CNS

Protect the young ones from tuberculosis

[Based on an exclusive interview of Dr Anne Detjen with CNS, at the recently concluded 42^nd Union World Conference on Lung Health, Lille, France]

Mikkel Vestergaard Frandsen, the CEO and owner of Vestergaard Frandsen (a company focused on achieving the United Nation's Millennium Development Goals of eradicating extreme poverty, combating infectious disease and reducing global warming) opened his Inaugural Lecture at the just concluded 42nd World Conference on Lung Health, by showing a video clip of a 14 years old poor African girl who contracted TB in a poor and indoor pollution ridden home and died of it a few months ago. The clip was a telling commentary on the status of childhood TB in poor household settings. TB in children is still highly under diagnosed, under reported and under estimated.

Hygiene and cleanliness should be maintained within the households and children should not be exposed to tobacco smoke or smoke coming out of cook stoves. Passive tobacco smoke is not only harmful for health but also puts children at high risk of contracting pneumonia. "Cleanliness and hygiene is very important for controlling pneumonia especially in children. In our country there is a tradition to put kohl (kajala) in the eyes of the children, give them oil massages, etc. We need to be very cautious regarding hygiene when it comes to children as their immunity is still developing" said Dr KN Dwivedi, noted Paediatrician from Gorakhpur.

Good nutrition can save a child from malnutrition and pneumonia both. "Nutritious diet is the fuel of life, just what petrol is to a car. The best nutrition for a newly born child for at least first six months is mother's milk. Only after first six months, other food items are introduced very gradually and mother's milk is recommended for two years. By one year of age, a child can nearly eat whatever an adult person can eat too. Point to remember is that good nutrition is fundamental to a child's healthy tomorrow" said Dr KN Dwivedi, noted Paediatrician from Gorakhpur.

Pneumonia is the leading single cause of childhood mortality. Childhood pneumonia accounts for 19 per cent deaths in children less than 5 years. Pneumonia kills more children than any other illness, more than measles, malaria and AIDS combined. According to the World Health Organization (WHO) globally 156 million new pneumonia cases are reported every year in the developing world. As many as 8.7 per cent of these cases are severe enough to be life-threatening and require hospitalization. India accounts for the maximum 43 million new cases followed by China (21 million cases) and Pakistan (10 million cases). Pneumonia is estimated to kill 410,000 children in India every year.

Photo credit: Jitendra Dwivedi

Pneumonia is the leading global killer of children under five, responsible for almost 1.6 million deaths per year, which is about one-fifth of all paediatric deaths around the world. Like other acute respiratory infections, pneumonia targets the world’s most vulnerable children—those who are poor and mal/undernourished. The burden of pneumonia in the developing world is nearly 10 times that of developed world In low income countries, pneumonia kills 7320 out of 100,000 children below 5 years of age, as compared to just 34 in developed countries. In South Asia and Sub Saharan Africa 21% of all deaths in children are due to pneumonia. According to the Acute Respiratory Infections Atlas 2010, lack of food contributes to 44% of deaths from pneumonia in children globally.

Effective vaccines are much needed shots in the arm of TB control

[Based on an exclusive interview with Dr Ann Ginsberg, Vice President of Scientific Affairs, Aeras, at the ongoing 42nd Union World Conference on Lung Health, Lille, France]

Dr Ann Ginsberg, Aeras (Left)
with Shobha Shukla - CNS (right)

Around 2 billion people or one third of the world population are estimated to be infected with the TB bacterium and are at risk of developing the disease. One in every 10-20 of those people will become sick with active TB in his or her lifetime. If not treated, each of these persons with active TB can infect 10 to 15 people in a year. TB is a leading killer of people living with HIV, as they have a much weakened immune system. According to the latest data, there were 8.8 million new cases of TB in 2010 and the disease killed a staggering 1.4 million people. Many more struggle with the disease which apart from causing human suffering, slows down economic growth. The annual economic loss is estimated to be 0.52% of the world’s gross national income. Although poverty driven, TB is present in all continents. It is said that 'the situation is serious in Europe, alarming in Africa and worrisome in parts of Asia.'

Despite making compelling public health sense to integrate pneumonia prevention, treatment and care services in public sector healthcare facilities as childhood pneumonia is a leading cause of mortality for children below 5 years of age, the reality remains grim. Not only healthcare services in public sector lack quality standard prevention and treatment services but also there is a lack of guidelines so that pneumonia related services can be uniform in private and public healthcare services.

Despite pneumonia is the lead killer of children below the age of five years still the government has not included pneumonia vaccination in the national vaccination programme for children that is provided free of cost in the government run public healthcare service centres. According to the 2008 data, 371605 children below the age of five years died due to pneumonia which is 20.3% of all deaths occurring in the under-5 children that year. Ironically children who are at an alarming risk of pneumonia are more likely to be poor, exposed to tobacco smoke or smoke from cook stoves, live in over-crowded and polluted surroundings with low levels of hygiene or cleanliness, among other risk factors that put them at a greater risk of pneumonia. These most-at-risk children are also least likely to get vaccinated against pneumonia as their parents or guardians are least likely to be able to afford the cost.

A balanced nutritious diet is a must for everyone especially for children as they are growing and their body’s self-defense mechanism is developing. If the food we consume is not nutritious then instead of benefiting us it can cause serious harms. One of the possible outcomes of malnutrition is pneumonia more so when it comes to children.

A report released online earlier this week states that effective partnerships can improve tuberculosis responses globally. The summary report, titled, "Whole Is Greater Than The Sum Of Its Parts", was also distributed at the 42nd Union World Conference on Lung Health in Lille, France. This report is the summary of the online consultation that was facilitated by CNS: www.citizen-news.org – a partner of the Stop TB Partnership - using social media platforms and also the Stop-TB eForum that was established by the Health and Development Networks (HDN) in early 2001, and currently is supported by the Stop TB Partnership, the International Union Against Tuberculosis and Lung Disease (The Union) and the International HIV/AIDS Alliance, and managed by CNS. The online consultation was held during October 2011.

New-born children after birth should be given exclusive mother's milk for first six months because it increases their body's resistance and immunity for rest of their lives. "Breast milk not only protects a child from pneumonia but also many other infections. Breast milk increases body's immunity of a child. That is why risk of contracting pneumonia in exclusively breastfed children is less compared to those children who don't get exclusive breast milk during first six months of their lives. Apart from exclusive breastfeeding there are many other steps one can take to protect children from pneumonia such as protecting children from cold exposure" said a noted paediatrician from Gorakhpur Dr KN Dwivedi.

Despite being the single largest cause of deaths of children below the age of 5 years, responses from the government of India’s health programmes to protect children from childhood pneumonia and diagnose early those who develop pneumonia and treat them, is far from satisfactory. Pneumonia vaccination is not included in the national immunization programme rolled out by the government of India through public healthcare services. Treatment guidelines are unclear to healthcare providers in India who come from a broad range of medical disciplines and unclear linkages of health programmes with those development programmes that reduce the risks for a child to develop pneumonia, such as tobacco control, housing, nutrition, environment or pollution control, among others, are key barriers.

There is increasing awareness about harms of pollution on one’s lungs but less on how the unborn child is harmed when her or his mother inhales polluted air. Indoor air pollution has serious consequences for the unborn child such as the smoke coming out of cook stoves or tobacco smoke. Tobacco consumption is associated with diseases, disabilities and deaths.

The 42nd Union World Conference on Lung Health, focusing on tuberculosis (TB), HIV, tobacco control and non-communicable diseases, is currently being held at Lille from 26-30 October. Lille is the place where Professors Albert Calmette and Camille Guerin developed the current TB vaccine BCG ninety years ago at the Institut Pasteur de Lille. Researchers and other experts from more than 100 countries are attending this 5-day conference, which has the theme of "Partnerships for Scaling-Up and Care". The conference is organised each year by the 91 years old organization International Union Against Tuberculosis and Lung Disease (The Union), which is headquartered in Paris with 13 additional offices worldwide and members from 150 countries.

Pneumonia is one of the most common infections in children who aren’t breastfed, are exposed to indoor air pollution, are malnourished or live in over-crowded or polluted surroundings. Pneumonia can be transmitted via bacteria, virus, among other pathogens. However the good news is that pneumonia is preventable and if it does occur then it is curable with standard treatment at the right time.

Indoor air pollution increases the risk for childhood pneumonia. Smoke coming out of cook stoves and second-hand or third-hand smoke that is a direct result of family members smoking tobacco within households also scales up the risk for childhood pneumonia. Since pneumonia adversely affects the lungs, indoor air pollution and inhaling tobacco smoke or smoke coming out of cook stoves puts children at risk of pneumonia.

Nutrition, cleanliness and hygiene should be paid attention more so when a woman becomes pregnant. Good balanced nutrition for the pregnant woman and postnatal for her new born child is a blessing in warding off infections and boosting child’s immunity. Childhood pneumonia is a common disease affecting an alarming number of children below 5 years of age.

Children, who are malnourished, undernourished or those who are not breastfed during the first six months of birth have less resistance towards diseases. As a result they are more prone to pneumonia. Thus good nutrition and mother’s milk have an important contribution in preventing childhood pneumonia. Globally 44% infant mortality due to pneumonia is caused by malnutrition.

In recent years, India’s trade policy is being determined more and more by Free Trade Agreements (FTAs) which threatens access to essential medicines, seeds, and domestic micro, small and medium enterprises. India is currently engaged in negotiating such bilateral agreements with several countries, having already signed FTAs with some of them. The latest, and also the most hotly debated, is the one it is negotiating with the European Union (EU). FTAs are trade agreements between two countries which aim to give each other access to markets by lowering or removing border protection measures, such as border taxes on exports and imports, and other barriers.

A National Workshop on the provisions, linkages and possible impacts related to India’s Free Trade Agreements and Micro Small and Medium Enterprises (MSMEs) was recently organized in Delhi, by Third World Network, in partnership with Traidcraft Exchange (UK) and Shramik Bharti, (Kanpur) and supported by the Commonwealth Foundation, Network for Social Change and the Heinrich Boll Foundation. The purpose of the workshop was to flag issues related to free trade agreements (FTAs) and facilitate a dialogue between different stakeholders with a view to protect the interests of MSMEs in FTA negotiations, by playing a role of intermediaries between government and entrepreneurs. However, the presence of a mere 5 entrepreneurs in the workshop, did rob it off some valuable inputs.

"Increase in the number of women journalists in the past two-three decades has helped to bring development issues, including writing on children to the fore, they are better equipped to deal with such issues with greater sensitivity," said senior journalist and Editor-in-Chief of Outlook, Vinod Mehta. He was addressing the 55th session of Media For Children organized on the fourth anniversary of Media Nest, a pan India forum of journalists at the UP Press Club.

[Images] People living with hepatitis C, International Treatment Preparedness Coalition - India (ITPC-India), and treatment activists at a press conference held recently in Delhi, questioned the silence maintained by the Indian Health Ministry on its response to the Hepatitis C virus (HCV) which is emerging as a growing public health threat, and in the absence of effective prevention programmes, millions are at risk of this deadly infection.

The nights are laden with the intoxicating smell of the white flowers of 'queen of night'. There is a rosy nip in the morning air, hinting at the approaching winters. The granaries are brimming with the recently harvested rice crop. For many businesses, the traditional (not the official) new financial year is about to begin. So what could be a more auspicious time to worship ‘lakshmi’ the goddess of wealth, and ‘ganesha’ the elephant god who removes all hurdles from our lives, than the festival of DEEPAWALI or Diwali (which literally means ‘rows of earthen lamps’).

Right after birth children should be given mother’s milk only for first six months of their lives because it protects them from infections such as pneumonia, diarrhoea, among others. “Mother’s milk has desirable and beneficial antibodies that help the child protect herself/ himself against pneumonia and other infections. That is why it is strongly recommended that mothers should exclusively breastfeed their child for the first six months” said Dr Abhishek Verma, Senior Paediatrician, Dr Ram Manohar Lohia Hospital in Gomti Nagar, Lucknow.

“Pneumonia vaccination as per the standards set by the World Health Organization (WHO) is available in the market as per the causative agent. However in public sector government hospitals vaccination for pneumonia is not available” said Dr Abhishek Verma, senior Paediatrician, Dr Ram Manohar Lohia Hospital, Gomti Nagar, Lucknow.

With changing weather condition children are more prone than adults to get sick. This is because of their low immunity and as they grow their body’s self defense mechanisms (immunity) develops too. Exclusive breastfeeding is a blessing for a child in her or his first six months of life which is not only a complete balanced diet for the child, but also prevents infections transmitted through unhygienic feeding habits and boosts up a child’s immunity significantly. If a child is not breastfed during first six months of life then the risk of contracting infections such as pneumonia goes up alarmingly. More than 1.6 million children under the age of 5 years die due to pneumonia despite pneumonia being preventable and curable too.

Indoor air pollution from tobacco smoke, cooking smoke from fuel wood and cow dung based chulhas plays an important role in predisposing children to pneumonia. According to the World Health Organization (WHO) environment related pollution like cooking on burning wood or cow dung or other organic fuels, smoking indoors, living in crowded homes, all increase the risk of pneumonia in children. Thus children must be kept in a clean and hygienic environment so that the risk of getting pneumonia and other infections is minimal.

National partnerships to stop tuberculosis (TB) bring varied partners together to develop and implement shared action plans to tackle TB. The partnering process allows national partnerships to maximize the efforts of existing state and non-state actors; bring more services and awareness-raising campaigns to the people, where they are; give a unified voice to non-state partners; and serve as a platform to develop funding proposals and implement grants. If you do not already have a national partnership, now is right time to start. The financial crisis, TB-HIV co-infection and the rise of drug-resistant TB are stretching the resources of TB programmes around the world. This makes the case for founding a national partnership through the partnering process all the more compelling.

She packs a powerful punch, given her pint size stature, yet the lady from Dora, a quaint hamlet of district Ghazipur in Uttar Pradesh, is a tall woman thanks to her achievements and she makes no bones about it. Having stood for the Gram Sabha elections and winning with a over 300 votes which was a total landslide victory for her, Savitri stands as a testimony to what a strong will power coupled with an effective communication skill can do, no matter what the physical constraints or societal traditions maybe.

Adopt sanitation, hygiene and clean water for healthy living

October 15th is Handwashing Day

Photo credit : Ayush Das

After India's most celebrated Bollywood star Shah Rukh Khan becoming the brand ambassador for Geneva-based Water Supply and SanitationCollaborative Council (WSSCC), now Indian cricket players are to promote sanitation and hygiene in the country. Yusuf Pathan and Irfan Pathan have already shot a clip, in which they are asking people: "Adopt the WASH hatrick - sanitation, hygiene, clean water - for healthy living".

[हिंदी] [Signature petition] To protest against the decision of Planning Commission of India to file an affidavit with ridiculous definition of poverty, growing number of people from many cities will observe a five-days fast (22-26 October) and observe a black Diwali (Indian festival of lights). "We have decided to observe five day fast from 22nd October 2011, to the morning after the Diwali at my Ashram in Lalpur village of Hardoi District of U.P. and will observe a black Diwali along with the villagers this year. The government has adopted an economic policy which is clearly benefitting the already well off sections of society at the cost of the poor. It has no idea how to deal with poverty and price rise making the survival of poor very difficult. It has not been able to check farmer suicides, hunger deaths, malnourishment of children or maternal mortality rate. While the ministers have made crores in corruption the government has chosen to remain insensitive to the issue of poor" said Dr Sandeep Pandey, Magsaysay Awardee and a visiting Professor at Indian Institute of Technology (IIT) Gandhinagar.

World Mental Health Day: 10 October
Buddha looked at the water and then he looked up at the disciple and said,"See what you did to make the water clean. You let it be, and the mud settled down on its own - and you have clear water. Your mind is like that too! When it is disturbed, just let it be. Give it a little time.... it will settle down on its own. You don’t have to put in any effort to calm it down. It will happen. It is effortless."

The 42nd Union World Conference on Lung Health will be held in Lille, France, on 26–30 October 2011 on the theme: "Partnerships for scaling up and care." The theme highlights the vital importance of collaboration in our common efforts to address the conditions affecting lung health. The CNS (www.citizen-news.org) is facilitating a time-limited online consultation in lead up to the above conference focussed on the following GUIDING QUESTION: What are the different types of groups, people, organizations or entities you have partnered with to fill a gap in TB prevention, care and/or control.