Showing posts with label Cancun 2009. Show all posts
Showing posts with label Cancun 2009. Show all posts
World Tuberculosis (TB) Day is on 24 March in Year of the Lung (2010)
2010 is Year of the Lungs
The year 2010 was declared as year of the lungs to recognize that hundreds of millions of people around the world suffer each year from treatable and preventable chronic respiratory diseases. This initiative acknowledges that lung health has long been neglected in public discourses, and understands the need to unify different health advocates behind one purpose of lung health, informed Dr Nils Billo, Chair of the Forum of International Respiratory Societies (FIRS). Read more
Not respecting confidentiality is unethical in TB Care
Not respecting confidentiality is unethical in TB Care
Why are people who might be having TB not going in for TB testing in Lesotho? "When it comes to confidentiality in TB care, going for testing often means that entire community comes to know of your TB status. This is a violation of human right" said Maketekete Alfred Thotolo, Treatment Literacy and Advocacy Coordinator at Adventist Development and Relief Agency (ADRA Lesotho) which works closely with AIDS and Rights Alliance in Southern Africa (ARASA). Alfred was sharing his experiences from Lesotho at the 40th Union World Conference on Lung Health.
People who might have TB need to have supportive and safe healthcare facilities that don't expose them to TB related stigma, says Alfred. Going for TB test is like taking a risk as healthcare facilities providing TB services are insensitive to the human rights of people who are seeking services from them.
"Normally we are told that somebody's illness is a private matter. But in clinics doctors identify TB patients violating confidentiality and trust. Lack of confidentiality further breeds stigma and discrimination related to TB for this patient" said Alfred. This fear of TB-related stigma and eventual discrimination at different levels, discourages people from going to existing TB-care services. We speak of intensified TB case finding, want people to complete anti-TB treatment successfully and prevent latent TB from becoming active TB disease by taking full course of isoniazid preventive therapy, but unless we address TB stigma and reduce discrimination, it will be difficult to achieve what we are aiming for in TB control, says he.
"In Lesotho, Isoniazid Preventive Therapy (IPT) to prevent latent TB infection from becoming active TB disease, is not available for ordinary citizens but only for health workers. Those people who have latent TB infection have a right to protect themselves and access IPT services to prevent latent TB from becoming active TB disease. I consider these people have a right to get IPT. Everybody has a right to health, when it comes to TB prevention" said Alfred. The Global TB/HIV Working Group of the Stop TB Partnership has clearly stated that: IPT works, IPT is safe, and IPT works with ART or by itself. TB is a major cause of illness and death in people living with HIV, even in those taking antiretroviral therapy. TB could be prevented in millions of people infected with both HIV and TB through the use of IPT. IPT is an important intervention for preventing and reducing active TB in communities affected by HIV - preventing active TB can prevent millions of people from being infected in the community and in health care services.
IPT is safe and effective and the treatment lasts for 6-9 months. It is only given to people who have confirmed latent TB infection (not to be given to those with active TB disease). Effective IPT treatment reduces the development of active TB disease in 40-60% of patients.
Despite of the potential public health outcomes of using IPT effectively in high burden TB countries, and IPT being one of the key interventions recommended by WHO in 1998 to reduce the burden of TB in people living with HIV, the uptake of IPT has been very low. Clearly there is a need to mobilize TB-HIV affected communities and other stakeholders to integrate IPT as part of the package of health services.
Everybody has a right to health - and this includes the right to access TB services - without any fear of healthcare facilities not respecting one's confidentiality or being denied IPT if one has latent TB and putting oneself at risk of developing active TB disease.
May be TB care and control programmes can get some lessons in reducing stigma and discrimination from other disease control programmes. Engaging community meaningfully at all levels of AIDS programmes has certainly yielded results - and reduced stigma, discrimination and increased access to AIDS services in different parts of the world. Community engagement is certainly suboptimal in TB care and control programmes in reality. There are good examples where genuine involvement of community, particularly cured TB patients, have improved TB programme performances in different parts of the world. But this is certainly not a generalized statement to the global TB control.
The WHO Global TB Strategy and the Global Plan to Stop TB (2006-2015) gives a major thrust to community engagement. The Patients' Charter for Tuberculosis Care (PCTC, The Charter) is an integral component of the WHO Global TB Strategy, as a tool to empower communities for advocating to achieve the International Standards of Tuberculosis Care (ISTC). Many national governments have adapted the Charter as official component of their national TB programmes. But in reality, genuine engagement of cured TB patients at all levels of TB programmes is a distant dream, despite of increasing number of examples where community has demonstrated their competence in improving TB responses locally. After all, why are governments reluctant to engage communities - which can address so many current impediments to TB care and control at local level?
A 2007 World Bank research report "The Economic Benefit of Global Investments in Tuberculosis Control" found that 22 countries with the world’s highest numbers of TB cases could earn significantly more than they spend on TB diagnosis and treatment if they signed onto a global plan to sharply reduce the numbers of TB-related deaths. Highly affected African countries could gain up to 9 times their investments in TB control. When the economic benefits of effective TB care and control are estimated to be greater than the cost, it is all the more reason for governments to not delay any further the improvement of TB responses by engaging communities with dignity as equal partners in TB care and control at all levels.
Why are people who might be having TB not going in for TB testing in Lesotho? "When it comes to confidentiality in TB care, going for testing often means that entire community comes to know of your TB status. This is a violation of human right" said Maketekete Alfred Thotolo, Treatment Literacy and Advocacy Coordinator at Adventist Development and Relief Agency (ADRA Lesotho) which works closely with AIDS and Rights Alliance in Southern Africa (ARASA). Alfred was sharing his experiences from Lesotho at the 40th Union World Conference on Lung Health.
People who might have TB need to have supportive and safe healthcare facilities that don't expose them to TB related stigma, says Alfred. Going for TB test is like taking a risk as healthcare facilities providing TB services are insensitive to the human rights of people who are seeking services from them.
"Normally we are told that somebody's illness is a private matter. But in clinics doctors identify TB patients violating confidentiality and trust. Lack of confidentiality further breeds stigma and discrimination related to TB for this patient" said Alfred. This fear of TB-related stigma and eventual discrimination at different levels, discourages people from going to existing TB-care services. We speak of intensified TB case finding, want people to complete anti-TB treatment successfully and prevent latent TB from becoming active TB disease by taking full course of isoniazid preventive therapy, but unless we address TB stigma and reduce discrimination, it will be difficult to achieve what we are aiming for in TB control, says he.
"In Lesotho, Isoniazid Preventive Therapy (IPT) to prevent latent TB infection from becoming active TB disease, is not available for ordinary citizens but only for health workers. Those people who have latent TB infection have a right to protect themselves and access IPT services to prevent latent TB from becoming active TB disease. I consider these people have a right to get IPT. Everybody has a right to health, when it comes to TB prevention" said Alfred. The Global TB/HIV Working Group of the Stop TB Partnership has clearly stated that: IPT works, IPT is safe, and IPT works with ART or by itself. TB is a major cause of illness and death in people living with HIV, even in those taking antiretroviral therapy. TB could be prevented in millions of people infected with both HIV and TB through the use of IPT. IPT is an important intervention for preventing and reducing active TB in communities affected by HIV - preventing active TB can prevent millions of people from being infected in the community and in health care services.
IPT is safe and effective and the treatment lasts for 6-9 months. It is only given to people who have confirmed latent TB infection (not to be given to those with active TB disease). Effective IPT treatment reduces the development of active TB disease in 40-60% of patients.
Despite of the potential public health outcomes of using IPT effectively in high burden TB countries, and IPT being one of the key interventions recommended by WHO in 1998 to reduce the burden of TB in people living with HIV, the uptake of IPT has been very low. Clearly there is a need to mobilize TB-HIV affected communities and other stakeholders to integrate IPT as part of the package of health services.
Everybody has a right to health - and this includes the right to access TB services - without any fear of healthcare facilities not respecting one's confidentiality or being denied IPT if one has latent TB and putting oneself at risk of developing active TB disease.
May be TB care and control programmes can get some lessons in reducing stigma and discrimination from other disease control programmes. Engaging community meaningfully at all levels of AIDS programmes has certainly yielded results - and reduced stigma, discrimination and increased access to AIDS services in different parts of the world. Community engagement is certainly suboptimal in TB care and control programmes in reality. There are good examples where genuine involvement of community, particularly cured TB patients, have improved TB programme performances in different parts of the world. But this is certainly not a generalized statement to the global TB control.
The WHO Global TB Strategy and the Global Plan to Stop TB (2006-2015) gives a major thrust to community engagement. The Patients' Charter for Tuberculosis Care (PCTC, The Charter) is an integral component of the WHO Global TB Strategy, as a tool to empower communities for advocating to achieve the International Standards of Tuberculosis Care (ISTC). Many national governments have adapted the Charter as official component of their national TB programmes. But in reality, genuine engagement of cured TB patients at all levels of TB programmes is a distant dream, despite of increasing number of examples where community has demonstrated their competence in improving TB responses locally. After all, why are governments reluctant to engage communities - which can address so many current impediments to TB care and control at local level?
A 2007 World Bank research report "The Economic Benefit of Global Investments in Tuberculosis Control" found that 22 countries with the world’s highest numbers of TB cases could earn significantly more than they spend on TB diagnosis and treatment if they signed onto a global plan to sharply reduce the numbers of TB-related deaths. Highly affected African countries could gain up to 9 times their investments in TB control. When the economic benefits of effective TB care and control are estimated to be greater than the cost, it is all the more reason for governments to not delay any further the improvement of TB responses by engaging communities with dignity as equal partners in TB care and control at all levels.
Community-led monitoring and advocacy is improving TB response in Zimbabwe
Community-led monitoring and advocacy is improving TB response in Zimbabwe
Despite of the Patients' Charter for Tuberculosis Care being an integral part of the Global Stop TB Strategy, and major thrust on community engagement in the Global Plan to Stop TB, communities are yet not optimally engaged by the TB programmes in high burden countries. However there are promising examples where community engagement has led to improved TB programme outcomes, and health outcomes over all.
At the 40th Union World Conference on Lung Health in Cancun, Mexico, co-chairs Dorothy Namutamba, East African Regional Coordinator for International Community of Women with HIV/AIDS (ICW) and Erin Howe from Public Health Watch, moderated a very interactive session on community engagement in TB responses. Albert Makone from Community Working Group on Health (CWGH) shared an inspiring example of how communities were engaged and mobilized for the uptake of intensified TB case finding in HIV-care settings.
"Our role has been over the past years to encourage community participation and to build mechanisms so that community can engage - our motto is health is your right and also your responsibility" said Albert Makone. "We began working on HIV in 1998 and integrated TB issues too in 2007" informed Albert. "The evidence that was coming from the civil society on people getting impacted by both: HIV and TB - led us to integrate TB in our initiatives."
"We engaged parliamentarians, national TB programme (NTP) managers, and other stakeholders" said Albert. "We elected the parliamentarians and we thought that engaging them will increase accountability of them towards their own electorate" said Albert. "The Abuja Declaration that demanded 15% budget allocation for health was a great tool to push parliamentarians for upping domestic funding on health. We believe one day we will invest more than 15% of budget on health" shares Albert.
"We began working closely with regional campaign for essential medicines. Nokia, mobile phone manufacturer, distributed mobile phones to every health centre and clinics so that clinics can communicate with the health centres and inform them about depleting drug stocks. This was an intervention in response to drug stock-outs in Zimbabwe" said Albert.
"There were reports about theft in dispensaries so we mobilized funds for security guards so that drugs go to the people who need it most" said Albert.
Speaking about community monitors called "TB Monitors" at village level, Albert says: "We were able to do community monitoring by training people to be TB monitors at the village level. These monitors were trained for five days on HIV and TB issues and screened local people to boost intensified new TB case finding - and increase treatment literacy for better treatment outcomes" says Albert.
"One of the key challenge was vertical programming of TB and HIV - and we need to find solutions to up the collaborative TB/HIV activities on the ground" remarks Albert.
The lack of coordinated mechanism between the new agencies addressing TB has required Albert's organization to take on a leadership role in pushing the TB/HIV advocacy agenda in Zimbabwe.
"It was a long process to engage parliamentarians as their awareness on health was low. We finally organized two days workshop with parliamentarians to sensitize them on health and emphasize the TB/HIV epidemics in Zimbabwe. We focussed on reaching out to the portfolio committee on health and slowly the role of community was becoming evident to policy makers - that community is there not only to criticize but also to help give input and shape solutions as informed and treatment literate partner" said Albert.
"Issue of infrastructure is there as it is in a very dilapidated state in Zimbabwe. Laboratory capacity is weak and domestic funding is low" shares Albert.
"NTP managers should consider community as equal partner and listen to their voices. If they don't involve affected communities in a meaningful manner, it will be a missing link. We will have good laboratories, diagnostics, drugs but continue to have higher infection rates. We need to listen to community voices and resolve the issues they face to improve TB programme performances" said Albert.
As a result of the growing movement for TB/HIV collaborative activities, a quarter of the AIDS service organizations in two districts of Zimbabwe are offering TB screening to their clients and referring them for diagnosis and treatment of TB.
Despite of the Patients' Charter for Tuberculosis Care being an integral part of the Global Stop TB Strategy, and major thrust on community engagement in the Global Plan to Stop TB, communities are yet not optimally engaged by the TB programmes in high burden countries. However there are promising examples where community engagement has led to improved TB programme outcomes, and health outcomes over all.
At the 40th Union World Conference on Lung Health in Cancun, Mexico, co-chairs Dorothy Namutamba, East African Regional Coordinator for International Community of Women with HIV/AIDS (ICW) and Erin Howe from Public Health Watch, moderated a very interactive session on community engagement in TB responses. Albert Makone from Community Working Group on Health (CWGH) shared an inspiring example of how communities were engaged and mobilized for the uptake of intensified TB case finding in HIV-care settings.
"Our role has been over the past years to encourage community participation and to build mechanisms so that community can engage - our motto is health is your right and also your responsibility" said Albert Makone. "We began working on HIV in 1998 and integrated TB issues too in 2007" informed Albert. "The evidence that was coming from the civil society on people getting impacted by both: HIV and TB - led us to integrate TB in our initiatives."
"We engaged parliamentarians, national TB programme (NTP) managers, and other stakeholders" said Albert. "We elected the parliamentarians and we thought that engaging them will increase accountability of them towards their own electorate" said Albert. "The Abuja Declaration that demanded 15% budget allocation for health was a great tool to push parliamentarians for upping domestic funding on health. We believe one day we will invest more than 15% of budget on health" shares Albert.
"We began working closely with regional campaign for essential medicines. Nokia, mobile phone manufacturer, distributed mobile phones to every health centre and clinics so that clinics can communicate with the health centres and inform them about depleting drug stocks. This was an intervention in response to drug stock-outs in Zimbabwe" said Albert.
"There were reports about theft in dispensaries so we mobilized funds for security guards so that drugs go to the people who need it most" said Albert.
Speaking about community monitors called "TB Monitors" at village level, Albert says: "We were able to do community monitoring by training people to be TB monitors at the village level. These monitors were trained for five days on HIV and TB issues and screened local people to boost intensified new TB case finding - and increase treatment literacy for better treatment outcomes" says Albert.
"One of the key challenge was vertical programming of TB and HIV - and we need to find solutions to up the collaborative TB/HIV activities on the ground" remarks Albert.
The lack of coordinated mechanism between the new agencies addressing TB has required Albert's organization to take on a leadership role in pushing the TB/HIV advocacy agenda in Zimbabwe.
"It was a long process to engage parliamentarians as their awareness on health was low. We finally organized two days workshop with parliamentarians to sensitize them on health and emphasize the TB/HIV epidemics in Zimbabwe. We focussed on reaching out to the portfolio committee on health and slowly the role of community was becoming evident to policy makers - that community is there not only to criticize but also to help give input and shape solutions as informed and treatment literate partner" said Albert.
"Issue of infrastructure is there as it is in a very dilapidated state in Zimbabwe. Laboratory capacity is weak and domestic funding is low" shares Albert.
"NTP managers should consider community as equal partner and listen to their voices. If they don't involve affected communities in a meaningful manner, it will be a missing link. We will have good laboratories, diagnostics, drugs but continue to have higher infection rates. We need to listen to community voices and resolve the issues they face to improve TB programme performances" said Albert.
As a result of the growing movement for TB/HIV collaborative activities, a quarter of the AIDS service organizations in two districts of Zimbabwe are offering TB screening to their clients and referring them for diagnosis and treatment of TB.
Global Fund approves TB funding for government and civil society led proposal in India
Global Fund approves TB funding for government and civil society led proposal in India
A defining moment in the history of tuberculosis control in India
A proposal that will launch a massive effort to address two of the main challenges to tuberculosis (TB) control in India has been approved for Round 9 funding by the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). The grant is by far the largest ever made to TB control in India, the country which bears the highest TB burden and also has highest estimated incidence of multi-drug resistant TB (MDR-TB) in the world.
The proposal submitted by the Government of India in partnership with civil society has three principal recipients – the Government’s Central TB Division, The International Union Against Tuberculosis and Lung Disease (The Union) and World Vision India – who will be responsible for implementing the five-year project.
“We’re very pleased to learn of the success of this proposal”, said Dr Nils E Billo, Executive Director of The Union. “In particular, the strengthening of civil society participation demonstrates the new awareness that health systems alone can not solve problems like TB control. Broader social commitment is required”.
The first component of the project will focus on providing universal access to MDR-TB diagnosis and treatment. It will establish and scale-up capacity for quality-assured rapid diagnosis of MDR-TB in 43 referral laboratories in India by 2015. In addition, it seeks to scale up care and management of MDR-TB across India in its 35 states and territories resulting in the treatment of 55,350 additional MDR-TB cases by 2015.
The second component seeks to strengthen civil society involvement in TB care and control to improve the reach, visibility and effectiveness of India’s Revised National Tuberculosis Control Programme (RNCTP) in 374 districts across 23 states, reaching about 744 million people by 2015.
While India has already made great strides in providing access to basic ‘DOTS’ (the globally recognised strategy for TB control), this project will provide better access to TB services, especially in geographically difficult areas, vulnerable communities and tribal populations.
Additionally, RNTCP will be supported and strengthened at the sub-district, district, state and national levels. The involvement of multiple stakeholders across civil society, from private practitioners and NGOs to technical agencies and community groups, on such a large scale, is expected to develop functional and sustainable networks, increase information sharing and accountability, and empower community monitoring and ownership of TB care and control.
The Global Fund Board has approved funding for the initial two years of the five-year proposal that seeks a total grant of US$ 199.54 million. The actual funding amount for the two years will be finalised in the next few months.
A defining moment in the history of tuberculosis control in India
A proposal that will launch a massive effort to address two of the main challenges to tuberculosis (TB) control in India has been approved for Round 9 funding by the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). The grant is by far the largest ever made to TB control in India, the country which bears the highest TB burden and also has highest estimated incidence of multi-drug resistant TB (MDR-TB) in the world.
The proposal submitted by the Government of India in partnership with civil society has three principal recipients – the Government’s Central TB Division, The International Union Against Tuberculosis and Lung Disease (The Union) and World Vision India – who will be responsible for implementing the five-year project.
“We’re very pleased to learn of the success of this proposal”, said Dr Nils E Billo, Executive Director of The Union. “In particular, the strengthening of civil society participation demonstrates the new awareness that health systems alone can not solve problems like TB control. Broader social commitment is required”.
The first component of the project will focus on providing universal access to MDR-TB diagnosis and treatment. It will establish and scale-up capacity for quality-assured rapid diagnosis of MDR-TB in 43 referral laboratories in India by 2015. In addition, it seeks to scale up care and management of MDR-TB across India in its 35 states and territories resulting in the treatment of 55,350 additional MDR-TB cases by 2015.
The second component seeks to strengthen civil society involvement in TB care and control to improve the reach, visibility and effectiveness of India’s Revised National Tuberculosis Control Programme (RNCTP) in 374 districts across 23 states, reaching about 744 million people by 2015.
While India has already made great strides in providing access to basic ‘DOTS’ (the globally recognised strategy for TB control), this project will provide better access to TB services, especially in geographically difficult areas, vulnerable communities and tribal populations.
Additionally, RNTCP will be supported and strengthened at the sub-district, district, state and national levels. The involvement of multiple stakeholders across civil society, from private practitioners and NGOs to technical agencies and community groups, on such a large scale, is expected to develop functional and sustainable networks, increase information sharing and accountability, and empower community monitoring and ownership of TB care and control.
The Global Fund Board has approved funding for the initial two years of the five-year proposal that seeks a total grant of US$ 199.54 million. The actual funding amount for the two years will be finalised in the next few months.
Community-led monitoring of anti-TB essential medicines in Uganda
Community-led monitoring of anti-TB essential medicines in Uganda
The Global Pan to Stop TB (2006-2015) identifies a need to empower communities to take ownership and drive the agenda for TB elimination. Communities are vital partners for policy makers and implementers in addressing TB, MDR-TB and TB-HIV, and diverse strategies are required to support their full participation.
Community-led monitoring of drug supply and procurement can be a vital tool to document challenges people with TB might be facing and also to lead to solutions. A good example rests in Uganda. "My organization was monitoring a list of 15 essential medicines in Uganda. After a training I underwent with Treatment Action Group (TAG) and ICW, I understood the importance of TB and HIV drugs and the need to monitor them as well. After considerable efforts, I could convince my organization to add the TB/HIV drugs to the list of essential drugs we monitor" said Prima Kazoora, Coalition for Health Promotion and Social Development, Uganda. "During monitoring of essential medicines, we discovered that there were frequent drug-stock outs and there were times when TB drugs were not available for more than three months! There were patients with TB who were put on anti-TB treatment who got their treatment disrupted due to drug stock-outs lasting months at times. This could lead to increase in drug resistance and poor treatment outcomes" shared Prima.
"We also found out that the TB laboratories were often out of reagents and therefore unable to conduct any TB test" said Prima. "TB treatment is available in public sector hospitals only. It is not available in private sector hospitals. Anti-TB drugs are also not available in pharmacies. So when government-run centres had drug stock-out, people with TB were left with no other option" said Prima Kazoora.
"Lack of paediatric formulations was another major challenge. Health workers were asked to break down tablets in equal parts for children" said Prima.
So Prima's organization continued monitoring, documenting and reporting these issues. They investigated using community networks that the problem due to which drug stock outs occur in Uganda are mostly in distribution system and interruption in funding cycles. Uganda government was mostly relying on external funding to procure these drugs. So when Uganda government wasn't able to access funds from the Global Fund to fight AIDS, TB and Malaria (GFATM), it led to stock outs.
"Government should earmark funds for essential medicines to ensure no drug stock outs occur" suggested Prima.
"Stop Medicine Stock-Out Campaign engaged a wide network of organizations and began lobbying to ensure regular drug supply of essential medicines. During this campaign, we highlighted issues and build pressure on authorities to respond. Eventually the President of Uganda came up with drug monitoring unit for drug distribution and procurement campaign increasing access and availability of essential medicines" said Prima.
Prima's work has allowed TB/HIV activists to be recognized as crucial partners in the fight against TB in Uganda. She was selected to serve on the Technical Working Group on Medicines that advises the Ugandan government on policies related to purchase and accessibility of essential medicines.
Published In:
Elites TV News, USA
Citizen News Service (CNS), India/Thailand
Health Dev.Net
NGO News Africa, Africa
Celebrifi News.com
The Global Pan to Stop TB (2006-2015) identifies a need to empower communities to take ownership and drive the agenda for TB elimination. Communities are vital partners for policy makers and implementers in addressing TB, MDR-TB and TB-HIV, and diverse strategies are required to support their full participation.
Community-led monitoring of drug supply and procurement can be a vital tool to document challenges people with TB might be facing and also to lead to solutions. A good example rests in Uganda. "My organization was monitoring a list of 15 essential medicines in Uganda. After a training I underwent with Treatment Action Group (TAG) and ICW, I understood the importance of TB and HIV drugs and the need to monitor them as well. After considerable efforts, I could convince my organization to add the TB/HIV drugs to the list of essential drugs we monitor" said Prima Kazoora, Coalition for Health Promotion and Social Development, Uganda. "During monitoring of essential medicines, we discovered that there were frequent drug-stock outs and there were times when TB drugs were not available for more than three months! There were patients with TB who were put on anti-TB treatment who got their treatment disrupted due to drug stock-outs lasting months at times. This could lead to increase in drug resistance and poor treatment outcomes" shared Prima.
"We also found out that the TB laboratories were often out of reagents and therefore unable to conduct any TB test" said Prima. "TB treatment is available in public sector hospitals only. It is not available in private sector hospitals. Anti-TB drugs are also not available in pharmacies. So when government-run centres had drug stock-out, people with TB were left with no other option" said Prima Kazoora.
"Lack of paediatric formulations was another major challenge. Health workers were asked to break down tablets in equal parts for children" said Prima.
So Prima's organization continued monitoring, documenting and reporting these issues. They investigated using community networks that the problem due to which drug stock outs occur in Uganda are mostly in distribution system and interruption in funding cycles. Uganda government was mostly relying on external funding to procure these drugs. So when Uganda government wasn't able to access funds from the Global Fund to fight AIDS, TB and Malaria (GFATM), it led to stock outs.
"Government should earmark funds for essential medicines to ensure no drug stock outs occur" suggested Prima.
"Stop Medicine Stock-Out Campaign engaged a wide network of organizations and began lobbying to ensure regular drug supply of essential medicines. During this campaign, we highlighted issues and build pressure on authorities to respond. Eventually the President of Uganda came up with drug monitoring unit for drug distribution and procurement campaign increasing access and availability of essential medicines" said Prima.
Prima's work has allowed TB/HIV activists to be recognized as crucial partners in the fight against TB in Uganda. She was selected to serve on the Technical Working Group on Medicines that advises the Ugandan government on policies related to purchase and accessibility of essential medicines.
Published In:
Elites TV News, USA
Citizen News Service (CNS), India/Thailand
Health Dev.Net
NGO News Africa, Africa
Celebrifi News.com
The year 2010 is declared as Year of the Lung
The year 2010 is declared as Year of the Lung
The Forum of International Respiratory Societies (FIRS) convening at the 40th Union World Conference on Lung Health in Cancun, Mexico, declared the year 2010 as the Year of the Lung. This was done to recognize that hundreds of millions of people around the world suffer each year from treatable and
preventable chronic respiratory diseases. This initiative acknowledges that lung health has long been neglected in public discourses, and understands the need to unify different health advocates behind one purpose of lung health, informed Dr Nils Billo, Chair of FIRS. The FIRS partners include the International Union Against Tuberculosis and Lung Disease (The Union), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociacion Latinoamericana de Torax (ALAT), European Respiratory Society (ERS), Pan African Thoracic Society and American College of Chest Physicians (ACCP).
The New York Times carried a series of articles on different parts of human body, but forgot the lungs! It is difficult to remain alive without lungs for more than few seconds!
The Declaration signed by the partners of the Forum of International Respiratory Societies (FIRS) read as following:
[Begin]
WE NOTE WITH GRAVE CONCERN THAT:
Hundreds of millions of people around the world suffer each year from treatable and preventable respiratory diseases, including tuberculosis (TB), asthma, lung cancer, H1N1, pneumonia, chronic obstructive pulmonary disease (COPD).
WE RECOGNIZE THAT:
Despite the magnitude of suffering and death caused by lung disease, lung health has long been neglected in public discourse and in public health decisions.
WE CALL UPON OUR PARTNERS TO:
Enact smoking cessation legislation and programs to reduce the prevalence and stigma of tobacco-related lung diseases.
[Ends]
There are a range of health and environmental factors that affect our lung health. This includes tuberculosis (TB), tobacco smoke, biomass fuel smoke, chronic obstructive pulmonary disease, asthma, pneumonia among other respiratory infections. The evidence of their potentially devastating effects on global public health is increasing and they require a coordinated approach for control. These diseases all occur in predominantly resource-poor countries. They are perpetuated by poverty and inadequate resources and their control and management require coordinated approach among health programmes at all levels.
Statistically, there is 1 TB-related death that takes place every 18 seconds, 1 HIV death every 16 seconds, 1 child dies of pneumonia every 15 seconds and 1 smoking-related death every 13 seconds. The enormous public challenge posed by the combined epidemics of tobacco smoking, HIV, TB and COPD, is undoubtedly alarming.
More than 2 billion people or a third of the world's total population, are infected with mycobacterium tuberculosis. Tuberculosis is now the world's seventh-leading cause of death. It killed 1.8 million people worldwide last year, up from 1.77 million in 2007. It is one of the three primary diseases that are closely linked to poverty, the other two being AIDS and malaria.
Tobacco smoking is unquestionably the primary risk factor for COPD. More than 5 million deaths are attributed to tobacco use every year. Smokers have two fold higher risk of developing active TB disease. Tobacco smokers have 2 times more risk of dieing of TB. Tobacco smoke increases the risk of pneumonia, influenza, menningococcal meningitis, among others. Evidence is accumulating that smoking is a risk factor for TB. However there is no published data on the cellular interactions of tobacco smoke and mycobacterium tuberculosis. The risk to develop active TB disease is higher when tobacco smoking is combined with alcohol.
Dr Donald Enarson stressed that tobacco smoking cessation is an important part of the comprehensive tobacco control programme, and not the only part. So all components of the comprehensive tobacco control measures should be implemented for improving public health outcomes. Dr Enarson was referring to MPOWER report from Tobacco Free Initiative (TFI) of WHO which outlines the MPOWER package, a set of six key tobacco control measures that reflect and build on the WHO Framework Convention on Tobacco Control (FCTC, global tobacco treaty). Another delegates remarked that MPOWER is in line with the global tobacco treaty - FCTC - and we should be demanding implementation of the treaty to which governments have committed to enforce. The WHO FCTC is the first public health and corporate accountability treaty, said a delegate from India. Comprehensive tobacco control programmes can yield major public health outcomes, as 30% of male TB patients die of tobacco smoking.
Asthma is yet another major lung health challenge. It is a chronic disease that affects airways. When people have asthma, the inside walls of their airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that they are allergic to or find irritating. When airways react, they get narrower and lungs get less air. This can cause wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night. When asthma symptoms become worse than usual, it's called an asthma attack. In a severe asthma attack, the airways can close so much that vital organs do not get enough oxygen. People can die from severe asthma attacks.
More than 300 million people around the world have asthma, and the disease imposes a heavy burden on individuals, families, and societies. The Global Burden of Asthma Report, indicates that asthma control often falls short and there are many barriers to asthma control around the world. Proper long-term management of asthma will permit most patients to achieve good control of their disease. Yet in many regions around the world, this goal is often not met. Poor asthma control is also seen in the lifestyle limitations experienced by some people with asthma. For example, in some regions, up to one in four children with asthma is unable to attend school regularly because of poor asthma control. Asthma deaths are the ultimate, tragic evidence of uncontrolled asthma.
According to the Global Burden of Asthma Report, the majority of asthma deaths in some regions of the world are preventable. Effective asthma treatments exist and, with proper diagnosis, education, and treatment, the great majority of asthma patients can achieve and maintain good control of their disease. When asthma is under control, patients can live full and active lives.
Pneumonia claims two million children under five each year, yet no new drug, vaccine or special diagnostic test is needed to save their lives. The answers are at hand, and effective treatment is both inexpensive and widely available.
Host of other conditions that affect the lungs, are preventable, and often treatable.
Let us hope that 2010 Year of The Lung initiative of FIRS puts the spotlight on the long neglected part of human body which New York Times missed, the lungs.
Published in:
Thai-Indian News, Bangkok, Thailand
Citizen News Service (CNS), India/Thailand
Modern Ghana News, Accra, Ghana
Media For Freedom, Nepal
Banderas News, Mexico
Elites TV News, USA
World News Network (WNN), USA
Orissa.Net, Orissa, India
Bihar And Jharkhand News Service (BJNS)
Allergyasthmasolutions.com
Health Dev.Net
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The Forum of International Respiratory Societies (FIRS) convening at the 40th Union World Conference on Lung Health in Cancun, Mexico, declared the year 2010 as the Year of the Lung. This was done to recognize that hundreds of millions of people around the world suffer each year from treatable and
preventable chronic respiratory diseases. This initiative acknowledges that lung health has long been neglected in public discourses, and understands the need to unify different health advocates behind one purpose of lung health, informed Dr Nils Billo, Chair of FIRS. The FIRS partners include the International Union Against Tuberculosis and Lung Disease (The Union), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociacion Latinoamericana de Torax (ALAT), European Respiratory Society (ERS), Pan African Thoracic Society and American College of Chest Physicians (ACCP).The New York Times carried a series of articles on different parts of human body, but forgot the lungs! It is difficult to remain alive without lungs for more than few seconds!
The Declaration signed by the partners of the Forum of International Respiratory Societies (FIRS) read as following:
[Begin]
WE NOTE WITH GRAVE CONCERN THAT:
Hundreds of millions of people around the world suffer each year from treatable and preventable respiratory diseases, including tuberculosis (TB), asthma, lung cancer, H1N1, pneumonia, chronic obstructive pulmonary disease (COPD).
WE RECOGNIZE THAT:
Despite the magnitude of suffering and death caused by lung disease, lung health has long been neglected in public discourse and in public health decisions.
WE CALL UPON OUR PARTNERS TO:
Enact smoking cessation legislation and programs to reduce the prevalence and stigma of tobacco-related lung diseases.
[Ends]
There are a range of health and environmental factors that affect our lung health. This includes tuberculosis (TB), tobacco smoke, biomass fuel smoke, chronic obstructive pulmonary disease, asthma, pneumonia among other respiratory infections. The evidence of their potentially devastating effects on global public health is increasing and they require a coordinated approach for control. These diseases all occur in predominantly resource-poor countries. They are perpetuated by poverty and inadequate resources and their control and management require coordinated approach among health programmes at all levels.
Statistically, there is 1 TB-related death that takes place every 18 seconds, 1 HIV death every 16 seconds, 1 child dies of pneumonia every 15 seconds and 1 smoking-related death every 13 seconds. The enormous public challenge posed by the combined epidemics of tobacco smoking, HIV, TB and COPD, is undoubtedly alarming.
More than 2 billion people or a third of the world's total population, are infected with mycobacterium tuberculosis. Tuberculosis is now the world's seventh-leading cause of death. It killed 1.8 million people worldwide last year, up from 1.77 million in 2007. It is one of the three primary diseases that are closely linked to poverty, the other two being AIDS and malaria.
Tobacco smoking is unquestionably the primary risk factor for COPD. More than 5 million deaths are attributed to tobacco use every year. Smokers have two fold higher risk of developing active TB disease. Tobacco smokers have 2 times more risk of dieing of TB. Tobacco smoke increases the risk of pneumonia, influenza, menningococcal meningitis, among others. Evidence is accumulating that smoking is a risk factor for TB. However there is no published data on the cellular interactions of tobacco smoke and mycobacterium tuberculosis. The risk to develop active TB disease is higher when tobacco smoking is combined with alcohol.
Dr Donald Enarson stressed that tobacco smoking cessation is an important part of the comprehensive tobacco control programme, and not the only part. So all components of the comprehensive tobacco control measures should be implemented for improving public health outcomes. Dr Enarson was referring to MPOWER report from Tobacco Free Initiative (TFI) of WHO which outlines the MPOWER package, a set of six key tobacco control measures that reflect and build on the WHO Framework Convention on Tobacco Control (FCTC, global tobacco treaty). Another delegates remarked that MPOWER is in line with the global tobacco treaty - FCTC - and we should be demanding implementation of the treaty to which governments have committed to enforce. The WHO FCTC is the first public health and corporate accountability treaty, said a delegate from India. Comprehensive tobacco control programmes can yield major public health outcomes, as 30% of male TB patients die of tobacco smoking.
Asthma is yet another major lung health challenge. It is a chronic disease that affects airways. When people have asthma, the inside walls of their airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that they are allergic to or find irritating. When airways react, they get narrower and lungs get less air. This can cause wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night. When asthma symptoms become worse than usual, it's called an asthma attack. In a severe asthma attack, the airways can close so much that vital organs do not get enough oxygen. People can die from severe asthma attacks.
More than 300 million people around the world have asthma, and the disease imposes a heavy burden on individuals, families, and societies. The Global Burden of Asthma Report, indicates that asthma control often falls short and there are many barriers to asthma control around the world. Proper long-term management of asthma will permit most patients to achieve good control of their disease. Yet in many regions around the world, this goal is often not met. Poor asthma control is also seen in the lifestyle limitations experienced by some people with asthma. For example, in some regions, up to one in four children with asthma is unable to attend school regularly because of poor asthma control. Asthma deaths are the ultimate, tragic evidence of uncontrolled asthma.
According to the Global Burden of Asthma Report, the majority of asthma deaths in some regions of the world are preventable. Effective asthma treatments exist and, with proper diagnosis, education, and treatment, the great majority of asthma patients can achieve and maintain good control of their disease. When asthma is under control, patients can live full and active lives.
Pneumonia claims two million children under five each year, yet no new drug, vaccine or special diagnostic test is needed to save their lives. The answers are at hand, and effective treatment is both inexpensive and widely available.
Host of other conditions that affect the lungs, are preventable, and often treatable.
Let us hope that 2010 Year of The Lung initiative of FIRS puts the spotlight on the long neglected part of human body which New York Times missed, the lungs.
Published in:
Thai-Indian News, Bangkok, Thailand
Citizen News Service (CNS), India/Thailand
Modern Ghana News, Accra, Ghana
Media For Freedom, Nepal
Banderas News, Mexico
Elites TV News, USA
World News Network (WNN), USA
Orissa.Net, Orissa, India
Bihar And Jharkhand News Service (BJNS)
Allergyasthmasolutions.com
Health Dev.Net
Connect in.com
Tweetmeme.com
Twitter.com
Human rights violations in people with TB
Human rights violations in people with TB
Human Rights have long been ignored in TB 'Control', but are a foundation for improving care as outlined in the International Standards for TB Care (ISTC) and the Patients' Charter for TB Care (PCTC). At the 40th Union World Conference on Lung Health, delegates spoke about human rights violations that challenge TB care and control on the frontlines in their national contexts.
"Dominant human rights violations in TB patients are in those who have co-infection of HIV. There is absolutely no doubt in my mind or in those who work in the field, that when you have HIV combined with TB, there is immense stigma and shame apparently associated with HIV. My own sense is that TB patients are partially discriminated against it is not as extreme not as severe and not as comprehensive open system that we have against HIV. But I am speaking in southern African environment and it might be different in other parts of the world. Certainly the struggle against both, stigma and discrimination against TB and HIV, or any other diseases, because sexually transmitted diseases are also discriminated against, should be fought against vehemently. In the case of TB and HIV one of the drawbacks of this discrimination and isolation of patients is that it drives the disease underground and actually leads to greater public health damage by being widespread and therefore is fundamentally a bad result from public health point of view not only from ethical or moral point of view" said Professor Hoosen Coovadia, noted paediatrician and expert in perinatal HIV transmission, former Head of the Department of Paediatrics at the University of Natal until 2000 and Victor Daitz Professor for HIV/AIDS research at the University of Natal, South Africa.
"Every TB patient has the right to get high quality standards of prevention, treatment and care services. At present TB programmes don't reach every patient who needs care in India. Some issues like working hours of TB-services which don't suit some patients, need to be addressed by adjusting timings. TB patients should get proper diagnosis and other services as required in reality - just drugs available on paper is not enough, the services must reach the patients. One of the good TB strategies should be to engage TB patients. The cured TB patients can advocate with new TB patients and in communities to improve TB responses. These cured TB patients can spread the message that TB is curable, thereby reducing TB-related stigma. They can also be engaged in strengthening social movement to eradicate TB" said Dr D Behera, Union Karel Styblo Awardee for Public Health 2009 and Director of LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.
"The literacy rates among TB patients are low, they are less aware of their own rights and responsibilities related to TB care and services. There is enormous social stigma related to TB prevalent in our society that further put them at risk of human rights violations. Patients of TB are often not comfortable with disclosure" said Dr Darakshan Badar, Programme Manager, Provincial TB control Programme (PTP), Lahore, Pakistan.
"Bangladesh is a success story in terms of TB control. However previously we had lot of TB-related stigma due to which TB patients were isolated at times from their families. Now TB patients go on their own to seek TB care" said Dr K Zaman from ICDDRB Bangladesh. All is not good too in Bangladesh. "Lot of TB patients go to general practitioners outside DOTS and get treated with a range of antibiotics instead of being referred to DOTS" says Dr Zaman. "I conducted study in the past, where 50% of new TB patients were found to be resistant to at least one anti-TB drug, and 5.5% had MDR-TB" adds Dr Zaman.
"In DRC, we have organizations of cured TB patients to help other patients to minimise stigma. TB patients can share their difficulties and concern with each other in this network during the treatment and successfully complete DOTS. These TB patients' groups have been there in DRC for the last ten years. In Kinshasa, many TB patients were defaulting earlier so NTP realized the importance of engaging cure TB patients and counselling new TB patients on taking TB treatment on time. These TB patients' led groups have upped the TB cure rate in DRC to 90%" said Dr Jean Pierre Kabuayi Nyengele, Deputy NTP Manager, Democratic Repubic of Congo (DRC).
"It is a right of TB patients to access prevention, diagnosis, treatment and care services. But that is not happening because of range of reasons including weak health systems, suboptimal infrastructure, lack of facilities" says Dr Peter Kimuu, TBCAP, Kenya.
"In our context, female TB patients have more problems in accessing existing services for TB. Female TB patients find it difficult to get engaged, married or those who are already married, often get divorced due to stigma related to TB" shares Dr Ejaz Qadeer, National TB control Programme (NTP), Pakistan.
"Female TB patients face a lot of problems and we need to establish protocol and guidelines to address gender-specific issues in TB programmes" suggests Dr Razia Fatima, Programme Officer, National TB Control Programme (NTP), Islamabad, Pakistan.
There are many more points to ponder and decide whether these qualify as human rights violations too:
- Requiring patients pay for any diagnosis and treatment of TB, a declared "threat to public health".
- Denying patients social support through peer-groups and hotline services.
- Forcing innocent people to take toxic drugs that are not quality assured by WHO standards.-
- Not adhering to treatment for infectious TB and knowingly putting others at risk.
- Refusing to treat extra-pulmonary MDR-TB because it is non infectious.
- Not informing patients of their Rights and Responsibilities (PCTC/ISTC).
- Requiring public healthcare personnel to work without adequate infection control.
- Not providing palliative care for MDR/XDR patients for whom treatment is not available or viable.
Do they and many other such situations people with TB deal with on daily basis, qualify as human rights violations? Speak your world!
Published in:
Citizen News Service (CNS), India/Thailand
Twitter.com
Elites TV News, USA
Human Rights have long been ignored in TB 'Control', but are a foundation for improving care as outlined in the International Standards for TB Care (ISTC) and the Patients' Charter for TB Care (PCTC). At the 40th Union World Conference on Lung Health, delegates spoke about human rights violations that challenge TB care and control on the frontlines in their national contexts.
"Dominant human rights violations in TB patients are in those who have co-infection of HIV. There is absolutely no doubt in my mind or in those who work in the field, that when you have HIV combined with TB, there is immense stigma and shame apparently associated with HIV. My own sense is that TB patients are partially discriminated against it is not as extreme not as severe and not as comprehensive open system that we have against HIV. But I am speaking in southern African environment and it might be different in other parts of the world. Certainly the struggle against both, stigma and discrimination against TB and HIV, or any other diseases, because sexually transmitted diseases are also discriminated against, should be fought against vehemently. In the case of TB and HIV one of the drawbacks of this discrimination and isolation of patients is that it drives the disease underground and actually leads to greater public health damage by being widespread and therefore is fundamentally a bad result from public health point of view not only from ethical or moral point of view" said Professor Hoosen Coovadia, noted paediatrician and expert in perinatal HIV transmission, former Head of the Department of Paediatrics at the University of Natal until 2000 and Victor Daitz Professor for HIV/AIDS research at the University of Natal, South Africa.
"Every TB patient has the right to get high quality standards of prevention, treatment and care services. At present TB programmes don't reach every patient who needs care in India. Some issues like working hours of TB-services which don't suit some patients, need to be addressed by adjusting timings. TB patients should get proper diagnosis and other services as required in reality - just drugs available on paper is not enough, the services must reach the patients. One of the good TB strategies should be to engage TB patients. The cured TB patients can advocate with new TB patients and in communities to improve TB responses. These cured TB patients can spread the message that TB is curable, thereby reducing TB-related stigma. They can also be engaged in strengthening social movement to eradicate TB" said Dr D Behera, Union Karel Styblo Awardee for Public Health 2009 and Director of LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.
"The literacy rates among TB patients are low, they are less aware of their own rights and responsibilities related to TB care and services. There is enormous social stigma related to TB prevalent in our society that further put them at risk of human rights violations. Patients of TB are often not comfortable with disclosure" said Dr Darakshan Badar, Programme Manager, Provincial TB control Programme (PTP), Lahore, Pakistan.
"Bangladesh is a success story in terms of TB control. However previously we had lot of TB-related stigma due to which TB patients were isolated at times from their families. Now TB patients go on their own to seek TB care" said Dr K Zaman from ICDDRB Bangladesh. All is not good too in Bangladesh. "Lot of TB patients go to general practitioners outside DOTS and get treated with a range of antibiotics instead of being referred to DOTS" says Dr Zaman. "I conducted study in the past, where 50% of new TB patients were found to be resistant to at least one anti-TB drug, and 5.5% had MDR-TB" adds Dr Zaman.
"In DRC, we have organizations of cured TB patients to help other patients to minimise stigma. TB patients can share their difficulties and concern with each other in this network during the treatment and successfully complete DOTS. These TB patients' groups have been there in DRC for the last ten years. In Kinshasa, many TB patients were defaulting earlier so NTP realized the importance of engaging cure TB patients and counselling new TB patients on taking TB treatment on time. These TB patients' led groups have upped the TB cure rate in DRC to 90%" said Dr Jean Pierre Kabuayi Nyengele, Deputy NTP Manager, Democratic Repubic of Congo (DRC).
"It is a right of TB patients to access prevention, diagnosis, treatment and care services. But that is not happening because of range of reasons including weak health systems, suboptimal infrastructure, lack of facilities" says Dr Peter Kimuu, TBCAP, Kenya.
"In our context, female TB patients have more problems in accessing existing services for TB. Female TB patients find it difficult to get engaged, married or those who are already married, often get divorced due to stigma related to TB" shares Dr Ejaz Qadeer, National TB control Programme (NTP), Pakistan.
"Female TB patients face a lot of problems and we need to establish protocol and guidelines to address gender-specific issues in TB programmes" suggests Dr Razia Fatima, Programme Officer, National TB Control Programme (NTP), Islamabad, Pakistan.
There are many more points to ponder and decide whether these qualify as human rights violations too:
- Requiring patients pay for any diagnosis and treatment of TB, a declared "threat to public health".
- Denying patients social support through peer-groups and hotline services.
- Forcing innocent people to take toxic drugs that are not quality assured by WHO standards.-
- Not adhering to treatment for infectious TB and knowingly putting others at risk.
- Refusing to treat extra-pulmonary MDR-TB because it is non infectious.
- Not informing patients of their Rights and Responsibilities (PCTC/ISTC).
- Requiring public healthcare personnel to work without adequate infection control.
- Not providing palliative care for MDR/XDR patients for whom treatment is not available or viable.
Do they and many other such situations people with TB deal with on daily basis, qualify as human rights violations? Speak your world!
Published in:
Citizen News Service (CNS), India/Thailand
Twitter.com
Elites TV News, USA
Hard talk on association between public health advocates and pharmaceutical companies
Hard talk on association between public health advocates and pharmaceutical companies
Is it ethical for public health advocates to accept funding from pharmaceutical companies, or organizations directly/ indirectly affiliated to them? Should all direct/indirect engagement with Pharmaceutical companies should be declared openly and publicly? The delegates at the 40th Union World Conference on Lung Health in Cancun, Mexico, responded differently to this contentious issue.
The World Health Organization (WHO) and many other indexed publications ask people to sign a declaration form to declare any association with tobacco companies. The Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC, the global tobacco treaty) give teeth to the treaty which states, "in setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law." The WHO FCTC Article 5.3 guidelines include the following recommendations, rooted in the principle that the tobacco industry has a fundamental and irreconcilable conflict with public health:
- governments should reject partnerships with the tobacco industry;
- conflicts of interest such as the "revolving door" between the tobacco industry and public health offices, government investments in the tobacco industry and tobacco industry representation on tobacco control bodies should be avoided;
- government interaction with the tobacco industry should be strictly limited and transparent;
- the tobacco industry should be required to be transparent about its activities, a measure which will help to counter interference by Big Tobacco's front groups and allied organizations.
Similar examples exist where people need to declare their association openly with formula food companies for instance. So is it ethical for public health advocates to take funding from pharmaceutical companies? Should it be declared openly?
When asked to respond to this question, Professor Hoosen Coovadia, noted paediatrician and expert in perinatal HIV transmission, former Head of the Department of Paediatrics at the University of Natal until 2000 and Victor Daitz Professor for HIV/AIDS research at the University of Natal, South Africa, said "unfortunately there is no simple yes or no answer to this. I guess in many instances that association [between pharmaceutical companies and public health advocates] has to be acknowledged and expressed fully. For example many of the good journals will not accept an article unless that association with food company, pharmaceutical company, depends what the company is, is openly acknowledged."
"People do believe in taking pharmaceutical companies' support in undertaking [clinical/ research] trials. It happens in National Institute of Health and many other institutions or these [public health] products will simply not have been tested. You can imagine a world where new drugs for TB and HIV are not available or not acceptable because those [clinical trials/ research] studies were not done" adds Professor Coovadia.
"There are some extreme examples on refusal to accept money [from companies]. One instance is taking money from tobacco companies because of their egregious behaviour of denying the damaging effects of tobacco. I am a paediatrician and we have been through decades of fighting formula food producing companies for the damage they do in developing world and probably in other parts of the world too in promoting their products in absence of support for exclusive breastfeeding for first six months. I think in those two instances public health advocates will take the position that any association with food company or tobacco company is inherently unacceptable" asserts Professor Coovadia.
"Any such association [between pharmaceutical companies and public health advocates] has to be declared openly. One of the examples is of one of the best drugs that we initially started off with to prevent mother to child transmission of HIV. It is a drug called nevirapine and we had the support from the manufacturers of nevirapine to do those studies. Now that is openly acknowledged, publications mention their association clearly, mention the role of drug company, and say in absolutely unambiguous terms that those companies have no influence on whatsoever in collection of the data, certainly not in the analysis of the data, or in the conclusions. In other words the scientific content of the paper or the article or the document was uninfluenced by that type of association. I think association with pharmaceutical companies can continue as long as those restrictions are adhered to" further adds Professor Coovadia.
"Pharmaceutical companies have enormous amounts of money that should be spent on research and development. It should be made mandatory for pharmaceutical companies to earmark funding for research and development, particularly in high burden countries" says Dr Darakshan Badar, Programme Manager, Provincial TB Control Programme (PTP), Punjab, Pakistan.
However, Dr Badar's colleague at the National TB Control Programme (NTP) in Pakistan, Dr Ejaz Qadeer, has a different opinion: "Public health advocates should not take money from pharmaceutical companies. There is an obvious conflict of interest and taking money from pharmaceutical company is risky for the [TB/ health] programme and also for the government. All association with pharmaceutical company of public health advocates should be open and [information regarding interaction should be] accessible to the public and other stakeholders to see what interaction is taking place between public health advocates and pharmaceutical companies."
"In Bangladesh, taking funds from pharmaceutical companies for TB is not common. Pharmaceutical companies are not willing to fund TB programmes because TB drugs are not available over-the-counter and given free to TB patients through DOTS" says Dr Zaman from Bangladesh.
"We can accept money from pharmaceutical companies to help TB patients but this should be open and publicly declared" says Dr Jean Pierre Kabuayi Nyengele, Deputy Manager, National TB Control Programme (NTP), Democratic Republic of Congo (DRC).
"The association between pharmaceutical companies and public health advocates should be openly declared" says Dr Peter Kimuu, TBCAP, Kenya.
"I don't think it is unethical to accept money from pharmaceutical companies. [However] the pharmaceutical companies shouldn't do unethical actions like promoting drugs or irrational use of drugs [after giving money]. It [association between pharmaceutical companies and public health advocates] should be declared openly and publicly, just like [we treat] tobacco companies" said Dr D Behera, Director, LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi, India. Dr Behera was also awarded the Union Karel Styblo Public Health Award for this year 2009 at the 40th Union World Conference on Lung Health.
"For public health advocates, it is not ethically right to take money from pharmaceutical companies. All association between public health advocates and pharmaceutical companies should be open, and the agenda should be made public too" says Dr Razia Kaniz Fatima, M&E (Monitoring and Evaluation) ACSM Officer, NTP, Pakistan.
Well, there might be extreme difference of opinion on how ethical it is to engage with pharmaceutical companies and taking funding from them, but there is clear support to making this association open and public. Dr Coovadia's example of how manufacturers of nevirapine funded the research but had no control on scientific outcomes is worth remembering. The debate is certainly on, and more viewpoints and perspectives on this contentious issue be coming forth.
Published in:
Citizen News Service (CNS), India/Thailand
Modern Ghana News, Accra, Ghana
Scoop.com, New Zealand
Media for Freedom, Nepal
Pakistan Christian Post, Pakistan
Banderas News, Mexico
Media For Freedom, Nepal
Bihar and Jharkhand News Service (BJNS)
Is it ethical for public health advocates to accept funding from pharmaceutical companies, or organizations directly/ indirectly affiliated to them? Should all direct/indirect engagement with Pharmaceutical companies should be declared openly and publicly? The delegates at the 40th Union World Conference on Lung Health in Cancun, Mexico, responded differently to this contentious issue.
The World Health Organization (WHO) and many other indexed publications ask people to sign a declaration form to declare any association with tobacco companies. The Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC, the global tobacco treaty) give teeth to the treaty which states, "in setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law." The WHO FCTC Article 5.3 guidelines include the following recommendations, rooted in the principle that the tobacco industry has a fundamental and irreconcilable conflict with public health:
- governments should reject partnerships with the tobacco industry;
- conflicts of interest such as the "revolving door" between the tobacco industry and public health offices, government investments in the tobacco industry and tobacco industry representation on tobacco control bodies should be avoided;
- government interaction with the tobacco industry should be strictly limited and transparent;
- the tobacco industry should be required to be transparent about its activities, a measure which will help to counter interference by Big Tobacco's front groups and allied organizations.
Similar examples exist where people need to declare their association openly with formula food companies for instance. So is it ethical for public health advocates to take funding from pharmaceutical companies? Should it be declared openly?
When asked to respond to this question, Professor Hoosen Coovadia, noted paediatrician and expert in perinatal HIV transmission, former Head of the Department of Paediatrics at the University of Natal until 2000 and Victor Daitz Professor for HIV/AIDS research at the University of Natal, South Africa, said "unfortunately there is no simple yes or no answer to this. I guess in many instances that association [between pharmaceutical companies and public health advocates] has to be acknowledged and expressed fully. For example many of the good journals will not accept an article unless that association with food company, pharmaceutical company, depends what the company is, is openly acknowledged."
"People do believe in taking pharmaceutical companies' support in undertaking [clinical/ research] trials. It happens in National Institute of Health and many other institutions or these [public health] products will simply not have been tested. You can imagine a world where new drugs for TB and HIV are not available or not acceptable because those [clinical trials/ research] studies were not done" adds Professor Coovadia.
"There are some extreme examples on refusal to accept money [from companies]. One instance is taking money from tobacco companies because of their egregious behaviour of denying the damaging effects of tobacco. I am a paediatrician and we have been through decades of fighting formula food producing companies for the damage they do in developing world and probably in other parts of the world too in promoting their products in absence of support for exclusive breastfeeding for first six months. I think in those two instances public health advocates will take the position that any association with food company or tobacco company is inherently unacceptable" asserts Professor Coovadia.
"Any such association [between pharmaceutical companies and public health advocates] has to be declared openly. One of the examples is of one of the best drugs that we initially started off with to prevent mother to child transmission of HIV. It is a drug called nevirapine and we had the support from the manufacturers of nevirapine to do those studies. Now that is openly acknowledged, publications mention their association clearly, mention the role of drug company, and say in absolutely unambiguous terms that those companies have no influence on whatsoever in collection of the data, certainly not in the analysis of the data, or in the conclusions. In other words the scientific content of the paper or the article or the document was uninfluenced by that type of association. I think association with pharmaceutical companies can continue as long as those restrictions are adhered to" further adds Professor Coovadia.
"Pharmaceutical companies have enormous amounts of money that should be spent on research and development. It should be made mandatory for pharmaceutical companies to earmark funding for research and development, particularly in high burden countries" says Dr Darakshan Badar, Programme Manager, Provincial TB Control Programme (PTP), Punjab, Pakistan.
However, Dr Badar's colleague at the National TB Control Programme (NTP) in Pakistan, Dr Ejaz Qadeer, has a different opinion: "Public health advocates should not take money from pharmaceutical companies. There is an obvious conflict of interest and taking money from pharmaceutical company is risky for the [TB/ health] programme and also for the government. All association with pharmaceutical company of public health advocates should be open and [information regarding interaction should be] accessible to the public and other stakeholders to see what interaction is taking place between public health advocates and pharmaceutical companies."
"In Bangladesh, taking funds from pharmaceutical companies for TB is not common. Pharmaceutical companies are not willing to fund TB programmes because TB drugs are not available over-the-counter and given free to TB patients through DOTS" says Dr Zaman from Bangladesh.
"We can accept money from pharmaceutical companies to help TB patients but this should be open and publicly declared" says Dr Jean Pierre Kabuayi Nyengele, Deputy Manager, National TB Control Programme (NTP), Democratic Republic of Congo (DRC).
"The association between pharmaceutical companies and public health advocates should be openly declared" says Dr Peter Kimuu, TBCAP, Kenya.
"I don't think it is unethical to accept money from pharmaceutical companies. [However] the pharmaceutical companies shouldn't do unethical actions like promoting drugs or irrational use of drugs [after giving money]. It [association between pharmaceutical companies and public health advocates] should be declared openly and publicly, just like [we treat] tobacco companies" said Dr D Behera, Director, LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi, India. Dr Behera was also awarded the Union Karel Styblo Public Health Award for this year 2009 at the 40th Union World Conference on Lung Health.
"For public health advocates, it is not ethically right to take money from pharmaceutical companies. All association between public health advocates and pharmaceutical companies should be open, and the agenda should be made public too" says Dr Razia Kaniz Fatima, M&E (Monitoring and Evaluation) ACSM Officer, NTP, Pakistan.
Well, there might be extreme difference of opinion on how ethical it is to engage with pharmaceutical companies and taking funding from them, but there is clear support to making this association open and public. Dr Coovadia's example of how manufacturers of nevirapine funded the research but had no control on scientific outcomes is worth remembering. The debate is certainly on, and more viewpoints and perspectives on this contentious issue be coming forth.
Published in:
Citizen News Service (CNS), India/Thailand
Modern Ghana News, Accra, Ghana
Scoop.com, New Zealand
Media for Freedom, Nepal
Pakistan Christian Post, Pakistan
Banderas News, Mexico
Media For Freedom, Nepal
Bihar and Jharkhand News Service (BJNS)
Responding to TB, HIV, COPD and tobacco smoking needs coordinated approach
Responding to TB, HIV, COPD and tobacco smoking needs coordinated approach
Tobacco smoking, TB, HIV and chronic obstructive pulmonary disease (COPD) are all burgeoning problems in resource poor settings. The evidence of their potentially devastating effects on global public health is increasing and they require a coordinated approach for control. These diseases all occur in predominantly resource-poor countries. They are perpetuated by poverty and inadequate resources and their control and management require coordinated approach for control, said delegates at the 40th Union World Conference on Lung Health, in Cancun, Mexico.
Statistically, there is 1 TB-related death that takes place every 18 seconds, 1 HIV death every 16 seconds and 1 smoking-related death every 13 seconds. The enormous public challenge posed by the combined epidemics of tobacco smoking, HIV, TB and COPD, is undoubtedly alarming. But is there a link between TB, HIV, COPD and tobacco smoking? Do they increase the risk of each other?
"At the beginning of 21st century we really are facing convergence of several epidemics like HIV, TB, COPD and tobacco smoking among others" said Richard N van Zyl-Smit work works with Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute, Department of Medicine, University of Cape Town, South Africa.
"Tobacco smoking is unquestionably the primary risk factor for COPD. The importance of "total burden of inhaled particles" (occupational, household, environmental) is increasing" said Richard.
"Smokers have two fold higher risk of developing active TB disease" said Dr Madhukar Pai from McGill University and Montreal Chest Institute in Canada. Dr Pai was referring to three meta-analysis studies from 2007/2008. "Tobacco smokers have 2 times more risk of dieing of TB" added Dr Pai, referring to the data from India. India has enormous tobacco use and COPD rates, and also the highest TB burden in the world. "It is not a universal estimate, and is population specific" cautioned Dr Pai, outlining the need for more research on the association between TB, tobacco smoking, COPD and HIV. "There is very little data to study association between TB and passive smoking" said Dr Pai. However there are studies to show that passive smoking escalates risk of developing active TB disease by three times. "How can passive smoking have higher risk (three times) for developing active TB disease than active smoking (two times), so we do need more data in this regard" said Dr Pai.
Tobacco smoke increases the risk of pneumonia, influenza, menningococcal meningitis, among others. Evidence is accumulating that smoking is a risk factor for TB. However there is no published data on the cellular interactions of tobacco smoke and mycobacterium tuberculosis, said Richard.
At least 15 more studies have been published since the three major meta-analyses in 2007/2008. All studies report a positive association between tuberculosis and tobacco smoking. Studies also show that current male smokers have a higher risk for active TB disease than former smokers. In a study conducted in India, 900 non-medical staff monitored 1.1 million people for 3 years for cause of death taking place in this population. TB was the biggest cause of death reported in this study in India, and 66% of those who died of TB during the study, were active smokers.
The risk to develop active TB disease is higher when tobacco smoking is combined with alcohol.
"Mortality rates, particularly from Asian countries suggest that there is an urgent need to target TB patients for smoking cessation interventions" said Dr Pai. However he stressed that tobacco cessation should be encouraged regardless in all disciplines of medicine because of proven public health outcomes.
The second edition of the International Standards of Tuberculosis Care (ISTC), which is an official component of the WHO Global Stop TB Strategy also mentions tobacco smoking cessation among other measures to improve TB treatment outcomes. The ISTC standard 17 says: "This plan should include assessment of and referrals for treatment of other illnesses with particular attention to those known to affect treatment outcome, for instance care for diabetes mellitus, drug and alcohol treatment programs, tobacco smoking cessation programs, and other psychosocial support services, or to such services as antenatal or well baby care.
Dr Donald Enarson stressed that tobacco smoking cessation is an important part of the comprehensive tobacco control programme, and not the only part. So all components of the comprehensive tobacco control measures should be implemented for improving public health outcomes. Dr Enarson was referring to MPOWER report from Tobacco Free Initiative (TFI) of WHO which outlines the MPOWER package, a set of six key tobacco control measures that reflect and build on the WHO Framework Convention on Tobacco Control (FCTC, global tobacco treaty). Another delegates remarked that MPOWER is in line with the global tobacco treaty - FCTC - and we should be demanding implementation of the treaty to which governments have committed to enforce. The WHO FCTC is the first public health and corporate accountability treaty, said a delegate from India. Comprehensive tobacco control programmes can yield major public health outcomes, as 30% of male TB patients die of tobacco smoking.
Although lethal association between tobacco smoking, COPD and TB was becoming clear, we needed more discussion on association between smoking with HIV. "Tobacco smoke increases the risk of human papiloma virus (HPV) and HPV increases the risk of HIV" said Richard in response to a question on the link between HIV and smoking.
Kristina Crothers from Department of Internal Medicine, Yale School of Medicine in USA, shed more light on this association with HIV. She was referring to long term complications of HIV and progression to AIDS, which does get influenced by the above risk factors.
TB continues to be the biggest cause of mortality among people living with HIV (PLHIV) worldwide. However, HIV related long-term complications get aggravated by noxious agents which include tobacco smoke. The risk to develop pulmonary infections and respiratory tract colonization is also upped. The history of childhood illnesses, low socio-economic status, malnutrition among PLHIV does increase their vulnerability to further severe the HIV-related long-term complications. All these are contributing factors for PLHIV to develop chronic lung disease, and COPD in case of smokers, among other conditions that include fibrosis, pulmonary hypertension and lung cancer.
Kristina cited smoking prevalence among PLHIV in northern America. Although tobacco smoking prevalence among general population in USA is 22%, yet the tobacco smoking prevalence goes up among PLHIV to 54%.
In India, in a study conducted by Tuberculosis Research Centre at Madurai, the following results were reported: 66% of PLHIV men were smokers.
In another study, those PLHIV who reported 12 pack years of smoking, had 37% of emphysema, and those who reported 25 pack years of smoking, had 46% of emphysema.
"HIV is associated with chronic lung disease, particularly COPD" said Kristina. "This chronic lung disease can substantially contribute to morbidity and mortality" added Kristina. However long term impact of HIV infection on lung health is unknown, said she.
Studies show that smoking may impact progression to AIDS among PLHIV, said Kristina.
Although more research and data may further clarify the lethal synergy between the epidemics of TB, HIV, tobacco smoking and COPD, among other public health challenges, there is no doubt that collaboration between different single disease or health programmes will be truly beneficial and have major public health outcomes.
Published in:
Citizen News Service (CNS), India/Thailand
The Seoul Times, Seoul, Korea
Elites TV News, USA
Modern Ghana News, Accra, Ghana
Media For Freedom, Nepal
Thai-Indian News, Thailand, Bangkok
News From Bangladesh, Bangladesh
World News Network, USA
Bihar and Kharkhand News Service (BJNS)
Connect.in.com
HealthDev.Net
World Care Council
Health News
Tobacco Industry Today
Tobacco smoking, TB, HIV and chronic obstructive pulmonary disease (COPD) are all burgeoning problems in resource poor settings. The evidence of their potentially devastating effects on global public health is increasing and they require a coordinated approach for control. These diseases all occur in predominantly resource-poor countries. They are perpetuated by poverty and inadequate resources and their control and management require coordinated approach for control, said delegates at the 40th Union World Conference on Lung Health, in Cancun, Mexico.
Statistically, there is 1 TB-related death that takes place every 18 seconds, 1 HIV death every 16 seconds and 1 smoking-related death every 13 seconds. The enormous public challenge posed by the combined epidemics of tobacco smoking, HIV, TB and COPD, is undoubtedly alarming. But is there a link between TB, HIV, COPD and tobacco smoking? Do they increase the risk of each other?
"At the beginning of 21st century we really are facing convergence of several epidemics like HIV, TB, COPD and tobacco smoking among others" said Richard N van Zyl-Smit work works with Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute, Department of Medicine, University of Cape Town, South Africa.
"Tobacco smoking is unquestionably the primary risk factor for COPD. The importance of "total burden of inhaled particles" (occupational, household, environmental) is increasing" said Richard.
"Smokers have two fold higher risk of developing active TB disease" said Dr Madhukar Pai from McGill University and Montreal Chest Institute in Canada. Dr Pai was referring to three meta-analysis studies from 2007/2008. "Tobacco smokers have 2 times more risk of dieing of TB" added Dr Pai, referring to the data from India. India has enormous tobacco use and COPD rates, and also the highest TB burden in the world. "It is not a universal estimate, and is population specific" cautioned Dr Pai, outlining the need for more research on the association between TB, tobacco smoking, COPD and HIV. "There is very little data to study association between TB and passive smoking" said Dr Pai. However there are studies to show that passive smoking escalates risk of developing active TB disease by three times. "How can passive smoking have higher risk (three times) for developing active TB disease than active smoking (two times), so we do need more data in this regard" said Dr Pai.
Tobacco smoke increases the risk of pneumonia, influenza, menningococcal meningitis, among others. Evidence is accumulating that smoking is a risk factor for TB. However there is no published data on the cellular interactions of tobacco smoke and mycobacterium tuberculosis, said Richard.
At least 15 more studies have been published since the three major meta-analyses in 2007/2008. All studies report a positive association between tuberculosis and tobacco smoking. Studies also show that current male smokers have a higher risk for active TB disease than former smokers. In a study conducted in India, 900 non-medical staff monitored 1.1 million people for 3 years for cause of death taking place in this population. TB was the biggest cause of death reported in this study in India, and 66% of those who died of TB during the study, were active smokers.
The risk to develop active TB disease is higher when tobacco smoking is combined with alcohol.
"Mortality rates, particularly from Asian countries suggest that there is an urgent need to target TB patients for smoking cessation interventions" said Dr Pai. However he stressed that tobacco cessation should be encouraged regardless in all disciplines of medicine because of proven public health outcomes.
The second edition of the International Standards of Tuberculosis Care (ISTC), which is an official component of the WHO Global Stop TB Strategy also mentions tobacco smoking cessation among other measures to improve TB treatment outcomes. The ISTC standard 17 says: "This plan should include assessment of and referrals for treatment of other illnesses with particular attention to those known to affect treatment outcome, for instance care for diabetes mellitus, drug and alcohol treatment programs, tobacco smoking cessation programs, and other psychosocial support services, or to such services as antenatal or well baby care.
Dr Donald Enarson stressed that tobacco smoking cessation is an important part of the comprehensive tobacco control programme, and not the only part. So all components of the comprehensive tobacco control measures should be implemented for improving public health outcomes. Dr Enarson was referring to MPOWER report from Tobacco Free Initiative (TFI) of WHO which outlines the MPOWER package, a set of six key tobacco control measures that reflect and build on the WHO Framework Convention on Tobacco Control (FCTC, global tobacco treaty). Another delegates remarked that MPOWER is in line with the global tobacco treaty - FCTC - and we should be demanding implementation of the treaty to which governments have committed to enforce. The WHO FCTC is the first public health and corporate accountability treaty, said a delegate from India. Comprehensive tobacco control programmes can yield major public health outcomes, as 30% of male TB patients die of tobacco smoking.
Although lethal association between tobacco smoking, COPD and TB was becoming clear, we needed more discussion on association between smoking with HIV. "Tobacco smoke increases the risk of human papiloma virus (HPV) and HPV increases the risk of HIV" said Richard in response to a question on the link between HIV and smoking.
Kristina Crothers from Department of Internal Medicine, Yale School of Medicine in USA, shed more light on this association with HIV. She was referring to long term complications of HIV and progression to AIDS, which does get influenced by the above risk factors.
TB continues to be the biggest cause of mortality among people living with HIV (PLHIV) worldwide. However, HIV related long-term complications get aggravated by noxious agents which include tobacco smoke. The risk to develop pulmonary infections and respiratory tract colonization is also upped. The history of childhood illnesses, low socio-economic status, malnutrition among PLHIV does increase their vulnerability to further severe the HIV-related long-term complications. All these are contributing factors for PLHIV to develop chronic lung disease, and COPD in case of smokers, among other conditions that include fibrosis, pulmonary hypertension and lung cancer.
Kristina cited smoking prevalence among PLHIV in northern America. Although tobacco smoking prevalence among general population in USA is 22%, yet the tobacco smoking prevalence goes up among PLHIV to 54%.
In India, in a study conducted by Tuberculosis Research Centre at Madurai, the following results were reported: 66% of PLHIV men were smokers.
In another study, those PLHIV who reported 12 pack years of smoking, had 37% of emphysema, and those who reported 25 pack years of smoking, had 46% of emphysema.
"HIV is associated with chronic lung disease, particularly COPD" said Kristina. "This chronic lung disease can substantially contribute to morbidity and mortality" added Kristina. However long term impact of HIV infection on lung health is unknown, said she.
Studies show that smoking may impact progression to AIDS among PLHIV, said Kristina.
Although more research and data may further clarify the lethal synergy between the epidemics of TB, HIV, tobacco smoking and COPD, among other public health challenges, there is no doubt that collaboration between different single disease or health programmes will be truly beneficial and have major public health outcomes.
Published in:
Citizen News Service (CNS), India/Thailand
The Seoul Times, Seoul, Korea
Elites TV News, USA
Modern Ghana News, Accra, Ghana
Media For Freedom, Nepal
Thai-Indian News, Thailand, Bangkok
News From Bangladesh, Bangladesh
World News Network, USA
Bihar and Kharkhand News Service (BJNS)
Connect.in.com
HealthDev.Net
World Care Council
Health News
Tobacco Industry Today
TB Voice network has improved TB responses locally
TB Voice network has improved TB responses locally
"TB Voice network is led by cured TB patients and other stakeholders and provides community treatment supporters in developing countries with the technical expertise they need to implement sustainable TB control programmes" said Chief Austin Arinze Obiefuna, who is the founder-President of Afro Global Alliance and National Coordinator for Stop TB Partnership in Ghana. Chief Austin was speaking at a pre-conference meeting of the 40th Union World Conference on Lung Health in Cancun, Mexico.
"Till today, in most developing countries DOTS (directly observed treatment shortcourse) which underpins the Stop TB Strategy, has improved greatly but now without challenges like inadequate public health personnel, inconsistent drug supply, more effective and accessible tools for testing and treating TB and community involvment" said Austin. "In order to address these challenges, Afro Global Alliance and Chest Department of Korle-Bu Teaching Hospital, with financial support from the Stop TB Partnership's Challenge Facility for Civil Society, created the initiative of TB Voice Network (TVN)" further explains Austin.
The TB Voice Network is committed to reinforce the role of community treatment supporters in the national policies and TB and HIV programmes in developing countries. Through its network of experts, TB Voice Network trains stakeholders in all areas of prevention, testing and comprehensive care related to TB and TB/HIV. It also assists in community DOTS implementation and conducts situational analysis of community treatment supporters in the field of TB. It provides counselling on DOTS adherence, referral and contact tracing of TB patients, among other community-led roles in TB programmes locally.
The TB Voice Network has also developed a website to give voice to the network of people who got cured of TB (www.tbvoice.net), informs Austin.
"75% population in Ghana lives in rural areas. There are many misconceptions related to TB - including the belief that offending Gods may get a person infected with TB" says Austin. Not surprising, the TB-related stigma and discrimination rages high in these communities and blocks access to existing TB services on prevention, treatment and care. This was a key motivation to bring cured TB patients together and establish ways in which they can have a voice to reduce TB-related stigma and increase access to existing services.
"The voices of cured TB patients are needed to help people understand that TB is curable" asserts Chief Austin. The TB case detection rates have gone up in communities TB Voice Network works, suggesting the role of community involvement in improving TB responses at all levels.
The National TB Programme (NTP) in Ghana also uses the TB Voice Network in its advocacy, communication and social mobilization initiatives. "TB Voice Network is one of the success stories of NTP" says Austin.
"We are meeting parliamentarians to declare TB as a national emergency and also demanding laboratories in Ghana [to test for anti-TB drug resistance]" says Austin.
Published in:
Citizen News Service (CNS), India/Thailand
Elites TV News, USA
Health Dev.Net
World Care Council
"TB Voice network is led by cured TB patients and other stakeholders and provides community treatment supporters in developing countries with the technical expertise they need to implement sustainable TB control programmes" said Chief Austin Arinze Obiefuna, who is the founder-President of Afro Global Alliance and National Coordinator for Stop TB Partnership in Ghana. Chief Austin was speaking at a pre-conference meeting of the 40th Union World Conference on Lung Health in Cancun, Mexico.
"Till today, in most developing countries DOTS (directly observed treatment shortcourse) which underpins the Stop TB Strategy, has improved greatly but now without challenges like inadequate public health personnel, inconsistent drug supply, more effective and accessible tools for testing and treating TB and community involvment" said Austin. "In order to address these challenges, Afro Global Alliance and Chest Department of Korle-Bu Teaching Hospital, with financial support from the Stop TB Partnership's Challenge Facility for Civil Society, created the initiative of TB Voice Network (TVN)" further explains Austin.
The TB Voice Network is committed to reinforce the role of community treatment supporters in the national policies and TB and HIV programmes in developing countries. Through its network of experts, TB Voice Network trains stakeholders in all areas of prevention, testing and comprehensive care related to TB and TB/HIV. It also assists in community DOTS implementation and conducts situational analysis of community treatment supporters in the field of TB. It provides counselling on DOTS adherence, referral and contact tracing of TB patients, among other community-led roles in TB programmes locally.
The TB Voice Network has also developed a website to give voice to the network of people who got cured of TB (www.tbvoice.net), informs Austin.
"75% population in Ghana lives in rural areas. There are many misconceptions related to TB - including the belief that offending Gods may get a person infected with TB" says Austin. Not surprising, the TB-related stigma and discrimination rages high in these communities and blocks access to existing TB services on prevention, treatment and care. This was a key motivation to bring cured TB patients together and establish ways in which they can have a voice to reduce TB-related stigma and increase access to existing services.
"The voices of cured TB patients are needed to help people understand that TB is curable" asserts Chief Austin. The TB case detection rates have gone up in communities TB Voice Network works, suggesting the role of community involvement in improving TB responses at all levels.
The National TB Programme (NTP) in Ghana also uses the TB Voice Network in its advocacy, communication and social mobilization initiatives. "TB Voice Network is one of the success stories of NTP" says Austin.
"We are meeting parliamentarians to declare TB as a national emergency and also demanding laboratories in Ghana [to test for anti-TB drug resistance]" says Austin.
Published in:
Citizen News Service (CNS), India/Thailand
Elites TV News, USA
Health Dev.Net
World Care Council
Patients' Charter for TB Care is in favour of doctors, not against them
Patients' Charter for TB Care is in favour of doctors, not against them
It was not surprising to hear from a community activist at the World Health Organization (WHO) Stop TB Symposium before 40th Union World Conference on Lung Health opens in Cancun, Mexico, that when she asked TB programme managers on why are they not implementing the Patients' Charter for Tuberculosis (TB) Care [PCTC], she got the response: "doctors say that it [PCTC] actually goes against them." Blessina Kumar, TB/HIV activist from India was addressing the WHO Stop TB Symposium in Mexico.
This is not surprising to hear because despite of community-centric Global Stop TB Strategy and rising mandate for community engagement in TB programmes, there are healthcare providers like the one quoted above who still belong to old school where TB was a medical problem and response too was medical.
The WHO Global Stop TB Strategy and Global Plan to Stop TB (2006-2015) support community involvement. The Patients' Charter for TB Care (PCTC) is an official part of the Global Stop TB Strategy which is meant to be a tool to mobilize and empower communities in achieving the International Standards of TB Care (ISTC). It is an official component of national TB programmes in many countries including India. However there is no doubt that the investment and efforts that have gone into rolling out the Charter, are grossly inadequate. It is not just a "chart" in the clinic, as commented a delegate yesterday.
The Charter (PCTC) is not against what doctors are trying to achieve in TB care and control - it is a tool to make their task easier in improving TB programmes - in terms of achieving earlier diagnosis, active TB case finding, counselling, contact tracing, adherence counselling, reducing stigma and discrimination related to TB, among other benefits this tool can provide if used in the right spirit.
"We need to raise awareness about the rights and responsibilities of people with TB, use the Charter as a tool for empowering the communities and mobilizing them to advocate for enhancing the standards of TB treatment and care in their localities" asserts Maxime Lunga, Vice President of World Care Council (WCC).
In South Africa, a MSF report released earlier this year on World TB Day (24 March) showed how community-based approaches to drug-resistant TB have improved treatment outcomes considerably.
The people with TB, particularly those who have successfully completed the anti-TB treatment, is central to improving the TB response. The communities have a key role in increasing TB case detection, reducing TB-related stigma, partnering with healthcare staff, community awareness, screening of household contacts, encouraging rapid diagnosis to decrease the delay before starting treatment, improving treatment protocols, providing education and adherence counselling for patients and implementing infection control measures in clinics, patients' homes, and in the community, believes Maxime.
Experts at the WHO Stop TB Symposium had earlier listed out the high risk populations the TB programmes should reach out to for earlier diagnosis of TB. With different levels of multi-faceted stigma-related to TB, how will the doctors operationalize these policies on active TB case finding? The answer honestly lies in The Charter among other approaches.
Affected communities need to be engaged meaningfully at all levels of TB programming to use the Charter as a tool to achieve higher standards of TB care (ISTC). They need to be treated as equal partners in TB care and control, and treated with dignity, along side other stakeholders including doctors. Innovative solutions often come up from among the affected communities - since they know what works in their communities best. Affected communities are more than passive recepients of pills - their rightful place as equal partners in solving issues that affect them most on daily basis - has been long denied to them.
"Unless TB patients are diagnosed earlier, the quality of life will be compromised despite of successful anti-TB treatment" said Dr M Muniyandi, Health Economist, TB Research Centre, Indian Council of Medical Research (ICMR). "To attain better quality of life, it is important to diagnose people earlier for TB and treat them successfuly" emphasized Dr Muniyandi.
Thanks Dr Muniyandi for speaking up - the point you make is right on-spot: quality of life. This should be an explicit and core aim of TB programmes to EARLY diagnose and treat people with TB successfully so that they can enjoy highest attainable standards of health and life. And in passive case finding, it is a distant dream. Engaging communities can up the active case finding among many other benefits TB conference is raising (and has been raising in past years).
The absence of the Charter (PCTC) in the local stop TB strategy operationally is often the very barrier that blocks access to existing TB care services. Long waiting hours, stigma and discrimination related to TB, lack of confidentiality at times, unfriendly healthcare services for people with certain conditions, are well documented barriers that impede access to existing services. Other obstacles that limit the impact of TB programmes which are now coming to light over past years, were the realities people with TB were dealing with. Long distances they have to travel to clinics, economic impact on their livelihood during anti-TB treatment which may further exacerbate vulnerabilities to TB and other conditions of them and their families/ communities, are just some of them. Communities knew it before, and knew it best. Empowering them will not only bring problems in light sooner, but also give them a right and responsibility as equal partner to come up with effective solutions that work in their own contexts.
HIV/AIDS programmes have shown remarkable outcomes by genuine community engagement at all levels, however the involvement of communities in TB programmes is clearly sub-optimal, if not absent.
The outcome of not implementing the Charter is what no nation can afford - affected communities need to be supported by the Charter, to use the rights and responsibilities framework it promotes in mobilizing them to work as equal partners with other stakeholders (including doctors) to achieve higher standards of TB care (ISTC).
Published in:
Thai-Indian News, Bangkok, Thailand
Modern Ghana News, Accra, Ghana
Elites TV News, USA
Citizen News Service (CNS), India/Thailand
World News Network (WNN), USA
Bihar And Jharkhand News Service (BJNS)
World Care Council
Health Dev.Net
ZivisoWorldpress.com
Celebrifi.com
It was not surprising to hear from a community activist at the World Health Organization (WHO) Stop TB Symposium before 40th Union World Conference on Lung Health opens in Cancun, Mexico, that when she asked TB programme managers on why are they not implementing the Patients' Charter for Tuberculosis (TB) Care [PCTC], she got the response: "doctors say that it [PCTC] actually goes against them." Blessina Kumar, TB/HIV activist from India was addressing the WHO Stop TB Symposium in Mexico.
This is not surprising to hear because despite of community-centric Global Stop TB Strategy and rising mandate for community engagement in TB programmes, there are healthcare providers like the one quoted above who still belong to old school where TB was a medical problem and response too was medical.
The WHO Global Stop TB Strategy and Global Plan to Stop TB (2006-2015) support community involvement. The Patients' Charter for TB Care (PCTC) is an official part of the Global Stop TB Strategy which is meant to be a tool to mobilize and empower communities in achieving the International Standards of TB Care (ISTC). It is an official component of national TB programmes in many countries including India. However there is no doubt that the investment and efforts that have gone into rolling out the Charter, are grossly inadequate. It is not just a "chart" in the clinic, as commented a delegate yesterday.
The Charter (PCTC) is not against what doctors are trying to achieve in TB care and control - it is a tool to make their task easier in improving TB programmes - in terms of achieving earlier diagnosis, active TB case finding, counselling, contact tracing, adherence counselling, reducing stigma and discrimination related to TB, among other benefits this tool can provide if used in the right spirit.
"We need to raise awareness about the rights and responsibilities of people with TB, use the Charter as a tool for empowering the communities and mobilizing them to advocate for enhancing the standards of TB treatment and care in their localities" asserts Maxime Lunga, Vice President of World Care Council (WCC).
In South Africa, a MSF report released earlier this year on World TB Day (24 March) showed how community-based approaches to drug-resistant TB have improved treatment outcomes considerably.
The people with TB, particularly those who have successfully completed the anti-TB treatment, is central to improving the TB response. The communities have a key role in increasing TB case detection, reducing TB-related stigma, partnering with healthcare staff, community awareness, screening of household contacts, encouraging rapid diagnosis to decrease the delay before starting treatment, improving treatment protocols, providing education and adherence counselling for patients and implementing infection control measures in clinics, patients' homes, and in the community, believes Maxime.
Experts at the WHO Stop TB Symposium had earlier listed out the high risk populations the TB programmes should reach out to for earlier diagnosis of TB. With different levels of multi-faceted stigma-related to TB, how will the doctors operationalize these policies on active TB case finding? The answer honestly lies in The Charter among other approaches.
Affected communities need to be engaged meaningfully at all levels of TB programming to use the Charter as a tool to achieve higher standards of TB care (ISTC). They need to be treated as equal partners in TB care and control, and treated with dignity, along side other stakeholders including doctors. Innovative solutions often come up from among the affected communities - since they know what works in their communities best. Affected communities are more than passive recepients of pills - their rightful place as equal partners in solving issues that affect them most on daily basis - has been long denied to them.
"Unless TB patients are diagnosed earlier, the quality of life will be compromised despite of successful anti-TB treatment" said Dr M Muniyandi, Health Economist, TB Research Centre, Indian Council of Medical Research (ICMR). "To attain better quality of life, it is important to diagnose people earlier for TB and treat them successfuly" emphasized Dr Muniyandi.
Thanks Dr Muniyandi for speaking up - the point you make is right on-spot: quality of life. This should be an explicit and core aim of TB programmes to EARLY diagnose and treat people with TB successfully so that they can enjoy highest attainable standards of health and life. And in passive case finding, it is a distant dream. Engaging communities can up the active case finding among many other benefits TB conference is raising (and has been raising in past years).
The absence of the Charter (PCTC) in the local stop TB strategy operationally is often the very barrier that blocks access to existing TB care services. Long waiting hours, stigma and discrimination related to TB, lack of confidentiality at times, unfriendly healthcare services for people with certain conditions, are well documented barriers that impede access to existing services. Other obstacles that limit the impact of TB programmes which are now coming to light over past years, were the realities people with TB were dealing with. Long distances they have to travel to clinics, economic impact on their livelihood during anti-TB treatment which may further exacerbate vulnerabilities to TB and other conditions of them and their families/ communities, are just some of them. Communities knew it before, and knew it best. Empowering them will not only bring problems in light sooner, but also give them a right and responsibility as equal partner to come up with effective solutions that work in their own contexts.
HIV/AIDS programmes have shown remarkable outcomes by genuine community engagement at all levels, however the involvement of communities in TB programmes is clearly sub-optimal, if not absent.
The outcome of not implementing the Charter is what no nation can afford - affected communities need to be supported by the Charter, to use the rights and responsibilities framework it promotes in mobilizing them to work as equal partners with other stakeholders (including doctors) to achieve higher standards of TB care (ISTC).
Published in:
Thai-Indian News, Bangkok, Thailand
Modern Ghana News, Accra, Ghana
Elites TV News, USA
Citizen News Service (CNS), India/Thailand
World News Network (WNN), USA
Bihar And Jharkhand News Service (BJNS)
World Care Council
Health Dev.Net
ZivisoWorldpress.com
Celebrifi.com
Denying IPT to people-with latent TB is a human rights violation
Denying IPT to people-with latent TB is a human rights violation
"In Lesotho, Isoniazid Preventive Therapy (IPT) to prevent latent TB infection from becoming active TB disease, is not available for ordinary citizens but only for health workers. Those people who have latent TB infection have a right to protect themselves and access IPT services to prevent latent TB from becoming active TB disease. I consider these people have a right to get IPT. Everybody has a right to health, when it comes to TB prevention" said Maketekete Alfred Thotolo, Treatment Literacy & Advocacy Coordinator, Adventist Development and Relief Agency (ADRA), Lesotho, who also represents AIDS and Rights Alliance for Southern Africa (ARASA). Alfred was speaking to this Key Correspondent on the sidelines of pre-conference sessions before the 40th Union World Conference on Lung Health opens in Cancun, Mexico this week (3-7 December 2009).
The Global TB/HIV Working Group of the Stop TB Partnership has clearly stated that: IPT works, IPT is safe, and IPT works with ART or by itself.
TB is a major cause of illness and death in people living with HIV, even in those taking antiretroviral therapy. TB could be prevented in millions of people infected with both HIV and TB through the use of IPT. IPT is an important intervention for preventing and reducing active TB in communities affected by HIV - preventing active TB can prevent millions of people from being infected in the community and in health care services.
IPT is safe and effective and the treatment lasts for 6-9 months. It is only given to people who have confirmed latent TB infection (not to be given to those with active TB disease). Effective IPT treatment reduces the development of active TB disease in 40-60% of patients.
Despite of the potential public health outcomes of using IPT effectively in high burden TB countries, and IPT being one of the key interventions recommended by WHO in 1998 to reduce the burden of TB in people living with HIV, the uptake of IPT has been very low. Clearly there is a need to mobilize TB-HIV affected communities and other stakeholders to integrate IPT as part of the package of health services.
Alfred is possibly right on-spot: everybody has a right to health - and this includes the right to access IPT services to prevent latent TB infection from becoming active TB disease. It also means increasing TB screening in the communities so that people go for TB test to ascertain whether they have latent TB or active TB disease or no TB at all. IPT advocacy boosts the effort behind scaling up TB screening among people living with HIV - so that appropriate services can be provided and this does include IPT if the person has latent TB. Is denying IPT and putting people at risk of developing active TB disease,not a human rights violation?
Integrating IPT services for TB prevention doesn't mean upping the cost at country level, possibly. A 2007 World Bank research report "The Economic Benefit of Global Investments in Tuberculosis Control" found that 22 countries with the world’s highest numbers of TB cases could earn significantly more than they spend on TB diagnosis and treatment if they signed onto a global plan to sharply reduce the numbers of TB-related deaths. Highly affected African countries could gain up to 9 times their investments in TB control. When the economic benefits of effective TB care and control are estimated to be greater than the cost, governments shouldn't delay improving TB responses by preventing TB in those who have latent TB effectively.
After all, Alfred is right: health is a fundamental human right and this includes right to have IPT for those who are eligible for it.
"In Lesotho, Isoniazid Preventive Therapy (IPT) to prevent latent TB infection from becoming active TB disease, is not available for ordinary citizens but only for health workers. Those people who have latent TB infection have a right to protect themselves and access IPT services to prevent latent TB from becoming active TB disease. I consider these people have a right to get IPT. Everybody has a right to health, when it comes to TB prevention" said Maketekete Alfred Thotolo, Treatment Literacy & Advocacy Coordinator, Adventist Development and Relief Agency (ADRA), Lesotho, who also represents AIDS and Rights Alliance for Southern Africa (ARASA). Alfred was speaking to this Key Correspondent on the sidelines of pre-conference sessions before the 40th Union World Conference on Lung Health opens in Cancun, Mexico this week (3-7 December 2009).
The Global TB/HIV Working Group of the Stop TB Partnership has clearly stated that: IPT works, IPT is safe, and IPT works with ART or by itself.
TB is a major cause of illness and death in people living with HIV, even in those taking antiretroviral therapy. TB could be prevented in millions of people infected with both HIV and TB through the use of IPT. IPT is an important intervention for preventing and reducing active TB in communities affected by HIV - preventing active TB can prevent millions of people from being infected in the community and in health care services.
IPT is safe and effective and the treatment lasts for 6-9 months. It is only given to people who have confirmed latent TB infection (not to be given to those with active TB disease). Effective IPT treatment reduces the development of active TB disease in 40-60% of patients.
Despite of the potential public health outcomes of using IPT effectively in high burden TB countries, and IPT being one of the key interventions recommended by WHO in 1998 to reduce the burden of TB in people living with HIV, the uptake of IPT has been very low. Clearly there is a need to mobilize TB-HIV affected communities and other stakeholders to integrate IPT as part of the package of health services.
Alfred is possibly right on-spot: everybody has a right to health - and this includes the right to access IPT services to prevent latent TB infection from becoming active TB disease. It also means increasing TB screening in the communities so that people go for TB test to ascertain whether they have latent TB or active TB disease or no TB at all. IPT advocacy boosts the effort behind scaling up TB screening among people living with HIV - so that appropriate services can be provided and this does include IPT if the person has latent TB. Is denying IPT and putting people at risk of developing active TB disease,not a human rights violation?
Integrating IPT services for TB prevention doesn't mean upping the cost at country level, possibly. A 2007 World Bank research report "The Economic Benefit of Global Investments in Tuberculosis Control" found that 22 countries with the world’s highest numbers of TB cases could earn significantly more than they spend on TB diagnosis and treatment if they signed onto a global plan to sharply reduce the numbers of TB-related deaths. Highly affected African countries could gain up to 9 times their investments in TB control. When the economic benefits of effective TB care and control are estimated to be greater than the cost, governments shouldn't delay improving TB responses by preventing TB in those who have latent TB effectively.
After all, Alfred is right: health is a fundamental human right and this includes right to have IPT for those who are eligible for it.
Implementation of right to health of indigenous peoples essential to Stop TB
Implementation of right to health of indigenous peoples essential to Stop TB
"Basic human rights as enjoyed by others have not benefitted indigenous peoples. Therefore the respect and recognition of the rights of indigenous peoples is critical to our dignity and survival. In particular, implementation of our right to health is essential if we are to stop TB" said Wilton Littlechild, Regional Chief, Assembly of First Nations, on the sidelines of the TB and human rights session before the 40th Union World Conference on Lung Health begins in Cancun, Mexico this week.
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" had 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.
Highlighting the problem of TB treatment default and risk of developing drug-resistant forms of TB in indigenous people, Chief Littlechild had earlier said to this Key Correspondent 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. In response to another question then, 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 peoples are much severe than in general population. "Countries like Canada report that poverty has gone down but poverty in indigenous peoples has gone up. In prisons too there are a significant number of indigenous peoples. 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" had said Chief Littlechild to this Key Correspondent.
The strategic framework to control TB among indigenous peoples 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.
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Human Right Today
"Basic human rights as enjoyed by others have not benefitted indigenous peoples. Therefore the respect and recognition of the rights of indigenous peoples is critical to our dignity and survival. In particular, implementation of our right to health is essential if we are to stop TB" said Wilton Littlechild, Regional Chief, Assembly of First Nations, on the sidelines of the TB and human rights session before the 40th Union World Conference on Lung Health begins in Cancun, Mexico this week.
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" had 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.
Highlighting the problem of TB treatment default and risk of developing drug-resistant forms of TB in indigenous people, Chief Littlechild had earlier said to this Key Correspondent 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. In response to another question then, 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 peoples are much severe than in general population. "Countries like Canada report that poverty has gone down but poverty in indigenous peoples has gone up. In prisons too there are a significant number of indigenous peoples. 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" had said Chief Littlechild to this Key Correspondent.
The strategic framework to control TB among indigenous peoples 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.
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Human Right Today
Rights and Responsibilities Roadshow: Raising standards for care in Indonesia
Rights and Responsibilities Roadshow: Raising standards for care in Indonesia
More than seventy people from across the country spoke about rights and responsibilities to improve tuberculosis (TB) and HIV responses on 24-25 November 2009 in Jakarta, Indonesia. From a 13 year old ex-patient (she was a TB patient when she was 9) to the representative from sub-directorate of National TB and HIV programmes had an open consultation to raise the right of access to care. The Director of HIV programme in Indonesia acknowledged the problem and committed to making the rights and responsibilities framework a reality. Yoana Anandita from National TB Programme (NTP) in Indonesia who was speaking at the Advocacy, Communications and Social Mobilization (ACSM) meeting before the 40th Union World Conference on Lung Health opens in Cancun, Mexico, reaffirmed the genuine engagement and consultation this roadshow provided between different stakeholders.
"The Roadshow rolled in Indonesia raising rights and responsibilities for HIV and TB up the agenda, down in the streets of our communities and on high in the towers of power. We invited diverse people to consult, discuss, write, plan, agree and act - to move forward locally in global common cause" said Case Gordon, President, World Care Council (WCC).
The World Care Council (WCC) has been a global leader in driving forward a Rights and Responsibilities approach to health, advocating that people suffering from infectious diseases have specific universal rights to quality care, and have an individual responsibility to prevent the spread of illness to others. Health providers, both public and private, have the responsibility to provide consumers with the highest possible quality of care, and the right to have the appropriate tools to do so.
The methodology of joining the human right to life through access to healthcare with the individual duty to act responsibly in face of a public health threat is one that allows people with TB, HIV and other communicable diseases to forge partnerships with care providers and programs. This relationship is a mutually beneficial one - people in need can work with providers to access better care and providers can work with patients to better succeed in managing the pandemics that impact on the populations they serve.
As both providers and people with the diseases need to know their rights and responsibilities, the World Care Council has developed innovative tools to reach a broad based agreement on what these are. Using its 'Outreach for Input' system of consultation, the WCC has produced two editions (2006 and 2009) of the Patients' Charter for Tuberculosis Care (PCTC) with the inputs of over one thousand people who have direct experience of the disease on four continents. The PCTC has been incorporated into the Strategies of the WHO and most of of the governments of high burdened countries, and is the tandem document to the International Standards for Tuberculosis Care. These two guidelines form the basis of the Patient Centered Care approach to TB treatment and prevention, and serve as levers for change from decades of poor programmatic TB 'Control' to quality TB 'Care', a major step forward for both people with the disease and the communities devastated by it.
The Rights and Responsibilities Workshop Roadshow 2009 which took place in Jakarta, Indonesia during 24-25 November 2009, is part of a series of public meetings and workshops in nine cities in Africa and Asia highly burdened by the TB and HIV pandemics.
The drive for Rights and Responsibilities is a core activity for the World Care Council, and has shown itself to be an effective tool for raising the standards of care on the ground. As it is powered by people with the diseases, it embodies the principles of greater and more meaningful involvement of TB Patients and PLHIV (GIPT and GIPA). Turning principles into practice, the drive for Rights and Responsibilities is rolling out the roadshow on the streets.
Published in:
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Elites TV News, USA
Modern Ghana News, Accra, Ghana
Health Dev.Net
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News from Bangladesh, Bangladesh
Bihar and Jharkhand News Service (BJNS)
Med India News, India
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More than seventy people from across the country spoke about rights and responsibilities to improve tuberculosis (TB) and HIV responses on 24-25 November 2009 in Jakarta, Indonesia. From a 13 year old ex-patient (she was a TB patient when she was 9) to the representative from sub-directorate of National TB and HIV programmes had an open consultation to raise the right of access to care. The Director of HIV programme in Indonesia acknowledged the problem and committed to making the rights and responsibilities framework a reality. Yoana Anandita from National TB Programme (NTP) in Indonesia who was speaking at the Advocacy, Communications and Social Mobilization (ACSM) meeting before the 40th Union World Conference on Lung Health opens in Cancun, Mexico, reaffirmed the genuine engagement and consultation this roadshow provided between different stakeholders.
"The Roadshow rolled in Indonesia raising rights and responsibilities for HIV and TB up the agenda, down in the streets of our communities and on high in the towers of power. We invited diverse people to consult, discuss, write, plan, agree and act - to move forward locally in global common cause" said Case Gordon, President, World Care Council (WCC).
The World Care Council (WCC) has been a global leader in driving forward a Rights and Responsibilities approach to health, advocating that people suffering from infectious diseases have specific universal rights to quality care, and have an individual responsibility to prevent the spread of illness to others. Health providers, both public and private, have the responsibility to provide consumers with the highest possible quality of care, and the right to have the appropriate tools to do so.
The methodology of joining the human right to life through access to healthcare with the individual duty to act responsibly in face of a public health threat is one that allows people with TB, HIV and other communicable diseases to forge partnerships with care providers and programs. This relationship is a mutually beneficial one - people in need can work with providers to access better care and providers can work with patients to better succeed in managing the pandemics that impact on the populations they serve.
As both providers and people with the diseases need to know their rights and responsibilities, the World Care Council has developed innovative tools to reach a broad based agreement on what these are. Using its 'Outreach for Input' system of consultation, the WCC has produced two editions (2006 and 2009) of the Patients' Charter for Tuberculosis Care (PCTC) with the inputs of over one thousand people who have direct experience of the disease on four continents. The PCTC has been incorporated into the Strategies of the WHO and most of of the governments of high burdened countries, and is the tandem document to the International Standards for Tuberculosis Care. These two guidelines form the basis of the Patient Centered Care approach to TB treatment and prevention, and serve as levers for change from decades of poor programmatic TB 'Control' to quality TB 'Care', a major step forward for both people with the disease and the communities devastated by it.
The Rights and Responsibilities Workshop Roadshow 2009 which took place in Jakarta, Indonesia during 24-25 November 2009, is part of a series of public meetings and workshops in nine cities in Africa and Asia highly burdened by the TB and HIV pandemics.
The drive for Rights and Responsibilities is a core activity for the World Care Council, and has shown itself to be an effective tool for raising the standards of care on the ground. As it is powered by people with the diseases, it embodies the principles of greater and more meaningful involvement of TB Patients and PLHIV (GIPT and GIPA). Turning principles into practice, the drive for Rights and Responsibilities is rolling out the roadshow on the streets.
Published in:
Citizen News Service (CNS), India/Thailand
Elites TV News, USA
Modern Ghana News, Accra, Ghana
Health Dev.Net
Wikio.com, UK
News from Bangladesh, Bangladesh
Bihar and Jharkhand News Service (BJNS)
Med India News, India
Twitter.com
Ziviso World Press News
World Care Council
Celebrifi.com
World TV News
Tweetmeme.com
Global TB Candlelight Meditation on 27th May
Global TB Candlelight Meditation on 27th May
The Global TB Candlelight Meditation (GTBCM), an initiative of Afro Global Alliance, began in Accra, Ghana, to scale up advocacy, communications and social mobilization campaigns for TB awareness in the world. The GTBCM is held on every 27th of May in remembrance of those who have died of TB. It is led by volunteer advocates who host meditation for their communities worldwide. Chief Austin Arinze Obiefuna, who is the founder-President of Afro Global Alliance and National Coordinator for Stop TB Partnership in Ghana, spoke to this Key Correspondent on this unique and community centric initiative at the Advocacy, Communications and Social Mobilization (ACSM) annual meeting of the Stop TB Partnership before the 40th Union World Conference on Lung Health opens in Cancun, Mexico later this week (3-7 December 2009).
The Global TB Candlelight Meditation (GTBCM) initiative has engaged different stakeholders at all levels, said Chief Austin. The programme has brought together a large number of stakeholders in the past including: Coalition of NGOs, Ghana Stop TB Partnership, TB Network, Ghana HIV/AIDS Network, WHO, National TB Control programme, Ministry of Health and the Ghana Health Service, said Chief Austin.
"The Global TB Candlelight Meditation aims to scale up global awareness through grassroots community involvement of all sectors and stakeholders in the annual GTBCM campaign on every 27th of May" said Chief Austin Arinze Obiefuna.
"The objectives of GTBCM were to honour and remember those lives lost to TB, to support TB patients by de-stigmatising the disease and preventing anti-TB drug resistance, to defend all those who are not infected with TB, to promote DOTS and the implementation of Millennium Development Goals (MDG) no. 6, and to support TB-HIV collaborative activities and forge more efforts towards the eradication of TB by 2050" further added Chief Austin.
"Annually the GTBCM selects a new theme which is designed to give the global community a strong commitment in the fight against TB" said Chief Austin. One of the themes of the meditation in past years was "Togetherness will eradicate TB."
"TB-related stigma and discrimination is a very serious issue. It is a barrier for suspected TB patients to seek existing TB-care services. What we have been advocating is to diagnose TB early and treat successfully and unless we address stigma and discrimination of those seeking TB care in healthcare facilities and in communities, it is difficult to improve TB responses" said Austin.
The Global TB Candlelight Meditation is one such initiative that engages communities and reduces stigma and discrimination related to TB in healthcare facilities and communities as well.
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