What do Varun Gandhi's pronouncements mean?

What do Varun Gandhi's pronouncements mean?

Varun Gandhi has chosen the shortcut to fame. Until yesterday he was an ordinary member of BJP. Today he is a nationally important leader in this party and in the same league as L.K. Advani and Narendra Modi for subscribing to virulent communal views. For a leader of BJP to have said the kind of things that Varun Gandhi said was not very surprising. BJP’s USP is anti-Muslim or anti-minority ideology. Remove the anti-Muslim, anti-Pakistan or anti-minority plank and BJP or the larger Sangh Parivar will face an identity crisis. In this sense the Hindutva organizations are basically reactionary. They have always used vitriolic language to attract attention and used violence to make their presence felt. Starting with Mahatma Gandhi’s assassination, the Babri Masjid demolition, Nuclear test, Gujarat massacre to the Orissa and Karnataka anti-Christian violence there are plenty of examples. They don’t have a constructive or positive agenda. They tried to project an ‘India Shining’ slogan of their achievements in the last general elections which backfired.

What was surprising was that these communal statements came from Varun Gandhi. Born to a Sikh mother and having a Parsi grandfather one would not expect Varun to be a hardcore Hindutva activist. Why did he say the things that he said? Did he say them himself or was he coached? Was it a case of a new convert trying to prove more faithful? Or, the BJP is using a new fodder in the old cannon? The BJP, which was feeling rudderless before the general elections with infighting and uninspiring leadership, suddenly has got a shot in the arm. The party has been electrified. Suddenly it is back to its basic anti-Muslim agenda after trying very hard to project itself as a genuine progressive alternative to the Congress Party. Narendra Modi tries very hard to sell the image of Gujarat as a model of modern development and doesn’t like the 2002 genocide of the Muslims to be remembered. In the last assembly elections the BJP Chief Ministers preferred to talk about their development achievement rather than focus on Congress’ failure to handle the Mumbai terrorist attack. But it finds that like a drug addict the only thing that inspires its cadres is the anti-Muslim venom.

The RSS must realize that the communal card cannot be played over and again. Human being by nature is a pacifist and likes to live in harmony with other human beings around him. He may get carried away once or twice by communal frenzy but sooner or later he realizes that it ultimately harms him. It was easy to gather people once to demolish Babri Masjid. It is difficult to bring them again to Ayodhya for the construction of the temple. Most of the Sadhus and Mahants in Ayodhya are now opposed to the Ram Mandir construction campaign as this movement has destroyed their peace and income. Narendra Modi cannot afford to repeat the 2002 massacre. The hate speeches of Sadhvi Rithambara or Uma Bharti don’t move people any more. Hence the BJP was looking for a new leader who could spew fire. But it must realize that Varun Gandhi cannot sustain in politics if he keeps repeating what he said in Pilibhit. People will stop going to his meetings after a while.

The reaction to Varun Gandhi’s communal statements in Pilibhit was that was shock from within and without his party. Even though some leaders of BJP, who now want to capitalize on his statements, have started supporting him. His cousins Rahul and Priyanka also expressed dismay. But then the Congress Party has used the communal card whenever it suits it. The only difference between the BJP and the Congress is that the former is ideologically communal and the later is opportunistically communal. Rahul Gandhi who would now like to be seen as a more moderate and liberal member of the Gandhi family needs to be reminded that it was not long back when campaigning in UP Assembly elections he had said that if there was a Prime Minister from the Gandhi family in 1992, the Babri Masjid would not have been demolished, raising doubts over the secular credentials of other leaders within the Congress Party. Worse still, and probably as crude as Varun Gandhi’s, was his statement that his grandmother Indira Gandhi should be given the credit for dismemberment of Pakistan . There were objections raised by Pakistanis on this statement. What was the need for Rahul Gandhi, who otherwise appears a very sensible person, to say those communal things? Was he any different from Varun Gandhi is making those statements?

It is a symptom of a disease which afflicts the India politics. The politicians don’t mind playing with the sentiments of the people if it can help them fetch votes no matter what the consequences. They can say and do the most atrocious things and know that they enjoy certain immunity so that they’ll never be punished. Navjot Singh Sidhu got back his Parliamentary seat after being convicted for a murder. Other criminals hope that their crimes will be pardoned by the courts so that they may remain active in politics. Politics, in fact, provides an immunity from punishment. On top of it Varun Gandhi is trying to gain mileage from this incident by trying to project himself as a martyr by getting arrested. This is sheer desperation.

The interesting fallout of the Philibhit incident is that now the two most upwardly mobile young leaders of India ’s two major parties are members of the same family. Or is one cousin being used to check the rise of the other who most certainly will be India ’s PM one day? Whatever may be the reason behind Varun Gandhi’s pronouncements he has degraded Indian politics down to one more level. He and his party may stand to gain in the short run but the Indian politics in the long run is the loser. One only hopes that the damage caused by him will be contained and he will not become a model to be imitated by other youth in society. If his performance from political stage were to be repeated by lesser mortals in real life it could cause havoc with peace and harmony in society.

Dr Sandeep Pandey

(The author is a Ramon Magsaysay Awardee (2002) for emergent leadership, member of National Presidium, People's Politics Front (PPF), 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: ashaashram@yahoo.com. Website: www.citizen-news.org)

Neglect of TB control among indigenous communities unethical

Neglect of TB control among indigenous communities unethical

The need to include indigenous people in the Global Plan to Stop TB was echoed by many participants at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil (23-25 March 2009).


"We demand inclusion of indigenous peoples in the Global Plan to Stop TB strategy and have launched a strategic framework aimed at addressing tuberculosis among indigenous peoples. The Stop TB Strategy builds on the successes of directly observed treatment shortcourse (DOTS) while also explicitly addressing the key challenges facing TB. Its goal is to dramatically reduce the global burden of tuberculosis by 2015" said Wilton Littlechild, Regional Chief, Assembly of First Nations.

There are approximately 370 million indigenous peoples globally in more than 70 countries. Although programmes have been designed to combat TB, indigenous populations globally have been left out of such efforts due to cultural barriers, language differences, geographic remoteness, and economic disadvantage. TB rates among indigenous people are consistently higher than general public. During the five year period 2002-2006, the first nations TB rate was 29 times higher than others born in Canada - for the Inuit, it was 90 times higher. Pacific islanders and Maoris are 10 times more likely to contract TB than other people living in New Zealand. In Kalaallit Nunaat, Greenland, residents have a risk rate more than 45 times greater than Danish born citizens.

"These challenges will not be easily met - but they can be met by ensuring indigenous peoples are true partners in global TB control. We have a comprehensive and achievable plan to stop indigenous TB globally, but to realize our goal we need support" said Chief Littlechild.

Indigenous people have a consistent pattern of health inequality across a variety of jurisdictions from resource poor to the resource rich. Indigenous health inequalities are multi-faceted, and are both social and political in nature.

"Indigenous leaders will continue to work with the United Nations Permanent Forum on indigenous issues, the World Health Organization (WHO) and the Stop TB Partnership in addressing indigenous TB globally" further added Chief Littlechild.

Highlighting the problem of TB treatment default and risk of developing drug-resistant forms of TB in indigenous people, Chief Littlechild said that "we wish to establish a secretariat to collect data of TB programmes in indigenous communities. Due to a broad range of reasons, indigenous people aren’t able to access TB-related treatment and care services and if they are, then they are more likely to default, increasing the risk to develop drug resistance" said Chief Littlechild. With the High Level Ministerial meeting on multi- and extensively- drug-resistant TB (M/XDR-TB) going to open in Beijing, China (1-3 April 2009) later this week, it is indeed a clear message from indigenous communities for their Health Ministers to commit to responding to their specific issues regarding TB control.

In response to another question, Chief Littlechild said that "human rights based approach calls for genuine partnership and indigenous communities can be part of the solution."

The inequities faced by indigenous communities are much severe than in general population. "Countries like Canada report that poverty has gone down but poverty in indigenous communities has gone up. In prisons too there are a significant number of indigenous communities. There are host of other life conditions that put these people at an elevated risk of infectious diseases like TB - overcrowded housing and lack of access to safe drinking water are just few of those challenges" said Chief Littlechild.

The strategic framework to control TB among indigenous populations was developed through consultations with indigenous leaders, TB experts and health advocates from over 60 countries. It is designed to take an indigenous approach that links the right to health, education, housing, employment, and dignity. It is based on equality of opportunity to the highest level of health attainable world wide. It will serve as a tool to build a social movement to raise awareness of indigenous TB, to develop targets and messages, to pilot interventions and to monitor TB trends among indigenous peoples. An important component to this framework calls upon indigenous peoples to demand access to TB prevention and treatment measures in their communities.

- Bobby Ramakant

Speak-Your-World: Sexual health rights of HIV sero-discordant couples

Sexual health rights of HIV sero-discordant couples

Denying sexual and reproductive health services to people living with HIV (PLHIV) or HIV sero-discordant couples increases their vulnerability to sexually transmitted infections (STIs) and makes it harder for women to protect themselves against sexual violence and unwanted pregnancies. At the 3rd Stop TB Partners' Forum, this correspondent was narrated an inspiring testimonial of a HIV sero-discordant couple that has taken up the responsibility of taking care of each other, and live with HIV/TB with dignity and care.

"For the last few years I have been falling ill with different illnesses. In 2005, I went with my wife for HIV testing. She explained she wasn't going to divorce me if I tested positive. She just wanted to know what was making me sick" saidChrispin Siang'ombwa from Community Initiative for Tuberculosis, HIV/AIDS and Malaria (CITAM) in Zambia, who was also a member of the on-site HDN Key Correspondent team at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil (23-25 March 2009).

"I tested HIV positive and she tested negative. The first thing she did was to hug me" shares Chrispin.

"Before I tested positive for HIV, I had tuberculosis (TB) three times in 1995, and TB relapses in 1997 and 2004" says Chrispin.

"As TB is curable I continued to work in a meat processing industry's sales and marketing division. However because of my illnesses, I lost my job in 2004. I felt so frustrated and when I was leaving I told my General Manager that it is better that I go home and die at home as no one cares about my health in my workplace" recollects Chrispin.

"My wife was so touched, and supportive. Later my wife was invited to a workshop related to HIV and when she came back she related my illness to HIV. She counseled me and I hope people can imagine how one feels on getting counseling by one's own wife. She said she is not saying that I have HIV but she is helping me to take care of my health and both of us need to find a solution - she don't want me to be sick or to die and they have a long life to live together. I developed a fear that as she already knows her HIV status (negative) and if my status comes out positive then I was afraid of thinking the outcome" said Chrispin.

"One day I told her that I am afraid that if I test positive for HIV, she may go for divorce. She counseled me and said she wants to take care of my health. She took me to a hospital and we took the test" shares Chrispin.

Chrispin and his wife were asked to come to the hospital after three days to collect their reports.

"We didn't go to pick up the test results for five days and finally I was counseled if I was ready to take the result. At the end of counseling the counselor posed a question to my wife on her response to a situation if wife's result is HIV negative and husband's result is HIV positive. She said whether the result is HIV positive or negative, he is my husband. I was also asked a similar question and I too responded in the same way. We were given the envelopes and we opened our own envelopes. I was HIV positive and she was HIV negative. She hugged me and sat down with me for a while. She said that she loves her husband and don't want him to die. She said she will encourage him to take care of his health and go for the treatment. She continued loving me" says Chrispin.

"The counselor said that we are a very unique couple - and she was earlier counseling a different couple in a similar situation (HIV sero-discordant couple), but they were fighting and blaming... instead my wife was so supportive, understanding and loving" said Chrispin.

"Anti-retroviral therapy (ART) clinics in Lusaka (Zambia) were very few in those times, so we selected a clinic which was very far from my community because I was afraid of people from my community seeing me going to an ART clinic" says Chrispin. He began taking ART in January 2006.

"At every clinic visit, my wife was with me. My wife never lost hope and she was there on my side. I withdrew myself from the community, and I wasn't seeing anyone. Now I understand the high-levels of HIV-related stigma I was confronted with, particularly self-stigma" says Chrispin.

One day on a TV, I saw a news about a conference on HIV/AIDS being organized in Lusaka. I thought I need to attend this conference. When I went there the conference registration was already closed but one lady directed me to a room where people living with HIV (PLHIV) were meeting" shares Chrispin.

"This room was fully packed - later I understood this is where I belong. I came to know about Treatment Advocacy & Literacy Campaign (TALC). Later I discussed forming support groups for PLHIV with my wife, and a lady from our local church helped me come up with a list of six members who were in a similar situation" says Chrispin.

"Later at TALC, a journalist came from local radio and TV station to interview four PLHIV on stigma and discrimination and I was one of the four selected. Many months passed by and I had nearly forgotten about this interview" says Chrispin.

"This programme was aired. My four children were told by their friends that your daddy is on TV and my children went to the neighbourhood and saw the TV show where I was revealing my HIV status. My children's friends said they are sorry to hear that their father is HIV positive" shares Chrispin.

"My children later said to me that they also have a right to be consulted before my going public about HIV status" says Chrispin.

Chrispin and his wife have four lovely children.

"I sat down with my children to have a discussion later that evening. My eldest son said that he wasn't aware of my HIV status and they are worried about my health. He was concerned about my health and my going public regarding my HIV status without consulting my own children. I was too touched. I apologized to my children and said that peer influence led me to do this on TV, and pleaded forgiveness if possible. Children said that they love me as their father just as before, and my going public will help them in schools as they will get information" shares Chrispin.

"My eldest son went for HIV test to support me, and get more information related to HIV. My youngest son is in grade 6, and found some information about HIV from school, and brought it back to me" shares Chrispin the inspiring story of a family united together in Zambia.

Chrispin always consistently uses condoms in every sexual act with his wife, because they love each other and want to take good care of each other. "Condoms are always available in our bedroom, we take care of ourselves of using condoms and have protected sex always - because we truly love each other and want to take care of each other and our children" says Chrispin.

Many health providers assume that people with HIV or HIV sero-discordant couples do not have sex and fail to provide them with the information they need to prevent further transmission. The healthcare services to meet sexual and reproductive healthcare needs of PLHIV and sero-discordant couples need to be available as well.

Chrispin's experiences from his own life on how they as a family are unitedly dealing with HIV and tuberculosis are undoubtedly an inspiring testimony of how affected communities can demonstrate leadership in coming up with best solutions to their own problems.

Health-care workers need to recognise the specific sexual and reproductive needs of PLHIV in order to help them protect their own health and the health of their families.

- Bobby Ramakant

Bloomberg Award for Thailand's pictorial warnings on tobacco products

Bloomberg Award for Thailand's pictorial warnings on tobacco products
Jittima Jantanamalaka

The first Bloomberg Award for Global Tobacco Control (2009) was conferred to Dr Prakit Vathisathokit, Executive Secretary of Action on Smoking and Health (ASH), Thailand.

Dr Prakit was awarded for his leadership to implement the pictorial health warning labels on tobacco products effectively in Thailand.

Talking about his campaign at ASH, he contributed extensively in raising awareness in society about tobacco-related health hazards. Working closely with the Ministry of Health in Thailand, Dr Prakit was part of the team which drafted a number of warnings for tobacco products. Thailand was the fourth country in the world after Canada, Brazil and Singapore, to print effective pictorial health warning labels on tobacco products. Thailand has nine photographs of people with tobacco-related life-threatening diseases which it uses on rotational basis for pictorial health warning labels on tobacco products.

Some other countries took these photographs from Thailand to use it as pictorial health warning labels in their own countries, including: Malaysia, Brunei Darussalam, Singapore, Viet Nam, Philippines and Caribbean countries.

The level of awareness about tobacco-related health hazards has certainly gone up, tobacco users are more inclined to quit and children and young people felt de-motivated to use tobacco as a result of strong and effective pictorial health warning labels on tobacco products, said Dr Prakit.

This wasn't an easy task. Tobacco industry tried to threaten and thwart efforts of Dr Prakit, but unsuccessfully. "At that time there were not many countries that had strong and effective pictorial health warning labels on tobacco products. That is why tobacco industry was trying to threaten us. The tobacco industry said that the pictorial health warning labels were breaking the International Trademark law, and they will take legal action against us" said Dr Prakit. "But there were no legal action, just threats."

"Even if the tobacco industry had gone to the court, they would have lost the case because the World Trade Organization (WTO) marks tobacco and cigarette as a special good, which is dangerous to the consumer" said Dr Prakit.

Thailand has signed and ratified the global tobacco treaty - World Health Organization Framework of Convention Tobacco Control (WHO FCTC) - which is a legally binding instrument. The FCTC strongly supports the pictorial health warning label provision, and Thailand is obligated to follow it. Also the WHO has recommended these warnings as they are cost-effective ways to control tobacco. The tobacco industry would have certainly lost in court, says Dr Prakit.

Presently there are 163 countries that have signed on the FCTC and all of them have to implement pictorial health warning labels on tobacco products within 3 years. "To prepare the photographs is not difficult but to handle the tobacco industry which tries to block and interfere with the health policies is most difficult" says Dr Prakit.

Tobacco is very addictive, as addictive as heroin, says Dr Prakit, which is why even many tobacco users are not easily able to quit even if they want to do so.

Due to strong and consistent tobacco control campaign in Thailand over the past 20 years, the number of smokers and sale of cigarettes are still the same - 10 million. If we didn't have a strong campaign and policy framework, estimated number of tobacco users in Thailand would have reached 14 million.

There is a lot more to be done in Thailand on tobacco control. We need to effectively enforce the smoke-free laws in Thailand, ban cross-border advertising and raise taxes on tobacco products so that tobacco cessation services can be scaled up, feels Dr Prakit.

[Audio podcast is available here]

Jittima Jantanamalaka - Citizen News Service (CNS)

Call in Africa to fund the gap in the fight against TB

Call in Africa to fund the gap in the fight against TB

Despite of African governments declaring tuberculosis (TB) as an emergency, Africa as a region, faces the largest funding gap of USD 10.7 billion to fully implement the Global Plan to Stop TB by 2015. This fact came in spotlight when the TB funding in Africa required to meet the TB-related targets of millennium development goals (MDG) by 2015 was analyzed, said Kenyan activist Lucy Chesire at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil (23-25 March 2009).

"The Ministers of health had recognized that TB is an emergency, but they don't act to mobilize resources to respond urgently to control TB and fully implement the Global Plan to Stop TB" stressed Lucy.

The countries in Africa had achieved a milestone by endorsing the African Union Abuja pledge of allocating 15% of national budgets to health, which was also reiterated at the 2008 African Union Summit in Egypt, the 2008 Conference of African Finance Ministers, and 2008 Special Conference of African Health Ministers. But they have failed to act on this pledge, said the activists. Only Botswana has kept the promise of allocating 15% of the national budget to health, the rest of the countries in Africa need to keep their promises.

To put pressure on these countries to fund the gap in TB control, the Africa Public Health Alliance had launched an 'African TB Partners Call on African Heads of State, Health and Finance Ministers to fund the gap in the fight against TB' at the 3rd Stop TB Partners' Forum.

Activists expressed their concern that 4.2 million Africans are currently living with TB and of these 2.8 million are new TB cases, making TB arguably Africa's biggest public health concern. An estimated 639,089 African lives are lost to TB annually.

"The current global economic crisis is all the more reason why high burden TB countries in Africa should invest in TB control. As per a report of World Bank and Stop TB Partnership (December 2007), high-burden TB countries are likely to recover 9-15 times of their investment in TB control" said Mayowa Joel of Nigeria. This report indicates that the economic cost of not treating TB to Africa between 2006 and 2015 would be USD 519 billion while TB can be controlled with USD 20 billion in the same period.

Even though Africa makes up only 11.7% of the global population, Africa alone contributes 27 of the 50 countries globally with the highest numbers of people living with TB, and also 26 of the 50 countries with the highest number of TB-related deaths globally.

Furthermore nine of the world's 22 high-burden TB countries are in Africa: Democratic Republic of Congo (DRC), Ethiopia, Mozambique, Nigeria, South Africa, Uganda, Kenya, United Republic of Tanzania and Zimbabwe.

The outbreaks of extensively drug-resistant TB (XDR-TB) and multi-drug resistant TB (MDR-TB) now threaten to further complicate the TB epidemic.

TB continues to be the leading killer of people living with HIV (PLHIV). The need for collaborative TB and HIV activities to respond to rising challenge of TB and HIV co-infection, is compelling. 22 high HIV prevalence countries with an estimated adult HIV prevalence rate equal to or greater than 4% are in Africa.

Five of the TB most affected countries: Nigeria, Ethiopia, South Africa, DRC and Kenya are all also amongst Africa's most highly populated countries, are all regional hubs or countries with the most number of common borders with other countries, says the activists.

Many organizations have signed on this call and those interested in signing on the call to Africa to fund the gap in TB control, can email Lucy Chesire at lucy_chesire@yahoo.com or Mayowa Joel at mayowajoel@yahoo.com

This call will be delivered to the Heads of State, ministers of Health and Finance at the forthcoming African Union summit in 2009.

The electorate wash UP Politics's dirty linen in public finally

The electorate wash UP Politics' dirty linen in public finally
Anjali Singh

Lucknow:This time round it promises to be an election with a difference, but then why not. As, at long last the citizens of India are now keen to elect and send clean and committed representatives to form the 15th Lok Sabha of the largest democracy in the world.

But is it possible to pick such candidates and place them in the parliament, given the years of dominance by leaders known to have criminal antecedents and whom the electoral process has been putting up with for decades?

It most certainly is, feel most activists in Uttar Pradesh (UP), a state which has earned the dubious distinction of electing and sending the largest number of tainted candidates to both the Lok Sabha and its own assembly the UP Vidhan Sabha.

Reasons Prabha Chaturvedi, a social activist whose organisation Exnora, has been campaigning against criminalisation in politics and has educated a good number in the city about such candidates, "The only way people with criminal antecedents can be kept out of the parliament is to actually vote them out. That's why exercising your franchise is of utmost importance. Until the electoral does not reject such candidates and say so by exercising their voting right even if it means going in for negative voting, the democratic process of the country will continue to give everyone even those with tainted background a right to contest the elections. It's up to the citizens to say 'NO' to such people who might end up leading our country."

Agrees Rajiv Hemkeshav a social activist aligned with the Jai Prakash Narayan (JP) movement, who started a signature campaign against the candidature of Sanjay Dutt to express the rejection of his candidature as Samajwadi Party (SP)'s candidate from Lucknow, "Based on the 1000 signatures a case was made to give a voice to the voters from Lucknow on Dutt's candidature. We have appealed to the Supreme Court to not give Dutt the permission to contest the elections, the hearing is up for 30 March 2009 and in all probability the voters' request will be considered. That's the power a common man's voice has, as people are supreme and have the power to change laws and stop such individuals from reaching the country's highest policy making machinery. Public awareness of the People's Representative Act also is a must to filter out tainted representatives."

But while the movement to clean up politics in UP is gaining grounds some feel it could also turn into a witch hunt taking a toll on many such candidates who are not criminals in the true sense of the word.

Says Himanshu Singh, a senior politician who has been associated with the Kisan Andolan movement against the large corporates out to privatise the Indian agrarian economy , "One must be sensitive to the fact that not everyone who has gone to jail or has cases filed against them are criminals. I myself have 17 cases filed against me and have gone to jail during my involvement in the andolan, so technically I too don't qualify as a clean candidate in the true sense of the word. But that's where a differentiation must be made between candidates like me and Sanjay Dutt etc. I also support the fact that it is necessary to project a clean candidate but it is crucial to be fully informed about the tainted one's too. Politics is a brutal game and just by negative voting things will not change, the focus has to be on arming the electorate with correct information too."

A fact that Ashish Tripathi, a senior journalist with the Times of India, and an expert on UP politics endorses,"I agree that a clear distinction is necessary when it comes to branding a contestant a criminal. For that FIRs should not be the deciding factor of a person's criminal antecedents we must see that a charge sheet has been filed post investigation and the person is facing a trail. In such circumstances he must not be allowed to contest elections at any cost, Sanjay Dutt being a fitting example. But then the question arises how will we decide about candidates like Narendra Modi, who does not have a single charge sheet filed against him and neither is he facing a trail but everyone knows that he is responsible for inciting riots in Godhra? In such cases the public role becomes paramount as they should give a clear verdict by rejecting such leaders. For that they must be made aware of such candidates, arming the voter with information about tainted candidates in the electorate has a very powerful impact, for instance in 2002 Lok Sabha elections out of 403 strength in the UP Vidhan Sabha a shocking 200 elected candidates were with criminal antecedents. But following the citizen's movements thereon to inform and make aware the electorate by groups like Associations of Democratic Reforms and many more working nationwide the tremendous fallout was seen in elections of 2007 when only 100 candidates with tainted backgrounds made it to the UP Vidhan Sabha. This year hopefully the numbers will reduce further. So the message is clear that finally it is the citizen who will have to exercise their democratic right and vote such individuals out, so that prospective candidates understand that if they have to be the people's representative their conduct has to be squeaky clean."

An added plus of such a people's initiative is that even the youth have been motivated enough to start their own anti-corruption campaign to expose tainted candidates at the block levels in rural India.

Say Himanshu and Mahendra Singh, young firebrand activist who have launched Project Vijay (www.lucknowmail.com/project_vijay) with a group of like minded youngsters to clean up the political system of criminals and corruption,"We educate the core of the political process which originates from rural India, and we tell them what is the actual democratic process. The governance of the people is for the people in which the leaders and bureaucrats are merely public servants. But that can only be reiterated if people exercise their franchise even if it means negative voting as that provision has been given to the voter in the constitution under Rule 49 (O) through which you can demand for the Form 17-A register which has to be provided by the election officer-on-duty and make a negative vote in the voter register. We advocate negative voting as this will ensure not only rejection of criminals as candidates but will also motivate the people to come till the polling booth and exercise their voting right."

Adds PN Kalki, a city based constitutional rights activists who has been promoting Rule 49 (O) extensively amongst the voters,"In present election procedure itself there is a facility to filter out uneligible candidates from reaching the parliament. During counting of votes the "not to vote" are separately counted as well but not many people know this. Although, there is no set procedure, or set of rules that could define what to do if the number of such kind of votes (not to vote) are more than the number of votes given to the wining candidate, nevertheless Rule 49 (O) is statutory rules and orders in The Code of conduct of Election Rules, 1961 of Election Commission of India that gives the right to the electorate to pick "not to vote". This rule states that if none of the candidates seem appealing or worthy enough to the voter he can be rejected. This can be done by informing the election officer of particular election booth, who will provide the voter with the Form 17-A. The rule can act as a powerful filter against candidates who do not have a clean background."

Finally the Indian voter is awakening from their slumber, will it herald a new era in the history of Indian politics we just have to wait and see.With bated breath of course!

Anjali Singh - Citizen News Service (CNS)

(The author is a senior journalist and Director of Saaksham Foundation. Email:

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'Ghar Bachao Ghar Banao Andolan' activists released

'Ghar Bachao Ghar Banao Andolan' activists released

* Arrested slum dwellers and activists released by the Metropolitan Magistrate, Bandra on signing of personnel bond in the false case against 200 andolankaries.

* Thousands of activist-slum-dwellers assemble outside the Court of Metropolitan Magistrate to seek the release of their jailed colleagues.

* Police under the influence of Builder nexus, files charge sheet within less than 12 hours of arrest under false charges of beating the police and unlawful assembly and rioting.

The Metropolitan Magistrate, Bandra (Mumbai, India) on 26 March 2009 ordered the release of 200 jailed activist-slum dwellers who were arrested on 25 March 2009 outside the office of Slum Rehabilitation Authority (SRA) where hundreds of them had assembled to have a dialogue on the issues related to rampant corruption and malpractices being engaged in by the corrupt nexus of builders-officials-politicians. The Magistrate ordered the release on the signing of the personal bond by those arrested as more than 2000 people awaited the release outside the Court since morning. The activists-slumdwellers were represented in the Court by Advocate Shakeel Ahmed, Advocate Parvinder Singh, Advocate Raman, Advocate Manisha Tulpule, Advocate Sheikh and Raj Awasthi.

The Kherwadi Police Station had filed the first-information-report (FIR) as well the Charge sheet the same day, falsely alleging that the protestors had attacked the police personnel, while it was other way round as innocent men-women were beaten up resulting in fracture to one women and many others injured. False case under IPC sections 241, 143, 145, 148, 332, 253, 135 was registered. The case is to come up for hearing on 9 April 2009.

Before the arrest, a delegation of slum dwellers-activists met the members of High Power Committee including Chief Executive Officer (CEO) -SRA Shri SS Jhende, Housing Secretary Shri S Kunte, Vice President-MHADA Shri Chaterjee. The delegation made them aware of the gross irregularities that were being followed in the implementation of the SRA, with the result being that instead of housing slum dwellers it was dis-housing them and at the same time Builders were reaping huge profits with vast tracks of land in Mumbai being transferred to them.

Today, while around 60 lakh people were forced to stay in in-human conditions of slums, thousands of square meters of land has been transferred to the builders in the guise of rehabilitating slum dwellers under the aegis of SRA. Latest in the line is the Shivalik Ventures project at Golibar, Bandra-Santa Cruz, where though more than 12,000 families are residing but according to the proposal of the builder, financially supported by notorious Lehman Brothers; only 3500 families are to be rehabilitated and in lieu around 100 acres of land to be transferred to the builder for free.

Later in the evening, Medha Patkar and other activists addressing thousands of slum dwellers outside the Court, lambasted the Authorities and the police administration that was working out - rightly to further the interests of the Builders - corporates and violating the rights of the poor. A resolve was taken to further the struggle for claiming the right to the city and just development.

Sumit Wajale, Hyder Imam, Nasrin Bano, Mangesh Sonawane, Simpreet Singh, Mohan Chavan, Suresh Banjan, Madhuri V, Amit Maru, Medha Patkar

Bringing in winds of change through Radio Ga Ga

Bringing in winds of change through Radio Ga Ga
Anjali Singh

Lucknow: 32 years old Kanshiram undergoes a complete transformation as he goes behind the microphone talking to his listeners on the Community Radio (CR). Formerly a bus conductor who used to ferry passengers to and fro from the remote village of Lalitpur, today he works as a radio jockey (RJ) at the newly set up community radio station here. "I can't believe I am now a RJ broadcasting and anchoring radio programmes. It gives me an immense sense of satisfaction that I am doing something for the society. What makes it even more meaningful is the fact that I get to see the real issues through my work and and also provide solutions for it."

Sentiments that are also echoed by Sunita Chandel, a village housewife, she is now one of the twelve community reporters the radio station has, “It was unheard of until now that a daughter-in law of the village, would be actually recording programmes, editing, reporting and getting involved in solving women related issues. Initially there were lots of questions and refusals to grant permission at home but once my family and society realised how productive the work was they gave their permission."

Interestingly both Kanshiram and Sunita are part of a new era in communication, one that was much needed until now. But then the concept of community radios has long been the demand of rural India, so much so that today it is a reality. Predictably doubling up as a medium of entertainment and an effective mode of information and awareness, the first community radio station in Lalitpur, UP is all set to go on air soon.

An initiative of department of Planning, Government of Uttar Pradesh (UP), UNICEF office for Uttar Pradesh and Ideosync Media Combine, community radio is being geared up as an important means of community outreach. Not only in the state of UP but Uttarakhand too. Jharkhand, Gujrat and Bihar these conventional radio stations have been making waves ushering in a change no other form of communication could achieve so far.

But will it work as a powerful mode of information dissemination for the community by the community?

Mr Tapas Datta, Programme Manager, UNICEF elucidates,"The few examples we have seen so far on how community radio can be used as a powerful tool of information and awareness goes on to prove that it is now become an integral part of democratic process. It is like a double edged sword which focuses not only on the interactive roles of individual shaping lives of people but at the same time facilitating a more horizontal spread of information which is ushering in a remarkable change in behaviours and attitudes."

And with Lalit Lokvani, situated 22 km from Lalitpur in Alapur village of Birdha block, making a beginning with over a lakh eager listeners within its 15 km transmission range covering 60 villages, radio will never be the same again. While dry run has been initiated the actual transmission will start after getting the license from the Ministry of Information and Broadcasting soon, the station has been granted the frequency at 90.4 Megahertz.

And what programmes will the villagers get to hear?

Says Mridul Srivastava, station director of Lalit Lokvani, “Community radio is the real voice of the people, it is a communication service that caters to the interests and needs of a certain area, its culture, craft, cuisine and above all social and development issues. Most of our programmes will have participants from within the village community itself. In fact the narrow casting has been so successful that we are getting requests by the local candidates of various political parties to campaign for them through our community radio station.”

Adds Mazboot Singh, Community Reporter, Lalit Lokvani, Lalitpur, UP, recounting his experiences on how CR station in Lalitpur helped bringing about women empowerment "Lalit Lokvani proved to be a powerful motivator for the local women to come and participate in the radio programmes and also campaign for their rights and rights of the community as a whole. Though we are yet to start broadcasting the demand for our programmes are so high that we are narrow casting even now."

But what is extraordinary is that the community radio stations are doubling up as nerve centres in the villages of Uttarakhand and Jharkhand as well.

Citing examples of how their community radio station 'Mandakini Ki Awaaz' in Uttarakhand was raising relevant issues, Manvendra Negi, Station Manager of the community radio station elaborated, "Community radio can be used to solve many issues of social and cultural nature simply as it involves active participation of the community. As its a collaborative effort of SSGs, NGOs, gram panchayats and community reporters the impact it has is far more lasting than any other medium. Every social issue and government run programmes for the benefit of the community gets attention and information reaches those who need it most. What more can a communication media ask for?"

Darmyan Rana, Station Manager, 'Hevalvani' a community radio station also in Uttarakhand explains how their community radio station was also using the local cable network to disseminate information and programmes to the community.

"Using photographs as the background we run programmes with audio provided by our CRs and it has been very well received. The two pronged approach of CR thus makes it doubly meaningful for community outreach programmes as the imapct of visuals are always more."

But does CR have a impact to address social evils like corruption?

"Why not," says Suresh Kumar, Programme Coordinator, AID Jharkhand and Radio Vikalp, Garwha, a community radio initiative, "Take the example of programmes like Chala Ho Gaon Mein, which addresses topical issues of the village community. Here matters of violence, women rights and even corruption are addressed regularly specuially now with the elections around the corner. I feel the community radio is not only a cheap and best option for rural outreach programmes but is also pro poor as it helps fight for solidarity justice and good governance. Through the folk songs and dramas that we produce we have managed to do away with social evils and superstitions, raise child labour issues, highlight corruption and campaign against illetracy etc. Awareness and information about AIDS, Polio, Malaria and TB have also been addressed through our CR programmes."

Making a mention of the utility the community radio can have for disseminating information of govt policies and schemes, Kumar further says,"CRs can support the govt efforts to spared awareness about their schemes and policies and at the same time also help educate the community about the how they can benefit from these policies. As far as we have seen the impact of the policies through listenership of CR is higher than publicity material the government has printed so far."

Now that's what we call making waves and literally!

Anjali Singh - Citizen News Service (CNS)

(The author is a senior journalist and Director of Saaksham Foundation. Email:

[Photo credit: Anjali Singh]

Photo captions:
Top photograph: Reporters and RJs planning a programme meeting.
Middle photograph: The team of reporters and producers at the Community Radio Station at Lalitpur, all members were picked up from the adjoining villages.
Bottom photograph: A community Radio Jockey presenting a programme for villagers in UP

Published in
Op-Ed News (OEN), USA
Bihar and Jharkhand News Service (BJNS)
Media for Freedom, Kathmandu, Nepal

Police brutal on 'Ghar Bachao Ghar Banao Andolan' activists

Police brutal on 'Ghar Bachao Ghar Banao Andolan' activists

On 25 March 2009, about 300 slum dwellers, along with activists Medha Patkar and Simpreet Singh, were arrested in Mumbai. More than a thousand slum evictees were protesting in front of the Maharashtra Housing Area Development Authority (MHADA) building. They were protesting against atrocities and corruption by the builders in the name of slum rehabilitation.

After a dialogue with the MHADA, Slum Rehabilitation Authority (SRA) and Mantralaya officials, the representatives were about to go and meet the collector at 3 pm when the police suddenly lathi-charged without any announcement or warning and began arrest.

Thousands of people in Mumbai are still living in transit camps after being evicted years back. The arrested women, more than 200 in number, were brutally lathi-charged and many women were molested and succumbed to injuries on the skull, legs and arms. When reports last came, the injured were being taken to hospital in batches. Many women and children are kept under custody in Bandra Kurla Complex.

Charges put against the people are absolutely fake. Police accused that people have attacked them while the reverse is what actually happened. They were charged under sections 353, 332, 142, 147, 149, some being non-bailable offences.

Vijaya Chauhan, Dipti Bhatnagar, Shrikantha, Medha Patkar

Supreme Court upholds right to peaceful protest

Supreme Court upholds right to peaceful protest



The Supreme Court heard the appeal filed by the Government of Madhya Pradesh (GoMP) against the Judgement of the Madhya Pradesh High Court (Principal Bench: Jabalpur) directing the Government to pay Rs. 10,000/- to each Narmada Satyagrahi (more than Rs 9 lakhs in total), who, while peacefully protesting against injustice through displacement without rehabilitation were subjected to ruthless police force, lathi charge and illegal detention.

Justice Rajinder Sacher pleaded the case very strongly on behalf of Medha Patkar and Narmada Bachao Andolan, vocally defending the Judgement of the High Court and the people’s right to protest peacefully when no brutal force becomes justifiable. The Interim Order delivered by Justice P. Sathasivam upholding the High Court Judgement partially directed the GoMP to immediately (within four weeks) pay Rs. 5000/- to each Satyagrahi totaling Rs. 4.5 lakhs.

The Sardar Sarovar Project affected adivasis and farmers: women, men and children of District Jhabua (now Alirajpur) and Badwani had camped at the Government lands of Krishi Vigyan Kendra as Satyagrahis, demanding the right to land for rehabilitation and right to life in July 2007. During the peaceful Satyagraha, they cultivated the land, without destroying anything belonging to the Government agency, nor did they disturb peace. When 91 of the Satyagrahis were arrested on the 25th July 2007, the women were manhandled and unjustifiable excessive force was used by the Madhya Pradesh police. The satyagrahis arrested under Sec 151 IPC were lodged in jail illegally without review even after 24 hours. The 5 days jail period for all and 3-5 days jail to senior NBA activists Ashish Mandloi and Medha Patkar maliciously invoking old cases was questionable and so was the whole procedure followed during the arrest with the use or brutal force and molestation of women.

The incidents and the role of the State was questioned through a letter sent by Medha Patkar and 25 women from the Indore District Jail which was admitted as a Public Interest Litigation and the Chief Justice of Madhya Pradesh heard the case, which was pleaded by Senior Advocate Shri N.S. Kale of Jabalpur and the Advocate General for the GoMP. The historic Judegment by the Chief Justice of Madhya Pradesh High Court Justice Shri A.K. Patnai, along with Justice Ajit Singh upheld the right to protest peacefully by the adivasis and other Satyagrahis in the situation of their right to life, i.e. right to be rehabilitated as per policy, in the face of displacement, being violated.

The Judgement delivered after full hearing and viewing of CDs provided by both the GoMP and Narmada Bachao Andolan found that Medha Patkar and other agitators were forcibly dragged and bodily lifted and put inside the police van. The High Court found that no circumstances existed to invoke Sections 151 and 107 Cr.P.C. Therefore, the High Court gave a finding that Medha Patkar and other agitators were exercising their fundamental rights – the freedom of speech and expression and their arrest was, therefore, gross violation of their fundamental right, namely Article 19(1)(a), 19(1)(c) and Article 21 (right to life). It upheld the right of the petitioners to be compensated for the illegalities involved in the brutal police action and ordered a compensation of Rs 10,000 to be paid to each Satyagrahi, which money would be recovered from GoMP and the responsible SDM of Badwani.

The GoMP went into appeal against the said judgement of the Supreme Court and the former Justice Rajinder Sacher pleaded for Narmada Bachao Andolan (NBA), on 27 March 2009. The Supreme Court admitted the case, heard the parties, and gave an interim Order directing the GoMP to pay 50% of the compensation amount (Rs 5000) to each Satyagrahi within 4 weeks.

Undoubtedly, the Interim Order is justice delivered not just to NBA Satyagrahis and Project affected, but to all those in people’s movements fighting for the right to land and livelihood and indeed the right to true, human and ecologically just development. Amidst the overall political space for people’s movements shrinking and the state becoming unjustifiably brutal and repressive, using force and intimidation to quell and kill people’s rightful resistance, this is indeed a historic path-breaking judgment that is welcome.

NBA looks forward to the further proceedings in the Court on this matter, which is highly important to people’s movements at large and is thankful to Justice Rajinder Sacher with Advocate Sanjay Parikh and also Advocate NS Kale with Advocate Abhijiit Bhowmik and Advocate Raghavendra for their very valuable contribution to public interest cause at hand.

Kailash Awasya, Ashish Mandloi, Clifton Rozario, Philip Mathew, Medha Patkar

High-level Ministerial meeting on drug-resistant tuberculosis in Beijing

High-level Ministerial meeting on drug-resistant tuberculosis in Beijing

The High Level Ministerial Meeting on multi- and extensively- drug resistant TB (M/XDR-TB) will be held in Beijing from 1 to 3 April 2009 and is being organized by the World Health Organization (WHO), the Ministry of Health of the People's Republic of China and the Bill and Melinda Gates Foundation.

This meeting is likely to bring together health ministers and other stakeholders from 27 high M/XDR-TB burdened countries, including justice and science ministry delegations and representatives from international agencies, civil society, research communities and the corporate sector.

"We have been able to convince the ministers of health of 27 high burden M/XDR-TB countries to come to the Beijing meeting and commit to achieve the targets of the Global Plan to Stop TB" said Dr Ernesto Jaramillo, Medical Officer, Stop TB Department, World Health Organization (WHO) at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil.

"The 2nd Global Plan to Stop TB which was launched in 2006 had laid out specific targets for MDR-TB, to provide universal access to diagnosis and treatment of MDR-TB by year 2015" said Dr Jaramillo.

"Only 3% of people who have MDR-TB have access to effective treatment. We have compelling evidence that we know how to prevent and treat MDR-TB and treatment success rate is 80% in low resource setting. Its intervention is complex but is effective, feasible and is cost-effective" stressed Dr Jaramillo.

The 27 countries represented will be Armenia, Azerbaijan, Bangladesh, Belarus, Bulgaria, China, the Democratic Republic of Congo, Estonia, Ethiopia, Georgia, India, Indonesia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, the Republic of Moldova, Myanmar, Nigeria, the Philippines, the Russian Federation, Pakistan, South Africa, Tajikistan, Ukraine, Uzbekistan and Viet Nam.

The highest levels of MDR-TB ever recorded were reported by WHO in its 'Anti-tuberculosis Drug Resistance in the World' report in February 2008 with nearly half a million new MDR-TB cases emerging worldwide. According to the new WHO report (Global Tuberculosis Control report 2009), the levels of multi-drug resistant TB might be more than half a million as previously thought.

The threat of MDR-TB and XDR-TB can be halted but few of the 27 high MDR-TB burdened countries have response plans in place. Many of these countries are not even properly equipped to diagnose drug-resistant TB.

"We need political commitment from the countries. The XDR-TB task force had met in April 2008 in order to assess the progress we had made in response to MDR-TB and XDR-TB. The Task Force came up with lot of positive things, major progress in many areas. However the number of people on treatment was far below the target. One of the clear recommendations coming out of the XDR-TB Task Force meeting was to convene a high level ministerial meeting where we can get ministers of countries responsible for the 85% of the global M/XDR-TB burden, to achieve the target of universal access to diagnosis and treatment of MDR-TB by 2015" explained Dr Jaramillo.

Countries with low resources are building their capacities to make things happen. Lesotho was able to make a state-of-the-art laboratory for diagnosis of MDR-TB in six months. "We have countries like Nepal, Philippines, Peru that despite of weakness in health systems are providing universal access to MDR-TB diagnosis and treatment" said Dr Jaramillo.

"So far the Green Light Committee (GLC) mechanism, which is an initiative of WHO, and has played an instrumental role in leading the response, began with only one country in the year 2000 - Philippines. Now 8 years later we have 58 countries that have 116 projects approved by GLC. However we have less than 20% of countries that are moving towards scale up country wide of these interventions" said Dr Jaramillo.

Dr Jaramillo expressed his concern that "Countries are not moving fast enough in order to prevent the death of 1000 people with MDR-TB every day."

Vice Premier of China, the Director-General of WHO and very likely that Bill Gates and ministers of health confirmed so far from 21 high burden M/XDR-TB countries will be taking part in the Beijing meeting opening next week.

"We are expecting that this will be a watershed meeting in response to M/XDR-TB" said Dr Jaramillo.

"After this meeting we will like to move towards a World Health Assembly (WHA) resolution. The resolution of WHA is powerful in the sense that countries really commit to do things. After the Beijing meeting, one month later, the Government of China has agreed to submit a proposal of a resolution to the WHA in order to accelerate the response to M/XDR-TB" shared Dr Jaramillo.

The aims of the WHO high-level ministerial meeting on M/XDR-TB include:

- Strengthening political commitment and boosting engagement among affected countries and the global community.
- Using the months leading up to April 2009 to support countries to develop costed MDR-TB components of TB control within health sector plans.
- Working towards solutions in areas such as:
* anti-TB drug quality, supply and rational use;
* laboratory capacity and fast adoption of new and rapid diagnostic tools;
* involvement of the private sector in MDR-TB prevention and control;
* prevention of transmission of TB in healthcare facilities (infection control), congregate settings, prisons and communities;
* promotion of patient and community rights and responsibilites (The Patients' Charter for Tuberculosis care);
* research and development of new drugs and diagnostics.

A new TB vaccine could be ready by 2016

A new TB vaccine could be ready by 2016

The current tools are not enough to control tuberculosis epidemic. The 2009 World Health Organization (WHO) Global Tuberculosis Report says that the incidence of TB per capita continues to go down since 2004 however the decline is just one per cent per year which implies that TB will not be eliminated for centuries if we conduct 'business as usual'.

The existing BCG vaccine which came into the market in 1921, has limited effectiveness in preventing people from TB. Further, the BCG vaccine which is used to prevent childhood TB may not be safe for children living with HIV.

That is why AERAS Global TB Vaccine Foundation and other agencies including Bill & Melinda Gates Foundation are pushing hard to accelerate research and development of safe and effective TB vaccines.

Currently there are seven vaccine candidate products in different stages of the research pipeline around the world.

One phase-III clinical trial in Tanzania which was sponsored by a US University, studied adults who were living with HIV, to see if there was any reduction in disseminated TB in that population. The promising results were announced in October 2008. "We are looking at this clinical trial and might repeat the trial to get a stronger end-point," says Peg Willingham, Senior Director, External Affairs, AERAS Global TB Vaccine Foundation.

"In our research pipeline at AERAS we have six vaccine candidate products" shares Peg Willingham.

One vaccine candidate is being tested if it can replace existing BCG vaccine with a better, modern and more effective BCG vaccine. "The BCG or the improved BCG alone would be strengthened by having a booster shot - a different vaccine that will make the effect last longer and be more effective" explains Peg Willingham.

So we have five boosters and one improved BCG vaccine candidate products in the research pipeline, adds Peg.

By end of 2009, there will be 3 different clinical trials that should be entering phase IIb of two vaccine candidate products. Phase IIb is a mid-way safety and effectiveness trial between phases II and III.

"We are going to test them in different populations. Our objective is to see if the vaccine will work in people of all ages, people living with HIV, and those who have latent tuberculosis. Almost 2 billion people have latent TB so if the vaccine will not work in those with latent TB then it will take a very long time to eliminate TB" says Peg Willingham.

"Currently there are seven vaccine candidate products in different stages of clinical trials since the last 2 years, and it will be a number of years before we get to know if they are successful. They all look very safe currently and we have seen some very early preliminary results that are promising but you cannot say that a Phase I result in a few people will guarantee similar results in large scale phase III clinical trial" explains Peg Willingham.

"With sufficient resources, a new TB vaccine could be ready by 2016" says Peg Willingham.

These clinical trials are likely to be conducted at the highest international standards of ethics and quality because the product developers do aim to get the product approval by the United States Food and Drug Administration (US FDA) and such agencies in different countries around the world.

- Bobby Ramakant

TB vaccine clinical trials may begin this year in India

TB vaccine clinical trials may begin this year in India

Very little research has been done on tuberculosis (TB) vaccine from the time BCG vaccine came into the market in 1921, until the last few years, says Peg Willingham, Senior Director, External Affairs, AERAS Global TB Vaccine Foundation.

In India, which has a high-burden of TB, particularly drug-resistant TB, the TB vaccine research is moving ahead through the regulatory approval processes at St Johns' Research Institute, Bangalore, India.

The existing BCG vaccine has limited effectiveness in preventing people from TB. The 2009 World Health Organization (WHO) Global Tuberculosis Report which was released on 24 March 2009, says that the incidence of TB per capita continues to go down since 2004 however the decline is just one per cent per year which implies that TB will not be eliminated for centuries if we conduct 'business as usual'. The WHO Report also confirms the notion that there might be more than half a million multi-drug resistant TB (MDR-TB) cases every year. Fifty-four (54) countries have reported extensively drug-resistant TB (XDR-TB), according to this report.

There is no doubt that as TB diagnosis and treatment efforts gets scaled up, the efforts to prevent TB should also get boosted. Alongside the compelling need to push research for new TB diagnostics, drugs and vaccines has to be accelerated.

"Sputum smear microscopy TB test was invented in 1882, so it is not the most technologically advanced way but it is the cheapest way to test TB that's why it is still being used in developing countries," says Peg Willingham. "Unfortunately it detects only 50% of TB cases unless the person is infected with HIV when it detects 20% cases" further explains Peg Willingham.

That is why the AERAS Global TB Vaccine Foundation gave expensive and sophisticated equipment called Mycobacteria Growth Indicator Tube (MGIT) to the Bangalore facility where the TB vaccine clinical trials may commence this year, to accurately diagnose TB. "This is one way in which a clinical trial may benefit the community where the research is taking place because we want to bring in very high standards of diagnosis because we want to get reliable results of a clinical trial" says Peg Willingham.

Presently in India, AERAS Global TB Vaccine Foundation is conducting epidemiological studies to find out how much TB is in the area. Since 2005, they have enrolled 11,000 babies and adolescents, not to give TB vaccine candidate products but to see how much TB is in the area. This information is important to evaluate if it is safe enough to do a large clinical trial in that area. AERAS Global TB Vaccine Foundation is also planning to conduct a Phase I clinical trial at St Johns' Research Institute, India, during the course of 2009, said Peg Willingham.

Just like other clinical trials that have taken place in India, AERAS Global TB Vaccine Foundation also is committed to engage communities through effective community advisory boards (CAB), and raising literacy about clinical trials in the community. "We want all our clinical trials to be conducted at the highest international standards of ethics and quality because we will like our vaccines approved by the United States Food and Drug Administration (US FDA) and such agencies in different countries around the world. So if we did anything to compromise the quality it will be tragic because vaccine will not have good uptake" said Peg Willingham.

In the course of conducting these epidemiological studies, AERAS Global TB Vaccine Foundation has already consistently worked upon involving communities, providing them information about tuberculosis and other related information and services.

In Bangalore for these epidemiological studies to assess the TB incidence in the community, babies are enrolled even before they are born because they get BCG vaccine at birth. "So it entails working with pregnant mothers. One important thing we have found which is very cultural to India, is that mother-in-law is very important in the informed consent process" shares Peg Willingham.

"Babies get the existing BCG vaccine. We follow them for two years and provide check up and medical care and refer them to the treatment as needed" adds Peg Willingham.

Finding information about TB incidence in the proposed site for clinical trial of a TB vaccine is crucial to assess the feasibility of a large-scale clinical trial, as an enormous investment is at stake.

"We are also looking at some other possible partnerships to conduct clinical trials elsewhere in India. We have a manufacturing agreement with SERUM Institute of India" shares Peg Willingham.

The TB vaccine research will take at least another seven years before any vaccine can reach the market. Activist Ezio Santos Filho said that there is a gap of USD 2 billion every year to push research and development of new diagnostics, drugs and vaccines. Along with pushing for new tools to fight TB, there is a clear need to scale up high-quality existing TB diagnostics, mobilize communities to test for TB and successfully complete treatment, scale up measures like infection control in congregated settings, provide isoniazid preventive therapy (IPT) wherever possible, and continue advocating for new TB diagnostics, drugs and vaccines.

- Bobby Ramakant

One-third of TB cases go undetected: WHO

One-third of TB cases go undetected: WHO

About 3 million people fail to access TB treatment under directly-observed treatment shortcourse (DOTS), according to the World Health Organization (WHO) Global Tuberculosis Control Report 2009.

Dr Mario Raviglione, Director of Stop TB Department of WHO, said to this correspondent that "more than one-third of all TB cases are not detected under DOTS. Some of these un-notified cases are never diagnosed."

Either the poor access to TB services in some African settings or people accessing TB services in private settings in Asia contribute to these cases going un-notified. There is a clear thrust to scale up new TB case detection and successfully treating those diagnosed.

"There are probably many more TB-HIV co-infection cases than we had previously thought", adds Dr Raviglione. "In 2007, out of the total 9.3 million TB cases, 1.4 million are due to HIV" says Dr Raviglione.

According to the new report released on World TB Day (24 March 2009) at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil, out of 1.7 million TB deaths, half a million deaths are due to TB-HIV co-infection, which is double than the number of deaths attributed to TB-HIV co-infection last year (one out of four TB deaths is HIV-related, twice as many as previously recognized). This figure reflects an improvement in the quality of the country data, which are now more representative and available from more countries than in previous years.
The report reveals a sharp increase in HIV testing among people being treated for TB, especially in Africa. In 2004, just 4% of TB patients in the region were tested for HIV; in 2007 that number rose to 37%, with several countries testing more than 75% of TB patients for their HIV status.

Because of increased testing for HIV among TB patients, more people are getting appropriate treatment though the numbers still remain a small fraction of those in need. In 2007, 200,000 HIV-positive TB patients were enrolled on co-trimoxazole treatment to prevent opportunistic infections and 100,000 were on antiretroviral therapy.

There is a clear mandate to accelerate collaboration between TB and HIV programmes at all levels.

"The incidence of TB per capita continues to go down since 2004 however the decline is just one per cent per year which implies that we will not be able to eliminate TB for centuries" says Dr Raviglione. "We need to fully implement the Stop TB Strategy" stresses Dr Raviglione.

The WHO Global Tuberculosis Control Report 2009 confirms the notion that there might be more than half a million multi-drug resistant TB (MDR-TB) cases every year. "54 countries have reported extensively drug-resistant TB (XDR-TB) to us" said Dr Raviglione.

- Bobby Ramakant

HIV-related TB deaths higher than past estimates

HIV-related TB deaths higher than past estimates

1.37 million new TB cases in 2007 among HIV-infected people, says new global TB control report

RIO DE JANEIRO: The total number of new tuberculosis (TB) cases remained stable in 2007, and the percentage of the world's population becoming ill with TB has continued the slow decline that was first observed in 2004, according to a new report released by the World Health Organization (WHO) on World TB Day, 24 March 2009.

However, the 2009 global TB control report also reveals that one out of four TB deaths is HIV-related, twice as many as previously recognized. In 2007, there were an estimated 1.37 million new cases of tuberculosis among HIV-infected people and 456 000 deaths. This figure reflects an improvement in the quality of the country data, which are now more representative and available from more countries than in previous years.

"These findings point to an urgent need to find, prevent and treat tuberculosis in people living with HIV and to test for HIV in all patients with TB in order to provide prevention, treatment and care. Countries can only do that through stronger collaborative programmes and stronger health systems that address both diseases," said Dr Margaret Chan, Director-General of WHO.
Sharp increase in HIV testing

The report reveals a sharp increase in HIV testing among people being treated for TB, especially in Africa. In 2004, just 4% of TB patients in the region were tested for HIV; in 2007 that number rose to 37%, with several countries testing more than 75% of TB patients for their HIV status.

Because of increased testing for HIV among TB patients, more people are getting appropriate treatment though the numbers still remain a small fraction of those in need. In 2007, 200 000 HIV-positive TB patients were enrolled on co-trimoxazole treatment to prevent opportunistic infections and 100 000 were on antiretroviral therapy.

"We have to stop people living with HIV from dying of tuberculosis," said Mr Michel Sidibe, Executive Director of UNAIDS. "Universal access to HIV prevention, treatment, care and support must include TB prevention, diagnosis and treatment. When HIV and TB services are combined, they save lives."

TB/HIV co-infection and drug-resistant forms of tuberculosis present the greatest challenges, the report says. In 2007 an estimated 500 000 people had multidrug-resistant TB (MDR-TB), but less than 1% of them were receiving treatments that was known to be based on WHO's recommended standards.

Given the current financial crisis, the report documents concerns over an increasing shortage in funding. Ninety-four countries in which 93% of the world's TB cases occur provided complete financial data for the report. To meet the 2009 milestones in the Stop TB Partnership's Global Plan to Stop TB, the funding shortfall for these 94 countries has risen to about US$ 1.5 billion. Full funding of the Global Plan will achieve its aim of halving TB prevalence and deaths compared with 1990 levels by 2015.

"We have made remarkable progress against both TB and HIV in the last few years. But, TB still kills more people with HIV than any other disease," said Dr Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. "The financial crisis must not derail the implementation of the Global Plan to Stop TB. Now is the time to scale-up financing for effective interventions for the prevention, treatment and care of TB worldwide."

The release of the report today coincides with World TB Day and a 1500-strong gathering at the 3rd Stop TB Partners’ Forum in Rio de Janeiro. Next week health leaders and ministers will gather in Beijing in a meeting organized by WHO, the Ministry of Health of the People's Republic of China and the Bill & Melinda Gates Foundation with the aim of securing commitments to actions and funding for drug-resistant TB.