CNS

The wages of protest

The wages of protest
Arundhati Dhuru & Dr Sandeep Pandey

[Published in THE HINDU, 5 April 2009]

While the RTI Act and the audit provisions of NREGA enable ordinary people to demand accountability from governments, it doesn’t always work like that on the ground. There have been several cases recently in U.P., where the demand for rights by workers has been met with violence…

The political ruling class has decided to deal with the demands being raised by workers for their legal rights strongly.

The advent of the Right to Information (RTI) Act and the National Rural Employment Guarantee Act (NREGA) were a breakthrough in Indian democracy. They provided the openings in a system which was opaque, insensitive and impersonal to the common citizens of this country. The ruling elite which was not prepared to be answerable to people at all had to relent. They realised that, after all, they are functioning in a democracy which is created in the name of the people. People began asking questions under the RTI Act and started conducting social audits under NREGA, which were revolutionary ideas given the kind of system we have inherited from the British and given the mindset bureaucracy develops when it is entrenched in this system. People did achieve success using the RTI and the social audit provision and a definite empowerment was taking place.

However, it looks as if it’s been decided that enough is enough. People could be allowed the luxury of only so much transparency and accountability. They could not transgress the limit beyond which the unquestioned supremacy of the ruling elites stood to be challenged. The initial fear in their minds towards these pro-people laws has vanished and now they are dealing with people demanding their basic rights under these Acts with vengeance. They have decided to quell every voice which raises questions about their highhandedness with utmost contempt and violence if necessary. The administrative machinery, which is supposed to be responsible for implementing these laws, is being used by the people’s representatives with impunity.

Plenty of discrepancies

In the Dumri Village Panchayat of Kasya Block of Kushinagar district of U.P., what started as an investigation into the discrepancies in Below Poverty Line survey, on a complaint made by some villagers, turned into a full fledged investigation into bungling in development funds which came through the Panchayat. Discrepancies were observed by an Assistant Commissioner in the Rural Development Department in the housing schemes for poor as well as NREGA. Advocate Udaybhan Yadav, who was instrumental in getting this investigation done, was threatened by the Gram Pradhan Dinesh Verma and his men. On February 28, 2009, when the men of Gram Pradhan were beating a dalit labourer Parasuram, who was vocal in questioning the fake muster roll in which wages were withdrawn in his name whereas he had not even worked under NREGA, Udaybhan intervened. He was also beaten up. A dalit, Kapil Dev, receiving patronage from the Pradhan, registered a FIR against Udaybhan and a case under (Prevention of) Atrocities against S.C./S.T. Act was filed. Under political pressure, Udaybhan and his father Hari Yadav were arrested on March 9. Parasuram’s brother Ram Bharat and father Jaikaran were also arrested but released later.

Fight for wages

In the village Panchayat Aira Kake Mau of Bharawan Block of Hardoi District, workers had assembled on January 14, 2009, at the door of the Gram Pradhan as previously agreed, to seek their unpaid wages. The husband of the Gram Pradhan, Ghanshyam, who runs the show here on behalf of his wife, first tried to threaten the labourers. The police arrived when the situation became tense. When the workers wanted to file complaints against the Gram Pradhan for violation of their rights under the NREGA, Ghanshyam ordered his men to rain lathis on the labourers and social activists present there in support of the workers in the presence of the Station House Officer and the police of Atrauli Police Station. One dalit labourer, Medai, and a social activist, Ram Bharose, sustained injuries on the head. Although a case was filed against Ghanshyam, in spite of repeated applications to various authorities by dalit labourers who were present at the site of incident, (Prevention of) Atrocities against S.C./S.T. Act has not been used against Ghanshyam and no action has thus far been taken against him.

In Kopaganj Block of Mau district, labourers from the villages Devkali, Bishunpur, Purana Kopa and Jairamgarh, mostly women and dalit, had assembled at the office of the Block Officer, merely eight km from the district headquarters, to demand wages due for the last six months. One of the labourers was called inside the office for dialogue and beaten up by those inside. The labourers were furious. The Block Development Officer, Ram Dular and an employee, Sanjiv Singh, had to bear the brunt of the anger. Some women also got hurt in this scuffle. Full wages have still not been paid and nobody involved in beating the worker has been punished.

In the village Panchayat Rura of Kasmanda Block of District Sitapur, a pond deepening work was in progress on February 28, 2009. Some women labourers wandered off to drink water from a hand pump. The hand pump belonged to a powerful person from the locality, Madan Dixit, popularly know as Madan Muni in this area. The women had to face obscene comments. When the male members of the families wanted to register their protest against these obscene remarks, they were beaten up. When the workers reached the police station to file a case against their tormentors, Madan Muni was already there. The workers wanted to register a case under the (Prevention of) atrocities against the S.C./S.T. Act. The police asked them to come next morning in an attempt to arrive at a compromise. When the workers were unmoved from their demand the next day, two men and two women labourers were beaten by the police inside the police station. premises. With the help of social organisations of the area a case was finally registered against Madan Muni under the (Prevention of) atrocities against the S.C./S.T. Act but no action has been taken against the police personnel who were involved in beating the workers.

Underpaid

In the Cholapur Block of District Varanasi, about 200 workers belonging to Dhaurahra, Saryan and Munari were not paid their wages for about a month for deepening a pond in Saryan G.P. The Junior Engineer had measured the work and calculated payment of wages at the rate of Rs. 39.80 per day. The workers were not satisfied as for similar work in Dhaurahra G.P. workers were paid the minimum wages of Rs. 100 per day. On February 26, 2009, the Village Development Officer gave in writing that all workers would be paid at the rate of Rs. 100 per day on March 3, 2009. When the workers assembled on March 5, at the Block Office, the BDO was absent. On the advice of a Block employee they decided to block the Varanasi-Azamgarh Highway. The SHO of Cholapur P.S. arrived and the workers were lathi-charged quite mercilessly. About 50 people including approximately 10 women were badly hurt. Heerawati, who was pregnant, was also hurt. The SHO took 20 people and 50 bicycles with him to the police station and the workers were released on personal bonds. When asked as to what action he would take against the VDO for violating the legal rights of workers under NREGA by not paying the wages, the SHO said he was merely following the orders from the higher ups. He refused to reveal the name of the officer who had ordered lathi charge. The next day, wages at the rate of Rs. 42 per day were transferred into the accounts of the labourers.

The repression of workers is now emerging as a trend. The political ruling class has decided to deal with the demands being raised by workers for their legal rights strongly. The workers will be punished. The ruling elites realise that these demands ultimately will lead to a clamour for a more equitable society and wider and deeper participation of workers in the decision making process in our democracy. They do not want to give away this power easily. The above-mentioned incidents also indicate that the workers are now getting better organised than before. NREGA has at least helped achieve that. We hope that the problems of workers will be resolved within the constitutional framework peacefully and will lead to further democratisation of society and government.

Arundhati Dhuru & Dr Sandeep Pandey

[

Arundhati Dhuru is a national convener of National Alliance of People's Movements (NAPM), and an Adviser to Supreme Court Commissioner on Right to Food. She is noted for her frontline leadership of the anti-dam movement (Narmada Bachao Andolan) and has extensive experience of working on people's issues across India. Email: arundhatidhuru@yahoo.co.uk]

[Dr Sandeep Pandey is a Ramon Magsaysay Awardee (2002) for

emergent leadership, member of National Presidium, People's Politics Front (PPF), heads the National Alliance of People's Movements (NAPM) and did his PhD from University of California, Berkeley in control theory which is applicable in missile technology. He taught at Indian Institute of Technology (IIT) Kanpur before devoting his life to strengthening people's movements in early 1990s. He can be contacted at: ashaashram@yahoo.com. Website: www.citizen-news.org]

[Published in THE HINDU, 5 April 2009]

Diagnosing the doctor

Diagnosing the doctor

[Published in THE TEHELKA, 3 April 2009]

Dr. Manmohan Singh has survived a full five year term in office as PM, which itself is an achievement in the post-Indira Gandhi era of coalition politics. It is a different matter that he jettisoned a more respectable and ideologically sound support from the Left Front in exchange for an opportunistic support from the Samajwadi Party on the issue of Indo-US Nuclear Deal when he was facing a confidence motion in Parliament last year. For him the Deal was a prestige issue and defending it he was his most assertive self, a rare sight, even launching a frontal attack on L.K. Advani for his role in supervising the Babri Masjid demolition.

Dr. Manmohan Singh will be remembered as the harbinger of neo-liberal economic policies of liberalization- privatization-globalization in this country first as Finance Secretary, then as Finance Minister and finally as the PM. However, it is ironical that towards the end of his term as PM he is abdicating his responsibility towards the desired results of these policies, even though his Party is desperately trying to project these policies as success by launching the ‘Jai Ho’ campaign. But isn’t ‘Jai Ho’ just another name for ‘India Shining?’ Actually, he gave indications of his shaking confidence in these policies in two meetings of CII, much before the global recession set in abroad and Satyam happened at home, by making utterances which scandalized the corporate barons of this country. He suggested that CEOs must consider placing voluntary ceilings on their salaries. He said that the gap between the rich and poor would produce social unrest. He said that for an unemployed youth a 9% growth rate didn’t mean anything. He added that CEOs must not treat their wealth for personal consumption only but should consider using it for general good of society. He invoked the much forgotten ‘trusteeship principle’ of Mahatma Gandhi, which probably no politician in independent India has ever mentioned. Now, these thoughts would make a very sound policy if the objective was to create a humane and equitable society instead of elevating the growth rate. But coming from Manmohan Singh, these appeared out of place. He probably didn’t take them seriously either. It was more of a frustration on account of his inability to control farmer suicides in spite of maintaining a very good growth rate of the overall economy. His abovementioned statements go against the basic training that he has got as an economist and probably his colleagues Montek Singh Ahluwalia and P. Chidambram, who were with him in implementing the LPG policies, wouldn’t endorse these utopian ideas. Nevertheless, any economist would agree that the effect of neo-liberal policies has been the widening gap between the rich and poor. In fact, before the Mumbai attack, Manmohan Singh has said more than once that naxalism is a bigger threat to India than terrorism.

Dr. Manmohan Singh failed to prevent the spread of either naxalism or terrorism. His government’s policy of using brute force to crush these forces has produced backlash. Irom Sharmila continues to fast in her ninth year in custody at the Jawaharlal Nehru Hospital in Imphal demanding the repeal of Armed Forces Special Powers Act. She came to New Delhi in 2006 but there was no positive response from the government. The government doesn’t know how to deal with people who take up arms and it doesn’t know how to deal with the most imaginable form of peaceful protest. It goofs up by keeping Dr. Binayak Sen in jail as a naxalite sympathizer, without any concrete evidence against him and denying him bail. On the other hand convicted persons like Navjot Singh Sidhu, Shibu Soren and Sanjay Dutt have no problem in pursuing their political goals.

By continuing to support the American policy of war against terror in addition to the economic policies of LPG, Manmohan Singh has helped the difference between the BJP and Congress Party disappear. The post-Mumbai response of the government appeared to be to deny the plank of terrorism to BJP in the forthcoming elections. Its tough stand against the civilian Pakistani government forced the Pakistani politicians to retract from their initial cooperative response and stalled the Indo-Pak peace process, an area in which Manmohan Singh probably made the most significant contribution along with Musharraf. The resumption of Srinagar-Muzaffarabad bus service in 2005 and opening of various trade routes produced a thaw in relationship. We also learn that the two governments were on the verge of a solution on Kashmir which was arrived at taking into confidence the Hurriyat. Manmohan Singh was able to achieve so much, as no PM in the past, possibly because his heart ruled over the traditional bureaucratic-military thinking in this matter. This is also probably the only area where he took decisions as an ordinary human being, his family affected by partition like that of Musharraf, instead of as a modern trained expert.

But he has compromised India ’s sovereignty by signing the Indo-US nuclear deal. His own planning commission doesn’t think that nuclear energy has a future. He was an ardent supporter of renewable sources of energy, like any right thinking individual, until he got invited to Washington DC in 2005. He became ambitious by the encouragement received from George Bush and possibly saw India ’s destiny as a great world power in this cooperation. By agreeing to become the junior military ally of the US and Israel , he reversed the policy of Nehru-Shashtri-Indira-Rajiv of maintaining a respectable distance from the US and being the leader of Non-Aligned Movement. Eager to sign the deal with US, he lost out not only on Iran but also on Myanmar . India was hoping that by stopping to support the cause of Aung San Sui Kyi, Myanmar might consider giving its gas to it. This would have made it easier for it to turn down the Iranian offer and hence please the US . In the end Myanmar gave its gas to China and India lost face on the issue of support to pro-democracy movement in Myanmar . Manmohan Singh has demolished the peace loving sovereign supporter of the people of third world image of India and made it the target of Islamic fundamentalists. His government couldn’t control the terrorist incidents in the country and his police continued to implicate innocent Muslim youth thereby producing further alienation among Muslims. The Batla House encounter will remain a blot on his government, on which in spite of widespread demands for a judicial enquiry, including from within his own Party, ultimately nothing happened. It was his bad luck that just when the Maharashtra ATS was beginning to unravel the Hindu terror network, attack on Mumbai took place, which compounded matters further.

The coming generations of democratic India will remember the Manmohan Singh government for RTIA and NREGA, two of the most pro-people Acts legislated so far in independent India . Sonia Gandhi probably deserves the credit for these more than the PM. Manmohan Singh was supportive of the attempts to scuttle the RTI Act in the name of making amendments until Sonia Gandhi intervened again. But these two Acts will have the same transformative effect on governance as probably the implementation of Mandal Commission report had had on the politics of this country, even though presently the bureaucracy, the judiciary and the ruling class with vested interests are working overtime to kill the spirit of these Acts. The RTI and the social audit provision in NREGA have opened a window for the common citizen where she can participate in the democratic system rather than merely be a voter once in five years and a mute spectator in between two elections.

Dr Sandeep Pandey

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

Published in THE TEHELKA, 3 April 2009

Will IMF deliver G-20's booster for world economy?

Earlier this week the Group of Twenty leaders announced a USD 1.1 trillion booster-dose into the world economy by the end of 2010 through multilateral institutions like the International Monetary Fund (IMF). However, in July 2008, analysts from Cambridge and Yale Universities had reported that tuberculosis (TB) in countries with IMF loans rose sharply.

The strict conditions on IMF loans were blamed for thousands of extra TB deaths in Eastern Europe, and former Soviet republics. A UK TB charity backed the Public Library of Science (PLoS) study findings - but the IMF had firmly rejected them, as per a BBC news (July 2008).

David Stuckler from Cambridge University had said to BBC in July 2008 that "If we really want to create sustainable economic growth, we need first to ensure that we have taken care of people's most basic health needs."

Most alarming was when the levels of drug-resistant TB shot up in eastern Europe and former soviet union.

The BBC news further said that "in recent years, it [IMF] has offered assistance to 21 countries in the region, in the form of loans offered in exchange for the meeting of strict economic targets. The researchers claimed it was efforts to meet these targets that were undermining the fight against TB by drawing funding away from public health."

Most striking was the analysis in BBC news that "without the IMF loans, they suggested, rates would have fallen by up to 10%, meaning at least 100,000 extra deaths. Countries which accepted IMF loans averaged an 8% fall in government spending, a 7% drop in the number of doctors per head of population, and a fall in a method of TB treatment called "directly observed therapy", which is recommended by the World Health Organisation."

It is not surprising that healthcare doesn’t get the mandate at forums like G-20 in the manner in which it should. Before the G-20 began, there was a growing public movement globally to put pressure on G-20 countries to put a currency transaction levy of 0.005% to raise dedicated resources for funding health programmes. This currency transaction levy of 0.005% can potentially generate USD 30-40 billion a year.

It is vital to understand the health funding in these times of global economic meltdown. The single largest donor of AIDS, TB and Malaria programmes globally - the Global Fund to fight AIDS, TB and Malaria (GFATM) has just 37.5% of its estimated budget for 2009-2010. The donor countries haven’t kept their promises to fund the 'Fund'. The GFATM projected budget for 2009-2010 was USD 8 billion and it just has USD 3 billion in its kitty, falling short of USD 5 billion.

The donor countries that haven’t kept their promises include the United States of America that is also the biggest defaulter. It is not that US doesn’t have money, it gave about the same amount it owed to GFATM to Merrill Lynch as bail out money. It gave hundreds of times more to other private banks as bail out money. The banks distributed this amount amongst themselves as 'holiday bonuses'.

Another example comes from one of the most severely TB-HIV hard-hit regions - Africa. Despite of African governments declaring TB as an emergency, Africa as a region, faces the largest funding gap of USD 10.7 billion to fully implement the Global Plan to Stop TB by 2015.

The countries in Africa had achieved a milestone by endorsing the African Union Abuja pledge of allocating 15% of national budgets to health but they have bitterly failed to act on this pledge. Only Botswana has kept the promise of allocating 15% of the national budget to health, the rest of the countries in Africa need to keep their promises.

As per a report of the World Bank and Stop TB Partnership (December 2007), high-burden TB countries are likely to recover 9-15 times of their investment in TB control. This report indicates that the economic cost of not treating TB to Africa between 2006 and 2015 would be USD 519 billion while TB can be controlled with USD 20 billion in the same period.

It is clear that despite evidence, health is not perceived as a smart investment. Possibly imposing currency transaction levy of 0.005% can generate a pool of dedicated financial resources to strengthen health systems globally.

It is high time to be clear on what kind of a development we want for the world - a model which serves the capital interests of corporations or a model which serves the most basic needs for all, including that of healthcare?

One good analysis which further highlights this debate is from India. The Indian Prime Minister Dr Manmohan Singh gave indications of his shaking confidence in neo-liberal economic policies of liberalization- privatization-globalization in India in two meetings of Confederation of Indian Industries (CII). "He suggested that CEOs must consider placing voluntary ceilings on their salaries. He said that the gap between the rich and poor would produce social unrest. He said that for an unemployed youth a 9% growth rate didn’t mean anything. He added that CEOs must not treat their wealth for personal consumption only but should consider using it for general good of society. He invoked the much forgotten ‘trusteeship principle’ of Mahatma Gandhi, which probably no politician in independent India has ever mentioned. Now, these thoughts would make a very sound policy if the objective was to create a humane and equitable society instead of elevating the growth rate" said Dr Sandeep Pandey, Ramon Magsaysay Awardee (2002) and a National Alliance of People's Movements (NAPM) leader.

Are G-20 leaders listening?

- Bobby Ramakant

Activists reject capitalist, communal, criminal and corrupt politics

Activists reject capitalist, communal, criminal and corrupt politics

The activists have launched a 'chunaav par nazar' abhiyaan to reject politics which is based on capitalism, communalism, caste, corruption or criminalization.

The National Alliance of People's Movements (NAPM) has launched this 'chunaav par nazar' abhiyaan to mobilize public opinion to increase transparency and accountability in the forthcoming 15th Lok Sabha elections in India.

Election dates for the 15th Lok Sabha have been announced and there is again a huge challenge before us to ensure that the real issues of people are buried by political rhetoric. All the existing and newly forming political fronts, if anything, have a most striking similarity with amoebas - whether it is the 1st Front or the 4th Front. It is impossible for people to grasp where a front stands either on issues or vis-à-vis other parties/fronts, whether they are independent fronts or fronts within fronts! Whatever little difference did exist between so-called 'communal and secular' parties or 'capitalist and socialist' parties is visibly diminishing day-by-day.

It is, therefore, highly important, for us, people's movements and organizations to raise basic and burning issues on the one hand as well as enable an opportunity to link up local and regional issues and struggles with the national.

During the Meeting of the National Conveners of NAPM held at Nagpur on the 1st and 2nd March, we had discussed our role during the upcoming Lok Sabha elections. We decided to organize the preparatory meetings at the earliest, as the poll dates are nearing and this process must be taken forward on a war-footing. The following key issues are being discusses during the state meet:

- Compliance with the Model Code of Conduct (MCC) for candidates and political parties as defined by the Election Commission of India.

- Analyse the records of the present member of parliaments (MPs) by trying to identify MPs with criminal record, involvement in corrupt practices, involvement with casteist and communal organizations, working as the frontman of any corporate or builder group and bring these facts into the public domain.

- Monitoring the existing property of candidates, income, the number of vehicles, amounts spent on literature, campaign material, advertising and other propaganda.

- Group/ State Unit should prepare the list of general malpractices during elections such as distribution of cash, kind, liquor, booth capturing, delivering communal/ casteist speeches, rigging of votes, making false promises or allurements etc. It may be re-stressed that after announcement of elections, no declaration of new schemes can be made by the state/ central Government ministries or politicians.

- Use the right to information Act (RTI) extensively to find out how many complaints were received during the last Assembly/ Parliamentary elections and the action taken on the complaints.

- Prepare a format to make complaints to the Returning Officer of the Lok Sabha constituency: Election Observer, State Election Commissioner (SEC) Member-in-charge of the State from the Election Commission of India, Delhi and also the Superintendent of Police of the District

- Bring together a state level Committee to observe elections and distribute work amongst the Committee.

- You may send a list of the NAPM Election Observers (from each state) to the Election Commission of India along with a letter to the State Election Commission for associating these persons in the election monitoring process to ensure free and fair elections. A delegation of the NAPM (State) Election Monitoring Committee can meet the SEC and maintain regular communication with him.

Methodology during the pro-people election watch campaign:
-----------

i. Details of the announced candidates of various political parties must be compiled.

ii. Fixing up of a date with the candidates for open discussion with the electorate (Try to call the candidate for a public meeting in the area). Obtain the oral and written commitment of candidates on specific laws and policies/issues.

iii. Prepare few people with questions about the common problems issues and problems like: displacement and rehabilitation, social security to unorganized sector workers, right to housing, water, unemployment, need for health services, schools, public rationing, better public transport, commitment to ban liquor etc.

iv. Prepare a list of speakers who will address the gathering on behalf of NAPM after the Q&A Session is over with candidates.

v. We request people's groups in the state to send us a brief summary of national as well as local/ regional issues that must highlighted during the campaign at the meeting in your area, along with soft copies of the manifestos of the parties contesting elections there.

vi. Prepare a note for need of the various electoral reforms on behalf of NAPM state unit. Nationally, identify at least 10-15 candidates / black list them to demonstrate what kind of politics we reject. (Politicians like Kamal Nath, LK Advani, Rajnath Singh, Sharad Pawar and others are to be questioned – add to the names please)

vii. NAPM has its People's Resolve, which is more or less the NAPM manifesto which needs to be publicized and presented during our aforesaid programmes and meetings. Any of you can propose or add anything specific to the Manifesto and use it in the meetings / dialogues. Please do send your suggestions to the below mentioned emails.

'chunaav par nazar' yatra

At least one major city / capital is planned to be covered in different states, which shall include a meeting with representatives of people's organizations, a press conference and a public meeting.

We also propose to organize a travelling poster exhibition and also have documents already prepared by Election Watch plus comparative analysis of party manifestoes (2004 and 2009) along with a People's Manifesto by NAPM. The posters would also contain data on various unlawful and unethical antecedents of candidates/ parties.

We will have with us at different places, former Advisor to the Election Commission of India, Shri K. Jagannatha Rao, along with mass-based people's representatives, thinkers and conscience-keepers such as you to address the mass gathering of people and also the press, which certainly create a positive impact.

Justice (Retd.) Rajinder Sacher, Trilochan Sastry, Association for Democratic Reforms, Sharad Chadra Behar, Former Chief Secretary, Govt. of Madhya Pradesh, Prof. Ramdayal Munda, Senior adivasi rights activists, Former Vice Chancellor, Birsa Munda University, Ranchi ,Meher Engineer (West Bengal) President, Indian Social Science Academy,Prof. Amit Bhaduri, Economist and supporter of people's movements, Ulka Mahajan, Sarvahara Jan Andolan and NAPM , Arvind Kejriwal, Right to Information Activist, Parivartan, Gautam Bandopadhyay, Nadi Ghati Morcha, Medha Patkar, National Convenor, NAPM and some other Convenors and Members of NAPM have confirmed their presence at different places. Other special invites are yet to finalize.

It would undoubtedly strengthen the process if you can join this effort from one or two places at least and raise the people's agenda before the elections. It would also greatly help, if you can in whatever way, try to mobilize resources for the campaign, which would include travel expenses, amounts for stationery and poster material etc.

Attached with this Note is a tentative schedule of the list of cities / places to be covered in the coming few weeks of April before the Phase I of the Lok Sabha Elections. We look forward to your support and involvement.

Anand Mazgaonkar: anandpss@gmail.com; napmindia@gmail.com
Medha Patkar: phone - 09423965153 (nba.medha@gmail.com)

ELECTIONS 2009: Lok Rajniti Manch to field 3 candidates in UP

E L E C T I O N S 2009
Lok Rajniti Manch to field 3 candidates in UP

The Lok Rajniti Manch has decided to field S.R. Darapuri from the Lucknow Lok Sabha constituency in the approaching general elections as part of its efforts to establish a pro-people politics. Darapuri, an IPS officer, retired as Inspector General of Police from the UP cadre and is a prominent social and human rights activist. He is part of the people's movements aimed at empowerment of common people. During service he was regarded as an honest and diligent officer.

Lok Rajniti Manch desires to build a new political culture which will be an alternative to the dominant money and muscle powered politics, which will bring the common people's issues to the core of politics, where the candidates will have a history of serving the people, where the politicians will not require armed security, where the candidates will strictly follow the code of conduct set up by Election Commission, where the election expenses will be made public and where the candidate will conduct himself/herself in a transparent manner and will be accountable to the people. The candidate irrespective of the result of the election will continue to serve the people.

This is a small beginning to challenge the stranglehold of crime and corruption over politics. We know that this is a long battle but we are into it for a long haul. The people, sooner or latter, will reject the corrupt and criminal candidates and elect honest and committed ones.

Until the dominant criminal and corrupt political culture is not challenged the true democracy can never be realized because the benefits of various social welfare and developmental schemes will never reach the people. To eliminate the conditions of poverty, unemployment, destitution, exploitation, crime from this society a new political culture will have to be nurtured which will build a pro-people alternative to the present anti-people system. This is India 's second freedom struggle. The majority population of the country which is yet to taste the benefits of freedom will wage this battle.

With Darapuri's joining the election fray now the LRM has three candidates from Uttar Pradesh in the forthcoming elections for the Lok Sabha. Ram Sagar Verma is contesting from the Mishrikh reserved seat and Ram Naumi Yadav is the candidate from Salempur in eastern part of the state. Overall, about a dozen LRM candidates will be contesting natioanally.

Dr Sandeep Pandey

If G-20 agrees, health financing might come from Currency transaction levy

If G-20 agrees, health financing might come from Currency transaction levy

There is a growing public movement globally to put pressure on the Group of Twenty (G-20) Finance Ministers and Central Bank Governors that will meet in London, UK, on 2 April 2009, to put a currency transaction levy of 0.005% to raise dedicated resources for funding health programmes. This currency transaction levy of 0.005% can potentially generate USD 30-40 billion a year.

It is vital to understand the health funding in these times of global economic meltdown. The single largest donor of AIDS, TB and Malaria programmes globally - the Global Fund to fight AIDS, TB and Malaria (GFATM) has just 37.5% of its estimated budget for 2009-2010. The donor countries haven’t kept their promises to fund the 'Fund'. The GFATM projected budget for 2009-2010 was USD 8 billion and it just has USD 3 billion in its kitty, falling short of USD 5 billion.

The donor countries that haven’t kept their promises include the United States of America that is also the biggest defaulter. It is not that US doesn’t have money, it gave about the same amount it owed to GFATM to Merrill Lynch as bail out money. It gave hundreds of times more to other private banks as bail out money. This was tax payers money of the people - which was handed over to the banks. The banks distributed this amount amongst themselves as 'holiday bonuses'. Outrageous? May be, but possibly the health advocates didn’t do a good job of convincing the policy makers that health investment is a smart investment, with promising returns.

Despite of African governments declaring tuberculosis (TB) as an emergency, Africa as a region, faces the largest funding gap of USD 10.7 billion to fully implement the Global Plan to Stop TB by 2015. This fact came in spotlight when the TB funding in Africa required to meet the TB-related targets of millennium development goals (MDG) by 2015 was analyzed, said Kenyan activist Lucy Chesire.

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

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

It is clear that health is not considered as a smart investment. Possibly imposing currency transaction levy of 0.005% can generate a pool of dedicated financial resources to strengthen health systems globally.

Trading volume in the foreign exchange (FX) market has now topped USD 1000 trillion a year. In this financial crisis, unlike most other areas of the finance industry, the FX market is still growing. This provides a very solid base from which the currency transaction levy can produce a sustainable and substantial income stream. As well, the market is fully electronic. Collection would be computerised with payment automatic every time a currency trade is settled. Thus it is efficient and inexpensive to implement with little scope for avoidance.

The proposed rate of 0.005% is too small to alter decision making in the FX market and yet high enough to yield a sizeable revenue stream. In recent work for the UN University, Professor Rodney Schmidt undertook the most detailed econometric modeling to date, showing this rate is too low to affect market structure whilst at the same time producing potential revenue of the order of USD 30-40 billion a year.

There are mechanisms like the currency transaction levy that have proven to work. Like the UNITAID. In 2006, France, Brazil, Chile, Norway and the United Kingdom decided to create an international drug purchase facility called UNITAID to be financed with sustainable, predictable resources. As an economically neutral tool the tax on air tickets was considered as the most suitable instrument. This mechanism seeks to fill a critical gap in the global health financing scenario: the need for sustained strategic market intervention to drive price reduction and increases in supply.

Potentially the currency transaction levy can radically change the global health financing landscape and bring in more sustainability but the world - for now the G-20 countries - need to be covninced why health financing is a smart investment.

- Bobby Ramakant

People with drug-resistant tuberculosis are neglected by governments

People with drug-resistant tuberculosis (TB) are neglected by governments

The countries that report high burden of tuberculosis (TB), particularly, drug-resistant strains of TB, are the ones not moving fast enough to provide life saving treatment. According to the International medical humanitarian organization, Medecins Sans Frontieres (MSF) or doctors without borders, less than one percent of those with multi-drug resistant TB (MDR-TB) get access to proper treatment as per the International standards of treatment and care guidelines of World Health Organization (WHO). Even the Stop TB Partnership agrees that about three per cent of those with MDR-TB might be receiving proper treatment.

"Only 3% of people who have MDR-TB have access to effective treatment. We have compelling evidence that we know how to prevent and treat MDR-TB and treatment success rate is 80% in low resource setting. Its intervention is complex but is effective, feasible and is cost-effective" stressed said Dr Ernesto Jaramillo, Medical Officer, Stop TB Department, World Health Organization (WHO) at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil.

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

As ministers from high-burden multi- and extensively- drug-resistant TB (M/XDR-TB) countries gather from 1-3 April 2009 in Beijing, China, for a high-level ministerial meeting on M/XDR-TB, MSF calls on them to commit to treating more people with MDR-TB, and to conducting necessary research to improve current treatment options.

The WHO reports that there are more than 500,000 new MDR-TB cases each year, but that under 30,000 people were detected and notified last year and only 3,681 are known to have started treatment according to international guidelines and with quality-assured medicines.

“The slow progress in treating people with MDR-TB is particularly striking because high-burden MDR-TB countries are definitely not the least developed in the world,” said Dr. Tido von Schoen-Angerer, Director of MSF’s Access to Essential Medicines Campaign. “They have the capacity to act, and need to make this a priority and put people on treatment.”

MSF is concerned that many countries, particularly those that are classified by WHO as ‘high-burden’, like China, South Africa or India, are not doing enough to provide treatment to patients in need. In addition, not providing appropriate treatment further contributes to the spread of drug-resistant TB.

China, for example, has a quarter of the world’s MDR-TB cases. Answering to an initial request made by the Chinese National TB Programme, MSF then failed to obtain the authorisation to provide care for MDR-TB patients in inner Mongolia, despite two years of negotiations with national, provincial and regional authorities. MSF has now abandoned its attempts to open the project.

“Not being able to act when there are people that need life-saving treatment is extremely frustrating,” said Meinie Nicolai, MSF Director of Operations. “Because we did not manage to reach an agreement, we could not put a single patient on treatment. And because they can’t get treated anywhere else, many people will have died while we were stalled in meetings these past two years.”

“Crucially, high-burden countries have the skills and some of the resources needed to conduct the research to improve MDR-TB treatment,” says Dr. von Schoen-Angerer. “The Beijing meeting is an opportunity for high-burden countries to take the lead in addressing this crisis, by setting targets to put more patients on treatment, by agreeing to import quality-assured drugs, and by establishing a joint research effort to improve existing treatment.”

In 2007, MSF treated 574 patients for MDR-TB in 12 projects including in South Africa, India, Uzbekistan, Georgia and Armenia.

According to the World Health Organization (WHO), the countries with the highest burden of MDR-TB are India (131,000 cases), China (112,000), Russia (43,000), South Africa (16,000) and Bangladesh (15,000).

The High Level Ministerial Meeting on M/XDR-TB is being organized by WHO, the Ministry of Health of the People's Republic of China and the Bill and Melinda Gates Foundation.

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

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

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

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

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

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

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

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

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

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

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

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

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

Investing in research is also necessary. Treating MDR-TB is complex, lengthy and involves the use of drugs that can cause severe side effects and are not optimally effective. There is therefore an urgent need to speed up the development of newer, better tests and drugs, and to conduct studies to optimise MDR-TB treatment.

What do Varun Gandhi's pronouncements mean?

What do Varun Gandhi's pronouncements mean?

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

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

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

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

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

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

Dr Sandeep Pandey

Neglect of TB control among indigenous communities unethical

Neglect of TB control among indigenous communities unethical

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

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

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

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

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

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

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

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

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

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

- Bobby Ramakant

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Chrispin and his wife have four lovely children.

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

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

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

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

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

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

- Bobby Ramakant

Bloomberg Award for Thailand's pictorial warnings on tobacco products

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

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

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

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

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

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

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

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

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

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

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

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

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

[Audio podcast is available here]

Jittima Jantanamalaka - Citizen News Service (CNS)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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