CNS

HIV prevention needs more tools such as microbicides

Vaginal and anal sex continue to put millions of people at risk those who are unable to use or negotiate the use of existing HIV prevention options. Microbicides although currently under research, are being seen as an important new HIV prevention tool that will expand the range of prevention options for men and women. Rectal and vaginal microbicides are antimicrobial agents formulated as gels, creams, films, or suppositories for application to the vagina or rectum for the prevention of HIV transmission, and/or other sexually transmitted infections (STIs). Microbicides have various modes of action like killing/ inactivating the pathogen by disrupting the viral envelope; strengthening the vagina's defence system and maintaining acidic pH; strengthening the rectum's defence system, creating a physical barrier between the pathogen and target; preventing infection spread to other cells by blocking viral replication within cells.

As world's largest AIDS conference (XIX International AIDS Conference) on the theme of 'turning the tide together' is about to open in US next month, CNS decided to share one of its interviews with noted expert on voluntary medical male circumcision and its role in HIV prevention. Voluntary medical male circumcision protects against HIV. "There are over 40 observational studies among heterosexual men, which show that circumcised men have about a 60% reduced risk of HIV compared to uncircumcised men. There were then three randomised controlled trials conducted in Sub Saharan Africa that showed circumcised men were at 60% less risk of HIV than uncircumcised men. All these three trials were stopped by independent Data Safety Monitoring Boards as the effect was so strong and it was thought unethical to not offer circumcision to men in the control arm" said Dr Helen Weiss, Reader in Epidemiology and International Health, The London School of Hygiene and Tropical Medicine (LSHTM). Dr Weiss works mainly on HIV and biomedical behavioural prevention strategies focussing mainly on sub-Saharan Africa and spoke to CNS at AIDS Vaccine 2011.

Members of the People's Union for Civil Liberties (PUCL), Bangalore and several other human rights organisations and individuals in the city gathered on Saturday, 16th June 2012 in front of Town Hall, Bangalore to express their outrage at the unjust sentencing of Seema Azad and her husband Vishwavijay Kamal by a sessions court in Allahabad, to life imprisonment and 10 years in jail, respectively. The ruling passed on 8th June 2012 was based on fabricated charges of 'waging war against the state', 'criminal conspiracy' and various sections of the draconian Unlawful Activities Prevention Act [UAPA].

Sounds funny, does it? But these plaintive cries (nay wails) are reverberating in every nook and corner of Lucknow these days, whose citizens are going to elect their mayor and 110 corporators on June 23, 2012. As per news paper reports, the city is divided into six zones and 110 wards. 10% (11) of these wards are reserved for scheduled castes (SC). Of this, 4 are reserved for women belonging to SC category. Similarly, out of the 22 wards of the city reserved for other backward castes (OBCs), in 8 of them only female OBC candidates can contest the local bodies' election. Another 25 wards are reserved solely for women candidates to test their political acumen. Thus, in effect, a total of 37 seats are reserved for women.

Close to the heels of making tuberculosis a notifiable disease, the Government of India has now banned the import, sale, manufacture and use of serodiagnostic/serological test kits for diagnosis of tuberculosis (also known as blood test or antibody test for TB). A notification (no.X-11014/13/2011-DFQC) dated 7.6.2012, issued by the Ministry of Health and Family Welfare, prohibits with immediate effect the manufacture for sale, distribution, import and use of these serodiagnostic test kits because ‘the government is satisfied that it is necessary and expedient to prohibit the use of these test kits for diagnosis of TB in public interest as they are giving inconsistent and imprecise results leading to wrong diagnosis and their use is likely to involve risk to human beings and whereas safer alternatives are available.’ Laudable sentiments indeed!

Indo-US Nuclear Deal was the first attempt by the Indian government to open up its nuclear establishment to the outside world. It was only after approval of International Atomic Energy Agency that India was officially allowed to do business with the Nuclear Suppliers Group countries in nuclear materials and technology. But the agreement to set up a nuclear power plant in Kudankulam with Russia predates Indo-US Nuclear Deal and hence was done outside the internationally accepted non-proliferation regime in an undemocratic manner. Essentially Russia, secretly and without any fuss, did what the US took one and a half years and much trouble to convince its Congress to do.

The National Hijra Habba (festival) held recently in Delhi brought out in the open the deep anguish and silent suffering of the transgender/hijra /kinnar population across the country. Although this issue is centuries old, yet the tolerance level of common people towards this community is very low. It is just one of the many paradoxes of our complex Indian culture that while on one hand it is considered auspicious to have the hijras bless our newborns and newlyweds for fertility, they are otherwise shunned and looked down upon by society.

A strong criticism of the irrational expenditure of Rs 35 lakhs on the renovation of Planning Commission toilets has been a blessing in disguise and done wonders for sanitation problem in India. A whole lot of progressive announcements in the sanitation sector have been made as a saving grace for the government, which was unable to justify the unnecessary spending on beautification of Planning Commission toilets while crying hoarse of austerity measures.

A Financial Boost For The Search Of New TB Vaccines

In a new fillip to the much needed TB Vaccine research, the Bill & Melinda Gates Foundation has given a grant of 3 million dollars to TuBerculosis Vaccine Initiative (TBVI), a non-profit organisation that supports the development of new vaccines against tuberculosis. The award spread over 3 years will help TBVI to support the development of several TB vaccine candidates and contribute to the fight against this deadly disease.

Right to Reject could have affected 'unopposed' elections

There is no candidate fielded by any major political party against Dimple Yadav, Samajwadi Party's candidate for Kannauj Lok Sabha seat. Dimple Yadav is also the daughter-in-law of Samajwadi Party supremo Mulayam Singh Yadav and Kannauj is undoubtedly a party stronghold. There are only two candidates as per newspaper reports against her (independent candidate Sanju Katiyar and Dashrath Shankhwar of Sanyukt Samajwadi Dal) and if these candidates withdraw their nominations before 9th June, then Dimple Yadav will walk into Lok Sabha unopposed. Without getting into the debate of 'samajwaad' vs 'parivarwaad', is it really fair in democracy for a candidate to get elected 'unopposed' because how will common people figure out whether she is a unanimous choice of people (of Kannauj in this instance) or behind the scene efforts were made to ensure no one fights election against her? If our Indian Constitution had taken right to vote and right to reject at par, then this power would rest with the voter and election outcomes could be different.

Engage affected communities as equal partners to wipe out TB

In the last week of March, 2012, I received an email from a stranger living in Chandigarh, requesting for counseling as his 34 years old wife was suffering from TB. This is his tale of woes about the problems faced by her and the family who are living in a metro city of India.

The transgender, 'hijra' or 'kinnar' community is visible as usually its members can be spotted easily by way of their attire and mannerisms. However they are invisible in the sense that society shuns them and does not even want to acknowledge their existence. They face problems in all spheres of life. But, the impediments they face in accessing quality healthcare services at times, cause irreparable physical and mental damage to them and may even be life threatening.

In the lead up to the XIX International AIDS Conference (AIDS 2012), Citizen News Service (CNS) is facilitating an online consultation and conducting key informant interviews on HIV-related issues. This is an opportunity for all those affected by HIV to have their say in lead up to the AIDS 2012. The theme of XIX International AIDS Conference (AIDS 2012) is “TURNING THE TIDE TOGETHER”.

Raveena Bariha, the fire brand graduate tribal hijra activist from Chattisgarh (a relatively backward state of India) is lovingly called the chhota bomb and chhota rocket. At the recently concluded National Hijra Habba Consultation and Cultural Event, which was organized by Pehchān project, in association with India HIV/AIDS Alliance in Delhi, her diminutive frame dressed in a cotton salwar kurta without any jewellery stood apart from the other ornately dressed participants of her community. Raveena spoke to CNS about the hopes and aspirations, the trials and tribulations of the transgender and hijra/kinnar community.

[हिंदी] Different political parties have been forwarding their choices for the President's post. In the beginning it appeared that Mulayam Singh will support the candidature of A.P.J. Abdul Kalam. This belief was strengthened when he supported Sharad Pawar's proposal that the President should be a apolitical person. However, now Mulayam Singh has retracted from his position. On the other hand Lalu Yadav proposed Vice-President Hamid Ansari's name for the post. Lalu is so close to the Congress that it appeared that he was essentially voicing Congress's choice. The names of West Bengal 's former Governor Gopal Krishna Gandhi, A.K. Antony, Sushil Kumar Shinde, Meira Kumar and even Dr. Manmohan Singh has since done the rounds. There seems to be a consensus emerging around Pranab Mukherjee's name. For most political parties whether belonging to UPA or NDA, he is the most acceptable for President's post.

Pehchān, in association with India HIV/AIDS Alliance, recently organized a national consultation, aptly called Hijra Habba (Habba is a Kannada word meaning festival), in Delhi to draw attention to the current challenges facing the transgender (TG) and hijra communities of India and to develop an action plan to address the problems affecting them. It was indeed a festival where dressed in stunningly beautiful attires and glittering jewelry, hijra and transgender community members from across India voiced their fears, doubts and misgivings in front of senior officials from the National AIDS Control Organisation (NACO), UNDP, and DFID in an atmosphere marked with solemn gaiety. They shared their trials and tribulations and discussed ways and means to protect their very existence and dignity in society. Their brightly lit eyes, their unwavering voices, and the glow of steely determination on their faces clearly reflected their sombre resolve to put an end to the indignities they had been facing for centuries.

The Union Defends Governments From Tobacco Industry Interference On World No Tobacco Day

With the theme “Stop Tobacco Industry Interference”, World No Tobacco Day 2012 highlights the critical need to meet head on the aggressive strategies and tactics used by the tobacco industry to dilute, delay and prevent tobacco control policies and measures. To assist governments and other agencies involved in tobacco control, The International Union Against Tuberculosis and Lung Disease (the Union) has developed a free FCTC Article 5.3 Toolkit: Guidance for Governments on Preventing Tobacco Industry Interference, which will be launched at an event at the University of Edinburgh today on the occasion of World No Tobacco Day 2012.

[हिन्दी][English report card] [हिन्दी रिपोर्ट कार्ड] Youth participants of Rights and Responsibilities Summer Training Camp currently underway released a REPORT CARD on implementation of tobacco control, other health and development policies in Lucknow city. The report card monitors and analyzes neighbourhood localities in Lucknow on four priority areas: 1) tobacco control laws, 2) alcohol advertising, 3) sanitation, hygiene and waste management, 4) chewing gums.

On this World No Tobacco Day (WNDT 2012) it would be worthwhile to remember that ‘tobacco products are the only legally available products that can kill up to one half of their regular users if consumed as recommended by the manufacturer.’ The International Union Against Tuberculosis and Lung Disease (the Union), recognizes that, “With its formidable economic and political resources, the tobacco industry is fighting to prevent passage of new tobacco control laws and policies around the world. Article 5.3 of the Framework Convention on Tobacco Control calls for parties to the treaty to resist these efforts to undermine public health and continue the spiralling pandemic of tobacco-related disease.”

The Cloud Of Tobacco Smoke Is Choking The World

Tobacco is the single most preventable cause of death in the world today. Yet it kills nearly 6 million people each year, which includes some 600,000 non-smokers who die due to exposure to second-hand smoke. In 2004, children accounted for 31% of these deaths. Almost half of the world’s children (through no fault of theirs) regularly breathe air polluted by tobacco smoke which is said to carry more than 4,000 chemicals, of which at least 250 are known to be harmful, and more than 50 are known to cause cancer. Tobacco is one of the greatest risk factors for Non Communicable Diseases which are responsible for 63% of all deaths globally. Also 50% of all deaths from lung disease are linked to tobacco.

[RTI applications] [हिन्दी] The Lucknow youth participants of the ongoing Rights and Responsibilities Summer Training Camp at Professor (Dr) Rama Kant’s Centre in C-block crossing, Indira Nagar, filed applications under the Right to Information (RTI) Act, 2005, demanding information pertaining to poor implementation of development programmes in the city including tobacco control. The youth, Ankur Verma, Diya Pandey, Sanjay Kumar Verma, Shikha Srivastava, Shikhar Agarwal, Shubham Dwivedi, and Udita Chandra, filed many RTI applications on tobacco control and other development schemes.

Photo credit: Shobha Shukla-CNS

Jyoti (name changed) hails from rural Uttar Pradesh which has a high prevalence rate of smokeless tobacco. Two years ago she became addicted to paan masala (a popular form of chewing tobacco) of a particular brand, under the influence of her friends. She began with one or two pouches a day, but the number quickly increased to 25. With one pouch costing one rupee (less than 2 cents) she had to cook stories to get money from her parents for this. She says, “I would ask them for money to buy eats and spend it on tobacco. I would eat outside the house, never in front of my parents. Then I would brush my teeth.” Eating tobacco put her on a high giving her momentary respite from the perpetual tension in the family. Her own marriage had broken and her father ill treated her mother. At the end of one year she started having difficulty in opening her mouth fully—‘It was difficult for me to open my mouth to put my three fingers inside it.’

Prof Rama Kant to be awarded honorary FCS by College of Surgeons, Sri Lanka

[हिंदी] Renowned Lucknow Surgeon Professor (Dr) Rama Kant will be conferred upon the honorary Fellowship of the College of Surgeons of Sri Lanka in their convocation on 15th August 2012. The Council of College of Surgeons of Sri Lanka informed Prof Rama Kant of the honorary fellowship award on Saturday, 16 June 2012. Prof Rama Kant will also deliver a lecture on ano-rectal surgery at the annual convention of SAARC Surgical Care Society in Colombo, Sri Lanka.

I am alive because of my children: Story Of Vani

This is the story of Vani (name changed), a 43 years old mother of two bubbly kids—Kajal and Tarun (names changed) aged 13 years and 10 years respectively. She is one of the lucky few who could eventually manage to access and successfully complete her treatment of MDR TB, outside the woefully inadequate government DOTS Plus programme. It is the story of the grit and determination of a mother who conquered all odds for the sake of her children. Her concern and love for them gave her strength to not only grapple with her infection of HIV/AIDS and drug resistant TB (MDR TB) but also to face singlehandedly the stigma and discrimination at the hands of her apathetic family and society.

Tobacco - a threat to human health

Tobacco, the age old slow poison, takes a human life every eight seconds, which means approximately 6 million deaths annually. It is consumed in many forms, all of which are equally harmful. It could be smoked as cigarettes and cigars, or used in smokeless forms such as chewing tobacco or inhaling tobacco such as hookah/sheesha. Globally approximately 10 million cigarettes are purchased a minute, 15 billion are sold each day, and an upward of 5 trillion are produced and used on an annual basis. It is estimated that worldwide, one in five teenagers in the age group 13-15 years smoke cigarettes. Youth and kids are still picking up smoking at the alarming rate of about 80,000 to 100,000 a day worldwide. Tobacco poses a serious danger to public health despite the fact that it is a preventable cause of death.

A study titled Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region was released in Bangkok today (17th May, 2012) to mark the International Day Against Homophobia and Transphobia. According to this research, which was jointly released by the United Nations Development Programme (UNDP) and the Asia Pacific Transgender Network (APTN), transgender persons are among the most socially ostracized in this region and lack fundamental rights, including basic access to health care and social protection schemes. So there is need for concerted action by governments, civil society, development partners and the transgender community itself to design and conduct further research to fill the lack of information about transgender people and their environments.

A beautiful healthy smile is an enviable asset one can possess but, despite longing for pearly white teeth, we willingly fall prey to some habits which not only trap us in their dangerous clutches but also deprive us of our health and happiness and sometimes even our life. Commonly, tobacco is consumed in two forms-smoking and smokeless. There is a strong scientific evidence that tobacco causes cancer and the commonest association of ‘spit’, ‘chew’ or ‘snuff’ forms of smokeless tobacco is with oral cancer.

India currently holds the dubious distinction of being the second largest producer and the second largest consumer of tobacco in the world. Not a particularly dignified title, considering that tobacco kills half of its dedicated users prematurely in their productive years! According to the Global Adult Tobacco Survey-2010, 47.9% of males and 20.3% of females currently use tobacco in some form in India. Globally, smoking prevalence is declining in developed nations while it is on the rise in developing countries. India is currently on an upward swing both in terms of tobacco use and mortality thereof.

By Jittima Jantanamalaka, CNS Thailand

Part 2: Take Control of Asthma - Assure Access to Quality Affordable Medicines [Thai version]

Special thanks:

International Union Against Tuberculosis and Lung Disease (The Union); Prof Nadia Ait-Khaled, Union advisor on asthma, ISAAC Steering Committee and ISAAC Africa Regional Coordinator, Executive Committee, BOLD (Burden of Lung Disease) study. Co-author of asthma management chapter, GAR, Muthita Trakultivakorn, MD, Associate Professor. Division of Allergy & Clinical Immunology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand, and The Asthma Foundation of Thailand.

Part 1: Taking Control - Understand Asthma and Its Triggers [Thai version]

What does making TB a notifiable disease mean to us?

[हिंदी] On one hand the Indian Revised National TB Control Programme (RNTCP) needs to be complimented for making tuberculosis (TB) a notifiable disease (read the government order issued on 7th May 2012 here), but on the other hand there are words of caution and oft-repeated list of actions RNTCP should consider to reach the unreached populations who need TB services. Probably in response to the alarm bells that went ringing when Mumbai reported ‘total drug-resistant TB cases’ the government has taken the step to make TB a notifiable disease.

The key to fighting the tobacco menace is engaging youth at the forefront of the battle, with both youth focused tobacco control programs and policies and youth-led health advocacy. According to the World Health Organization, nearly 80 percent of the all adult smokers begin before 18 years of age. In India, 5500 youth initiate smoking every day. Of the 1000 teenagers smoking today, 500 will eventually die of tobacco related diseases - 250 in their middle age and 250 in their old age. The most susceptible time for initiating and experimenting with tobacco use in India is during adolescence and young adulthood, between 15-24 years of age. Estimates from the Global Tobacco Youth Survey (GYTS) show the growing concern of tobacco use by youth in both developed and developing countries. Nearly 15 % of Indian youth use tobacco in one form or the other – smoking or smokeless forms.

Tobacco is the only legal consumer product that kills when used exactly as indicated by the manufacturer. This catastrophe called tobacco gives out a scary factsheet. According to the estimates of the World Health Organization (WHO) about 1 billion people around the world will die from smoking in the 21st century, which is ten times the numbers killed throughout the 20th century. The World Health Organisation's 2012 Global Report on Mortality attributable to tobacco shows that seven percent of all deaths for age 30 years and over in India are attributable to tobacco.

Chewing Tobacco Chews Away Your Life

Tobacco was considered as an alien product in India and was not welcome to begin with. However, the widespread uptake of tobacco habit as we see it today marks a huge victory for the tobacco promoters. In a milieu of social changes in India, fuelled by foreign news media, influence of foreign films and global economic players, a tug of war is going on in the women’s minds between the tobacco pushers on one hand and societal values on the other. In a country where smoking is generally not socially acceptable for women, it is increasing among certain social groups. The aspirations of some independent and so called liberated women match with what the tobacco companies are promoting and they are getting hooked to smoking cigarettes.