CNS

First-Ever Targeted Roadmap Outlines Steps to End Childhood TB Deaths

The "Roadmap for Childhood Tuberculosis: Towards Zero Deaths" - the first ever plan which specifically addresses TB in children and outlines the path towards zero deaths from childhood TB - was jointly launched on 1st October 2013, in Washington DC by global leaders in TB control: the International Union Against Tuberculosis and Lung Disease (The Union), the World Health Organization (WHO), the Stop TB Partnership and other partners.

Children and women are at risk of heart disease too: Dr Rishi Sethi

World Heart Day, 29 September

Dr Rishi Sethi
Senior Cardiologist

This year’s World Heart Day (29 September) theme focusses on a life-course approach to the prevention and control of cardiovascular diseases (CVD) with a focus on women and children. "It is a myth that heart disease and stroke only affect older, male, rich populations. CVDs affect as many women as men however, their risk is seriously underestimated. In fact, heart disease is actually the number one killer of women, causing 1 in 3 female deaths: shockingly, that’s about one death per minute! It is vital that women learn the truth about their CVD risk and take action to protect themselves and their family" said Dr Rishi Sethi, Associate Professor, Department of Cardiology, King George's Medical University (KGMU).

Swapna Majumdar - CNS
In Bangladesh, a man forced into marriage vents his frustration by beating his wife when she disobeys him. In Cambodia, a husband justifies slapping his wife on the grounds that she must have done something she shouldn’t. In Indonesia, some men believe that if a wife doesn’t look after her husband’s needs, she deserves to be punished.

Health Minister Maithripala Sirisena blasts tobacco industry for attempting to bribe

Manjari Peiris, Sri Lanka
(First published in The Asian Tribune, Sri Lanka on 26 September 2013)
The Minister of Health Sri Lanka, recently made a shocking revelation proving the worldwide well established notorious demeanour of the tobacco industry-- their attempts to bribe politicians, policy makers and journalists etc. -- to hinder bringing in people friendly health policies in the country. Generally laws are meant to protect the people of a country, but very strangely the tobacco industry demands and seeks legal remedy for itself to further engage in ‘man slaughtering’.

Chhatra Karki, Nepal
(First published in Kapan Online, Nepal on 26 September 2013)
The tobacco producers across the world have often been challenging the government’s bid to control the productions and sales of the tobacco containing products. The tobacco industries in different countries of Asia, Africa, Middle-East and Europe have been charged with not abiding by the policies relating to public health.

Mukta Srivastava - CNS
The Ministry of Health and Family Welfare, Public Health Foundation of India (PHFI), Health Related Information Dissemination Amongst Youth (HRIDAY) and World Health Organization (WHO) jointly organized the ‘International Conference on Public Health Priorities in the 21st Century: The Endgame for Tobacco’ recently in New Delhi.

[Read/ download full report] The report of the day-long Advocacy Training Workshop on WHO Framework Convention on Tobacco Control (FCTC) Article 5.3 which was organized in Lucknow, India, on Saturday, 7th September 2013 went online on 24th September 2013 and is being disseminated to different government authorities in India. This training culminated with a list of action points, one of which was to create a committee charged with passing and implementing a UP state policy in line with WHO FCTC Article 5.3.

A nineteenth-century, tin box of
Kyriazi Frères brand, Egyptian cigarettes

Dr. Essam Elmoghazy, Egypt
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of these deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke. Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths.

Carolyn Kavita Tauro - CNS
Most smokers would reply that no one tricked them into smoking. It was and has always been their sole decision to smoke. However, when one looks back it is not uncommon to see the different reasons why people, both young and old smoke. The common ones we all know: “we need it to be part of the group; it makes us look cool; it helps keep my weight down; it relieves my tension; …. the list is endless.

Shobha Shukla - CNS
The 2013 Asia Pacific Association for the Control of Tobacco (APACT) Conference was held in August, 2013 in Chiba, Japan to address the prevention and control of tobacco use worldwide, with a special focus on the Asia Pacific region. One of the important achievements of the conference was the signing of A Declaration on Tobacco Control in Indonesia which was adopted by over 785 delegates from 42 countries assembled at the conference.

Shobha Shukla - CNS
Anirban Mukherjee is from Kolkata. An only child, he is 32 years old and educated till Class 10. No one else, except him, in his family has ever had TB. He has never smoked nor ever eaten gutkha/paan masala, but used to take alcohol occasionally in the past.

Shobha Shukla - CNS
The WHO Framework Convention on Tobacco Control (FCTC) is the world’s first global public health and corporate accountability treaty and to date 177 countries are Parties to it. By signing and ratifying this treaty, these countries are committed to adopt a range of measures to reduce tobacco use, including increasing taxes on tobacco products, banning tobacco advertising, creating smokefree public and work places, implementing health warnings, combating illicit trade and, above all, preventing industry interference in influencing health policies.

Mukta Srivastava - CNS
The ‘International Conference on Public Health Priorities in the 21st Century: The Endgame for Tobacco’, jointly organized by The Ministry of Health and Family Welfare, Public Health Foundation of India (PHFI) and Health Related Information Dissemination Amongst Youth (HRIDAY) was held recently in Delhi. The World Health Organization (WHO) was the technical co-sponsor of this event. The conference, which was attended by around 500 delegates from around 55 countries across the world, proved to be a whistle blower to the tobacco epidemic.

Bobby Ramakant - CNS
[Images] Earlier this year we at CNS had visited many biosafety level (BSL) III laboratories in India where one of the latest diagnostic tools were available to do drug susceptibility testing (DST) for tuberculosis (TB). One red-coloured sticker on most of these diagnostic tools caught our attention: UNITAID. This organization not only raises 70% of its core funding by innovative financing mechanisms such as by levying a small fee on airline tickets, but also has made a difference differently when compared with other traditional donors.

Mrs Bimla Misra

On 12th September 2013, former Principal of Kasturba Gandhi Balika Vidyalaya Mrs Bimla Misra (84 years) bid farewell to this world - but not before teaching another lesson: as per her wish, her body was donated to the cause of medical education to King George's Medical University (KGMU) sans rituals. Mrs Misra taught her students most of her life till mid-August 2013.

Anatomy, the study of the structure of the human body, is one of the most important courses in the medical education. The need for human bodies is pressing and no doubt Mrs Misra's gift will be valued and honoured.

Affectionately addressed as 'Mamma' by most of us, she always stood as a living example of empowerment and living life with dignity and grace. Mother of CNS Executive Director Shobha Shukla, she could not have given a more powerful example when it was the time to go by donating her body and rising above traditional customs and rituals to support the cause of science.

As her daughter and CNS head Shobha Shukla said, let us celebrate the years she lived...

Go well 'Mamma'....

Citizen News Service - CNS family
September 2013

Integrated TB and HIV care in Myanmar gives hope

Bobby Ramakant - CNS
[Images] There is no doubt that tuberculosis (TB) and HIV care should be integrated at different levels, particularly in high burden settings. Being part of the UNITAID mission to report from the global launch of the largest-ever roll-out of Gene Xpert MTB/RIF machines in Yangon, Citizen News Service - CNS got an opportunity to witness an inspiring work done in Myanmar since 2005 where TB and HIV care services are getting increasingly integrated at different levels, with support from the International Union Against Tuberculosis and Lung Disease (The Union) and partners.

[हिंदी] Just when it appeared that Samajwadi Party government had handled the 84 Kosi Parikrama incident quite well and had emerged as a hero in the eyes of Muslims, Muzaffarnagar has happened. It has painted the government in a very bad light, said a statement jointly issued by Socialist Party (India), Rihai Manch and National Alliance of People's Movements (NAPM).

Okeoghene Oghenekaro, Nigeria
(First published in National Mirror, Nigeria on 3 September 2013)
The incidence of tuberculosis and HIV seem to be rising in Nigeria, as it has been recorded that more than 3.4 million people are now infected. More agonising is the fact that those diagonised with the diseases are constantly stigmatised in the society. This piece examines efforts being made to mitigate their effects.

Bobby Ramakant - CNS
[Images] Diagnosing tuberculosis (TB) and also getting to know with accuracy about resistance to one of the two most powerful anti-TB drugs (Rifampicin) within two hours is increasingly becoming a reality on the ground. The largest-ever roll-out of Gene Xpert MTB/RIF machines in countries most severely hit by drug-resistant TB was launched on 10th September 2013 at the National Tuberculosis Reference Laboratory in Yangon, Myanmar, with support from UNITAID, an organization whose 70% funding is raised by innovative financing mechanisms such as levying a small fee on airline tickets.

Shobha Shukla - CNS
Some years ago, 30 years old Tanveer (name changed), a noted tabla percussionist, sustained a fall that lead to a spinal fracture and complete paralysis of both his lower limbs. Although orthopaedic surgeons fixed his spinal bony fracture, he continued to have paraplegia.

HIV patients vulnerable to TB

Chhatra Karki, Nepal

(First published in Kapan, Nepal)
Tuberculosis (TB) and HIV co-infection is now emerging as a big threat in the health sector around the world. As people living with HIV (PLHIV) gradually lose their immune power, they become more vulnerable to the infection of TB. As per a report, there are 34 million PLHIV around the world; and 11 million of them have been affected by severe forms of TB.

Shobha Shukla - CNS
40 years old Rukmini lives close to the Civil Hospital of BJ Medical College in Ahmedabad. She used to sell fruits to supplement her daily wage earner husband’s meager income till tuberculosis struck her in 2010. She has a 17 year old daughter and an elder son who is married. Rukmini is illiterate but has managed to educate her children up to elementary level.

Carolyn Kavita Tauro, India
Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) – can we continue to tackle these separately? According to the Global TB Report (2012), in 2011, out of 8.7 million people who developed TB worldwide 1.1 million (13%) were HIV positive. An approximate of 0.4 million HIV-associated TB deaths took place in 2011 and TB is the most common opportunistic infection among people living with HIV (PLWH). HIV increases chances that latent TB infection can become active TB disease and also increases the risk of death due to this.

A day-long Advocacy Training Workshop on WHO Framework Convention on Tobacco Control (FCTC) Article 5.3 will be held in Lucknow, India, on Saturday, 7th September 2013. Several civil society and government representatives implementing the domestic tobacco control law are likely to participate.

Photo credit: CNS, January 2010

Shobha Shukla - CNS
[Hindi] 48 years old Deepak, was leading a happy normal life with his wife and 3 children. He was working in a government job as a driver in the police department in Ramgarh district of Uttarakhand when, way back in 1997, he suddenly vomited blood one day. The doctor diagnosed him with pulmonary TB on the basis of a chest X-Ray and put him on a 6 month Anti TB Treatment under DOTS (Directly Observed Treatment Shortcourse). Deepak was presumably cured and remained okay for a year and a half. Meanwhile he had been transferred from Ramgarh to Uttar Kashi. There his problem recurred and he vomited blood again.

Alice Tembe, Swaziland
‘I had to choose between being deaf and being dead’, this is what Dalene von Delft, a Medical Doctor from Stellenbosch University in South Africa, said in her testimony at a two-day Southern Africa meeting held recently to strengthen and scale up TB /HIV responses in the workplace. The meet was supported under the TB Care II program by University Research Company in collaboration with USAID. In the meeting, Swaziland, Namibia, South Africa were represented by their government, workers and employers’ organizations working in the field of TB.

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?