CNS

Living with HIV and infected with TB: The Double Struggle

Diana Esther Wangari - CNS
Lying in bed at Kenyatta National hospital, Joshua Lule stared at the ceiling lost in thought. The hospital had been his home for the past three months and while the rest of the patients prepared to see their friends and relatives at half past noon every day, Joshua remained in his recumbent position. No one would be coming to visit him; in fact no one had visited him in the past two months. He had remained hopeful during those first few weeks but as days passed by his hopes of seeing a friendly or family face dwindled. The grim reality that they had all given up on him gradually dawned on him.

Shobha Shukla - CNS
Meena (name changed), a 35 years old mother of 3, comes from a village in district Gonda of Uttar Pradesh, India. She is living with HIV and has suffered from TB also. I met her at the antiretroviral therapy (ART) centre of a Government Hospital in Lucknow and was instantly struck by her infectious smile and cheerful disposition. Three years ago, both she and her husband were diagnosed with HIV. She was immediately put on ART, but not her husband as the doctor did not find his CD4 count below the critical level. Ironically, her husband died six months later of a fall, but Meena is still up and about.

(First published in THE HINDUSTAN TIMES on Tuesday, 6th August 2013)
Diabetes has proved itself a silent killer disease. Today in the world maximum numbers of the patients are suffering from this disease, and moreover they are passing through the complications too. The World Health Organisation estimated that in the year 2000, 150 million people had diabetes mellitus, and it is predicted that this number will rise to 366 million by the year 2030.The life style, diet and addictions are adding fuel to fire. Evidence prove that the patho-physiological process of diabetes have put the foot at increased risk for tissue damage. As soon as tissue damage has occurred,the foot is at risk for end stage complication including gangrene and amputations.

Paidamoyo Chipunza, Zimbabwe
(First published in The Herald, Zimbabwe on 8 August 2013): GOVERNMENT has been urged to create 100 percent smoke-free environments to help reduce the risk of contracting cancer. The calls come amid chilling revelations that more than 4 000 chemicals are found in tobacco smoke, from which at least 250 are known to be harmful and more than 50 known to cause cancer. Ministry of Health and Child Welfare deputy director for the department of mental health and drug abuse Mrs Dorcas Sithole said while current laws forbid anyone to smoke in public spaces such as in buses, commuter omnibuses, airlines, halls, schools and public offices, people still do so.

Okeoghene Oghenekaro, Nigeria
(First published in News Agency of Nigeria, on 6 August 2013): Bidemi, a widowed petty trader, feels her life is crumbling because all her children frequently go down with cold. Joshua, her five-year old son, has just been discharged from the hospital after treating a debilitating cold. After medical tests, the doctor said Joshua had a respiratory tract infection the symptoms which Bidemi’s three other children are already having. She then wonders what could have caused this.

Bobby Ramakant - CNS
[Online poster image gallery] [हिन्दी] Over a hundred poster exhibits made on "Lessons From Japan" theme by Lucknow youth had sent a strong message on Hiroshima Day, 6th August 2013 in favour of low carbon and no-nuclear energy. Using nuclear energy for power generation is a very dangerous and expensive option with serious risk of irreparable and/or long term damage to environment and human life, argued the activists. This Lessons From Japan poster exhibition was organized at Daffodils Convent Inter College campus in Lucknow by Vote For Health campaign, CNS, Asha Parivar and National Alliance of People's Movements (NAPM).

Dr Ram Puniyani
A friend with dogged determination to show that the BJP is a lesser culprit of communal violence and that Congress is the major party to be blamed, listed the major communal riots in India and showed that most of the time when violence took place, it was Congress which has been the ruling party. He asks, so why get stuck with one episode of Gujarat violence and put it as a major point against Narendra Modi or BJP for that matter?

The International Management Development Programme (IMDP) of the International Union Against Tuberculosis and Lung Disease (The Union) ) has joined hands with the World Health Organization (WHO) TBTEAM network to support health systems strengthening by delivering accredited health management training courses. TBTEAM, the Tuberculosis Technical Assistance Mechanism, whose secretariat is hosted in the WHO Global TB Programme, is a global coalition of partners, countries and funding agencies, which aims to build up the national capacity of countries and focuses on assisting national TB programmes and other stakeholders in improving implementation of grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund).

[Report is online here] CNS with support from Lilly MDR TB Partnership visited 14 sites of Programmatic Management of Drug-resistant Tuberculosis (PMDT) in India and conducted key informant interviews on four key themes (counselling, infection control, diagnostics and laboratory services, and treatment and care services) and came up with specific recommendations. Those interviewed included patients of multidrug-resistant TB (MDR-TB), extensively drug-resistant TB (XDR-TB), cured MDR-TB patients, their family members, nurses, laboratory technicians, scientists, physicians, home-based care workers, counsellors, among others. The report, was submitted to Planning Commission; Central TB Division of Government of India; among other authorities. It was also disseminated at 8th World Conference of Science Journalists (WCSJ 2013) in Helsinki. Fifth part of this report also includes personal stories of MDR-TB and XDR-TB patients currently on treatment and cured MDR-TB patients.

5 years survival after lung cancer treatment remains low

Bobby Ramakant - CNS
Lung cancer is lurking around along with known risk factors such as tobacco smoke. Although with recent advancements in medical science 5 years survival rate for other forms of cancer has increased considerably yet the same remains as low as 14% for lung cancer patients since past two decades. Professor (Dr) Rajendra Prasad, Director of Vallabhbhai Patel Chest Institute (VPCI) was speaking to Citizen News Service - CNS before a lung cancer update in Delhi.

Alice Tembe - CNS
The impact of indoor air quality, on airborne infections is often ignored or unknown even though it relates to the health of our lungs—one of the most vital organ of or bodies. Indoor air pollution arising out of inhaling solid cooking fuel smoke directly caused 3.5 million premature deaths in 2010 and 1.3 million children under 5 years of age died from pneumonia in 2011 according to UNCEF Reports of 2012. The WHO report of 2011 further confirms that three types of lung diseases have been shown to have a strong association with solid fuel smoke: acute lower respiratory infections (ALRIs) in children, chronic obstructive pulmonary disorder (COPD) in women, and lung cancer in women exposed to coal smoke.

Bobby Ramakant - CNS
Three billion people around the world still cook their daily meals with wood, charcoal, coal and other forms of solid fuel. According to the latest Global Burden of Disease update released in December 2012, resulting health impacts lead to four million deaths annually which after high blood pressure, alcohol and tobacco is the greatest killer in the world. In India at least over a million people died each year due to health impacts of using solid fuels for cooking (25% of the global burden) which is quite alarming and a significant problem in the country" said Sean Bartlett, Senior Communications Officer, Global Alliance for Clean Cookstoves.

Carolyn Kavita Tauro - CNS
As we stand at a pedestrian crossing or walk by a bridge, and a vehicle passes by, letting out a cloud of smoke in our face, our immediate reaction is to fan it away with our hands. We are also quick to give the driver of the vehicle a stare and even make a comment about how unclean and unsafe the air in the atmosphere around us is.

Sumita Thapar - CNS
Family planning is a key strategy for child survival, said Michael Stern, USAID India, in Delhi this week. “We look towards India as a development innovation hub,” he added. In Delhi this week, health practitioners, researchers and policy makers discussed how the Standard Days Method (SDM) for family planning fulfils an unmet need, specially in resource poor settings. The SDM is a simple fertility awareness-based method of family planning based on a woman`s menstrual cycle. Appropriate for women who usually have menstrual cycles between 26 and 32 days long, SDM identifies days 8 through 19 as the fertile days. To prevent pregnancy, the couple avoids unprotected sex on the fertile days.

Bobby Ramakant - CNS
If women and girls, and their male partners where possible, are aware of fertility cycle, then it is very likely to increase access to existing family planning services, improve communication between partners, and help them prevent unintended pregnancies and space childbirths. Natural fertility awareness methods such as Standard Days Method (SDM) have proven to be effective. SDM has 95% effectiveness which is comparable to other family planning options. Most importantly, SDM users highlighted that one of the reasons they prefer SDM is because it has no side effects.

Non-communicable diseases (NCDs) are causing two-third of deaths worldwide. There is no doubt that latest launch of a robust programme to help civil society work on improving responses to NCDs is a welcome step forward. The NCD Alliance launched a new programme, formally called "Strengthening Health Systems, Supporting NCD Action" at The Economist event "New Approaches to Non-Communicable Diseases" in South Africa, where experts discussed strategies to accelerate the prevention and control of NCDs.

Shobha Shukla - CNS
Air, water and food are the 3 basic essentials (in that order) to sustain human life. One can stay without water and food for long periods but not without oxygen laden clean air even for a few moments. So breathing fresh air is essential to let us live to eat and drink and be merry. While we have the wherewithal to monitor and control the quality of what we eat or drink by using boiled/filtered water and hygienic food for our individual use, we cannot carry with us our personal container of purified air to breathe. The air around us (whether good or bad) has to be necessarily shared with others. Yet the importance of keeping it clean for all of us seems to have taken a backseat.

Bobby Ramakant - CNS
[Images] Leave aside safe nuclear waste disposal, we are not even able to take care of domestic waste on our roads, said retired Justice Rajinder Sachchar while speaking at a book launch held in New Delhi on 12th July 2013. A Hindi language book, ‘Towards A Nuclear-free World’, penned by Magsaysay Awardee, scientist and noted social activist Dr Sandeep Pandey and published by Vani Prakashan, was also released by two women activists from Kudankulam anti-nuclear struggle, Ms Immaculate and Ms Maryaselvi at this Delhi meet.

Shobha Shukla - CNS
The fourth WHO Report on the Global Tobacco Epidemic 2013, which was released recently in Panama City, shows that one-third of the world’s population – 2.3 billion people (from 92 countries) – are now covered by at least one of the 6 life-saving policy measures to curb tobacco use. This represents an increase of nearly 1.3 billion people (and 48 countries) in the past five years. This year’s report focuses on complete bans on tobacco advertising, promotion and sponsorship (TAPS), which is a highly effective way to reduce or eliminate exposure to cues for tobacco use.

The Delhi Network of Positive People (DNP+) is calling on the Health Ministry and National AIDS Control Organization’s (NACO) Director General to urgently address the stock out of CD4 kits and/or reagents in Anti Retroviral Treatment (ART) centres in the North-East, UP, Maharastra, Delhi and other parts of the country. The never-say-die AIDS treatment activists are on an indefinite dharna (sit in strike) in front of the National AIDS Control Organization (NACO) office, New Delhi, from 9th July onwards till the CD4 laboratory services are resumed across the country. There seems to be a stock out of CD4 reagents in some North Eastern states of India.

Bobby Ramakant - CNS
[हिन्दी] The new World Health Organization (WHO) guidelines on HIV treatment and prevention which were released at the 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur do provide hope that more people living with HIV will be able to live healthy - only if these guidelines get implemented in letter and spirit on the ground. "These guidelines are a landmark in the fight against AIDS," said Mitchell Warren, Executive Director of AVAC. "But guidelines alone do not save lives - money, pills and smart programmes save lives. Investment and effective implementation will be critical."

Global coalition of organizations and individuals calls for research agenda to determine safety of sexual lubricants
Over 500 organizations and individuals from nearly 60 countries have endorsed a Global Call to Action on Lubricant Safety. They all demand answers on whether sexual lubricants are safe for vaginal and anal intercourse. As the Call to Action points out, there are more questions than answers about the safety of sexual lubricants, and there are concerns that some of the products available on store shelves and at community-based organizations worldwide may actually cause harm.

To make an impact on new HIV infections globally, antiretroviral (ARV)-based HIV prevention strategies need to be closely tailored to local contexts and cultures, according to a new report released by RAND Europe and AIDS Foundation of Chicago. "Mapping Pathways: Developing Evidence-Based, People-Centred Strategies for the Use of Antiretrovirals as Prevention provides an important resource to help communities, prevention programmers, funders and policymakers decide whether, and how, an ARV-based strategy could work in their locality," said Jim Pickett, director of prevention advocacy at AIDS Foundation of Chicago and project director.

Results from the Bangkok Tenofovir Study published online in The Lancet provide additional evidence that daily oral tenofovir-based pre-exposure prophylaxis (PrEP) reduces HIV infection risk when taken consistently. The results from the study - the first conducted among people who inject drugs - are consistent with previous studies among men and women primarily at risk of acquiring HIV through sex. They provide additional support for moving forward to ensure that people who can benefit from PrEP have access to it.

Okeoghene Oghenekaro, Nigeria
(First published in News Agency of Nigeria, on 5 June 2013): Dr Kingsley Osagie, a consultant physician/pulmonologist at the National Hospital, Abuja, believes that for every stick of cigarette smoked, between five and seven minutes of the smoker’s life are cut. Alarmist as this may sound, it is quite logical, as health experts also say that whenever a smoker takes a puff on a cigarette; he or she is gradually moving towards the grave. Osagie says that Nigerian men often start smoking earlier in life than women, adding that it is estimated that a smoker could lose up to seven to 14 years of his or her life-span because of the habit.

Dr Nomita Chandhiok,ICMR

Bobby Ramakant - CNS
We are, perhaps, more likely to use a single product to simultaneously protect ourselves against unintended pregnancies and a wide range of sexually transmitted infections (STIs) including HIV than to use different products to meet our specific needs. Multipurpose Prevention Technologies (MPTs) have been around for many years such as male and female condoms although their poor utilization has been of deep concern. There is a growing mandate globally to push for more investment in research and development of new, safe and effective MPTs. This makes more sense in terms of public health and getting most value of every dollar spent.

Bobby Ramakant - CNS
In the region of Asia and the Pacific - though there has been continued progress towards fulfilling the International Conference on Population and Development (ICPD) Programme of Action (PoA) – progress in sexual and reproductive health and rights and gender equality is unacceptably slow and inconsistent, calling for urgent prioritization and investment. The Asia Pacific Alliance for Sexual and Reproductive Health and Rights (APA) launched a latest publication at Women Deliver 2013 to strengthen investments for sexual and reproductive health and rights (SRHR) in Asia and the Pacific. This publication, "Resource Flows for Sexual and Reproductive Health and Rights in Asia and the Pacific: Gaps and Opportunities" highlights the striking disparities both between and within countries in this region.

Surabhi Agarwal

(First published in The Hindustan Times on 5th June 2013): Despite acute power shortage in rural areas, varying levels of poverty and impoverishment, why is, government's heavily subsidized programme to encourage people in rural areas to install biogas and manure plants for renewable energy production, not an outstanding success? Engineer Surabhi Agarwal, MTech from IIT Kanpur, studied biogas plants installed in the past decade or more in four villages of Bharawan block in Hardoi district in 2013 to find the status of these plants, record experiences and challenges if any. She presented her study findings in a meeting held in Giri Institute of Development Studies in Lucknow.

Moses Wasamu, Kenya
(First published in The Star, Kenya on 27th May 2013): Asthma deaths will increase by almost 20 per cent in the next 10 years if urgent action is not taken, the World Health Organisation says. At the moment, WHO says over 80 per cent of asthma deaths occur in low and lower-middle income countries. Sharlene (not her real name), a Nairobi resident, understands the challenges associated with asthma only too well. She was diagnosed with asthma in childhood. Due to her condition, she cannot participate in vigorous activities like sports that require a lot of energy, or carry heavy loads.

Carolyn Kavita Tauro - CNS
'Tobacco kills nearly half its consumers'! “That can't be possible,” exclaimed Tesh (name changed) as his friend read out one of the new posters pasted at a bus stop. In most countries No Tobacco Day went by just like any other day, with probably just as many smokes up in flames. How much do we know about this much used substance Tobacco?

Types of Tobacco consumption

The different forms of consuming tobacco around the world include the cigarette, cigar, cigarillo and little cigar, dissolvable tobacco, electronic cigarette, beedi, roll your own, hookah, kreteks, the pipe, the french inhale and vaporiser, passive smoking and other forms of smokeless tobacco including paan, gutkha, mawa, chewable tobacco, snuff, snus, spit tobacco and dips among others.

[हिन्दी] Shailendra Kumar, a Masters student at Tata Institute of Social Sciences, Mumbai, and Mudit Shukla, a volunteer with Lucknow-based organisation Asha Parivar, addressed a press conference at Lohia Mazdoor Bhawan on status of implementation of Section 4(1)(b) of the Right to Information Act, 2005, in Uttar Pradesh; and on the functioning of Janta Soochna Kendra (JSK or public information centres) respectively.

Kulsum Mustafa - CNS
In UP the child sex ratio is 904 per thousand and 899 for 0-6 years. The national figure is 954: Like in all other development indicators, Uttar Pradesh also lags behind in the child birth registration. While only 67.08% children in the state get their birth registered in the government records, out of this it is a very miniscule percentage which actually are issued the birth registration certificate. Unknown to the child and his parents this lack of data puts the child in the ‘invisible’ category and it becomes a big hurdle in getting a correct picture of the number of children born and living, greatly affecting planning. The process of registration is governed by the 1969 national Act of Registration of Births and Deaths.

Diana Wangari, Kenya
(First published in The Star, Kenya on 25 May 2013): By the time the cock crows, Sarah Wambui is already up and in the kitchen preparing breakfast. Contrary to the usual modern kitchen where tea is boiling on the cooker or for those fortunate enough, the coffee maker is on, she places her pot on top of three stones with firewood underneath which is her designated ‘cooker’. Furthermore, her kitchen is a mud hut built a few meters away from the main house perhaps to shield any guest from the thick smoke emanating from it. It is in this make shift kitchen that I found her busy blowing into the flame using a steel pipe to keep the fire going.