CNS

You can manage your asthma!

(In the lead up to World Asthma Day 2012)
“The suffering and waste of resources caused by not managing asthma effectively are much greater than the cost of effective action.” Dr Nils E Billo, MD, MPH, Executive Director, International Union Against Tuberculosis and Lung Disease (The Union). 42 years old Raashid Ali (name changed), a former TB patient, has been living with asthma since 2004, when he first developed symptoms of breathlessness. Raashid comes from a middle class family and is engaged in his business of 'zardozi' (embroidery with golden threads), the famous work of Lucknow. He underwent an 18 months anti TB treatment in 1990. His uncle died of TB a few years ago and his mother was also suspected of it when he was a kid. “I am okay and fit now, but am in constant touch with the doctor. He has given me an inhaler which I now use intermittently— may be once a week or less. I do not take any oral medication. I spend around Rs 150 (3 US $) per month on my treatment. I do not have any problems in my daily routine. I am indebted to my doctor who has helped me manage the disease and keep it under control.”

Close to the heels of the Indian Patent Controller order granting a compulsory license to an Indian company to produce and market a generic version of a patented cancer drug, (thus bringing down its cost by 97%, from US$5600 to US$176 per month) we have another landmark judgement delivered by the Kenyan High Court, with a view to safeguard the interests of people living with HIV (PLHIV) in accessing low cost generic HIV drugs.

With economic recession, shrinking health funds and competing priorities, it is likely that donors might put in the dollar where they perceive to get the most value. Although the research for new HIV prevention technologies has indeed made some progress, yet a formidable way lies ahead to find enough money to finish the research and to make ‘from discovery to delivery’ a reality for those in need of protecting themselves from HIV. This issue of health financing of new HIV prevention technologies was in spotlight at the closing day plenary of the International Microbicides Conference (M2012) in Sydney, Australia.

Award honours Forbes's advocacy for microbicides and women's rights

2012 Omololu Falobi Award For Excellence In HIV Prevention Research Community Advocacy presented to longtime advocate Anna Forbes

Anna Forbes, a long-time microbicide advocate, has received the third Omololu Falobi Award for Excellence in HIV Prevention Research Community Advocacy. The award was presented during the Microbicides 2012 Conference in Sydney, Australia. Forbes was honored for her significant contributions to microbicides advocacy over a long career devoted to fostering civil society engagement in HIV care, treatment and prevention and women’s rights. She has been involved in the fight against AIDS for almost three decades and was an early champion for microbicides when the field had few strong advocacy voices.

Rectal microbicides (currently under development) are products that could take the form of gels or lubricants – being developed to reduce a person’s risk of HIV or other sexually transmitted infections (STIs) through anal receptive sex. Rectal microbicide research is progressing ahead with a thrust presently. One of the phase-I study results presented by scientists at the International Microbicides Conference (M2012) in Sydney, Australia, is all set to enter Phase-II because of the positive study outcomes in phase I. This study called MTN-007 (phase I) evaluated the rectal safety of a reformulated version of tenofovir gel. It has found that tenofovir gel was both safe and acceptable.

Despite safe and effective HIV prevention options such as male and female condoms among others, and considerable thrust on research and development of new HIV prevention technologies, new HIV infections continue to occur daily. Milly Katana from Wisdom Centre, who has been a noted AIDS advocate, had successfully put the spotlight on making access to HIV prevention services a reality for all those in need, at the International Microbicides Conference (M2012) in Sydney, Australia. Incidentally the theme of the conference is “From Discovery to Delivery.”

A two days “State Level Convention of Women Leaders" of feisty rural women began at Gandhi Bhawan in Lucknow on 16th April 2012, bringing together over 650 women leader delegates (organizers were expecting not more than 500) from 9 districts of east UP, and proved once again that more changes can be wrought in society by women than we can think of. They were from all age groups—the youngest 18 years old and the eldest 75 years old--all dressed neatly in colourful clothes, with bright eyes, determined faces and an infectious enthusiasm. None gave the impression of the labourer or the underprivileged, which almost all of them were.

The International Rectal Microbicides Advocacy (IRMA) has launched a special report on rectal microbicides in Africa. Titled 'On the map: Ensuring Africa's place in rectal microbicide research and advocacy', this report was released at the International Microbicides Conference (M2012) in Sydney, Australia. A cornerstone of IRMA's Project ARM (Africa for Rectal Microbicides) initiative, the strategy document developed by African advocates, researchers, and global allies outlines priority actions to ensure Africa fully engages in rectal microbicide research and advocacy activities, including the integration of safe anal-sex messaging into HIV prevention programs.

“It is high time that anal health [and hygiene] comes out of the closet” said Dr Ross Cranston, Assistant Professor, University of Pittsburgh, USA. Dr Cranston was referring to the multitude of anal health complications people practicing receptive anal intercourse are likely to be dealing with in their lives and very little quality care and products that exist to relieve them. Dr Cranston was speaking at the International Microbicides Conference (M2012) in Sydney, Australia. According to the UNAIDS, United Nations joint programme on HIV/AIDS, men-who-have-sex-with-men (MSM) are at a high risk of HIV around the world.

There is a growing realization that there is a significant issue of HIV acquisition through anal intercourse not only for men who have sex with men (MSM) who are clearly very visible HIV high risk group but increasingly for women who may be exposed to the virus through anal intercourse with their male partners. Also in recent studies, most people (men and women) who practice anal intercourse reported using some kind of a lubricant (such as gel, cream, or saliva among others).

Fly Single And Sleep Double

Recently I came across an advertisement of IndiGo Airlines, which won the Budgie $ world low cost airlines Asia Pacific Awards 2010, for the best LCC print advertisement. It reads as ‘Sleep with your wife’ followed by the key message or the sub-head—‘Same day return flights from all metros’. The advertisement has been termed as innovative, catchy, clear, crisp, refreshing and cool. According to Sanjay Kumar, Chief Commercial Officer, IndiGo “The ‘Sleep with your wife’ advertisement is our way of showing to our passengers to keep things simple & hassle free.”

Safe drinking water and proper sanitation facilities are basic necessities of life and the likes of you and me perhaps have never faced the ignominy of trading our privacy for want of basic sanitary needs like proper toilets and clean drinking water. Yet, according to the 2011 Census data, 50% of India’s population defecates in the open, 53% have no drinking water availability within the premises and 49% households are without any drainage facility. Contrast this with over 53% households owning a mobile phone and 47% having a television set. Great progress indeed!

Special on World Health Day

In India, population more than 60 years of age in 2001 was 6.9% which is now increased to 8.3% (2011) and is estimated to be 17% (30 crores) by 2050. If today’s young India is not made healthy then in future these would suffer from large number of diseases in their older age. It’s true that neonatal and child mortality rate is decreasing and life expectancy is increasing and therefore the population of elderly is also on rise.

39 years old Sukhram Yadav hails from Azamgarh, a backward district of east Uttar Pradesh. Although he works in a flour mill in Mumbai, his family, consisting of his wife, his parents and two daughters aged 14 and 12 years, lives in his native place. He has been on anti retroviral therapy (ART) since 2001 and was referred to MSF in 2006 with drug resistant TB (DR-TB), where he has since been successfully treated. Recently he spoke to Medicins Sans Frontiere (MSF) about his life during and after his tryst with the bacteria-virus co-infection.

Chandrika Gaud is a 28 years old transgender of Mumbai who is living with HIV as well as with drug resistant TB (DR TB). She is currently on second line anti retroviral drugs and DR-TB medication. Her HIV status was detected in 2006 and DR-TB status was confirmed in 2010 when she was referred to MSF. Before coming to MSF she had already taken TB treatment twice. She recently spoke to MSF about her struggles to cope with the double burden of her illness.

Shanti is a 38 year old semi literate woman of slender means living in Mumbai. She has been living with HIV since the last 5 years and had developed multidrug-resistant tuberculosis (MDR-TB). Her story is the story of the common person on the street for whom each day’s survival is an ordeal, even when there is no illness. Taking treatment for the double burden of HIV-TB co-infection makes it like the last straw on the camel’s back. Shanti recently spoke about her trials and tribulations to Medicins Sans Frontieres (MSF) — in whose care she was brought for treatment of MDR-TB around 4 months ago.

Jugalkishore is a six year old boy whose impish smile hides the ugly germs of TB that are ravaging his health. He is the third child of Ramdulari - the charming, but uneducated, hapless wife of daily wage earner Shivprasad, who uses excessive alcohol and tobacco, and is also a former TB patient who successfully completed TB treatment. Jugalkishore, has recently been diagnosed with pulmonary TB and put on a 6 months course of free anti-tuberculosis treatment (ATT) since the last one month, at a DOTS centre. He is just one of the estimated one million children under 14 years of age who will need treatment for tuberculosis this year (approx. 10–15% of 9 million cases estimated by the WHO Global TB Control Report 2011).

[हिंदी] Growing number of Lucknow citizens came out to demonstrate in Hazratganj in support of ongoing anti-nuclear movement in Kudankulam, Tamil Nadu. Members of All India Power Engineers' Federation (AIPEF), National Alliance of People's Movements (NAPM), Asha Parivar, Lok Rajniti Manch and Coalition for Nuclear Disarmament and Peace (CNDP) had also actively participated to vote for no-nuclear and no-carbon energy policy.

“Arrest Ankit Garg, Release Soni Sori”, “Attn: Ms. President, Mr. Prime Minister, Chattisgarh state, NHRC, Stop Torture of Soni Sori” - These were among the slogans from nearly 20 Karnataka based human rights organizations to the Government of India in support of Soni Sori, a 35 year old adivasi school teacher who has been incarcerated in Chattisgarh police custody since October 2011 despite medical evidence revealing their brutal custodial torture, electrocution, beating, and sexual assault on her, shoving stones into her private parts. Around 100 persons gathered at 6 pm on 24th March 2012 in front of Town Hall in Bangalore to appeal for the immediate transfer of Soni Sori out of Chhattisgarh police custody and her speedy trial. Expressing solidarity with Soni Sori, the people also demanded the arrest of Ankit Garg, Superintendent of Police, Dantewada under whose supervision Soni Sori was subject to verbal and sexual assault in jail. They join people across the country in condemning the award of the Police Gallantry medal to Garg on Republic Day, 2012.

[हिंदी] Growing protests across the country have strengthened the call against nuclear power in India. Activists of the National Alliance of People's Movements (NAPM), Coalition for Nuclear Disarmament and Peace (CNDP) and Lok Rajniti Manch, are organising a protest and fast from 26 March 2012 till 1st April 2012, at Jantar Mantar, New Delhi, in solidarity with ongoing fast by activists of the anti-nuclear movement at Idinthakarai, Tamil Nadu against the Koodankulam nuclear power plant. Social activist and Magsaysay Awardee Dr Sandeep Pandey is sitting on a seven day fast.

CNS Video: Reality Check on childhood tuberculosis: Part II

(Part I is online here)

Less than half a per cent Indian villages can be termed clean

World Water Day, 22 March

On the eve of World Water Day Indian government honoured 2,857 villages in 23 states with Nirmal Gram Puraskars [clean village awards]. Nirmal Gram Puraskar is given by the Indian government in acknowledgement of hundred per cent water, sanitation and hygiene coverage in a village. The President of India Ms Pratibha Patil, in a ceremony held in Delhi, awarded these 2,857 villages for their cleanliness achievements. India has more than 600,000 inhabited villages, of which less than half a per cent have qualified to get the award for cleanliness.

Harare, Zimbabwe – Tuberculosis (TB) is a major public health problem in Zimbabwe yet very little is known about the impact of the disease on children. Without a functional healthcare system and research into paediatric TB, Zimbabwe is likely to continue losing its children to this hidden public health problem. Among African nations, Zimbabwe is one of those most heavily affected by TB. The Global Tuberculosis Control Report from the World Health Organisation (WHO) ranks Zimbabwe 17th among 22 countries worldwide with the highest TB burden.

Tobacco Industry Profits By $6,000 For Each Death Caused By Tobacco

During the last decade 4 almost 50 million people have died from tobacco usage, and annual revenues of the global tobacco industry have increased to US $ 35 billion. These and other startling revelations were unveiled in the fourth edition of the Tobacco Atlas which was launched today, (21st March, 2012), a little while ago, at the 15th World Congress on Tobacco OrHealth being held in Singapore.

The following is a guest blog post by Dr Lucica Ditiu, executive secretary of the Stop TB Partnership, and was published on the Science Speaks Blog on occasion of the newly released document Tuberculosis Vaccines: A Strategic Blueprint for the Next Decade. The new strategy reflects the consensus of members of the TB vaccine research and development community to develop new vaccines that could help stop TB in our children’s lifetimes.

Some 10 million children have been orphaned by the death of a parent from tuberculosis (TB). That number is shocking, but it does not begin to account for the children who must quit school to care for sick parents, or go to work to keep the family fed, or those who catch TB from a parent or another relative, or those who die from TB without ever accessing proper treatment.

Against a backdrop of growing concern about the impact of tuberculosis on children, top scientific experts of the TB vaccine community have come up with a global plan of action for developing safe and effective TB vaccines that are critical to eliminating the disease. A strategic blueprint titled ‘Tuberculosis Vaccines: A Strategic Blueprint for the Next Decade’ was published today (20th March, 2012) in a special issue of the journal, Tuberculosis. It emphasizes that effective vaccines will remain out of reach unless the world scales up efforts to solve the scientific puzzles now hindering their development. Authors have called for researchers, scientists, clinicians, advocates in endemic communities, vaccine manufacturers, and governments around the world to work together on creative new approaches from initial research in the laboratory to clinical trials in the field to global introduction.

In 2005, Tariro Jack, 27, fell ill with Tuberculosis (TB) during her first year at college. She said that she struggled to cope not only with her own health but also managing people's perceptions. TB is an infectious disease that spreads through the air. The disease mostly affects young adults in their most productive years and 95% of TB deaths are in the developing world. Estimated TB incidence rates are highest in sub-Saharan Africa with over 350 cases per 100,000 population. Among African nations, Zimbabwe is one of those most heavily affected by TB. The deadly combination of TB and HIV epidemics is igniting a silent and uncontrollable epidemic of drug resistant TB that will negate previous national health gains.

In a press release dated March 19th 2012, the The Kudankulam Antinuclear Struggle Support Group, Keralam said: "As the Tamil Nadu Government has shown the green signal today for the commissioning of the Kudankulam nuclear plant, thousands of policemen have been deployed at Kudankulam and they have arrested about 150 activists. It has become clear that the government is using high handed methods to suppress the struggle.

Children and TB: A Hidden Epidemic

Tuberculosis (TB) among children is rarely discussed. Because children, more often than not cannot speak for themselves, not much about how they're affected by the disease ever hits the headlines. This is despite the fact that TB remains among the top ten killers of children worldwide. In spite of this, virtually no public or political attention is paid to TB as a children’s health issue. The World Health Organization (WHO) estimates that approximately 176,000 children died, but the consensus among researchers says that actual figures are higher. In 2009 alone, at least 1 million children became sick with TB.

All of us know that there is a pool where TB bacilli that can flourish and can cause TB infection in children. We are the ones who together with our knowledge and experience aim to eliminate the pool, so that no more infections can occur. How does infection take place? Infection is caused by a TB patient excreting Acid Fast Bacilli (AFB) in sputum. While coughing he will disseminate sputum into the air. The smallest particles called the droplet nuclei will remain floating and when inhaled, can pass the mouth/nose/bronchi and bronchioli to end up at the alveoli of the healthy person. The bigger sputum particles will reach the ground and cannot cause infection (unable to form floating droplet nuclei).

Tuberculosis vaccine research gets a boost

Aeras announces the receipt of a grant by the Bill and Melinda Gates Foundation of up to USD 220 million over five years, placing it at the forefront of a global scientific initiative aimed at developing safe, effective vaccines against tuberculosis, a disease that infects two billion people worldwide. One of the world’s largest not-for-profit biotechs, Aeras is developing modern vaccines to combat TB against the backdrop of a significant increase in drug-resistant strains.

In India, virtually every second person is defecating in the open, every third person is drinking unsafe water and at least 1,000 children are dying every day due to a preventable disease like diarrhoea. This grim picture of the world’s third fastest growing economy was unveiled through the country’s latest census report on drinking water and sanitation, which the Government of India released this month. Earlier on March 6, the Joint Monitoring Programme for Water and Sanitation (JMP) report, released by UNICEF and WHO, too confirmed that in India 59 per cent of people [626 million] defecate in the open. The report had pointed out that - “India is lagging behind 11 years to meet the Millennium Development Goal target, in which the government has resolved that the statistics of open defecation [base 1990] would be halved by 2015.