show that sugar does not necessarily have to be swallowed to act on glucose levels: by simple contact with the tissues in the oral cavity, particularly those under the tongue, a rapid elevation of blood sugar is observed, in fact even faster acting than if the sugar was swallowed.

In the race against time faced by children with severe malaria, evidence showing the benefits of administering sugar under the tongue can be life changing for the poorest regions where malaria hits the hardest. Now the challenge is to make this procedure known to tropical medicine specialists worldwide, and that the WHO and other health agencies include this procedure in their guidelines.

Anti-Dalit and Anti-poor action by a pro-dalit Government

Anti-Dalit and Anti-poor action by a pro-dalit Government

Nadwa slums brutally demolished

Today at the behest of Bahujan Samaj Party’s Satish Chandra Mishra, the local administration came into swing to brutally demolish the slums in Nadwa (daliganj), Lucknow . More than 250 poor people were rendered homeless when UP’s Chief Minister Mayawati on her birthday had claimed that every poor will get a home.

When the senior activist and Magsaysay Awardee (2002) Dr Sandeep Pandey was on his way to intervene, police forcibly stopped him from going to the Nadwa slums and detained him at the Hasanganj police station. Representatives of many social organizations and invidivuals came to the Hasanganj Police station and Nadwa area where slums were being demolished. Heavy police was deployed to ward off any intrusion in Gomti Action Plan under which the slums were being cleared off from the coast of Gomti river. Activists of National Alliance of People's Movements (NAPM) and Asha Parivar took the centrestage in the demonstation against this brutal onslaught on the underserved communities in Lucknow.

The residents of Nadwa slums are mostly dalits and have been saving from their daily earnings to qualify for housing under Basic Services for Urban Poor (BSUP). But the local administration demolished the slums even when these alternative housing facilities are not yet ready to use.

In the afternoon Dr Sandeep Pandey was allowed to go out of the Hasanganj Police station. By this time the slums were already completely demolished. When the displaced people of these slums were marching towards the Vidhan Sabha to stage a protest to demand their alternative housing facilities, a woman among those displaced went into labour pains. Due to timely intervention by Additional District Magistrate (ADM) OP Pathak, a government ambulance reached in time to take this woman to a hospital.

Residents of Lucknow , representatives of various social organizations and those displaced due to the demolition are demanding that government should immediately provide temporary housing facilities to the displaced communities, meantime the construction work at BSUP should be expedited so that these people can move into their houses at the earliest.

How will the world begin to see TB care as a smart investment?

How will the world begin to see TB care as a smart investment?

Unless the tuberculosis (TB) advocates reach out to decision makers to impress upon them the urgency of strengthening TB care and control programmes, the global economic meltdown is likely to threaten to reverse the gains made in TB care over past decades.

“I believe we should not lower our sights one bit. Rather, we should broadcast far and wide irrefutable arguments for more and better TB control now. The fight against TB is more than a humanitarian cause – it is also a smart investment, at a time when many investments seem insecure” had said Dr Marcos Espinal, in an editorial on the Stop TB Partners’ Forum blog (online here).

Time is running out. How can the world begin to see TB care as a smart investment?

The cross-cutting linkages of TB control to other development issues - need to be more highlighted, more pronounced and worked upon in terms of advocacy, outreach and engagement. For example, those working on poverty, health systems, HIV, and other connected issues, need to say the same – ‘TB control is a smart investment!’

For instance, at least in high burden TB countries, with TB continuing to the biggest cause of death for people living with HIV (PLHIV), the AIDS advocates should be the lead partners in TB care initiatives – they are demonstrating the leadership in some communities but this certainly needs to be happening more often wherever synergy is most appropriate. TB and HIV programmes need to join forces to improve TB and HIV responses locally.

With the economic recession taking its toll in the developing world as well, the need to forge effective and genuine partnerships with different stakeholders was rarely so compelling! Promoting greater transparency and participatory approaches in our efforts to engage allies in TB care and control, might prove to be definitive on how effectively we can convince the world that TB care is a smart investment.

Bobby Ramakant

Agriculture extension systems should be strengthened in India

Agriculture extension systems should be strengthened in India

The arrangements for agricultural extension in India have grown, over the last five decades, in terms of activities, organizational types and available manpower. However, public investments in agriculture, (investments in irrigation, rural roads, rural electrification, storage, marketing, agricultural research and education, land development, co-operation etc) in real terms have been declining consistently in all the states since the mid seventies.

In this context, Dr. Shiraj A Wajih, Senior Environmentalist and President, Gorakhpur Environment Action Group, GEAG, says,"The agriculture scenario is undergoing rapid changes and having the right information at the right time can make a huge difference to farmers' incomes. Farmers need information from different sources and often need help to integrate them. So the success of a farmer, in the years to come, is going to be primarily dependent upon his level of knowledge.

Advice and assistance to farmers to help them improve their methods of production and marketing is conventionally called agricultural extension. Historically, it has often been seen only in terms of increasing agricultural output. However, extension is a part of overall effort to achieve a balance between the productive and the social, environmental, and economic development of rural areas.

The basic objective of the agricultural extension system is dissemination of useful and practical information relating to agricultural activities focused mostly on improved seeds, fertilizers, farm implements, pesticides, poultry, livestock, etc. ; expert advice to farmers on cropping practices, innovation technology dissemination, crop protection from pests and diseases, market trends and prices of various crops in the markets and also dissemination of information about occupational health facilities, risk covers and provisions of crop and personal insurance."

He further said, "The major constraints of the public extension system in Uttar Pradesh are--(i) the public extension services are not need based but supply driven, (ii) there is no clear policy or practice of involving women in the extension system, (iv)lack of skills and knowledge in village level extension worker, (v) low level of involvement of small and marginal farmers in technology development and dissemination process. Thus most extension services have a curative rather than a problem solving approach.''

Small and marginal farmers and women farmers, who constitute a major part of the farming community and are the main contributors to food production, are both entrepreneurs and clients. They cannot be ignored in the extension mechanisms. Extension services have to provide space for the articulation of needs and knowledge development. Extension services should be problem solving devices, rather than be a supply-driven mechanism. They will succeed only if they address the local problems of the farmers. There needs to be a strong linkage between Extension, Need, and Supply in order to fulfill the genuine demands of the farmers.

The alternate extension system initiated by GEAG stands as a successful working model today. This model ,at household and village level, shows that poor people can actually achieve food sufficiency on their own. They can create control over agricultural inputs and escape the negative effects of the so-called free market. They can link through their groups to obtain substantial amounts of bank credit, where the groups ensure repayment and create an enduring credit-worthiness. This has benefitted all, especially the poor who have little self worth. It has actually resulted in their economic betterment, making them more self reliant.

Amit Dwivedi

(The author is a Special Correspondent to Citizen News Service (CNS). Website:, email:

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A police officer who ably quelled riots - Rahul Sharma

A police officer who ably quelled riots - Rahul Sharma

Another person who withstood his ground and emerged as hero was Mr Rahul Sharma, a 1992 batch IPS officer, who was posted as Superintendent of Police (SP) of Bhavnagar district about whom Mr Shreekumar has written so high about in his book “The Diary of a Helpless Man” saying that he was the only other officer who stood to himself in the affidavit before the Nanavati commission probing the riots.

In Mr Sharma’s district a mob was fired at killing four when it was attacking an orphanage with 350 inmates in it. He dealt with the other riotous elements with the same firmness and neutrality (almost with an iron hand as is desired on such occasions) and thus Bhavnagar became the first district in Gujarat where the rioters got so much discouraged and frightened that they simply chickened out and the riots got controlled with immediate effect.

About Mr Rahul Sharma’s contribution in the Gujarat riots, Vikram Rautela of the Indian Express on Feb 08, 2009 titled- "IPS Rahul Sharma expresses willingness to rejoin state police" , writes- "Sharma had provided the Supreme Court-appointed Special Investigation Team (SIT) with a set of two compact discs containing records of all mobile phone calls made in and around Ahmedabad during the 2002 riots. He had procured the call records from Cellforce and AT&T, which were providing mobile phone service at that time."

It further says- "During his brief tenure as
Superintendent of Police (SP) from February 27 to March 26, 2002, he had successfully controlled rioting in the district. The Modi government, however, shunted him to the low profile post of DCP in the Ahmedabad police's control room on April 8, 2002. Less than a week after he got the CDs in June 2002, Sharma was taken off the riot probe and sent to group 11 SRP at Vav near Surat on July 6. The transfer was being considered by some as a punishment posting for having ruffled several feathers. On August 22, 2003, Sharma joined the CID (crime), and six months later, he joined the Central Bureau of Investigation (CBI) on February 17, 2004."

In another news-article titled "On hold for 7 yrs, probe picks up Gujarat riot phone CDs" dated Feb 06, 2009, Vikram Rautela writes – "A set of CDs containing mobile phone records of all calls made in Ahmedabad during the 2002 Gujarat riots, ignored by at least one probe panel but preserved by an IPS officer, is now helping the Supreme Court-appointed Special Investigation Team (SIT) in the reinvestigation of the ten worst riot cases." Adding- "The SIT has relied heavily on the interpretation of the data in the CDs. “It took us almost six months to analyse this huge data. It was on the basis of these findings that we got a clear picture of who was where on February 28, 2002 and we prepared questionnaires for the accused and suspects accordingly," said an SIT officer who did not wish to be identified.

Rautela further writes- "In October 2004, Sharma, appearing before the Nanavati Commission, caused a stir when he took out copies of the CDs from a bag and placed it before the panel. Shunted to Surat after the riots, Sharma kept a copy of the CDs."

Here I would like to add that I belong to the same batch as Mr Rahul Sharma and feel doubly proud to have been there with this brave person for nearly two years at the National Police Academy, Hyderabad sharing hours together.

What makes Mr Sharma so very special in our eyes is the fact that he is so unassuming and gentle-mannered that one would tend to disbelieve that all the exploits being mentioned are really his own. How could a person who can hardly harm a fly get transformed into one in whose district the riots were quelled and crushed in the most effective manner, going to the extent of being ruthless almost in the copybook style? He is very decent in his words and speech, very cool and helping and very much a friend’s friend. Yet when it comes to his obligations towards his duty and his commitment to his job, he gets the Arjun’s eyes leaving everything else other than the work assigned. This is our Rahul Sharma. He is now going back to the Gujarat cadre from the CBI where we all know that he would continue doing his good work.

Amitabh Thakur

(The author is a senior police officer serving as Superintendent of Police (Intelligence), and can be contacted on mobile phone:

Children of a lesser God? Abandoned and stricken too!

Children of a lesser God? Abandoned and stricken too!
Anjali Singh

In the first ever incident of its kind the state of Uttar Pradesh is struggling with its growing disabled population. As grim as that sounds the fact remains that a single seven year old blind and deaf destitute child has become a huge challenge for not only the government of UP but its citizen's at large as well.

Consider the case of a blind and deaf destitute child Rinku who was abandoned on the railway station at Lucknow, Uttar Pradesh in 2007. The child was picked up a local NGO and brought to the Chattrapatti Sahuji Maharaj Medical University (CSMMU) in Lucknow for treatment for chest congestion. The welfare of the child was not followed up by the NGO thereon.

Following completion of the treatment the child was discharged but there was no one to take his responsibility. After which he was left to fend for himself as no NGO in the city including the one that rescued him came forward to take the child under their care.

For eight months the child continued to live on the footpath of the Paediatric Department at CSMMU while the hospital administration and a social activist working with terminally ill children kept writing and requesting private and state agencies involved in care and protection of the child to take his responsibility and provide him proper shelter and training at the blind school.

But no one came forward and the child continued to be on the footpath. The social welfare commissioner in Lucknow was approached and requested for admitting the child to Sparsh Blind School In Mohan Road in Lucknow. A letter was issued by the Commissioner to the Principal of Blind School Omkar Nath Shukla and the child was given admission in Class One.

On the condition that a guardian be provided to take the child home during holidays. Conditions were fulfilled and guardianship for the child arranged for to help facilitate the admission of the child by Saaksham Foundation, an organization working for protection of child rights.

But when the Blind School was approached after fulfilling the conditions they refused to admit the child asking that the NGO go to court and legally adopt the child first if they wanted to admit the child.

The case was then brought before the Child Welfare Committee in Lucknow on 3 February 2009. The five member committee ruled in favor of the child and instructed the Blind School to give the child admission as all the procedures were fulfilled. The order was then produced to the Blind School.

In complete defiance of the order the principal flatly refused to accept the child stating he did not recognise the authority of the CWC. He again placed the condition before the Saaksham Foundation that they have to go to court and legally adopt the child.

The matter was brought to the notice of the CWC members on 4th Feb 2009. The five member committee in a well meaning move then instructed handing over the child Rinku to Child Line Lucknow from where he was to be sent to an orphanage for normal children at Mohan Road.

This again meant that the child was denied his right to get admission to a school that would benefit him and give him proper care and protection, especially in view of the fact that the state lacks a special home for children with multi disability.

But Rinku is not the only child who raises a question mark when it comes to rehabilitation, care and protection of children suffering from multi-disabilities and abandoned by their families due to it.

As per data available between 2007-2008 with Child Line Lucknow, out of the 27 new born abandoned children, 21 were females and handicapped either mentally or physically. While out of 19 boys abandoned, 10 were handicapped and out the total 50 found abandoned in one year 31 were handicapped and females. The numbers though are on the rise even now.

Informs Dharamendra Singh Chauhan, a para professional at ChildLine Lucknow who has conducted many such rescues, "The problem of rehabilitation and care and protection of handicapped and destitute children is a huge one. Specially when in the absence of a home dedicated just for such children with special needs. No NGO or government home is ready to take the children we rescue if they have a disability and if they suffer from multi-disability the rejection from these homes is a surety. Most institutions plead lack of expertise and specially trained staff to care for these children and turn them away. The worst resistance is faced from NGOs and government run Bal Grihas and orphanages when we have to place mentally challenged children with them."

Quoting a recent example, Chauhan says, "Recently a 11 years old mentally challenged child was brought to child line. He had been abandoned at a residential colony in Lucknow. We produced him before the five member bench of the Child Welfare Committee UP who ordered for the child to be sent to government run home at Rajikiya Bal Griha for boys at Mohan Road. Orders were complied with and we took the child there but the Director refused to admit the child and turned us away. We had no option but to bring the child back to child line and he is still staying at the call helpline centre which doesn’t have adequate facilities to care for him and his condition is indeed pathetic."

As is the state of another two year blind old girl also abandoned on the streets of a market place. She too has no takers either at the state run orphanages or shelters run by NGOs. And this despite the state government sanctioning a monetary help of Rs 850 for ever child that is housed at its state run orphanages.

With the numbers of children with multi-disability being abandoned on the rise in UP the lack of any home or orphanage to house them the situation is indeed worrisome.

Says Sapna Upadhyaya, a social activist with sick and abandoned children at CSMMU, "The options to place girls with multi-disabilities is also non-existent in UP. Though some are sent to the government run Rajkiya Bal Griha for girls at Motinagar, the condition is horrifying as no special care is available for them and neither are they segregated from the normal children. The effect it has on underage girls is emotionally very troubling, thus a separate facility with specialized care is of utmost importance for such children."

This is something that the Child Welfare Committee (CWC) has been asking the government for years now.

Avers Dr Brigeetha VV, Chairman, CWC, "It is very unfortunate that there is no option for such children. Despite 10% of the population of the city having such special children no effort has been made up to now to provide an option for destitute children who are also suffering from multi disabilities like deafness, blindness, mental retardation etc. Every time such a child is brought before the committee it is a huge challenge for us to find a place to send them to. But Following Rinku's case which is the worst ever brought before us we have decided enough is enough. The committee will be meeting with some government officials soon and seeking to set up a home for such children. For years now we have been asking the government to provide us a building to run as a home for such children and even suggested to give the staff trained to care for them a pay scale grade higher than the staff at orphanages for normal children but government has not responded."

Sadhna Mehrotra, also a member of the CWC committee and Secretary Laxmi, Women and Child Welfare Organisation, feels,"NGOs have no right to refuse a destitute child shelter. They have set up organisations to work for such children, yet we have seen in Rinku's case that making the disabilities he is suffering from an excuse every NGO that CSMMU administration contacted refused to accept the child forcing him to live on the footpath in CSMMU for eight months which is inhuman. There are many children like him who are suffering like this so CWC has decided to take concrete steps to urge the state government to set up a home for such children and staff it with teachers and care givers with trained to take of such children with special needs."

But will it work?

Says A Singh, Director, Saaksham Foundation, a local NGO that is campaigning for protection of child rights in Lucknow, "When it comes to fighting for legal rights of such children as per the Juvenile Justice Act 2006 (Care and Protection) the scenario is shameful in UP. Most NGOs, police and related agencies don't even know the proper procedure of getting these acts implemented. The apathetic attitude of the government makes it even more difficult to get these children their right to care and protection despite all the laws being in place."

Augustine Veliath, Communication Specialist, UNICEF, Lucknow, commenting on their stand on the attitude towards special children in the state said, "How long are we supposed to be duty bearers because of the excuse of not having specialized care. If the skills are non-existent to care for special children with multi-disabilities then the state government should now launch a programme to provide to find out where such training is available and how to get it. It is the right of a child to get inclusive protection without any discrimination. Special children have a right to go to normal schools and live as part of the normal community and whenever we come face to face with such children in the society it gives us an opportunity to make them a part of the community. For which specialised skills to do that needs to be acquired."

But who will help do that is the question to be reckoned.

Anjali Singh

(The author is a senior journalist based in Lucknow, India. Email:

Will recession impede TB care and control?

Will recession impede TB care and control?

Despite of Indian government’s assurance that India will not be affected by the global economic recession, about 2.5 million people are estimated to lose their jobs in India by end of 2009 (read more). Not only that more people than ever in the past decade will be jobless, but even the governments are resorting to extreme cost-cutting measures to tide through these times of financial meltdown. Although the Global Fund to fight AIDS, TB and Malaria (GFATM) is falling short of USD 5 billion of its estimated budget for 2009-2010, the Wall Street corporations have disbursed USD 18 billion holiday bonuses in January 2009 (read more). The newspapers say this money came from the bail-out money provided by the government (read ‘tax payers’).

Where do tax payers want to invest their money – in holiday bonuses or to save lives from AIDS, TB and Malaria in the most hard-hit countries globally?

Jeffery Sachs, Director of Columbia University’s Earth Institute and a Special Adviser to the UN Secretary General, had called on the US government to take back the USD 18 billion in bonuses that Wall Street bankers paid themselves while receiving taxpayer bailout money, and use the money instead on HIV drugs and mosquito nets. Calling the bonuses "unbelievably egregious," he said: "Those bonuses are being paid out of our bailout funds... I suggest the U.S. government reclaim that funding and put the money into the Global Fund immediately." (read more)

According to a news published last week (read more), the GFATM provides a quarter of all international financing for AIDS, two-thirds for tuberculosis and three quarters for malaria.

"I would suggest the U.S. reclaim those bonuses, which are absolutely unjustified and completely unconscionable, and put the money in the Global Fund immediately," Jeffery Sachs said.

The USD 5 billion shortfall is less than one-half of one percent of what G8 countries have approved to bail out failing banks in the last three months, Sachs said (read more).

The US is certainly one of the donor countries that haven’t kept the promises to fund the GFATM thereby – directly or indirectly - adversely impacting and reversing the tremendous gains made over years in strengthening responses to AIDS, TB and Malaria, and other communicable and non-communicable diseases too.

The GFATM will need USD 8 billion to support AIDS, TB and Malaria initiatives in 2009 – 2010, however it has only USD 3 billion in its kitty. The donor countries had pledged to support the GFATM by committing about 0.7% of 1% of Gross National Product (GNP).

On when hand when US doles out USD 18 billion to bail out corporations (so that these corporations can disburse holiday bonuses), the country hasn’t kept its promises to GFATM. The US is the smallest donor among the rich nations that contribute to GFATM. "We're at 0.16 of 1% of our income for development assistance. It's the lowest level of all 22 donor countries" had said Jeffery Sachs.

The Merrill Lynch bonuses alone would be enough to close the gap in US contributions to GFATM (read more).

In the lead up to the forthcoming 3rd Partners Forum in Brazil next month, let us think how we can economize to utilize every penny we have for TB care and control – while we find ways to mobilize more resources to fill the gap.

Bobby Ramakant

Our response to terror

Our response to terror
: Dr Sandeep Pandey

In the clamour for asking the Pakistani government to take decisive action against the terrorist organizations in that country and shut down their camps we forget one thing. The civilian government in Pakistan is probably simply not in a position to do what we except from it. It is a well known fact that military and ISI in Pakistan are quite independent of the civilian government. The terrorists function quite independently too - sometimes with overt and at others with covert support of the military and ISI. In fact, the situation is such in Pakistan that probably none of the players is in a position to dictate terms to another. How may we expect any coordinated action in this anarchy?

The best course of action for the government of India would be to strengthen the civilian democratic government of Pakistan and not see it as its adversary. For only when the civilians government and the civil society will have any say in running the affairs of the Pakistani society can we hope for an order there. The military and intelligence cannot have an upper hand in any civilized society and definitely the terrorists have no place. But it is easier said than done. The Pakistani society has to cope with its problems. But the least we can do is to encourage the elements in there to help restore normalcy and democracy.

In the aftermath of the terrorist incidents in Mumbai it was easiest thing to have put the entire blame on Pakistan , treating it as a monolith. Thus people's anger was channelized away just like in the US after the September 11 attacks the entire blame was put on Al-Quaida. For, if the blame had not been put on Pakistan , people would have started asking very inconvenient questions.

First and foremost is, we've yet to know who exactly were responsible for the security lapses and why are they not being held accountable? The Home Minister and the Chief Minister or his deputy were only the tip of the iceberg. What about people below who were more directly responsible for day to day security and intelligence? It is humanly not possible to launch the kind of attack that we saw over three days by ten Pakistani citizens coming from outside through the sea route without any inside help. Are we completely denying it? Or, have we begun the process of identifying the insiders, in or outside the government-administrative-security apparatus, who might have helped the aggressors? Why has nobody not raised the last piece of information that Hemant Karkare's investigations had begun to reveal before his unfortunate death- the links between RSS and the ISI? Why were Bal Thakerey and Raj Thakerey silent during those three days? Have we forgotten that Bal Thakerey had offered to the then PM Vajpayee to send his Shiv Sainiks to fight the Pakistanis during the last build up at border? This time the enemy had obliged by coming to his doorsteps. But why did the Shiv Sainiks, or for that matter any group of combatants or non-combatants, not storm the Taj or the Oberoi to end the ordeal sooner? Is it possible for a Class IV educated daily wage labourer from Pakistan to operate sophisticated electronic devices during the attack? Has the letter written by Ajmal Kasab to Pakistani High Commissioner asking for legal help actually written by him or like in plethora of other cases police got him to sign on what they wanted to be written? Indian Express carried a front page story soon after the attack about the European and US connection to the attack by disclosing that two SIMs used in the mobile phones carried by the terrorists were bought in Vienna and New Jeresy. Was there or was there not any European and US connection?

If we start seeking answers to the question like the abovementioned ones skeletons might start tumbling out of our own cupboard. We are so obsessed as a nation with nailing down Pakistan that we are loosing objectivity. A.R. Antulay is looked at condescendingly when he raises a question. We can reach the truth only when we explore all possibilities of how things might have happened.

The response of the Indian government amidst a frenzy demanding action to gear up its laws and beef up the security, with possibly US and Israeli help, is ignoring the basic issues. Which laws and security have been able to stop people on suicide mission? If the terrorists in Mumbai were given another chance would they care for a stricter Unlawful Activities (Prevention) Act, the newly created National Investigative Agency or better equipped Indian security forces?

We did not face such terrorist threats when we were a non-aligned nation. The problems for India began with the demolition of Babri Masjid. The first bomb blasts took place, in Mumbai, soon thereafter. With India going nuclear and the right wing Indian government unilaterally declaring after the September 11 attacks that India would join US in the 'war against terror,' the terrorists incidents in India have increased. As we went closer to US and Israel we began loosing friends in the Muslim world. It will be in our interest to reverse this entire process.

Actually, to feel secure from Pakistan there is only one option. To end the animosity with Pakistan . All outstanding issues must be taken up with the government of Pakistan and amicably resolved once and for all. The nuclear weapons possessed by India and Pakistan are the biggest threat to the people of South Asia . People giving a war cry in moments such as after the Mumbai incident forget the tragedy of Hiroshima and Nagasaki . True security can prevail only when there is disarmament and withdrawl of military from both sides of the border.

But for this to happen conducive situation must exist in Pakistan . The democratic government must assert its control over the military, ISI and the terrorist outfits. This is not going to happen overnight and will require lot of effort. Are we prepared for the long haul? It is almost like rebuilding the Taj, Oberoi and the Nariman House as the best response to the terror attacks. We need to build friendship and peace with Pakistan and not create further enmity.

Dr Sandeep Pandey

(The author is a Ramon Magsaysay Awardee (2002) for emergent leadership, heads the National Alliance of People's Movements (NAPM) and did his PhD from University of California, Berkeley in control theory which is applicable in missile technology. He taught at Indian Institute of Technology (IIT) Kanpur before devoting his life to strengthening people's movements in early 1990s. He can be contacted at:,

Kala Azar patients lack adequate diagnosis and drugs

Kala Azar patients lack adequate diagnosis and drugs

At the fourth Leishmaniasis World Congress in Lucknow, India, Medecins Sans Frontieres (MSF) said that there is a serious need to expand availability of effective treatments and diagnosis for visceral leishmaniasis (kala azar) in order to reduce the present burden of disease and resistance to treatments. At the Congress, MSF is presenting important results showing that liposomal amphotericin B (Ambisome) could play a critical role in the fight against the disease.

Operational research in MSF's project in Bihar, one of the most endemic areas, shows that treatment with liposomal amphotericin B is very effective, with a 98% cure rate and a low death and defaulter rate. The drug is also linked to a lower rate of relapse, less toxicity and a shorter length of treatment than with other medications.

"While liposomal amphotericin B is not the only possible treatment, it has been shown to be one of the most effective and safe. We believe it should be included in the Indian treatment protocol as a first line treatment option," says MSF tropical medical advisor Dr Nines Lima.

Fatal, if left untreated, kala azar is transmitted by the bite of an infected sand fly. Largely unknown in the developed world, it is a parasitic disease that affects over 12 million people worldwide. The annual incidence is estimated to be 500,000 cases, with 50% occurring in India. The disease is endemic in the eastern States of Bihar, Jharkhand, Uttar Pradesh and West Bengal. In these states it is marginalized communities living in rural poverty who bear the greatest disease burden.

The most common treatment currently used is sodium stibogluconate (SSG). However, resistance to the drug is a growing problem - especially in India, where as many as 65% of patients acquire drug resistant parasites. Kala azar remains neglected by research and development initiatives.

"Patients of kala azar in developing countries have been neglected for far too long. In our project, most patients come to our facilities when the disease is already at an advanced stage because people are still not familiar with the signs and symptoms or do not know where they can find adequate diagnosis and medication," says Gareth Barrett, MSF Medical Coordinator in India. "Many communities with high prevalence lack access to diagnostics, and poverty often means that the quality of treatment is poor, which in turn poses serious risks of outbreaks and increasing drug resistance".

"Worrying number of our patients, are treatment failures that have come from private sector" says Dr Mrityunjay Kumar Pandey who works with MSF in Bihar.

The drug liposomal amphotericin B is expensive at Rs. 21,855 (350 €) per patient per treatment. "There is an urgent need for reducing the cost of the drug, developing generic formulations and validating combination therapy so that the drug can be included as a first line treatment in the protocols of countries such as India", stresses Gareth Barrett.

In Bihar at the Hajipur referral hospital, MSF is providing diagnosis and treatment for people suffering from kala azar. Since July 2007, MSF has screened over 6,500 patients for kala azar and the 2,500 patients found to be positive received treatment with liposomal amphotericin B – a relatively new therapy for the disease.

"Until combination therapy is available we need as many people as possible to access diagnosis and effective treatment. We believe dose reduction is a natural next step, and there is enough evidence to support this," says Dr Gareth Barrett.

MSF welcomes the fact that India is hosting the World Congress and calls on India to show a strong commitment to fighting kala azar, by strengthening its health structures to improve access to effective treatment and diagnosis for marginalized communities who make up the majority of people who become infected by the disease.

Bobby Ramakant

Photo captions:
Top photograph: Copyright: Juan Carlos Tomasi/MSF
In July 2007, Médecins Sans Frontières (MSF) began treating visceral leishmaniasis, also known as kala azar, at Sadar Hospital in Hajipur in Bihar, India.

Middle photograph:
Copyright: Juan Carlos Tomasi/MSF
In Bihar, MSF uses the most effective treatment available so far to treat kala azar: AmBisome®

Bottom photograph:
Copyright: Juan Carlos Tomasi/MSF
Sadar Hospital in Hajipur. As many other tropical diseases, kala azar mainly affects the poorest populations.

Published in
The Seoul Times, Seoul, South Korea
Pakistan Christian Post, Karachi, Pakistan
Media for Freedom, Kathmandu, Nepal
Citizen News Service (CNS)

Why did Sapamcha Kangleipal run away from custody?

Why did Sapamcha Kangleipal run away from custody?

Sapamcha Kangleipal is the 27 years old leader of Manipur Forward Youth Front, an organization working for the democratic rights and peace in Manipur. He had organized a peace march in April 2008 for 15 days through the districts Imphal East, Imphal West, Bishunpur, Churchandrapur, Thoubal and Ukhrul in which about 600 youth participated. He was arrested on 7th May, 2008 for having organized a meeting in Imphal on the 'Implications of Arming Citizens,' in the wake of government's decision to recruit Special Police Officers for Heirok village in Thoubal district to protect villages from attacks of militants. One is reminded of the Salwa Judun experiment in Chhattisgarh, which has received condemnation from various quarters. Kangleipal described the government's decision as 'raping of democracy' and asked the Chief Minister Okram Ibobi Singh to resign if he was not able to control the violence. Between 250 to 350 people, including civilians, security personnel and insurgents, have been getting killed in insurgency related violence every year over the last decade in Manipur. The figure this year 426 is the highest in this period.

Kangleipal was given bail on 13th May as the Magistrate found the charge of sedition against him not genuine. But before Kangleipal could be set free he was arrested again in front of the Magistrate under National Security Act. Since then he had been under judicial custody. The message was clear to the civil society and human rights groups that anybody who would dare to question the government's decision would meet the same fate as Kangleipal.

For the first 7 days in lockup Kangleipal didn't eat anything. Because of which he developed erosive gastritis and had to be moved after two months from Sajiwa Jail to Jawahar Lal Nehru Hospital in Imphal, where Irom Sharmila has also been kept in custody who is fasting for the last eight years to demand repeal of Armed Forces Special Powers Act.

Irom Chanu Sharmila's long drawn struggle, which is partially of spiritual nature, has become legendary. The Meira Paibees, literally meaning ' torch bearers', network of organization of mothers, have come together as 'Sharmila Kanba Lup' (Save Sharmila Group) to launch a relay fast at PDA Complex near the J.L. Nehru Hospital beginning on the international human rights day, 10th December, in 2008, with the slogan 'Save Sharmila', Repeal AFSPA.' Hundreds of women come out every day from nearby areas to participate in this fast. The movement against AFSPA is gaining ground.

It is beyond comprehension why the government - either the state or the central - is not talking to Sharmila, She doesn't belong to any organization, she has no banner. Unlike SIMI she doesn't believe in any pan-Islamism idea which could pose a threat to Indian state. She is a devotee of Lord Krishna and thinks that she is following the will of God. Yet it is most unfortunate that her voice is falling on deaf ears. If the government will not listen to the most peaceful of voices and protests they loose the right to complain against people who take recourse to violence - the insurgents, the naxalites and the terrorist.

People in Manipur ask when the central government in the aftermath of Mumbai terrorist incident has now amended the Unlawful Activities (Prevention) Act to make it more stringent and the government in Manipur is increasingly using the state police force more than the army to deal with the law and order situation, they must think of doing away with AFSPA. This would at least save Sharmila's life. Otherwise if Sharmila dies while fasting it would present the government in a very bad light.

The approach of government to use force to curb insurgency related violence is not bearing fruit as can be seen from the number of people who have died during this period. After training 301 SPOs for protecting Heirok, the government is now planning to recruit about 1200 more such personnel to be deployed in other parts of four valley districts. This inexpensive outsourcing of the task of security, with each SPO to be paid Rs.3000 per month, to civilians can have only one outcome - increase in fratricidal killing.

The logic of countering violence with violence, resulting in more weapons in more people's hands, can only result in more entangled situation. Stringent laws and use of force has never been able to control violent opposition. The government must find ways of addressing the aspirations of youth who have taken up arms by engaging them in dialogue and create more employment opportunities so that the youth have an alternative to extortion. Innovative solutions are needed in Manipur rather than the high handed ways the government has chosen to deal with the situation.

Sapamcha Kangleipal helped us organize a five day fast to express solidarity with Irom Sharmila in September 2007, in which activists from other states of India participated. He was a popular youth leader as can be seen from the participation in April peace march. He was trying to get a democratic process going in the society. Rather than channelizing his energies in a constructive manner the government chose to deal with him like an insurgent. While in judicial custody he was fearing for his life. He believed that some insurgent groups in connivance with the police wanted to eliminate him. This can be the only possible reason for his escape from the hospital ward under security on the night of 28th-29th December, 2008. Unfortunately, it'll become more difficult for him to carry forward the process that he was spearheading in Manipur, especially among the youth, as the government and security forces will be more ruthless with him now. The youth of Manipur is caught in a vicious trap. The government must extend them an olive branch so that they can join the political mainstream.

Sapamcha Kangleipal may not have the patience of Irom Sharmila but he is definitely not a criminal. The charges against him of trying to procure arms and ammunition from Mayanmar are false. The government must deal with him in a humane manner. He represents the youth who is a legitimate citizen of this country with a grievance. The grievance must be addressed.

Dr Sandeep Pandey

(The author is a Ramon Magsaysay Awardee (2002) for emergent leadership, heads the National Alliance of People's Movements (NAPM) and did his PhD from University of California, Berkeley in control theory which is applicable in missile technology. He taught at Indian Institute of Technology (IIT) Kanpur before devoting his life to strengthening people's movements in early 1990s. He can be contacted at:,

Published in
The Seoul Times, Seoul, South Korea
Media for Freedom, Kathmandu, Nepal
Citizen News Service (CNS)