CNS

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.

According to the The Global Asthma Report 2011, published by The International Union Against Tuberculosis and Lung Disease (The Union) and the International Study of Asthma and Allergies in Childhood (ISAAC): Asthma is the most common chronic disease among children and also affects millions of adults. The burden of asthma has been growing over the past 30 years, particularly in low- and middle-income countries, where a large majority of asthma patients are treated only on an emergency basis – when they arrive at a health care facility with an acute attack of asthma. Part of the problem is that quality-assured asthma inhalers, that are essential to well-managed asthma, are either not available or are prohibitively expensive. Another barrier is that the health services lack the strategy, systems and trained staff for providing good asthma care. The Union urges the international community and countries to make sources of funding rapidly available, so that access to quality-assured essential asthma medicines and asthma care can be scaled up and improve the patients’ quality of life, significantly reducing costs for patients and health systems.

By Jittima Jantanamalaka, CNS Thailand

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

Special thanks: International Union Against Tuberculosis and Lung Disease (The Union); Orapan Poachanukoon, MD, Associate Professor. Department of Pediatrics, Faculty of Medicine, Thammasat University, Thailand, and The Asthma Foundation of Thailand.

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

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.