3rd Global Tobacco Treaty Action Guide 2008 released
The 3rd edition of the "Global Tobacco Treaty Action Guide 2008: Protecting Against Tobacco Industry Interference" was released earlier this week in many countries including India, during International Week of Resistance (IWR) to tobacco transnationals (22-28 September 2008). The Global Tobacco Treaty Action Guide 2008 is produced by Corporate Accountability International [which is in official relations with the World Health Organization (WHO)], along with the Network for Accountability of Tobacco Transnationals (NATT).
The need for IWR was never so acute - when on one hand government of India is resolved to enforce the nation-wide ban on smoking from 2 October 2008, the tobacco industry and others including ITC ltd and Indian Hotel Association, have challenged these smoke-free policies in the court of law.
Secondhand smoke, also know as environmental tobacco smoke (ETS), is a mixture of the smoke given off by the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. It is involuntarily inhaled by nonsmokers, lingers in the air hours after cigarettes have been extinguished and can cause or exacerbate a wide range of adverse health effects, including cancer, respiratory infections, and asthma. Secondhand smoke has been classified by the Environmental Protection Agency (EPA) as a known cause of cancer in humans (Group A carcinogen).
Despite of such overwhelming evidence, the industry is hell-bent to choose profits over people.
"The repeated delay, at times weakening, and postponing the implementation of public health policies, mustn't occur again" said Dr Sandeep Pandey, national convener of National Alliance of People's Movements (NAPM) and Magsaysay Awardee (2002).
"For years the tobacco industry has operated with the express intention of subverting public health policies. If the tobacco giants were truly serious about saving lives, they would back off and let governments swiftly, fully implement the public health policies, including the national health policies and also the Framework Convention on Tobacco Control (FCTC) -- the first global corporate accountability and public health treaty" added Dr Pandey.
In July 2007, at the second implementation and enforcement meeting on the FCTC, parties took the courageous step of initiating the development of guidelines on the implementation of Article 5.3 of the FCTC. These guidelines will help governments anticipate and thwart attempts by the vested commercial interests of the tobacco industry to undermine the implementation of the tobacco control policies.
Tobacco kills 5.4 million people around the world each year. Tobacco is a risk factor in six of the eight leading causes of death worldwide. The death toll is projected to rise to eight million a year by 2030, with 80 percent of those deaths occurring in developing countries. If current trends are not reversed, tobacco will claim one billion lives this century.
Published in
Assam Times, Guwahati, Assam, India
Thai Indian news, Bangkok, Thailand
Ghana News, Accra, Ghana
Media for Freedom, Kathmandu, Nepal
Khabar Express, Bikaner, Rajasthan, India
The Seoul Times, Seoul, South Korea
News Track India, Delhi
Bihar and Jharkhand News Service (BJNS)
The Liberian Journal, Liberia
Northern News Lines
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Yahoo! News
Central Chronicle, Madhya Pradesh and Chhattisgarh
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Uphold public health over corporate interests
Uphold public health over corporate interests
It is a pity that India's robust smoke-free policies have been challenged by those with vested interests neglecting the immense and undisputed proven public health benefits of implementing such policies for people at-large.
India is to ban smoking in public places nation-wide from October 2. However the ITC Limited and the Indian Hotel Association are among those who have challenged these public health policies in the court of law.
"Secondhand smoke, also know as environmental tobacco smoke (ETS), is a mixture of the smoke given off by the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. It is involuntarily inhaled by nonsmokers, lingers in the air hours after cigarettes have been extinguished and can cause or exacerbate a wide range of adverse health effects, including cancer, respiratory infections, and asthma" informs Professor (Dr) Rama Kant, who heads the Tobacco Cessation Clinics at CSM Medical University and Gandhi Memorial & Associated Hospitals.
"Secondhand smoke has been classified by the Environmental Protection Agency (EPA) as a known cause of cancer in humans (Group A carcinogen)" informs Dr Rishi Sethi, Department of Cardiology, CSM Medical University.
Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke. Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic, including formaldehyde, benzene, vinyl chloride, arsenic ammonia and hydrogen cyanide. Secondhand smoke causes approximately 3,400 lung cancer deaths and 22,700-69,600 heart disease deaths in adult nonsmokers in the United States each year, further adds Dr Sethi.
Nonsmokers exposed to secondhand smoke at work are at increased risk for adverse health effects.
There is enough data to de-bunk the apprehensions of ban on smoking at the workplace. Since 1999, 70 percent of the U.S. workforce worked under a smoke-free policy, ranging from 83.9 percent in Utah to 48.7 percent in Nevada. Workplace productivity was increased and absenteeism was decreased among former smokers compared with current smokers.
Secondhand smoke is especially harmful to young children. Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year, and causes 430 sudden infant death syndrome (SIDS) deaths in the United States annually, says Dr Sethi.
Secondhand smoke exposure may cause buildup of fluid in the middle ear, resulting in 790,000 physician office visits per year.10 Secondhand smoke can also aggravate symptoms in 400,000 to 1,000,000 children with asthma.11
The Surgeon General's Report concluded that scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke.
The 3rd edition of the "Global Tobacco Treaty Action Guide 2008: Protecting Against Tobacco Industry Interference" was released earlier this week in many countries including India. The Global Tobacco Treaty Action Guide 2008 is produced by Corporate Accountability International [which is in official relations with the World Health Organization (WHO)], along with the Network for Accountability of Tobacco Transnationals (NATT).
"The repeated delay, at times weakening, and postponing the implementation of public health policies in India, particularly the provisions of the Cigarettes and Other Tobacco Products Act, 2003, mustn't occur again. With few days to go before India enforces ban on smoking in public places from 2 October 2008, and few more weeks to go before mandatory pictorial warnings on tobacco products from 30 November 2008 get enforced, it is high time to prepare ourselves to contribute effectively in the implementation of these health policies" said Dr Sandeep Pandey, national convener of National Alliance of People's Movements (NAPM) and Magsaysay Awardee (2002).
"For years the tobacco industry has operated with the express intention of subverting public health policies. If the tobacco giants were truly serious about saving lives, they would back off and let governments swiftly, fully implement the public health policies, including the national health policies and also the Framework Convention on Tobacco Control (FCTC) -- the first global corporate accountability and public health treaty" added Dr Pandey.
Let us hope that good sense prevails and public health and welfare is upheld above corporate interests.
Published in:
Asian Tribune, Thailand/ Sri Lanka
Thai Indian News, Bangkok, Thailand
Kerala Online News, Thiruvananthapuram, Kerala
News Track India, Delhi
Two Circles
Assam Times, Guwahati, Assam
Ghana News, Accra, Ghana
Guatemala Times, Guatemala
The Liberian Journal, Liberia
The Seoul Times, Seoul, South Korea
Bihar Times, Patna, Bihar
Central Chronicle, Madhya Pradesh and Chhattisgarh
Scoop Independent News, New Zealand
News from Bangladesh, Dhaka, Bangladesh
Media for Freedom, Kathmandu, Nepal
Bihar and Jharkhand News Service (BJNS)
Sindh Today, Sindh, Pakistan
It is a pity that India's robust smoke-free policies have been challenged by those with vested interests neglecting the immense and undisputed proven public health benefits of implementing such policies for people at-large.
India is to ban smoking in public places nation-wide from October 2. However the ITC Limited and the Indian Hotel Association are among those who have challenged these public health policies in the court of law.
"Secondhand smoke, also know as environmental tobacco smoke (ETS), is a mixture of the smoke given off by the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. It is involuntarily inhaled by nonsmokers, lingers in the air hours after cigarettes have been extinguished and can cause or exacerbate a wide range of adverse health effects, including cancer, respiratory infections, and asthma" informs Professor (Dr) Rama Kant, who heads the Tobacco Cessation Clinics at CSM Medical University and Gandhi Memorial & Associated Hospitals.
"Secondhand smoke has been classified by the Environmental Protection Agency (EPA) as a known cause of cancer in humans (Group A carcinogen)" informs Dr Rishi Sethi, Department of Cardiology, CSM Medical University.
Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke. Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic, including formaldehyde, benzene, vinyl chloride, arsenic ammonia and hydrogen cyanide. Secondhand smoke causes approximately 3,400 lung cancer deaths and 22,700-69,600 heart disease deaths in adult nonsmokers in the United States each year, further adds Dr Sethi.
Nonsmokers exposed to secondhand smoke at work are at increased risk for adverse health effects.
There is enough data to de-bunk the apprehensions of ban on smoking at the workplace. Since 1999, 70 percent of the U.S. workforce worked under a smoke-free policy, ranging from 83.9 percent in Utah to 48.7 percent in Nevada. Workplace productivity was increased and absenteeism was decreased among former smokers compared with current smokers.
Secondhand smoke is especially harmful to young children. Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year, and causes 430 sudden infant death syndrome (SIDS) deaths in the United States annually, says Dr Sethi.
Secondhand smoke exposure may cause buildup of fluid in the middle ear, resulting in 790,000 physician office visits per year.10 Secondhand smoke can also aggravate symptoms in 400,000 to 1,000,000 children with asthma.11
The Surgeon General's Report concluded that scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke.
The 3rd edition of the "Global Tobacco Treaty Action Guide 2008: Protecting Against Tobacco Industry Interference" was released earlier this week in many countries including India. The Global Tobacco Treaty Action Guide 2008 is produced by Corporate Accountability International [which is in official relations with the World Health Organization (WHO)], along with the Network for Accountability of Tobacco Transnationals (NATT).
"The repeated delay, at times weakening, and postponing the implementation of public health policies in India, particularly the provisions of the Cigarettes and Other Tobacco Products Act, 2003, mustn't occur again. With few days to go before India enforces ban on smoking in public places from 2 October 2008, and few more weeks to go before mandatory pictorial warnings on tobacco products from 30 November 2008 get enforced, it is high time to prepare ourselves to contribute effectively in the implementation of these health policies" said Dr Sandeep Pandey, national convener of National Alliance of People's Movements (NAPM) and Magsaysay Awardee (2002).
"For years the tobacco industry has operated with the express intention of subverting public health policies. If the tobacco giants were truly serious about saving lives, they would back off and let governments swiftly, fully implement the public health policies, including the national health policies and also the Framework Convention on Tobacco Control (FCTC) -- the first global corporate accountability and public health treaty" added Dr Pandey.
Let us hope that good sense prevails and public health and welfare is upheld above corporate interests.
Published in:
Asian Tribune, Thailand/ Sri Lanka
Thai Indian News, Bangkok, Thailand
Kerala Online News, Thiruvananthapuram, Kerala
News Track India, Delhi
Two Circles
Assam Times, Guwahati, Assam
Ghana News, Accra, Ghana
Guatemala Times, Guatemala
The Liberian Journal, Liberia
The Seoul Times, Seoul, South Korea
Bihar Times, Patna, Bihar
Central Chronicle, Madhya Pradesh and Chhattisgarh
Scoop Independent News, New Zealand
News from Bangladesh, Dhaka, Bangladesh
Media for Freedom, Kathmandu, Nepal
Bihar and Jharkhand News Service (BJNS)
Sindh Today, Sindh, Pakistan
Bringing diabetes to light
Bringing diabetes to light
There is a growing consensus to raise awareness about diabetes in the 50 days leading up to World Diabetes Day on 14 November 2008. The International Diabetes Federation announced that the theme for this year's campaign is "Diabetes in Children and Adolescents."
Diabetes is one of the most common chronic diseases to affect children. It can strike children of any age, even toddlers and babies. Every day more than 200 children are diagnosed with type 1 diabetes, requiring them to take multiple daily insulin shots and monitor the glucose levels in their blood. It is increasing at a rate of 3% each year among children and rising even faster in pre-school children at a rate of 5% per year. Over 70,000 children a year under the age of 15 get diabetes.
"If not detected early enough in a child, diabetes can be fatal or result in serious brain damage. The obvious warning signs of increased urination, increased thirst, weight loss and tiredness are at times completely overlooked and the disease is misdiagnosed as the flu or not diagnosed at all" said Professor (Dr) Rama Kant, who heads the Diabetic Foot clinic at Chhatrapati Shahuji Maharaj Medical University and is a senior consultant at Gandhi Memorial & Associated Hospitals in Lucknow, India.
"Every parent, school teacher, school nurse, doctor and anyone involved in the care of children should be familiar with the warning signs and alert to the diabetes threat," said Dr Martin Silink, President of the International Diabetes Federation. "Children who are not diagnosed or misdiagnosed can die from DKA (diabetic coma). In the developing world insulin is not reaching many children who need it and the children are dying. The International Diabetes Federation is advocating that access to appropriate medication and care should be a right for a child with diabetes and not a privilege."
World Diabetes Day made a global splash last year, organizing the lighting of several of the world's most recognizable monuments in blue. For 2008 the Federation is reaching out to the global community for their ideas on how to raise awareness.
"There are activities planned worldwide. We hope to have them all listed on the World Diabetes Day website," said Campaign Director Phil Riley. "We're encouraging people to join in with activities in their community and contact us with their ideas."
Countries like India have an estimated 34 to 35 million of people suffering from diabetes, which is the highest in the world. The prevalence of Diabetes in urban population is 17% and in rural it is 2.5%. This indicates impact of life style and nutritional habits. Among the chronic complications of diabetes, diabetic foot is the most devastating complication and is the leading cause of leg amputation among diabetics. It is estimated that in India alone about 50,000 legs are amputated every year, of which almost 75 percent are potentially preventable, said Professor (Dr) Rama Kant.
This problem is further compounded by the lack of awareness, practice of barefoot walking, home surgery, faulty footwear (slippers) and delay in reporting. The cost, both in terms of human health as well as economic burden of the foot ulcer treatment and complication is very high. In countries like Thailand or India, foot care is very critical as a significant majority of the population stays in rural areas. Therefore prevention of ulcer and its subsequent complications is of utmost importance, stressed Professor Kant.
Recent trends are focusing on prevention by life style modifications, adequate control, multi-speciality treatments and aggressive debridements, open traditional and endovascular surgery, use of stents for improving circulation followed by free use of latest dressing techniques, use of different growth factors, off-loading of pressure points, use of modified shoes and also occasional use of boot therapy or modified boot therapy with a special equipments, said Professor Kant.
Let us hope that the 50 days awareness raising campaign in lead up to the World Diabetes Day this year will be effective in bringing down the incidence in times to come.
Published in
News Blaze, USA
Media for Freedom, Kathmandu, Nepal
Bihar and Jharkhand News Service (BJNS)
The Seoul Times, Seoul, South Korea
The New Times, Rwanda
There is a growing consensus to raise awareness about diabetes in the 50 days leading up to World Diabetes Day on 14 November 2008. The International Diabetes Federation announced that the theme for this year's campaign is "Diabetes in Children and Adolescents."
Diabetes is one of the most common chronic diseases to affect children. It can strike children of any age, even toddlers and babies. Every day more than 200 children are diagnosed with type 1 diabetes, requiring them to take multiple daily insulin shots and monitor the glucose levels in their blood. It is increasing at a rate of 3% each year among children and rising even faster in pre-school children at a rate of 5% per year. Over 70,000 children a year under the age of 15 get diabetes.
"If not detected early enough in a child, diabetes can be fatal or result in serious brain damage. The obvious warning signs of increased urination, increased thirst, weight loss and tiredness are at times completely overlooked and the disease is misdiagnosed as the flu or not diagnosed at all" said Professor (Dr) Rama Kant, who heads the Diabetic Foot clinic at Chhatrapati Shahuji Maharaj Medical University and is a senior consultant at Gandhi Memorial & Associated Hospitals in Lucknow, India.
"Every parent, school teacher, school nurse, doctor and anyone involved in the care of children should be familiar with the warning signs and alert to the diabetes threat," said Dr Martin Silink, President of the International Diabetes Federation. "Children who are not diagnosed or misdiagnosed can die from DKA (diabetic coma). In the developing world insulin is not reaching many children who need it and the children are dying. The International Diabetes Federation is advocating that access to appropriate medication and care should be a right for a child with diabetes and not a privilege."
World Diabetes Day made a global splash last year, organizing the lighting of several of the world's most recognizable monuments in blue. For 2008 the Federation is reaching out to the global community for their ideas on how to raise awareness.
"There are activities planned worldwide. We hope to have them all listed on the World Diabetes Day website," said Campaign Director Phil Riley. "We're encouraging people to join in with activities in their community and contact us with their ideas."
Countries like India have an estimated 34 to 35 million of people suffering from diabetes, which is the highest in the world. The prevalence of Diabetes in urban population is 17% and in rural it is 2.5%. This indicates impact of life style and nutritional habits. Among the chronic complications of diabetes, diabetic foot is the most devastating complication and is the leading cause of leg amputation among diabetics. It is estimated that in India alone about 50,000 legs are amputated every year, of which almost 75 percent are potentially preventable, said Professor (Dr) Rama Kant.
This problem is further compounded by the lack of awareness, practice of barefoot walking, home surgery, faulty footwear (slippers) and delay in reporting. The cost, both in terms of human health as well as economic burden of the foot ulcer treatment and complication is very high. In countries like Thailand or India, foot care is very critical as a significant majority of the population stays in rural areas. Therefore prevention of ulcer and its subsequent complications is of utmost importance, stressed Professor Kant.
Recent trends are focusing on prevention by life style modifications, adequate control, multi-speciality treatments and aggressive debridements, open traditional and endovascular surgery, use of stents for improving circulation followed by free use of latest dressing techniques, use of different growth factors, off-loading of pressure points, use of modified shoes and also occasional use of boot therapy or modified boot therapy with a special equipments, said Professor Kant.
Let us hope that the 50 days awareness raising campaign in lead up to the World Diabetes Day this year will be effective in bringing down the incidence in times to come.
Published in
News Blaze, USA
Media for Freedom, Kathmandu, Nepal
Bihar and Jharkhand News Service (BJNS)
The Seoul Times, Seoul, South Korea
The New Times, Rwanda
India to treat multi-drug resistant tuberculosis country-wide by 2010
India to treat multi-drug resistant tuberculosis nation-wide by 2010
Amit Dwivedi
India is gearing up to strengthen tuberculosis (TB) control so as to provide TB prevention, diagnostics and treatment, particularly for multi-drug resistant tuberculosis (MDR-TB), nation-wide by 2010.
MDR-TB is TB that is resistant to at least two of the best anti-TB drugs, isoniazid and rifampicin. These drugs are considered first-line drugs and are used to treat all persons with TB disease.
"The 4th Global Survey on anti-TB drug resistance does not indicate that the rates of MDR-TB are increasing sharply in India or in Indonesia, or in the South-East Asian Region as a whole. The overall rates for MDR-TB among new smear-positive cases in the Region is 2.8% among new cases and 18.8% among people receiving prior treatment for TB for one month or more. However given population sizes in our larger countries, the numbers of cases are indeed large" said Dr Jai P Narain, Director, Communicable Diseases Department, South East Asian Regional Office (SEARO) of the World Health Organization (WHO).
MDR-TB is a result of inadequate programme performance of Directly Observed Treatment Short-Course (DOTS). DOTS is the WHO-recommended treatment strategy for detection and cure of TB which combines five elements: political commitment, microscopy services, drug supplies, surveillance and monitoring systems and use of highly efficacious regimes with direct observation of treatment.
"National TB control programmes in our Region have moved steadily to achieving the case detection and treatment success targets under DOTS. Treatment success rates in excess of 85% have been consistently achieved since 2002" further explains Dr Narain.
However due to a broad range of reasons, some people with drug-susceptible TB (which is not resistant to any anti-TB drug) develop resistance to anti-TB drugs, or may contract the drug-resistant strain of TB, which is also a possibility. People living with HIV (PLHIV) or those with compromised immunity are at particularly alarming TB risk (both drug susceptible and drug-resistant TB strains).
"MDR-TB cases arise among patients failing Category 1 and 2 regimens, contacts of MDR-TB cases, congregate settings and in other at risk populations such as PLHIV" adds Dr Narain.
Testing or diagnosing these drug-resistant strains of TB and providing effective medication (which is many times more expensive, and treatment duration is much longer) and improving DOTS programme performance for successfully diagnosing and curing drug-susceptible TB (and preventing development of any further anti-TB drug-resistance) can certainly make TB control more effective.
"We see this as an opportunity to strengthen our efforts to focus on prevention of MDR-TB so that we do not have to make the larger investments in treating additional cases of MDR-TB" says Dr Narain.
"India has adopted policy and is now rapidly building laboratory capacity through a network of 24 reference laboratories qualified to undertake culture and drug susceptibility testing (DST) to offer testing to all those who may have drug-resistant forms of TB. There is also an expansion plan to treat MDR-TB cases country-wide by the end of 2010" informs Dr Narain.
Dr Narain points out two specific areas that require attention: To determine how/ where MDR-TB is being generated, and to prevent further emergence of MDR-TB.
While achieving good cure rates under DOTS, we need to focus also on reasons for default and other unfavourable outcomes" says Dr Narain. "Given good cure rates under DOTS, are most MDR-TB cases arising from unsupervised treatment, through unsustainable out-of-pocket expenditure, outside of DOTS programmes?" asks he.
Dr Narain suggests some ways to prevent further emergence of MDR-TB. "By addressing all causes of adverse TB treatment outcomes, enhancing involvement of private sector and unlinked public health facilities, and promoting wider acceptance and application of the International Standards of TB Care" can possibly improve TB programmes in the region.
Amit Dwivedi
(The author is a Special Correspondent to Citizen News Service (CNS). He can be contacted at: amit@citizen-news.org)
Published in
Thai Indian News, Bangkok, Thailand
Assam Times, Guwahati, Assam
Bihar and Jharkhand News Service
Drug and Policy Control, Delhi
The Seoul Times, Seoul, South Korea
News Track India, Delhi
Central Chronicle, Madhya Pradesh and Chhattisgarh
Manipur Comments, Imphal, Manipur
Amit Dwivedi
India is gearing up to strengthen tuberculosis (TB) control so as to provide TB prevention, diagnostics and treatment, particularly for multi-drug resistant tuberculosis (MDR-TB), nation-wide by 2010.
MDR-TB is TB that is resistant to at least two of the best anti-TB drugs, isoniazid and rifampicin. These drugs are considered first-line drugs and are used to treat all persons with TB disease.
"The 4th Global Survey on anti-TB drug resistance does not indicate that the rates of MDR-TB are increasing sharply in India or in Indonesia, or in the South-East Asian Region as a whole. The overall rates for MDR-TB among new smear-positive cases in the Region is 2.8% among new cases and 18.8% among people receiving prior treatment for TB for one month or more. However given population sizes in our larger countries, the numbers of cases are indeed large" said Dr Jai P Narain, Director, Communicable Diseases Department, South East Asian Regional Office (SEARO) of the World Health Organization (WHO).
MDR-TB is a result of inadequate programme performance of Directly Observed Treatment Short-Course (DOTS). DOTS is the WHO-recommended treatment strategy for detection and cure of TB which combines five elements: political commitment, microscopy services, drug supplies, surveillance and monitoring systems and use of highly efficacious regimes with direct observation of treatment.
"National TB control programmes in our Region have moved steadily to achieving the case detection and treatment success targets under DOTS. Treatment success rates in excess of 85% have been consistently achieved since 2002" further explains Dr Narain.
However due to a broad range of reasons, some people with drug-susceptible TB (which is not resistant to any anti-TB drug) develop resistance to anti-TB drugs, or may contract the drug-resistant strain of TB, which is also a possibility. People living with HIV (PLHIV) or those with compromised immunity are at particularly alarming TB risk (both drug susceptible and drug-resistant TB strains).
"MDR-TB cases arise among patients failing Category 1 and 2 regimens, contacts of MDR-TB cases, congregate settings and in other at risk populations such as PLHIV" adds Dr Narain.
Testing or diagnosing these drug-resistant strains of TB and providing effective medication (which is many times more expensive, and treatment duration is much longer) and improving DOTS programme performance for successfully diagnosing and curing drug-susceptible TB (and preventing development of any further anti-TB drug-resistance) can certainly make TB control more effective.
"We see this as an opportunity to strengthen our efforts to focus on prevention of MDR-TB so that we do not have to make the larger investments in treating additional cases of MDR-TB" says Dr Narain.
"India has adopted policy and is now rapidly building laboratory capacity through a network of 24 reference laboratories qualified to undertake culture and drug susceptibility testing (DST) to offer testing to all those who may have drug-resistant forms of TB. There is also an expansion plan to treat MDR-TB cases country-wide by the end of 2010" informs Dr Narain.
Dr Narain points out two specific areas that require attention: To determine how/ where MDR-TB is being generated, and to prevent further emergence of MDR-TB.
While achieving good cure rates under DOTS, we need to focus also on reasons for default and other unfavourable outcomes" says Dr Narain. "Given good cure rates under DOTS, are most MDR-TB cases arising from unsupervised treatment, through unsustainable out-of-pocket expenditure, outside of DOTS programmes?" asks he.
Dr Narain suggests some ways to prevent further emergence of MDR-TB. "By addressing all causes of adverse TB treatment outcomes, enhancing involvement of private sector and unlinked public health facilities, and promoting wider acceptance and application of the International Standards of TB Care" can possibly improve TB programmes in the region.
Amit Dwivedi
(The author is a Special Correspondent to Citizen News Service (CNS). He can be contacted at: amit@citizen-news.org)
Published in
Thai Indian News, Bangkok, Thailand
Assam Times, Guwahati, Assam
Bihar and Jharkhand News Service
Drug and Policy Control, Delhi
The Seoul Times, Seoul, South Korea
News Track India, Delhi
Central Chronicle, Madhya Pradesh and Chhattisgarh
Manipur Comments, Imphal, Manipur
Andhra Pradesh should gear up to enforce tobacco control policies
Andhra Pradesh should gear up to enforce tobacco control policies
Thankfully, the commitment of Andhra Pradesh state-capital's Medical and Health Officer Ms Jaya Kumari to enforce smoke-free policies and that of Union Health and Family Welfare Minister Dr Anbumani Ramadoss is indeed unprecedented.
Smoking in public places will be banned from 2 October 2008 in compliance with the rulings of The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production Supply and Distribution) Act, 2003.
However a recent walk around in city of nawabs - Hyderabad - makes me wonder if the city is geared to enforce this public health policy. Walking around Abids - one of the most happening streets in Hyderabad, one can clearly see tobacco retail shops within 100 meters of educational institutions, people were smoking on the banks of the Hussain Sagar Lake in Hyderabad when I went for morning walk, the auto-richshaw driver was smoking, and to top it all, while having dinner at a restaurant, the waiter approached me if I will like to have a hookah!
The Bombay Municipal Corporation (BMC) in compliance with court orders, is coming down heavily on hookah parlours to enforce smoke-free air policies. Hyderabad Metropolitan Development Authority (HMDA) has something to learn here!
Also while walking around in Golconda fort, I found quite a few instances where people were having a puff - however the city's Medical and Health officer Ms Jaya Kumari says smoking will be banned from 2 October in monuments as well. With less than two weeks left to enforce the ban, I am wondering how this rapid transformation will be implemented?
The repeated delay, at times weakening, and postponing the implementation of public health policies in India, particularly the provisions of the Cigarettes and Other Tobacco Products Act, 2003, mustn't occur again. With two weeks to go before India enforces ban on smoking in public places from 2 October 2008, and few more weeks to go before mandatory pictorial warnings on tobacco products from 30 November 2008 get enforced, it is high time to prepare ourselves to contribute effectively in the implementation of these health policies
At the launch of the 3rd edition of the "Global Tobacco Treaty Action Guide 2008: Protecting Against Tobacco Industry Interference" in Hyderabad on Saturday, 20 September 2008, it is clear that the tobacco giants have disqualified themselves from participating in the development of public health policy. Worldwide release of the Global Tobacco Treaty Action Guide is a centerpiece of this year's 9th International Week of Resistance (IWR) to Tobacco Transnationals (22-28 September 2008).
The Global Tobacco Treaty Action Guide 2008 is produced by Corporate Accountability International [which is in official relations with the World Health Organization (WHO)], along with the Network for Accountability of Tobacco Transnationals (NATT).
For years the tobacco industry has operated with the express intention of subverting public health policies. If the tobacco giants were truly serious about saving lives, they would back off and let governments swiftly, fully implement the public health policies, including the national health policies and also the Framework Convention on Tobacco Control (FCTC) – the first global corporate accountability and public health treaty. India, along with more than 150 countries, has ratified the global tobacco treaty (FCTC). The WHO estimates that broad implementation of the treaty could save 200 million lives by 2050.
In July 2007, at the second implementation and enforcement meeting on the FCTC, parties took the courageous step of initiating the development of guidelines on the implementation of Article 5.3 of the FCTC. These guidelines will help governments anticipate and thwart attempts by the vested commercial interests of the tobacco industry to undermine the implementation of the tobacco control policies.
Tobacco kills 5.4 million people around the world each year. Tobacco is a risk factor in six of the eight leading causes of death worldwide. The death toll is projected to rise to eight million a year by 2030, with 80 percent of those deaths occurring in developing countries. If current trends are not reversed, tobacco will claim one billion lives this century.
Proven tobacco control measures required in Andhra Pradesh, as well as in rest of India, by the global tobacco treaty (FCTC), and also by the Cigarettes and other Tobacco Products Act, 2003, such as the ban on tobacco advertising, promotion and sponsorship, graphic and effective warning labels, strong tax policies and protection from exposure to tobacco smoke, will bring in the desired change. However, the enforcement of some of these policies in India got delayed repeatedly, owing to pressure from the tobacco-growers' associations and other such agencies. The various governmental and non-governmental stakeholders need to be vigilant so as to facilitate the enforcement of these policies and guard them against undue interference, said activists.
Published in
Central Chronicle, Madhya Pradesh and Chhattisgarh
News Track India, Andhra Pradesh
Thai Indian News, Bangkok, Thailand
American Chronicle, USA
The Seoul Times, Seoul, South Korea
Thankfully, the commitment of Andhra Pradesh state-capital's Medical and Health Officer Ms Jaya Kumari to enforce smoke-free policies and that of Union Health and Family Welfare Minister Dr Anbumani Ramadoss is indeed unprecedented.
Smoking in public places will be banned from 2 October 2008 in compliance with the rulings of The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production Supply and Distribution) Act, 2003.
However a recent walk around in city of nawabs - Hyderabad - makes me wonder if the city is geared to enforce this public health policy. Walking around Abids - one of the most happening streets in Hyderabad, one can clearly see tobacco retail shops within 100 meters of educational institutions, people were smoking on the banks of the Hussain Sagar Lake in Hyderabad when I went for morning walk, the auto-richshaw driver was smoking, and to top it all, while having dinner at a restaurant, the waiter approached me if I will like to have a hookah!
The Bombay Municipal Corporation (BMC) in compliance with court orders, is coming down heavily on hookah parlours to enforce smoke-free air policies. Hyderabad Metropolitan Development Authority (HMDA) has something to learn here!
Also while walking around in Golconda fort, I found quite a few instances where people were having a puff - however the city's Medical and Health officer Ms Jaya Kumari says smoking will be banned from 2 October in monuments as well. With less than two weeks left to enforce the ban, I am wondering how this rapid transformation will be implemented?
The repeated delay, at times weakening, and postponing the implementation of public health policies in India, particularly the provisions of the Cigarettes and Other Tobacco Products Act, 2003, mustn't occur again. With two weeks to go before India enforces ban on smoking in public places from 2 October 2008, and few more weeks to go before mandatory pictorial warnings on tobacco products from 30 November 2008 get enforced, it is high time to prepare ourselves to contribute effectively in the implementation of these health policies
At the launch of the 3rd edition of the "Global Tobacco Treaty Action Guide 2008: Protecting Against Tobacco Industry Interference" in Hyderabad on Saturday, 20 September 2008, it is clear that the tobacco giants have disqualified themselves from participating in the development of public health policy. Worldwide release of the Global Tobacco Treaty Action Guide is a centerpiece of this year's 9th International Week of Resistance (IWR) to Tobacco Transnationals (22-28 September 2008).
The Global Tobacco Treaty Action Guide 2008 is produced by Corporate Accountability International [which is in official relations with the World Health Organization (WHO)], along with the Network for Accountability of Tobacco Transnationals (NATT).
For years the tobacco industry has operated with the express intention of subverting public health policies. If the tobacco giants were truly serious about saving lives, they would back off and let governments swiftly, fully implement the public health policies, including the national health policies and also the Framework Convention on Tobacco Control (FCTC) – the first global corporate accountability and public health treaty. India, along with more than 150 countries, has ratified the global tobacco treaty (FCTC). The WHO estimates that broad implementation of the treaty could save 200 million lives by 2050.
In July 2007, at the second implementation and enforcement meeting on the FCTC, parties took the courageous step of initiating the development of guidelines on the implementation of Article 5.3 of the FCTC. These guidelines will help governments anticipate and thwart attempts by the vested commercial interests of the tobacco industry to undermine the implementation of the tobacco control policies.
Tobacco kills 5.4 million people around the world each year. Tobacco is a risk factor in six of the eight leading causes of death worldwide. The death toll is projected to rise to eight million a year by 2030, with 80 percent of those deaths occurring in developing countries. If current trends are not reversed, tobacco will claim one billion lives this century.
Proven tobacco control measures required in Andhra Pradesh, as well as in rest of India, by the global tobacco treaty (FCTC), and also by the Cigarettes and other Tobacco Products Act, 2003, such as the ban on tobacco advertising, promotion and sponsorship, graphic and effective warning labels, strong tax policies and protection from exposure to tobacco smoke, will bring in the desired change. However, the enforcement of some of these policies in India got delayed repeatedly, owing to pressure from the tobacco-growers' associations and other such agencies. The various governmental and non-governmental stakeholders need to be vigilant so as to facilitate the enforcement of these policies and guard them against undue interference, said activists.
Published in
Central Chronicle, Madhya Pradesh and Chhattisgarh
News Track India, Andhra Pradesh
Thai Indian News, Bangkok, Thailand
American Chronicle, USA
The Seoul Times, Seoul, South Korea
Peter McDermott, Opening Session: Global Situation and Response for Children Affected by HIV/AIDS
Unite for Children, Unite Against AIDS.
The Technical Consultation on Children Affected by HIV AIDS bought together around 100 representatives of civil society, governments, bilateral and multilateral donors, UN agencies and academics. This was the first time that the Global Partners Forum on Children Affected by HIV and AIDS was preceded by a 'Technical Consultation' that provided an opportunity for discussions on the key actions required to eliminate barriers to scaling up effective services for children affected by HIV and AIDS.
Recommendations from the Technical Consultation were to be presented at the Global Partners Forum, 9-10 February, 2006.
Peter McDermott, chief, HIV/AIDS section, UNICEF speaking on the global situation and the response to children affected by HIV and AIDS, said that though children and AIDS have become the subject of growing local, national and international attention over recent years, significant momentum is needed to make a real difference. While there has been a paradigm shift, children are still missing from the global response.
There were 700,000 new HIV infections among children in 2005 and 2.3 million children are estimated to be living with HIV as of the end of the year. 15 million children have so far been orphaned by AIDS, but the worst is yet to come - the number of orphans will rise even after the number of adults infected stagnates or declines.
Children are affected by HIV/AIDS for many reasons, but the majority of children affected by AIDS are made vulnerable because the adults around them are sick, dying or have recently died. Orphans are not always the most vulnerable, though they are often at higher risk of becoming infected themselves and are less likely to receive a proper education.
Peter Mc Dermott explained the global campaign 'Unite for Children, Unite Against AIDS', which aims to unite the efforts of all those fighting AIDS to meet children's needs in four key areas. This provides a child-focused framework for nationally owned programmes around the 'Four Ps' - urgent imperatives that will make a real difference in the lives and life chances of children affected by AIDS. These are:
* Prevent mother-to-child transmission of HIV
* Provide paediatric treatment
* Prevent infection among adolescents and young people
* Protect and support children affected by HIV/AIDS
To prevent mother-to-child transmission of HIV, the campaign seeks to expand services to 80 percent of women in need by 2010, up from the current 10 percent.
By providing pediatric drug treatment, the campaign seeks to cut in half the number of children who are infected at birth and die each year before reaching the age of one year -currently about 500,000. The target is to provide either antiretroviral treatment or cotrimoxazole, or both to 80 percent of the children in need by 2010.
By preventing new infections among adolescents and young people, the campaign hopes to reduce by 25 percent the number of children between the ages of 4 and 15 infected annually by 2010.
The 'Unite for Children, Unite against AIDS' campaign advocates for improved birth and death registration systems - at present it is often difficult for children and extended family members to obtain official records proving that they are orphans, which can make them ineligible for such benefits as food aid or free medical care.
The campaign also advocates for education and health services to be strengthened, and for governments and agencies to work towards the elimination of user fees for primary education and, where appropriate health-care services. Thus, the campaign provides a platform for continued action and advocacy to promote the implementation of the Convention on the Rights of the Child and other international conventions.
The global momentum to fight HIV/AIDS now includes the US President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, and the World Bank Multi-Country HIV/AIDS Program for Africa, as well as a significant increase in responses from civil society and faith-based organisations. Coordinating the contributions of all these actors is a daunting but essential task. But unless it is successful, there is a danger that isolated interventions will lead to the proliferation of small projects that are not linked to wider and longer-term programmatic, sectoral or national interventions.
The number of international contributions to the fight against HIV/AIDS often strains the capacity of national coordinating bodies, leaves gaps in national responses and increases the risk of duplication. The Unite for Children, Unite against AIDS Campaign provides a platform for all agencies involved in halting and reversing the spread of HIV/AIDS among children, adolescents and young people. It helps ensure that the children's face of HIV/AIDS is represented at every level of the 'Three Ones'.
Ishdeep Kohli-CNS
The Technical Consultation on Children Affected by HIV AIDS bought together around 100 representatives of civil society, governments, bilateral and multilateral donors, UN agencies and academics. This was the first time that the Global Partners Forum on Children Affected by HIV and AIDS was preceded by a 'Technical Consultation' that provided an opportunity for discussions on the key actions required to eliminate barriers to scaling up effective services for children affected by HIV and AIDS.
Recommendations from the Technical Consultation were to be presented at the Global Partners Forum, 9-10 February, 2006.
Peter McDermott, chief, HIV/AIDS section, UNICEF speaking on the global situation and the response to children affected by HIV and AIDS, said that though children and AIDS have become the subject of growing local, national and international attention over recent years, significant momentum is needed to make a real difference. While there has been a paradigm shift, children are still missing from the global response.
There were 700,000 new HIV infections among children in 2005 and 2.3 million children are estimated to be living with HIV as of the end of the year. 15 million children have so far been orphaned by AIDS, but the worst is yet to come - the number of orphans will rise even after the number of adults infected stagnates or declines.
Children are affected by HIV/AIDS for many reasons, but the majority of children affected by AIDS are made vulnerable because the adults around them are sick, dying or have recently died. Orphans are not always the most vulnerable, though they are often at higher risk of becoming infected themselves and are less likely to receive a proper education.
Peter Mc Dermott explained the global campaign 'Unite for Children, Unite Against AIDS', which aims to unite the efforts of all those fighting AIDS to meet children's needs in four key areas. This provides a child-focused framework for nationally owned programmes around the 'Four Ps' - urgent imperatives that will make a real difference in the lives and life chances of children affected by AIDS. These are:
* Prevent mother-to-child transmission of HIV
* Provide paediatric treatment
* Prevent infection among adolescents and young people
* Protect and support children affected by HIV/AIDS
To prevent mother-to-child transmission of HIV, the campaign seeks to expand services to 80 percent of women in need by 2010, up from the current 10 percent.
By providing pediatric drug treatment, the campaign seeks to cut in half the number of children who are infected at birth and die each year before reaching the age of one year -currently about 500,000. The target is to provide either antiretroviral treatment or cotrimoxazole, or both to 80 percent of the children in need by 2010.
By preventing new infections among adolescents and young people, the campaign hopes to reduce by 25 percent the number of children between the ages of 4 and 15 infected annually by 2010.
The 'Unite for Children, Unite against AIDS' campaign advocates for improved birth and death registration systems - at present it is often difficult for children and extended family members to obtain official records proving that they are orphans, which can make them ineligible for such benefits as food aid or free medical care.
The campaign also advocates for education and health services to be strengthened, and for governments and agencies to work towards the elimination of user fees for primary education and, where appropriate health-care services. Thus, the campaign provides a platform for continued action and advocacy to promote the implementation of the Convention on the Rights of the Child and other international conventions.
The global momentum to fight HIV/AIDS now includes the US President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, and the World Bank Multi-Country HIV/AIDS Program for Africa, as well as a significant increase in responses from civil society and faith-based organisations. Coordinating the contributions of all these actors is a daunting but essential task. But unless it is successful, there is a danger that isolated interventions will lead to the proliferation of small projects that are not linked to wider and longer-term programmatic, sectoral or national interventions.
The number of international contributions to the fight against HIV/AIDS often strains the capacity of national coordinating bodies, leaves gaps in national responses and increases the risk of duplication. The Unite for Children, Unite against AIDS Campaign provides a platform for all agencies involved in halting and reversing the spread of HIV/AIDS among children, adolescents and young people. It helps ensure that the children's face of HIV/AIDS is represented at every level of the 'Three Ones'.
Ishdeep Kohli-CNS
Stephen Kidd - Social Welfare: A Core Response to Child Poverty
Promoting Social Welfare to Reduce Child Poverty.
The Technical Consultation preceding the Global Partners Forum on Children Affected by HIV and AIDS, February, 2006, highlighted the importance of improving outcomes for children through integrated national systems of social welfare that guarantee basic living standards to the most vulnerable.
All children in highly impacted communities are negatively affected by the social and economic impact of HIV and AIDS. Recent evidence suggests that the impact on children is worsening as households and communities become less able to cope with the burdens of care associated with the disease. Current responses to children affected by HIV and AIDS are inadequate. Tackling child poverty and enabling households to meet the needs of children in their care necessitates a coherent policy mix of direct and indirect instruments.
Mexico, Brazil and India are examples of nations that are developing their social welfare systems and enhancing state capacity to deliver social outcomes. Certain countries in Africa are also adapting social policy frameworks and institutions to meet the challenges of poverty and HIV and AIDS.
Successful direct instruments that have demonstrated positive impacts on child poverty and on children affected by HIV and AIDS include the cash grant system of social transfers in South Africa, Namibia, Botswana and Lesotho, including child support grants and non-contributory old age pensions.
Those countries which have moved towards strengthened national capacity in social welfare have adopted strong coherent social policy frameworks and have invested in state capacity to deliver policy and benefits. Direct instruments will assist families affected by HIV and AIDS to support children in their care. Such instruments need to be part of a national response situated within a national social policy framework ensuring best policy coherence for social outcomes for the most vulnerable children.
Mr Stephen Kidd, of DFID's Social Protection Division, called attention to social welfare as being a core human right, specifically quoting from the Convention on the Rights of the Child, Article 26: "for every child the right to benefit from social security" and Article 27: " the right of every child to a standard of living adequate for the child's physical, mental, spiritual, moral and social development". These rights have attracted little attention in poor countries, yet they should be a core response to tackling child poverty, especially in the context of AIDS.
Social transfers can improve household food security, increase rates of participation in education and the uptake of health services. A study commissioned by UNICEF in Southern and Eastern Africa found that cash transfers in the form of child care grants and social pensions were effective in helping families support children in their care. The study concluded that transfers had the potential to strengthen the capacities of families and individuals to support children affected by HIV and AIDS; that predictable ongoing support was most effective and that cash payments afforded flexibility in utilisation which in turn allowed recipients to maximise other multiplier effects.
Social protection can promote growth by allowing people to take up higher return - but also more risky - economic activities. It is also an investment in people, generating a healthier workforce and gives children the opportunity to break the poverty cycle; especially important in the context of HIV and AIDS. This increases the number of people contributing to the economy, as those receiving transfers are more likely to be in work than non-beneficiaries.
Social welfare should complement other interventions though and should not replace interventions in health, education and tackling HIV and AIDS. Social welfare is essential to improving impact on child poverty outcomes, including in health and education.
Fee waivers, for example, are not sufficient for many of the poorest to access school and health as they face other barriers. Even antiretroviral drugs are less effective when recipients have poor nutrition. Other interventions can build on the platform provided by social welfare.
National governments should develop a strategic framework for social welfare provision, integrate social welfare and child poverty outcomes into national Poverty Reduction Strategies, revise National OVC Action Plans to incorporate social protection and embed them within national social policy frameworks.
It is essential that governments take forward national planning on social welfare and increase budget allocations. The international community also needs to invest in building coherent institutions to deliver social welfare for the most vulnerable.
Ishdeep Kohli-CNS
The Technical Consultation preceding the Global Partners Forum on Children Affected by HIV and AIDS, February, 2006, highlighted the importance of improving outcomes for children through integrated national systems of social welfare that guarantee basic living standards to the most vulnerable.
All children in highly impacted communities are negatively affected by the social and economic impact of HIV and AIDS. Recent evidence suggests that the impact on children is worsening as households and communities become less able to cope with the burdens of care associated with the disease. Current responses to children affected by HIV and AIDS are inadequate. Tackling child poverty and enabling households to meet the needs of children in their care necessitates a coherent policy mix of direct and indirect instruments.
Mexico, Brazil and India are examples of nations that are developing their social welfare systems and enhancing state capacity to deliver social outcomes. Certain countries in Africa are also adapting social policy frameworks and institutions to meet the challenges of poverty and HIV and AIDS.
Successful direct instruments that have demonstrated positive impacts on child poverty and on children affected by HIV and AIDS include the cash grant system of social transfers in South Africa, Namibia, Botswana and Lesotho, including child support grants and non-contributory old age pensions.
Those countries which have moved towards strengthened national capacity in social welfare have adopted strong coherent social policy frameworks and have invested in state capacity to deliver policy and benefits. Direct instruments will assist families affected by HIV and AIDS to support children in their care. Such instruments need to be part of a national response situated within a national social policy framework ensuring best policy coherence for social outcomes for the most vulnerable children.
Mr Stephen Kidd, of DFID's Social Protection Division, called attention to social welfare as being a core human right, specifically quoting from the Convention on the Rights of the Child, Article 26: "for every child the right to benefit from social security" and Article 27: " the right of every child to a standard of living adequate for the child's physical, mental, spiritual, moral and social development". These rights have attracted little attention in poor countries, yet they should be a core response to tackling child poverty, especially in the context of AIDS.
Social transfers can improve household food security, increase rates of participation in education and the uptake of health services. A study commissioned by UNICEF in Southern and Eastern Africa found that cash transfers in the form of child care grants and social pensions were effective in helping families support children in their care. The study concluded that transfers had the potential to strengthen the capacities of families and individuals to support children affected by HIV and AIDS; that predictable ongoing support was most effective and that cash payments afforded flexibility in utilisation which in turn allowed recipients to maximise other multiplier effects.
Social protection can promote growth by allowing people to take up higher return - but also more risky - economic activities. It is also an investment in people, generating a healthier workforce and gives children the opportunity to break the poverty cycle; especially important in the context of HIV and AIDS. This increases the number of people contributing to the economy, as those receiving transfers are more likely to be in work than non-beneficiaries.
Social welfare should complement other interventions though and should not replace interventions in health, education and tackling HIV and AIDS. Social welfare is essential to improving impact on child poverty outcomes, including in health and education.
Fee waivers, for example, are not sufficient for many of the poorest to access school and health as they face other barriers. Even antiretroviral drugs are less effective when recipients have poor nutrition. Other interventions can build on the platform provided by social welfare.
National governments should develop a strategic framework for social welfare provision, integrate social welfare and child poverty outcomes into national Poverty Reduction Strategies, revise National OVC Action Plans to incorporate social protection and embed them within national social policy frameworks.
It is essential that governments take forward national planning on social welfare and increase budget allocations. The international community also needs to invest in building coherent institutions to deliver social welfare for the most vulnerable.
Ishdeep Kohli-CNS
India must not delay enforcing public health policies
India must not delay enforcing public health policies
The repeated delay, at times weakening, and postponing the implementation of public health policies in India, particularly the provisions of the Cigarettes and Other Tobacco Products Act, 2003, mustn''t occur again. With two weeks to go before India enforces ban on smoking in public places from 2 October 2008, and few more weeks to go before mandatory pictorial warnings on tobacco products from 30 November 2008 get enforced, it is high time to prepare ourselves to contribute effectively in the implementation of these health policies.
At the launch of the 3rd edition of the "Global Tobacco Treaty Action Guide 2008: Protecting Against Tobacco Industry Interference" in New Delhi today, it is clear that the tobacco giants have disqualified themselves from participating in the development of public health policy. Worldwide release of the Global Tobacco Treaty Action Guide is a centerpiece of this year's 9th International Week of Resistance (IWR) to Tobacco Transnationals (22-28 September 2008).
The Global Tobacco Treaty Action Guide 2008 is produced by Corporate Accountability International [which is in official relations with the World Health Organization (WHO)], along with the Network for Accountability of Tobacco Transnationals (NATT).
For years the tobacco industry has operated with the express intention of subverting public health policies. If the tobacco giants were truly serious about saving lives, they would back off and let governments swiftly, fully implement the public health policies, including the national health policies and also the Framework Convention on Tobacco Control (FCTC) -- the first global corporate accountability and public health treaty. India, along with more than 150 countries, has ratified the global tobacco treaty (FCTC). The WHO estimates that broad implementation of the treaty could save 200 million lives by 2050.
In July 2007, at the second implementation and enforcement meeting on the FCTC, parties took the courageous step of initiating the development of guidelines on the implementation of Article 5.3 of the FCTC. These guidelines will help governments anticipate and thwart attempts by the vested commercial interests of the tobacco industry to undermine the implementation of the tobacco control policies.
Tobacco kills 5.4 million people around the world each year. Tobacco is a risk factor in six of the eight leading causes of death worldwide. The death toll is projected to rise to eight million a year by 2030, with 80 percent of those deaths occurring in developing countries. If current trends are not reversed, tobacco will claim one billion lives this century.
Proven tobacco control measures required in India by the global tobacco treaty (FCTC), and also by the Cigarettes and other Tobacco Products Act, 2003, such as the ban on tobacco advertising, promotion and sponsorship, graphic and effective warning labels, strong tax policies and protection from exposure to tobacco smoke, are now being implemented gradually in India. However, the enforcement of some of these policies in India got delayed repeatedly, owing to pressure from the tobacco-growers' associations and other such agencies. The various governmental and non-governmental stakeholders need to be vigilant so as to facilitate the enforcement of these policies and guard them against undue interference, said activists.
Published in
Central Chronicle, Madhya Pradesh and Chattisgarh
My News, Delhi
The repeated delay, at times weakening, and postponing the implementation of public health policies in India, particularly the provisions of the Cigarettes and Other Tobacco Products Act, 2003, mustn''t occur again. With two weeks to go before India enforces ban on smoking in public places from 2 October 2008, and few more weeks to go before mandatory pictorial warnings on tobacco products from 30 November 2008 get enforced, it is high time to prepare ourselves to contribute effectively in the implementation of these health policies.
At the launch of the 3rd edition of the "Global Tobacco Treaty Action Guide 2008: Protecting Against Tobacco Industry Interference" in New Delhi today, it is clear that the tobacco giants have disqualified themselves from participating in the development of public health policy. Worldwide release of the Global Tobacco Treaty Action Guide is a centerpiece of this year's 9th International Week of Resistance (IWR) to Tobacco Transnationals (22-28 September 2008).
The Global Tobacco Treaty Action Guide 2008 is produced by Corporate Accountability International [which is in official relations with the World Health Organization (WHO)], along with the Network for Accountability of Tobacco Transnationals (NATT).
For years the tobacco industry has operated with the express intention of subverting public health policies. If the tobacco giants were truly serious about saving lives, they would back off and let governments swiftly, fully implement the public health policies, including the national health policies and also the Framework Convention on Tobacco Control (FCTC) -- the first global corporate accountability and public health treaty. India, along with more than 150 countries, has ratified the global tobacco treaty (FCTC). The WHO estimates that broad implementation of the treaty could save 200 million lives by 2050.
In July 2007, at the second implementation and enforcement meeting on the FCTC, parties took the courageous step of initiating the development of guidelines on the implementation of Article 5.3 of the FCTC. These guidelines will help governments anticipate and thwart attempts by the vested commercial interests of the tobacco industry to undermine the implementation of the tobacco control policies.
Tobacco kills 5.4 million people around the world each year. Tobacco is a risk factor in six of the eight leading causes of death worldwide. The death toll is projected to rise to eight million a year by 2030, with 80 percent of those deaths occurring in developing countries. If current trends are not reversed, tobacco will claim one billion lives this century.
Proven tobacco control measures required in India by the global tobacco treaty (FCTC), and also by the Cigarettes and other Tobacco Products Act, 2003, such as the ban on tobacco advertising, promotion and sponsorship, graphic and effective warning labels, strong tax policies and protection from exposure to tobacco smoke, are now being implemented gradually in India. However, the enforcement of some of these policies in India got delayed repeatedly, owing to pressure from the tobacco-growers' associations and other such agencies. The various governmental and non-governmental stakeholders need to be vigilant so as to facilitate the enforcement of these policies and guard them against undue interference, said activists.
Published in
Central Chronicle, Madhya Pradesh and Chattisgarh
My News, Delhi
Father Kelly - Education Access and the Abolition of School Fees
Presenting on the importance of education access and the abolition of school fees during the Technical Consultation on Children Affected by HIV and AIDS, London 7-8 February, 2006, Father Michael J Kelly, an educationalist at the forefront of research on the interconnection between education and HIV/AIDS, proposed the novel Millennium Schools Project. This undertaking would be first identify schools serving marginalised children in specific areas (rural, high density township, border towns, and squatter settlements).
Each of these schools should be given every resource required to respond to the educational needs of the community. What is innovative about the idea is that each school will be a multipurpose community development and welfare centre - a health promoting centre for birth registration, immunisation, deworming, distribution of bed-nets, vitamin supplementation, school meals; a community centre for health, agriculture, and social improvements. Teachers would be well respected, trustworthy community leaders who are adequately compensated. The curriculum will be based on the four pillars (learning to know, learning to do, learning to live together, learning to be) and relevant to the community and the families of learners.
Stressing the need to accelerate the abolition of school fees and remove other barriers to education, Father Kelly emphasised that education is a basic human right, necessary for personal and socio-economic development. This is critically important for orphans and marginalised children, who have limited access to education. The barriers to abolition are that many fees originate within communities, Parent-Teacher Associations (PTAs) and schools, so it becomes critically important to engage these communities in the process. This should be approached jointly with the establishment of social support mechanisms. It should be considered whether fee abolition should be undertaken in isolation from more comprehensive education reforms that look into the provision of ECD, revisiting the curriculum, expansion of secondary opportunity and improvement of tertiary access and quality. It is important to understand the barriers as to why schools/PTAs impose fees or require uniforms. Responses need to be tailored to the specific circumstances of the country or institution.
Planning is required at the systemic level for finance, policy, management issues and resources. It is important to find ways to access resources and to compensate schools for lost revenues. At the institutional level, planning is required to preserve and improve quality, cope with enrolment surges, ensure meaningful learning, deal with large classes, ensure security at school and to provide water and sanitation.
Governments should develop nationally-owned education reform strategies that will clearly ensure full school participation by every child, including those affected by AIDS (and those with disabilities); broader education reforms within a framework of comprehensive social welfare; harness momentum for abolition of school fees and mobilise political will (in the framework of EFA, FTI, Bold Initiative, etc), with resource-backed commitment to action and legislation backing fee abolition. The explicit support of Heads of State for greater investment in free education needs to be mobilised (as in the Abuja Declaration for health). The lead actors are UNICEF, the World Bank, Education, Finance, and Social Ministries, PTAs and teachers' unions.
National governments (principally education ministries) with civil society and international NGOs need to explore ways of involving, strengthening and cooperating with PTAs and teacher unions. Only by involvement of the PTAs and teacher unions can success be ensured; not involving them almost guarantees the re-emergence of illegal fees.
The knowledge base should be improved by involving national governments,
UNICEF, UNESCO, and the World Bank along with local and international NGOs. The information base on the factors (including stigma and opportunity costs) that are preventing the school participation of children affected by AIDS needs to be extended. As does the information base on fees (what is being charged, for what purposes, how children affected by AIDS cope and how this affects access). This momentum needs to be maintained by establishing representative free basic education groups to maintain the pressure and interest. These groups should work together to gather information and serve as watchdogs.
Ishdeep Kohli-CNS
Each of these schools should be given every resource required to respond to the educational needs of the community. What is innovative about the idea is that each school will be a multipurpose community development and welfare centre - a health promoting centre for birth registration, immunisation, deworming, distribution of bed-nets, vitamin supplementation, school meals; a community centre for health, agriculture, and social improvements. Teachers would be well respected, trustworthy community leaders who are adequately compensated. The curriculum will be based on the four pillars (learning to know, learning to do, learning to live together, learning to be) and relevant to the community and the families of learners.
Stressing the need to accelerate the abolition of school fees and remove other barriers to education, Father Kelly emphasised that education is a basic human right, necessary for personal and socio-economic development. This is critically important for orphans and marginalised children, who have limited access to education. The barriers to abolition are that many fees originate within communities, Parent-Teacher Associations (PTAs) and schools, so it becomes critically important to engage these communities in the process. This should be approached jointly with the establishment of social support mechanisms. It should be considered whether fee abolition should be undertaken in isolation from more comprehensive education reforms that look into the provision of ECD, revisiting the curriculum, expansion of secondary opportunity and improvement of tertiary access and quality. It is important to understand the barriers as to why schools/PTAs impose fees or require uniforms. Responses need to be tailored to the specific circumstances of the country or institution.
Planning is required at the systemic level for finance, policy, management issues and resources. It is important to find ways to access resources and to compensate schools for lost revenues. At the institutional level, planning is required to preserve and improve quality, cope with enrolment surges, ensure meaningful learning, deal with large classes, ensure security at school and to provide water and sanitation.
Governments should develop nationally-owned education reform strategies that will clearly ensure full school participation by every child, including those affected by AIDS (and those with disabilities); broader education reforms within a framework of comprehensive social welfare; harness momentum for abolition of school fees and mobilise political will (in the framework of EFA, FTI, Bold Initiative, etc), with resource-backed commitment to action and legislation backing fee abolition. The explicit support of Heads of State for greater investment in free education needs to be mobilised (as in the Abuja Declaration for health). The lead actors are UNICEF, the World Bank, Education, Finance, and Social Ministries, PTAs and teachers' unions.
National governments (principally education ministries) with civil society and international NGOs need to explore ways of involving, strengthening and cooperating with PTAs and teacher unions. Only by involvement of the PTAs and teacher unions can success be ensured; not involving them almost guarantees the re-emergence of illegal fees.
The knowledge base should be improved by involving national governments,
UNICEF, UNESCO, and the World Bank along with local and international NGOs. The information base on the factors (including stigma and opportunity costs) that are preventing the school participation of children affected by AIDS needs to be extended. As does the information base on fees (what is being charged, for what purposes, how children affected by AIDS cope and how this affects access). This momentum needs to be maintained by establishing representative free basic education groups to maintain the pressure and interest. These groups should work together to gather information and serve as watchdogs.
Ishdeep Kohli-CNS
Victim of terrorism - the common man
Victim of terrorism - the common man
Shobha Shukla
Recently I had the privilege to hear Mr. Ajit Sahi, the Editor-at-large of Tehelka, speak on the 'Myth Of Terrorist Organisations----SIMI fictions'.
His painstakingly collected and carefully analyzed information speaks of scores of innocent Indian Muslims languishing in the countries' prisons on false police accusations. He feels that it is a premeditated government (read Hindu) campaign to implicate and harass Muslim youth and demonise the Muslim community----all in the name of curbing terrorist activities. His findings indicate that in not a single case has it so far been conclusive that SIMI ( students' Islamic movement of India ) activists were involved in terrorist offences. Police have killed scores of innocent persons during the last several years, wrongly branding them as terrorists, whereas the the real culprits remain untouched. All this has helped to reinforce hatred against the Muslims who no longer feel safe in the country.
However they need not despair, as they are not alone in their fear and mistrust. It is the common ,hapless person on the street who is being hounded by the powers-that-be irrespective of her/his caste, creed or religion. How else do we explain the thrashing of the UPites and Biharis in Mumbai by the Shiv Sena and the Nav Nirman Sena in the name of purging Maharashtrian territory,( thus usurping the right of an Indian citizen to work in any part of the country), unleashing a wave of violence and hatred amongst members of the same religion.
Or the vandalism by the saffron brigade during a recent painting exhibition of artist Manjit Singh in New Delhi . They not only smashed his paintings but manhandled him too, as they thought his works of art to be against Hindu culture.
Or the barbaric burning to death of Rajni Majhi---a twenty year old Hindu girl in Orissa---whose only fault was that she was living in an orphanage run by Christian missionaries.
Or the police firings on the poor farmers who dared to protest against the acquisition of their farmlands at ridiculously low prices by the Government in the name of economic development.
Whether it is the heinous bomb blasts, or attacks on a particular minority community/ caste, or illegal coercion of farmers; the perpetrator is always the more powerful and the victim is the helpless poor. The new world order seems to have fuelled our brutal passion to tread upon the down trodden and to oppress the weak. It could be the State/executive against the minorities; the economically powerful industrialists against the poor farmers; the police excesses on the innocents. Everywhere it is the same blatant signature tune that I am racially/socially/economically superior to you.
A few months ago the son of my sister's domestic help was rounded by the police on a false complaint of theft, with no evidence whatsoever. When she approached a senior police officer, the charges against him were withdrawn, but his poor mother had to shell out a thousand rupees for his release. On top of it a police constable pestered him to name someone else for some other uncommitted crime, just to add numbers to the police record list. Even after his release, the boy and his mother are living in constant fear of the police. This is just one of the several cases which must be happening every day and we seem to have become immune to these indignities as long as they do not affect us directly.
Isn't the police terrorizing the common public with impunity and getting away with it?
Aren't the Bajrang Dal/ Shivsainiks/ political parties terrorizing the law abiding citizens and zealous missionaries and social activists( like Binayak Sen) for their narrow parochial gains?
Isn't the State machinery terrorizing us by usurping the fundamental rights of the common person by forcibly taking away his/her land and siphoning off funds earmarked for flood/ drought/ riot victims?
Isn't our army, deemed to be the custodians of law and order in troubled areas, violating the dignity of women and committing excesses against human rights?
How often have seen traffic rules being broken with impunity and no action taken against the culprits; cases of road rage resulting in deaths;women being subjugated and treated like dirt ( that is if they are allowed to be born) for bringing insufficient dowry/ not producing a male child / daring to exercise their choices.
All these are acts of terrorism unleashed on the weak and powerless by the strong and mighty. It is not just the Muslims, but about anyone and everyone without a political/ economic clout who are living in constant fear of the unbridled and brute force of the executive/ police/ judiciary. It is rare to find an influential person becoming a victim of any act of terrorism.
It is time for the oppressed to stand up in solidarity against all forms of terrorism, irrespective of their faith and affiliations.
The stupid (wo)man on the street ,who has been dumped by all, must stand up in non violent resistance and abide by the truth, ( just like the farmers of Jharkhand and villages adjoining New Delhi ).
We may be grateful to have survived bomb attacks but our spirit is dying and needs to be resurrected.
Published in
Thai Indian News, Bangkok, Thailand
News Track India, Delhi
Scoop Independent News, New Zealand
Assam Times, Guwahati, Assam
Indo Asian News Service (IANS)
The Bangladesh Today, Dhaka, Bangladesh
Bihar and Jharkhand News Service
Central Chronicle, Madhya Pradesh and Chhattisgarh
Asian Tribune, Bangkok, Thailand
The Seoul Times, Seoul, South Korea
Shobha Shukla
Recently I had the privilege to hear Mr. Ajit Sahi, the Editor-at-large of Tehelka, speak on the 'Myth Of Terrorist Organisations----SIMI fictions'.
His painstakingly collected and carefully analyzed information speaks of scores of innocent Indian Muslims languishing in the countries' prisons on false police accusations. He feels that it is a premeditated government (read Hindu) campaign to implicate and harass Muslim youth and demonise the Muslim community----all in the name of curbing terrorist activities. His findings indicate that in not a single case has it so far been conclusive that SIMI ( students' Islamic movement of India ) activists were involved in terrorist offences. Police have killed scores of innocent persons during the last several years, wrongly branding them as terrorists, whereas the the real culprits remain untouched. All this has helped to reinforce hatred against the Muslims who no longer feel safe in the country.
However they need not despair, as they are not alone in their fear and mistrust. It is the common ,hapless person on the street who is being hounded by the powers-that-be irrespective of her/his caste, creed or religion. How else do we explain the thrashing of the UPites and Biharis in Mumbai by the Shiv Sena and the Nav Nirman Sena in the name of purging Maharashtrian territory,( thus usurping the right of an Indian citizen to work in any part of the country), unleashing a wave of violence and hatred amongst members of the same religion.
Or the vandalism by the saffron brigade during a recent painting exhibition of artist Manjit Singh in New Delhi . They not only smashed his paintings but manhandled him too, as they thought his works of art to be against Hindu culture.
Or the barbaric burning to death of Rajni Majhi---a twenty year old Hindu girl in Orissa---whose only fault was that she was living in an orphanage run by Christian missionaries.
Or the police firings on the poor farmers who dared to protest against the acquisition of their farmlands at ridiculously low prices by the Government in the name of economic development.
Whether it is the heinous bomb blasts, or attacks on a particular minority community/ caste, or illegal coercion of farmers; the perpetrator is always the more powerful and the victim is the helpless poor. The new world order seems to have fuelled our brutal passion to tread upon the down trodden and to oppress the weak. It could be the State/executive against the minorities; the economically powerful industrialists against the poor farmers; the police excesses on the innocents. Everywhere it is the same blatant signature tune that I am racially/socially/economically superior to you.
A few months ago the son of my sister's domestic help was rounded by the police on a false complaint of theft, with no evidence whatsoever. When she approached a senior police officer, the charges against him were withdrawn, but his poor mother had to shell out a thousand rupees for his release. On top of it a police constable pestered him to name someone else for some other uncommitted crime, just to add numbers to the police record list. Even after his release, the boy and his mother are living in constant fear of the police. This is just one of the several cases which must be happening every day and we seem to have become immune to these indignities as long as they do not affect us directly.
Isn't the police terrorizing the common public with impunity and getting away with it?
Aren't the Bajrang Dal/ Shivsainiks/ political parties terrorizing the law abiding citizens and zealous missionaries and social activists( like Binayak Sen) for their narrow parochial gains?
Isn't the State machinery terrorizing us by usurping the fundamental rights of the common person by forcibly taking away his/her land and siphoning off funds earmarked for flood/ drought/ riot victims?
Isn't our army, deemed to be the custodians of law and order in troubled areas, violating the dignity of women and committing excesses against human rights?
How often have seen traffic rules being broken with impunity and no action taken against the culprits; cases of road rage resulting in deaths;women being subjugated and treated like dirt ( that is if they are allowed to be born) for bringing insufficient dowry/ not producing a male child / daring to exercise their choices.
All these are acts of terrorism unleashed on the weak and powerless by the strong and mighty. It is not just the Muslims, but about anyone and everyone without a political/ economic clout who are living in constant fear of the unbridled and brute force of the executive/ police/ judiciary. It is rare to find an influential person becoming a victim of any act of terrorism.
It is time for the oppressed to stand up in solidarity against all forms of terrorism, irrespective of their faith and affiliations.
The stupid (wo)man on the street ,who has been dumped by all, must stand up in non violent resistance and abide by the truth, ( just like the farmers of Jharkhand and villages adjoining New Delhi ).
We may be grateful to have survived bomb attacks but our spirit is dying and needs to be resurrected.
Shobha Shukla
The author teaches Physics at India's Loreto Convent and has been writing extensively in English and Hindi media. She serves as Editor of Citizen News Service (CNS).
Published in
Thai Indian News, Bangkok, Thailand
News Track India, Delhi
Scoop Independent News, New Zealand
Assam Times, Guwahati, Assam
Indo Asian News Service (IANS)
The Bangladesh Today, Dhaka, Bangladesh
Bihar and Jharkhand News Service
Central Chronicle, Madhya Pradesh and Chhattisgarh
Asian Tribune, Bangkok, Thailand
The Seoul Times, Seoul, South Korea
Regional Perspectives Successes and Challenges - Africa
Orphans and vulnerable children: Communities in need of support.
The Regional Psychosocial Support Initiative for Children Affected by HIV/AIDS (REPSSI) provided the regional perspective for East and Southern Africa during the Technical Consultation on Children and HIV/AIDS in London, 7-8 February, 2006. The initiative is a psychosocial support (PSS) network for children affected by HIV and AIDS. REPSSI operates in 13 countries and has a partner base of nearly 60 organisations in the region working to mainstream PSS into their activities and policies. Ms Noreen M Huni, speaking for the region, told participants that the family system has not collapsed, but is very overstretched. Communities are committed to caring for and supporting the children themselves; extended families, communities, faith-based and non-governmental organisations (NGO) provide the majority of care and support for orphans and vulnerable children (OVC) in the HIV/AIDS context.
In this region, OVC programming has recognised that cultural systems, practices and beliefs are a valuable entry point for successful and sustainable interventions. For example, Malawian initiation ceremonies have included HIV/AIDS prevention messages in their curriculum. The elderly are increasingly taking up this responsibility, yet their own material, physical, social, spiritual and emotional needs remain unmet. The overall capacity to responding is extremely inadequate. Knowledge, skills and resources are far from sufficient. Communities need resources and technical capacity enhancement to manage these resources.
The comprehensive care and support packages provided so far are physical, spiritual and material in nature, ignoring the psychosocial well-being of the children. Thus, there is a huge gap requiring unique interventions to strengthen the existing responses. Access to essential services has been agreed upon but tremendous barriers hinder access to these basics. Access to antiretroviral (ARV) drugs remains limited due to issues of affordability, accessibility and treatment literacy. Children are still not accessing ARVs, which as a priority are given to adults. Appropriate dosages and formulations for children are unavailable.
National Plans of Action are in place and most governments are attempting to address OVC needs with the necessary policies, for example the 'Free Education for All' campaign, although other barriers continue to hinder children from attending school. But there is no legislative review to support the Convention on the Rights of the Child; these rights remain inaccessible to most OVCs. Many OVC have no legal existence at national level due to lack of birth registration - therefore no resources are allocated for OVC. Most countries have no national social policy on OVC - leaving NGOs and faith-based organisations (FBOs) to take the lead in responding.
Government officials have begun to include the plight of orphans in their campaign and advocacy strategies. Schools are becoming centres of care and support. Hospitals are also being used as meeting places for support groups, counselling centres and provide information on the well-being of orphans. Certain print and broadcast media are taking a positive responsibility to educate and create awareness of issues pertaining to children within an HIV/AIDS context. There has also been a major increase in the number of NGOs focusing on OVC issues. But challenges remain - there are too many soldiers and no generals in this fight. It is not clear which ministries are mandated for OVC and what status these ministries have. The OVC challenge has a very low profile among the national governments. Noting that children constitute 50% of the population in most countries, isn't it time to create a special ministry for them?
International funding partners, UN agencies, regional and national political structures have all emphasised the seriousness of the problem. But the funding duration is usually less than 5 years, which ignores the fundamentals of child rights programming. Donors often arrive with pre-planned interventions, rather than supporting existing multi-sectoral responses - searching for 'quick results'. Some interventions are unrealistic, and do not take into account succession plans, such as exit strategies. A lack of coordinated donor activities is reported in most African countries and information-sharing is limited between funding partners and recipients. FBOs and CBOs often do not have the technical capacity to access available funds. An additional problem is that regional political structures (i.e. Pan African Parliamentarians, AU, SADC and NEPAD) have failed to mainstream OVC in regional HIV/AIDS, poverty reduction and budgeting and planning frameworks.
UNICEF in collaboration with REPSSI and some African universities have started working on a 'Children at Risk' certificate level programme for child care and support service providers in response to the knowledge and skills gap. Children, families, communities, non-governmental and faith-based organisations are providing the majority of OVC with care and support. But there is an urgent need to make these interventions more visible and respected by the communities themselves, before trying out 'new' interventions. The programme for orphans and vulnerable children should be high on the international, regional and national agendas. The nature and duration of interventions should ensure there is no additional trauma by placing the child and family at the centre of the programmes.
Ishdeep Kohli-CNS
The Regional Psychosocial Support Initiative for Children Affected by HIV/AIDS (REPSSI) provided the regional perspective for East and Southern Africa during the Technical Consultation on Children and HIV/AIDS in London, 7-8 February, 2006. The initiative is a psychosocial support (PSS) network for children affected by HIV and AIDS. REPSSI operates in 13 countries and has a partner base of nearly 60 organisations in the region working to mainstream PSS into their activities and policies. Ms Noreen M Huni, speaking for the region, told participants that the family system has not collapsed, but is very overstretched. Communities are committed to caring for and supporting the children themselves; extended families, communities, faith-based and non-governmental organisations (NGO) provide the majority of care and support for orphans and vulnerable children (OVC) in the HIV/AIDS context.
In this region, OVC programming has recognised that cultural systems, practices and beliefs are a valuable entry point for successful and sustainable interventions. For example, Malawian initiation ceremonies have included HIV/AIDS prevention messages in their curriculum. The elderly are increasingly taking up this responsibility, yet their own material, physical, social, spiritual and emotional needs remain unmet. The overall capacity to responding is extremely inadequate. Knowledge, skills and resources are far from sufficient. Communities need resources and technical capacity enhancement to manage these resources.
The comprehensive care and support packages provided so far are physical, spiritual and material in nature, ignoring the psychosocial well-being of the children. Thus, there is a huge gap requiring unique interventions to strengthen the existing responses. Access to essential services has been agreed upon but tremendous barriers hinder access to these basics. Access to antiretroviral (ARV) drugs remains limited due to issues of affordability, accessibility and treatment literacy. Children are still not accessing ARVs, which as a priority are given to adults. Appropriate dosages and formulations for children are unavailable.
National Plans of Action are in place and most governments are attempting to address OVC needs with the necessary policies, for example the 'Free Education for All' campaign, although other barriers continue to hinder children from attending school. But there is no legislative review to support the Convention on the Rights of the Child; these rights remain inaccessible to most OVCs. Many OVC have no legal existence at national level due to lack of birth registration - therefore no resources are allocated for OVC. Most countries have no national social policy on OVC - leaving NGOs and faith-based organisations (FBOs) to take the lead in responding.
Government officials have begun to include the plight of orphans in their campaign and advocacy strategies. Schools are becoming centres of care and support. Hospitals are also being used as meeting places for support groups, counselling centres and provide information on the well-being of orphans. Certain print and broadcast media are taking a positive responsibility to educate and create awareness of issues pertaining to children within an HIV/AIDS context. There has also been a major increase in the number of NGOs focusing on OVC issues. But challenges remain - there are too many soldiers and no generals in this fight. It is not clear which ministries are mandated for OVC and what status these ministries have. The OVC challenge has a very low profile among the national governments. Noting that children constitute 50% of the population in most countries, isn't it time to create a special ministry for them?
International funding partners, UN agencies, regional and national political structures have all emphasised the seriousness of the problem. But the funding duration is usually less than 5 years, which ignores the fundamentals of child rights programming. Donors often arrive with pre-planned interventions, rather than supporting existing multi-sectoral responses - searching for 'quick results'. Some interventions are unrealistic, and do not take into account succession plans, such as exit strategies. A lack of coordinated donor activities is reported in most African countries and information-sharing is limited between funding partners and recipients. FBOs and CBOs often do not have the technical capacity to access available funds. An additional problem is that regional political structures (i.e. Pan African Parliamentarians, AU, SADC and NEPAD) have failed to mainstream OVC in regional HIV/AIDS, poverty reduction and budgeting and planning frameworks.
UNICEF in collaboration with REPSSI and some African universities have started working on a 'Children at Risk' certificate level programme for child care and support service providers in response to the knowledge and skills gap. Children, families, communities, non-governmental and faith-based organisations are providing the majority of OVC with care and support. But there is an urgent need to make these interventions more visible and respected by the communities themselves, before trying out 'new' interventions. The programme for orphans and vulnerable children should be high on the international, regional and national agendas. The nature and duration of interventions should ensure there is no additional trauma by placing the child and family at the centre of the programmes.
Ishdeep Kohli-CNS
More ways to change...Same sex relationships and stigma
During the first plenary of the conference, Anandi Yuvaraj, from the Programme for Appropriate Technology in Health (PATH) in India, described the discrimination she personally faced from relatives - and also how she and her close family were able to shift their attitudes by showing open acceptance of her HIV status.
Stigma and discrimination was also the highlight of one of the following sessions, which focused on consulting community when addressing the needs of men who have sex with men (MSM) in China. Mr Xu Jie outlined some of the ways in which the government in China is now partnering with the MSM community. This is in stark contrast to a few years ago when the government did not even mention MSM. According to Edmund Settle, from UNDP in China, the government now sees the MSM community as a partner in AIDS programmes. This has led to increased funding for MSM groups at both the national and local levels.
In a presentation from Japan in the same session, Jane Koerner described the situation for young MSM in central Japan, where homosexuality is largely invisible in society - as a result, MSM groups in the country have not been mobilized and funds are in short supply.
As part of the discussion, the question arose of whether reducing stigma is the government or civil society's responsibility. Jan W De Lind, from UNESCO in Bangkok argued that society follows policy.
"If there is a legal policy in place then the society is expected to abide by it," de Lind commented. "Policy-makers should follow evidence; there is good data available now about the rising HIV rates in the MSM communities. Collaborating with MSM communities is a good way forward."
Participants had an active discussion, stressing that public health researchers should play a stronger role in pushing the government towards framing policies to reduce stigma and discrimination.
Ms Revati Chawla, the Sri Lankan co-chair, remarked that leadership at the community and government levels plays an important role in reducing stigma and discrimination. The other co-chair, Mr Aditya Bandyopadhyay from India, highlighted that same sex discriminating laws exist in India, Pakistan, Sri Lanka, Bangladesh, Malaysia and Nepal.
"Legal reforms should be the first step," he commented.
Some of the participants agreed that if international pressure on governments in these countries to reform the laws would be helpful. Collective measures across countries could play an important role in ensuring that governments repeal laws that discriminate and block interventions for HIV prevention work among same-sex communities.
Representatives from the MSM group Bandhu, from Bangladesh, argued that HIV is a good background to start mobilizing work with the MSM communities and partnering with governments. Even in India, which is in the process of drafting the anti-discrimination law, it is being suggested that the idea of a 'safe-area' of working with MSM groups as part of HIV prevention work is being accepted has been identified as part of the way forward.
Ishdeep Kohli-CNS
Stigma and discrimination was also the highlight of one of the following sessions, which focused on consulting community when addressing the needs of men who have sex with men (MSM) in China. Mr Xu Jie outlined some of the ways in which the government in China is now partnering with the MSM community. This is in stark contrast to a few years ago when the government did not even mention MSM. According to Edmund Settle, from UNDP in China, the government now sees the MSM community as a partner in AIDS programmes. This has led to increased funding for MSM groups at both the national and local levels.
In a presentation from Japan in the same session, Jane Koerner described the situation for young MSM in central Japan, where homosexuality is largely invisible in society - as a result, MSM groups in the country have not been mobilized and funds are in short supply.
As part of the discussion, the question arose of whether reducing stigma is the government or civil society's responsibility. Jan W De Lind, from UNESCO in Bangkok argued that society follows policy.
"If there is a legal policy in place then the society is expected to abide by it," de Lind commented. "Policy-makers should follow evidence; there is good data available now about the rising HIV rates in the MSM communities. Collaborating with MSM communities is a good way forward."
Participants had an active discussion, stressing that public health researchers should play a stronger role in pushing the government towards framing policies to reduce stigma and discrimination.
Ms Revati Chawla, the Sri Lankan co-chair, remarked that leadership at the community and government levels plays an important role in reducing stigma and discrimination. The other co-chair, Mr Aditya Bandyopadhyay from India, highlighted that same sex discriminating laws exist in India, Pakistan, Sri Lanka, Bangladesh, Malaysia and Nepal.
"Legal reforms should be the first step," he commented.
Some of the participants agreed that if international pressure on governments in these countries to reform the laws would be helpful. Collective measures across countries could play an important role in ensuring that governments repeal laws that discriminate and block interventions for HIV prevention work among same-sex communities.
Representatives from the MSM group Bandhu, from Bangladesh, argued that HIV is a good background to start mobilizing work with the MSM communities and partnering with governments. Even in India, which is in the process of drafting the anti-discrimination law, it is being suggested that the idea of a 'safe-area' of working with MSM groups as part of HIV prevention work is being accepted has been identified as part of the way forward.
Ishdeep Kohli-CNS
World Ozone Day (16 September) and our commitments
World Ozone Day (16 September) and our commitments
Vasu Shena Misra
September 16 every year is observed as "World Ozone Day". The celebration of this day is made to pay our homage to the ozone layer, that saves our earth from the harmful ultra-voilet radiation of the Sun.
The life on the Earth , depends on the energy provided by the Sun in the form of various radiations.
* Out of total energy received by the Earth, 35% will be reflected back to the space by the clouds, dust-particles and ice particles present in the atmosphere.
* 14% of the energy , which comes in the form of ultra violet radiation gets absorbed by the ozone layer, thus saving the earth from the harmful effects like over warming of the Earth or diseases like cancer
* 34% of the energy is radiated back from the Earth in the form of direct solar radiation and 17% radiated back from the Earth in the form of terrestrial radiation.
The part of the energy radiated back from the Earth unabsorbed is called "Albedo". Average Albedo ranges between 29% to 34%. Because of the artificial cover provided by the green house gases the Earth surface is unable to reflect the total energy thus gets heated. So lesser the Albedo more will be the temperature on the Earth and viceversa.
Besides this the tarnishing of ozone layer provides the way to ultra violet rays to enter in the Earth's atmosphere which can cause great destruction , catastrophies (famines ,droughts etc.) and diseases like cancer.
The fact that the density of ozone layer reduced considerably making the situation more horrified. (from 1956 to 1970 the density of the ozone layer was nearly 280 to 325 doveson which in 1994 got reduced to mere 94 doveson. The density has been on a decline since then.)
The gases which are responsible for increasing the Earth temperature artificially are called "green house gases " which includes:- carbon di-oxide, methane, chloro floro carbon (CFC), sulphur herxa-floride, nitrous oxide, perflorocarbon. These gases are called green house gases because they increase the temperature in the glass house made artificially to provide higher temperature in colder areas which in turn helps plants that are native to warmer climates, to grow in the hilly areas.
The gases like CFC, or carbon di-oxide have been used in the modern appliances like air-conditioners, refrigerators, fire extinguishers etc. So its looks like where there is more industrialisation there is greater chance of causing harm to the ozone layer.
But the reality is unbelievable and horrifying. Unbelievable because the ozone hole was discovered in the polar regions where there is negligible industrialisation and horrifying because this reality can cause more destruction in less time. The reason behind this reality is the polar stratosphere clouds provide basis for chlorine molecules (present in the CFC) to act freely in the colder regions ( as in polar regions) and in the presence of sunlight in the Antarctica region the chlorine molecules attacks on the ozone molecules (O3) and kill them in the process. More damaging fact is this molecule could have a life of 45 years to 250 years. This is also causing the glaciers to melt.
The recent report of the Inter-governmental Panel On Climate Change (IPCC) states that Earth's temperature has increased by 0.74% in the past hundred years. Its effects are disastrous like:
* Unexpected increase in the sea level that can submerge low lying regions including UK
* The melting of glaciers like Himadri in India, which will first result in floods and then a long lasting drought
* Exposure to ultra-violet rays can up the risk of cancers
* Unexpected climatic changes
USA which pretends itself as a global leader, is also the biggest producer of these harmful green-house gases (nearly 30%) but hasn't signed the "Kyoto Protocal" - a legally binding global treaty for reducing the emission of these gases.
To efficiently deal with this current fearsome situation, we have to take stringent steps. Some are:-
1. Save trees as they save life by inhaling harmful gas carbon-di-oxide.
2. more sustainable behaviour in our daily lives like saving energy at every step.
3. To use technologies which are environment-friendly, like bio-fertilizers.
4. The expansion of carbon trading by the developed countries from developing countries.
5. Globalize the technologies to the under developed nations that supports the climate.
Let us act now before it is too late.
Vasu Shena Misra
(The author is a development activist who did his post-graduation from University of Lucknow. He serves on the CNS board of writers)
Published in
Thai Indian, Bangkok, Thailand
News Track India, Delhi
Bihar and Jharkhand News Service (BJNS)
The Seoul Times, Seoul, South Korea
Khabar Express, Bikaner, Rajasthan
Pakistan Post, Karachi, Pakistan
Central Chronicle, Madhya Pradesh/ Chhattisgarh
My News, Delhi
Assam Times, Guwahati, Assam
Vasu Shena Misra
September 16 every year is observed as "World Ozone Day". The celebration of this day is made to pay our homage to the ozone layer, that saves our earth from the harmful ultra-voilet radiation of the Sun.
The life on the Earth , depends on the energy provided by the Sun in the form of various radiations.
* Out of total energy received by the Earth, 35% will be reflected back to the space by the clouds, dust-particles and ice particles present in the atmosphere.
* 14% of the energy , which comes in the form of ultra violet radiation gets absorbed by the ozone layer, thus saving the earth from the harmful effects like over warming of the Earth or diseases like cancer
* 34% of the energy is radiated back from the Earth in the form of direct solar radiation and 17% radiated back from the Earth in the form of terrestrial radiation.
The part of the energy radiated back from the Earth unabsorbed is called "Albedo". Average Albedo ranges between 29% to 34%. Because of the artificial cover provided by the green house gases the Earth surface is unable to reflect the total energy thus gets heated. So lesser the Albedo more will be the temperature on the Earth and viceversa.
Besides this the tarnishing of ozone layer provides the way to ultra violet rays to enter in the Earth's atmosphere which can cause great destruction , catastrophies (famines ,droughts etc.) and diseases like cancer.
The fact that the density of ozone layer reduced considerably making the situation more horrified. (from 1956 to 1970 the density of the ozone layer was nearly 280 to 325 doveson which in 1994 got reduced to mere 94 doveson. The density has been on a decline since then.)
The gases which are responsible for increasing the Earth temperature artificially are called "green house gases " which includes:- carbon di-oxide, methane, chloro floro carbon (CFC), sulphur herxa-floride, nitrous oxide, perflorocarbon. These gases are called green house gases because they increase the temperature in the glass house made artificially to provide higher temperature in colder areas which in turn helps plants that are native to warmer climates, to grow in the hilly areas.
The gases like CFC, or carbon di-oxide have been used in the modern appliances like air-conditioners, refrigerators, fire extinguishers etc. So its looks like where there is more industrialisation there is greater chance of causing harm to the ozone layer.
But the reality is unbelievable and horrifying. Unbelievable because the ozone hole was discovered in the polar regions where there is negligible industrialisation and horrifying because this reality can cause more destruction in less time. The reason behind this reality is the polar stratosphere clouds provide basis for chlorine molecules (present in the CFC) to act freely in the colder regions ( as in polar regions) and in the presence of sunlight in the Antarctica region the chlorine molecules attacks on the ozone molecules (O3) and kill them in the process. More damaging fact is this molecule could have a life of 45 years to 250 years. This is also causing the glaciers to melt.
The recent report of the Inter-governmental Panel On Climate Change (IPCC) states that Earth's temperature has increased by 0.74% in the past hundred years. Its effects are disastrous like:
* Unexpected increase in the sea level that can submerge low lying regions including UK
* The melting of glaciers like Himadri in India, which will first result in floods and then a long lasting drought
* Exposure to ultra-violet rays can up the risk of cancers
* Unexpected climatic changes
USA which pretends itself as a global leader, is also the biggest producer of these harmful green-house gases (nearly 30%) but hasn't signed the "Kyoto Protocal" - a legally binding global treaty for reducing the emission of these gases.
To efficiently deal with this current fearsome situation, we have to take stringent steps. Some are:-
1. Save trees as they save life by inhaling harmful gas carbon-di-oxide.
2. more sustainable behaviour in our daily lives like saving energy at every step.
3. To use technologies which are environment-friendly, like bio-fertilizers.
4. The expansion of carbon trading by the developed countries from developing countries.
5. Globalize the technologies to the under developed nations that supports the climate.
Let us act now before it is too late.
Vasu Shena Misra
(The author is a development activist who did his post-graduation from University of Lucknow. He serves on the CNS board of writers)
Published in
Thai Indian, Bangkok, Thailand
News Track India, Delhi
Bihar and Jharkhand News Service (BJNS)
The Seoul Times, Seoul, South Korea
Khabar Express, Bikaner, Rajasthan
Pakistan Post, Karachi, Pakistan
Central Chronicle, Madhya Pradesh/ Chhattisgarh
My News, Delhi
Assam Times, Guwahati, Assam
Creating a national enabling environment for AIDS vaccine trials - China Interview with Dr Joan Kaufman
1. HDN: China is an important player in the global effort to find an AIDS vaccine. The second phase I AIDS vaccine trial was launched in 2005 in China. What lessons have been learnt and what have been the results of the trial?
JK: The trial was launched in Nanning, capital of Guangxi Zhuang Autonomous Region, in March 2005 in China. The clinical trial indicated that the vaccine is safe. But there will be further testing with this product to determine its immunological effect and ultimately its efficacy. The vaccine trial was conducted under the guidance of the local provincial CDC in Guangxi; this was a wholly owned Chinese venture. The trial created an understanding around issues relating to safety and recruiting of volunteers for AIDS vaccine trials in China.
2: HDN: Community Advisory Boards (CABs) play a significant role in linking communities and researchers to help facilitate the introduction of education and prevention programs. What is the role of the CAB in China to inform and educate volunteers, and to link the community and science?
JK: The development of AIDS vaccines depends on community participation and advocacy. There is a general enthusiasm for activities such as developing vaccine education materials, organizing ethics committees, and CAB development. While the concept is similar, CABs in China are not necessarily constructed in the same way that CABs are constructed in other countries.
IAVI is in the process of working with its partners in China to foster a more meaningful CAB process. IAVI plans to conduct a CAB assessment in some of the key sites for AIDS vaccine trials. We also plan to hold a workshop later this year regarding CAB efforts in China.
3. HDN: There may be concerns about ethical issues in AIDS vaccine research, such as standards of care, informed consent, risks and benefits to participants and communities, and issues relating to women, adolescents and other vulnerable groups. What steps are in place to ensure that the trials are conducted in an ethical manner and how is the community informed?
JK: We have played a role in vaccine preparedness program in China and we are working with local partners to introduce state of the art international understanding of ethics in AIDS vaccine research to the Chinese research community. We are doing this through a number of different mechanisms. We have translated IAVI's AIDS vaccine literacy materials into Chinese. A number of other publications focusing on ethics in AIDS vaccine research has been translated and widely disseminated to our partner organizations.
A one day satellite meeting on ethics in AIDS vaccine clinical research was held in 2006 at the International Bio-Ethics conference in Beijing, during which we translated a great deal of material for. Chinese speakers.
International experts including Ruth Macklin from Albert Einstein College of Medicine, Ezekiel Emmanuel from the US NIH, and Solomon Benatar from South Africa, discussed issues around the conduct of ethical research related to AIDS vaccines internationally and in China, standards of care and adequate volunteer protection. The report of that meeting will be published shortly.
4. HDN: What is the role of the national government in vaccine research and development? Are there specific political commitments laid out in the by the Chinese government for AIDS vaccine research? Is the level of co-ordination between local governments and healthcare providers satisfactory?
JK: The Chinese government is very committed to AIDS vaccines and they are putting significant resources into research. For example, the new 15 year science and technology development plan includes a large provision for AIDS vaccine research. Some of the provincial governments, such as the Guangdong province, have invested heavily in attracting leading Chinese AIDS vaccine researchers to work locally in state-of-the-art labs
Regarding the link between government and healthcare providers, it is too preliminary right now to say whether it is satisfactory. I can tell you that one identified need in AIDS vaccine clinical trials is for a higher level of understanding among the local healthcare providers. Given the strengthening of the government's response, it seems the link to healthcare providers should be a priority.
5. HDN: The draft blueprint for AIDS Vaccine Preparedness was generated by participants of the CAMS-IAVI AIDS Vaccine Network Meeting in Beijing in February 2006. What are the priority areas of action laid out in the blueprint?
JK: We drafted the blueprint based on the input of the participants in the Network meeting, which included the scientific community members and others working on AIDS vaccine research and vaccine preparedness issues in China.
Based on consensus of the discussion, we laid out an action plan of priority activities. Activities were proposed in five key areas: Community Relations; Stakeholder Outreach; Ethical Issues including Standards of Care; Policy Advocacy; Communicating and Networking. This was made widely available to all the stakeholders, and IAVI is now trying to interest other stakeholders to take on board the recommendations from the blueprint.
There are a number of science groups working on different vaccine candidates, and IAVI has been taking the lead in pushing preparedness issues for the field, such as the CAB process and the national ethics symposium described previously, and a follow-up meeting to provide scientific updates.
IAVI is also supporting a website to provide updates on AIDS vaccine trials in China, and is facilitating translation and dissemination of vaccine literary materials.
Ishdeep Kohli-CNS
JK: The trial was launched in Nanning, capital of Guangxi Zhuang Autonomous Region, in March 2005 in China. The clinical trial indicated that the vaccine is safe. But there will be further testing with this product to determine its immunological effect and ultimately its efficacy. The vaccine trial was conducted under the guidance of the local provincial CDC in Guangxi; this was a wholly owned Chinese venture. The trial created an understanding around issues relating to safety and recruiting of volunteers for AIDS vaccine trials in China.
2: HDN: Community Advisory Boards (CABs) play a significant role in linking communities and researchers to help facilitate the introduction of education and prevention programs. What is the role of the CAB in China to inform and educate volunteers, and to link the community and science?
JK: The development of AIDS vaccines depends on community participation and advocacy. There is a general enthusiasm for activities such as developing vaccine education materials, organizing ethics committees, and CAB development. While the concept is similar, CABs in China are not necessarily constructed in the same way that CABs are constructed in other countries.
IAVI is in the process of working with its partners in China to foster a more meaningful CAB process. IAVI plans to conduct a CAB assessment in some of the key sites for AIDS vaccine trials. We also plan to hold a workshop later this year regarding CAB efforts in China.
3. HDN: There may be concerns about ethical issues in AIDS vaccine research, such as standards of care, informed consent, risks and benefits to participants and communities, and issues relating to women, adolescents and other vulnerable groups. What steps are in place to ensure that the trials are conducted in an ethical manner and how is the community informed?
JK: We have played a role in vaccine preparedness program in China and we are working with local partners to introduce state of the art international understanding of ethics in AIDS vaccine research to the Chinese research community. We are doing this through a number of different mechanisms. We have translated IAVI's AIDS vaccine literacy materials into Chinese. A number of other publications focusing on ethics in AIDS vaccine research has been translated and widely disseminated to our partner organizations.
A one day satellite meeting on ethics in AIDS vaccine clinical research was held in 2006 at the International Bio-Ethics conference in Beijing, during which we translated a great deal of material for. Chinese speakers.
International experts including Ruth Macklin from Albert Einstein College of Medicine, Ezekiel Emmanuel from the US NIH, and Solomon Benatar from South Africa, discussed issues around the conduct of ethical research related to AIDS vaccines internationally and in China, standards of care and adequate volunteer protection. The report of that meeting will be published shortly.
4. HDN: What is the role of the national government in vaccine research and development? Are there specific political commitments laid out in the by the Chinese government for AIDS vaccine research? Is the level of co-ordination between local governments and healthcare providers satisfactory?
JK: The Chinese government is very committed to AIDS vaccines and they are putting significant resources into research. For example, the new 15 year science and technology development plan includes a large provision for AIDS vaccine research. Some of the provincial governments, such as the Guangdong province, have invested heavily in attracting leading Chinese AIDS vaccine researchers to work locally in state-of-the-art labs
Regarding the link between government and healthcare providers, it is too preliminary right now to say whether it is satisfactory. I can tell you that one identified need in AIDS vaccine clinical trials is for a higher level of understanding among the local healthcare providers. Given the strengthening of the government's response, it seems the link to healthcare providers should be a priority.
5. HDN: The draft blueprint for AIDS Vaccine Preparedness was generated by participants of the CAMS-IAVI AIDS Vaccine Network Meeting in Beijing in February 2006. What are the priority areas of action laid out in the blueprint?
JK: We drafted the blueprint based on the input of the participants in the Network meeting, which included the scientific community members and others working on AIDS vaccine research and vaccine preparedness issues in China.
Based on consensus of the discussion, we laid out an action plan of priority activities. Activities were proposed in five key areas: Community Relations; Stakeholder Outreach; Ethical Issues including Standards of Care; Policy Advocacy; Communicating and Networking. This was made widely available to all the stakeholders, and IAVI is now trying to interest other stakeholders to take on board the recommendations from the blueprint.
There are a number of science groups working on different vaccine candidates, and IAVI has been taking the lead in pushing preparedness issues for the field, such as the CAB process and the national ethics symposium described previously, and a follow-up meeting to provide scientific updates.
IAVI is also supporting a website to provide updates on AIDS vaccine trials in China, and is facilitating translation and dissemination of vaccine literary materials.
Ishdeep Kohli-CNS
Youth Leadership on Sexual and Reproductive Health Issues
Nearly half of the world’s population is currently under the age of 25 and across the globe young people face unique challenges that increase their risk of sexual and reproductive health morbidity and mortality. Young people aged 15-24 account for an estimated 45% of new HIV infections world wide and approximately 6000 people are infected with HIV everyday according to the UNAIDS 2008 report on the global AIDS epidemic. The largest proportion of STIs is believed to occur in young people below the age of 25 years. The Youth Forum at the 9th International Congress on AIDS in Asia and the Pacific (ICAAP) Pre-Congress Activity, Bali, Indonesia focused on meaningful and active youth participation to robust Youth Leadership on Sexual and Reproductive Health issues among Asia and the Pacific region.
The Youth Forum being very vibrant and energetic aimed to strengthen the networks of youth organizations and independent youth activists in Asia and the Pacific. The participants identified and exchanged views on key and emerging issues of concern related to young people. Knowledge, experience and skills were shared among the youth forum delegates. Discussions included better ways to manage and implement youth programs in the future. The forum ensured that young people’s voices, needs and issues will be heard in the Congress and followed after it. These deliberations among the participants will be presented as comprehensive recommendations for governments, UN agencies, non-governmental and international organizations. Skills building training were provided for the youth to be empowered from each others diversity and similarity.
It becomes critical to address the sexual and reproductive health and rights (SRHR) of young people in order to achieve universal access to reproductive health (RH). This being target 5.B of the Millennium Development Goals (MDGs), which is: “Achieve by 2015, universal access to reproductive health”. Access to sexual and reproductive health is a human right, it is a right that all people, including young people are entitled to. The four official indicators for MDG Target 5.B are contraceptive prevalence, adolescent birth rate, antenatal care coverage and unmet need for family planning. These are all important factors, but achieving universal access to RH for young people requires a broader more comprehensive approach to address social, economic, political, environmental and biological determinants of SRH.
Some other important aspects of Universal Access to young people are ensuring access to youth friendly SRH services that include prevention, diagnosis and treatment of HIV and STIs. Comprehensive sexuality education to be provided in formal and informal educational settings that include medically accurate information about sexuality, reproductive, human development, contraceptive methods, STIs and HIV, relationships, decision-making, skills-building to resist social/peer pressure, sexual orientation, body-image and gender relations. Ensuring that youth have access to a variety of modern contraceptive methods and safe abortion services Elimination of harmful practices and gender based violence through policies, programmes and laws that address the social, economic and cultural practices that lead to these practices. Making modifications to the health systems to facilitate the integration SRH, family planning, HIV and STI services. Providing services in a non-discriminatory way to marginalized young people, including YPLWHA, sex workers, injecting drug users, refugees, internally displaced people and undocumented migrants. Young people need to meaningfully participate in the design, delivery and evaluation of SRH interventions.
To achieve Universal Access for sexual and reproductive health and rights to young people it is necessary to foster an enabling environment, with sustaining commitment from governments, community leaders, young people and donors. The right to SRH is clearly articulated in the International Conference on Population and Development (ICPD) Programme of Action (PoA), which was endorsed by 179 UN member states in 1994. The ICPD PoA remains just as relevant today as it did 15 years ago. The PoA’s focus on a rights-based approach to population, health, environment and development issues is pre-requisite to achieve the broader goals outlined in the MDG framework.
Ishdeep Kohli-CNS
The Youth Forum being very vibrant and energetic aimed to strengthen the networks of youth organizations and independent youth activists in Asia and the Pacific. The participants identified and exchanged views on key and emerging issues of concern related to young people. Knowledge, experience and skills were shared among the youth forum delegates. Discussions included better ways to manage and implement youth programs in the future. The forum ensured that young people’s voices, needs and issues will be heard in the Congress and followed after it. These deliberations among the participants will be presented as comprehensive recommendations for governments, UN agencies, non-governmental and international organizations. Skills building training were provided for the youth to be empowered from each others diversity and similarity.
It becomes critical to address the sexual and reproductive health and rights (SRHR) of young people in order to achieve universal access to reproductive health (RH). This being target 5.B of the Millennium Development Goals (MDGs), which is: “Achieve by 2015, universal access to reproductive health”. Access to sexual and reproductive health is a human right, it is a right that all people, including young people are entitled to. The four official indicators for MDG Target 5.B are contraceptive prevalence, adolescent birth rate, antenatal care coverage and unmet need for family planning. These are all important factors, but achieving universal access to RH for young people requires a broader more comprehensive approach to address social, economic, political, environmental and biological determinants of SRH.
Some other important aspects of Universal Access to young people are ensuring access to youth friendly SRH services that include prevention, diagnosis and treatment of HIV and STIs. Comprehensive sexuality education to be provided in formal and informal educational settings that include medically accurate information about sexuality, reproductive, human development, contraceptive methods, STIs and HIV, relationships, decision-making, skills-building to resist social/peer pressure, sexual orientation, body-image and gender relations. Ensuring that youth have access to a variety of modern contraceptive methods and safe abortion services Elimination of harmful practices and gender based violence through policies, programmes and laws that address the social, economic and cultural practices that lead to these practices. Making modifications to the health systems to facilitate the integration SRH, family planning, HIV and STI services. Providing services in a non-discriminatory way to marginalized young people, including YPLWHA, sex workers, injecting drug users, refugees, internally displaced people and undocumented migrants. Young people need to meaningfully participate in the design, delivery and evaluation of SRH interventions.
To achieve Universal Access for sexual and reproductive health and rights to young people it is necessary to foster an enabling environment, with sustaining commitment from governments, community leaders, young people and donors. The right to SRH is clearly articulated in the International Conference on Population and Development (ICPD) Programme of Action (PoA), which was endorsed by 179 UN member states in 1994. The ICPD PoA remains just as relevant today as it did 15 years ago. The PoA’s focus on a rights-based approach to population, health, environment and development issues is pre-requisite to achieve the broader goals outlined in the MDG framework.
Ishdeep Kohli-CNS
Effective Community Involvement in HIV/AIDS Response
Nearly five million people are living with HIV in Asia with 440,000 people acquiring the infection in 2007 and 300,000 dying from AIDS related illness in the same year. If the current rate of transmission continues an additional eight million people will become newly infected by 2020, costing the region $ 2 billion annually and pushing 6 million people into poverty. HIV could emerge as the leading cause of death among 15 to 44 year olds. However Asian nations could avert increases in infections and death and save millions of people from poverty with high-impact interventions, such as HIV prevention programmes focused on key populations and increased antiretroviral treatment. These were among the findings of the "Redefining AIDS in Asia – Crafting an Effective Response" report published by the Commission on AIDS in Asia (CAA). The report believes that governments in Asia have the potential to make the ambitious international targets – 2001 Declaration of Commitment on HIV/AIDS as well as Millennium Development Goal 6 to halt and reverse the epidemic by 2015 a reality if they take the decisive steps set out in this new report.
The independent Commission on AIDS in Asia was created in June 2006 to give an opportunity to look at the unfolding realities of the HIV epidemic in Asia from a wide socioeconomic perspective reaching beyond the public health context. In order to deliver on this mandate, nine leading economists, scientists, civil society representatives and policy makers from across the region were appointed to the Commission, led by Professor C. Rangarajan, Chief Economic Adviser to the Prime Minister of India. While recognizing that epidemics vary considerably from country to country across Asia, the report highlights certain shared characteristics. Epidemics centre mainly around behaviours of unprotected paid sex, use of contaminated needles and syringes by people who inject drugs, and unprotected sex between men. By pragmatically focusing prevention programmes on key populations – commercial sex workers and their clients, intravenous drug users and men having sex with other men, the commission suggested a considerable impact could be made by governments in halting and reversing the number of new infections across this region.
Noting that stigma against HIV patients remains a major issue in Asia’s health care systems, the commission recommended a more meaningful role for civil society and community-based initiatives. Community organizations of Injecting drug users, sex workers, MSM populations and HIV positive people should be involved and engaged in planning and service delivery. National HIV responses tend to be strengthened when community based organizations are able to participate in policy development, programme planning, and implementation. Community participation is essential for reaching people involved in risky behavior with information and services they are likely to trust. Community participation is the key to understand and influence the contexts in which risk occurs, and to help create supportive environments for risk reduction. This is vital in understanding the issues that affect these populations, and to achieve overall transparency and accountability in the HIV response. Enabling environments need to be created to facilitate services and remove obstacles for most at risk groups.
The report called for political, religious, business and local community leaders to speak out against discrimination, repeal laws that discriminated against men who have sex with men, support HIV-prevention services for sex workers and decriminalize intravenous drug use. Interventions should incorporate elements that address some of the other pressing, subjective needs of beneficiaries such as child care for sex workers, legal support for dealing with police harassment, safe spaces that offer shelter against violence, hygiene and medical facilities for street-based sex workers and IDUs. Further vast social security networks must be created with special attention on vulnerable groups, such as women, children and orphans. Necessary support should be provided for setting up and running local community organizations. National programme budgets must include funding for these activities.
The commission stressed that existing resources are not only inadequate but are currently not being spent on priority interventions that produce an impact. At present, donors provided the lion’s share of funding for such programmes, but Governments really needed to invest more. A focused prevention package between 2008 and 2020 will raise condom use among sex workers to over 80%; halve needle sharing among IDUs; a reduction in cumulative infections by 5 million, a reduction in the number of people living with HIV in 2020 by 3.1 million and a reduction in the number of AIDS related deaths by 40%.
Countries in Asia have the resources, technology and organizational capacity to vastly scale up their response, but strong political will, Government leadership and active community involvement of key populations are lacking. Community and civil society involvement should be ensured at all stages of policy, programme design, implementation and monitoring and evaluation. Communities and non-governmental organizations must take the Commission’s report to their respective Governments to demand the legal protection, policy space and the action necessary to stem the epidemic.
Ishdeep Kohli-CNS
The independent Commission on AIDS in Asia was created in June 2006 to give an opportunity to look at the unfolding realities of the HIV epidemic in Asia from a wide socioeconomic perspective reaching beyond the public health context. In order to deliver on this mandate, nine leading economists, scientists, civil society representatives and policy makers from across the region were appointed to the Commission, led by Professor C. Rangarajan, Chief Economic Adviser to the Prime Minister of India. While recognizing that epidemics vary considerably from country to country across Asia, the report highlights certain shared characteristics. Epidemics centre mainly around behaviours of unprotected paid sex, use of contaminated needles and syringes by people who inject drugs, and unprotected sex between men. By pragmatically focusing prevention programmes on key populations – commercial sex workers and their clients, intravenous drug users and men having sex with other men, the commission suggested a considerable impact could be made by governments in halting and reversing the number of new infections across this region.
Noting that stigma against HIV patients remains a major issue in Asia’s health care systems, the commission recommended a more meaningful role for civil society and community-based initiatives. Community organizations of Injecting drug users, sex workers, MSM populations and HIV positive people should be involved and engaged in planning and service delivery. National HIV responses tend to be strengthened when community based organizations are able to participate in policy development, programme planning, and implementation. Community participation is essential for reaching people involved in risky behavior with information and services they are likely to trust. Community participation is the key to understand and influence the contexts in which risk occurs, and to help create supportive environments for risk reduction. This is vital in understanding the issues that affect these populations, and to achieve overall transparency and accountability in the HIV response. Enabling environments need to be created to facilitate services and remove obstacles for most at risk groups.
The report called for political, religious, business and local community leaders to speak out against discrimination, repeal laws that discriminated against men who have sex with men, support HIV-prevention services for sex workers and decriminalize intravenous drug use. Interventions should incorporate elements that address some of the other pressing, subjective needs of beneficiaries such as child care for sex workers, legal support for dealing with police harassment, safe spaces that offer shelter against violence, hygiene and medical facilities for street-based sex workers and IDUs. Further vast social security networks must be created with special attention on vulnerable groups, such as women, children and orphans. Necessary support should be provided for setting up and running local community organizations. National programme budgets must include funding for these activities.
The commission stressed that existing resources are not only inadequate but are currently not being spent on priority interventions that produce an impact. At present, donors provided the lion’s share of funding for such programmes, but Governments really needed to invest more. A focused prevention package between 2008 and 2020 will raise condom use among sex workers to over 80%; halve needle sharing among IDUs; a reduction in cumulative infections by 5 million, a reduction in the number of people living with HIV in 2020 by 3.1 million and a reduction in the number of AIDS related deaths by 40%.
Countries in Asia have the resources, technology and organizational capacity to vastly scale up their response, but strong political will, Government leadership and active community involvement of key populations are lacking. Community and civil society involvement should be ensured at all stages of policy, programme design, implementation and monitoring and evaluation. Communities and non-governmental organizations must take the Commission’s report to their respective Governments to demand the legal protection, policy space and the action necessary to stem the epidemic.
Ishdeep Kohli-CNS
South Asia Regional Workshop On the Prevention of HIV Related to Drug Use
Photo by sassenfrazz17th-18th, March 09 - Kathmandu, Nepal
Response Beyond Borders – Over 100 delegates present from the SAARC countries, Iran and Afghanistan are attending the South Asian Workshop on poverty, drug use and HIV. The aim of the South Asian workshop is to bring together parliamentarians, civil society organisations and affected populations (including drug users) to review the challenges to be faced in affecting policy change, reducing stigma and ensuring effective action and interventions to address the gaps in HIV Prevention among risk populations. “HIV does not respect borders so we need to build alliances which go beyond country perimeters”, said Tariq Zafar, the Chair of the workshop. The action plans developed will build on current capacity, identify gaps and respond co-operatively across borders.
With its young democracies and political turbulence the region is all the more vulnerable due to its proximity to the drug-producing Golden Triangle and Golden Crescent regions. Added to this the existing HIV epidemic is adding pressure to the already overburdened health systems. The responses to HIV have seen significant involvement of affected communities, with the notable exception of drug users who are both marginalised and stigmatised. “The position of women drug users is especially neglected, we are a forgotten people”, says Parina Subba, Programme Director of Dristi Nepal. If societies do not address the concentrated epidemic among drug users, the burden of disease will reach breaking point.
This workshop is a follow-up to The First Asian Consultation on the prevention of HIV related to Drug Use, which was held in Goa, India in January 2008. The Goa Consultation recommended that in order to respond effectively to the HIV epidemic, policies that effectively address the health risks associated with drug use should be introduced in all countries. Measures that reduce the stigma and discrimination experienced by drug users and people affected by HIV, should also be taken, to enable provision of effective treatment.
As an outcome of the Goa consultation, three workshops are organised to develop more detailed action plans for specific regions – South, Central and South Eastern Asia. The South East Asia workshop was held in Phnom Penh Cambodia on 8-9, October 2008. The Central Asian workshop takes place in early summer 2009.
The South Asia workshop will focus on the following:
1. Highlight the Continuum of Care and Services and identify capacity, gaps and opportunities for collaborative growth across the region.
2. Identify, review and respond to challenges faced in providing services to emerging populations i.e. wives of drug users, women drug users and young people.
3. Identify, discuss and develop an action plan to ameliorate the criminalisation and incarceration of Drug Users in prisons and custodial settings.
4. Effectively respond to the hepatitis C co-infection epidemic among drug users in Asia.
5. Support parliamentarians in their leadership in introducing enabling policies and achieving a balance between human rights, access to health and law enforcement in Asia and provide parliamentarians and activists with evidence to support their campaigns for change.
Ishdeep Kohli-CNS
Response Beyond Borders – Over 100 delegates present from the SAARC countries, Iran and Afghanistan are attending the South Asian Workshop on poverty, drug use and HIV. The aim of the South Asian workshop is to bring together parliamentarians, civil society organisations and affected populations (including drug users) to review the challenges to be faced in affecting policy change, reducing stigma and ensuring effective action and interventions to address the gaps in HIV Prevention among risk populations. “HIV does not respect borders so we need to build alliances which go beyond country perimeters”, said Tariq Zafar, the Chair of the workshop. The action plans developed will build on current capacity, identify gaps and respond co-operatively across borders.
With its young democracies and political turbulence the region is all the more vulnerable due to its proximity to the drug-producing Golden Triangle and Golden Crescent regions. Added to this the existing HIV epidemic is adding pressure to the already overburdened health systems. The responses to HIV have seen significant involvement of affected communities, with the notable exception of drug users who are both marginalised and stigmatised. “The position of women drug users is especially neglected, we are a forgotten people”, says Parina Subba, Programme Director of Dristi Nepal. If societies do not address the concentrated epidemic among drug users, the burden of disease will reach breaking point.
This workshop is a follow-up to The First Asian Consultation on the prevention of HIV related to Drug Use, which was held in Goa, India in January 2008. The Goa Consultation recommended that in order to respond effectively to the HIV epidemic, policies that effectively address the health risks associated with drug use should be introduced in all countries. Measures that reduce the stigma and discrimination experienced by drug users and people affected by HIV, should also be taken, to enable provision of effective treatment.
As an outcome of the Goa consultation, three workshops are organised to develop more detailed action plans for specific regions – South, Central and South Eastern Asia. The South East Asia workshop was held in Phnom Penh Cambodia on 8-9, October 2008. The Central Asian workshop takes place in early summer 2009.
The South Asia workshop will focus on the following:
1. Highlight the Continuum of Care and Services and identify capacity, gaps and opportunities for collaborative growth across the region.
2. Identify, review and respond to challenges faced in providing services to emerging populations i.e. wives of drug users, women drug users and young people.
3. Identify, discuss and develop an action plan to ameliorate the criminalisation and incarceration of Drug Users in prisons and custodial settings.
4. Effectively respond to the hepatitis C co-infection epidemic among drug users in Asia.
5. Support parliamentarians in their leadership in introducing enabling policies and achieving a balance between human rights, access to health and law enforcement in Asia and provide parliamentarians and activists with evidence to support their campaigns for change.
Ishdeep Kohli-CNS
Living with the HIV Virus - Challenges for Children
Photo by blmurchAmong the estimated 2.5 million people in India living with HIV/AIDS, 70,000 are children under 15 years old (UNAIDS 2007). Every year about 21,000 children are infected through mother to child transmission and thousands of children are affected because their parents are HIV positive.
Children continue to be ignored and discriminated against in India's fight against HIV. A study carried out by the Population Council of India in collaboration with the Social Awareness Services Organization (SASO), Asha Foundation and Freedom Foundation in three high prevalence states Manipur, Karnataka and Andhra Pradesh, found that less than a fifth of the children had been diagnosed with HIV infection before 18 months of age. The study found that most of the children are diagnosed for HIV when they are 30 months or older thus creating a barrier to accessing care and treatment for HIV infected children. Many children are often tested when one or both parents report positive.
Among the key findings of the study were the difficulties faced by a third of the caregivers in getting a confirmed HIV diagnosis and getting referred to the treatment centres. The study also states that disclosure of HIV status to children is low and the reasons for not informing the children varied from ‘the child being too young to understand’ to ‘fear that the child would tell others in the community leading to stigma and discrimination by society.’
The late diagnosis of the positive status of children indicates a delay in treatment. Late testing also means delayed initiation of co-trimoxazole prophylaxis which prevents life threatening opportunistic infections in infancy. It also means there is a gap with regard to PPTCT (prevention of parent to child transmission) as an entry point for diagnosis and access to treatment. Even the 21,000 children that are born with HIV each year through mother-to-child transmission is due to lack of services including access to preventive medication. Without treatment, these newborns stand an estimated thirty percent chance of becoming infected during the mother’s pregnancy, labor or through breastfeeding after six months. There is effective treatment available, but this is not reaching all women and children who need it. Dr Vaswani, consultant UNICEF, MDACS (Mumbai District AIDS Society), states that even for those children accessing treatment difficulties exist for the caregivers in getting transport to the ART centres across the city for treatment and care.
HIV positive children face discrimination in their everyday life. This stigma and discrimination practiced by the general public against the HIV positive children denies their access to education, health and many other crucial government provided services. Caregivers at the Ashray center for children in Mumbai mentioned that stigma and discrimination continue to be the major challenge in obtaining school admissions for HIV infected and affected children. It is clear from various studies in India, that HIV positive children who are being denied an education based on their HIV status are due to lack of knowledge or awareness about how HIV/AIDS spreads in the general population.
The number of children who are positive and affected by HIV and AIDS, including those who have to head households, care for infected parents and siblings and lose their childhood, is increasing. With every passing day the number of street children and those sold into the sex trade is also increasing, making these children more susceptible to HIV. Now with a large number of perinatally infected children approaching adolescence, issues of adherence, substance use, sexuality, secrecy, peer relationships, vocational training and guidance and planning for the future have become increasingly important.
Children have the right to love, care, affection and protection against exploitation. Providing care and support for those who are infected results in realization of protecting their rights – which is enshrined in India’s ratification of the UN Convention on the Rights of the Child. HIV/AIDS affected children have many of the same needs as other children – good nutrition, exercise, education, love and affection. Beyond these, affected children whether orphaned or not, may have special needs such as counseling, medical treatment, vocational training and encouragement of self-reliance. Legal support may be required in fighting discrimination in schools and medical care settings, also to help with guardianship issues and inheritance disputes. A child’s development is dependent on all of these needs and each must be adequately addressed.
What we need to understand is that -- HIV is a problem for the whole society and the solutions must have the involvement, support and effort of the whole community. Children affected by AIDS need adults (each and every one of us) to voice and protect their rights. Multiple partnerships and collaborations are needed at all levels, with Governments and NGOs, to International Agencies and Donors working together with Health care providers, Nurses, Pediatricians, Religious leaders, Faith communities, Pharmaceutical companies, Industrial houses, Child Advocates, Academic and Research institutions, Media, and legal and human rights activists. Coordination and cooperation through an Intersectoral approach with government commitment at the highest level.
For Children affected and infected by HIV/AIDS the approach is of an emergency. We must put care and protection of these children high on the national HIV/AIDS agenda.
Ishdeep Kohli-CNS
Children continue to be ignored and discriminated against in India's fight against HIV. A study carried out by the Population Council of India in collaboration with the Social Awareness Services Organization (SASO), Asha Foundation and Freedom Foundation in three high prevalence states Manipur, Karnataka and Andhra Pradesh, found that less than a fifth of the children had been diagnosed with HIV infection before 18 months of age. The study found that most of the children are diagnosed for HIV when they are 30 months or older thus creating a barrier to accessing care and treatment for HIV infected children. Many children are often tested when one or both parents report positive.
Among the key findings of the study were the difficulties faced by a third of the caregivers in getting a confirmed HIV diagnosis and getting referred to the treatment centres. The study also states that disclosure of HIV status to children is low and the reasons for not informing the children varied from ‘the child being too young to understand’ to ‘fear that the child would tell others in the community leading to stigma and discrimination by society.’
The late diagnosis of the positive status of children indicates a delay in treatment. Late testing also means delayed initiation of co-trimoxazole prophylaxis which prevents life threatening opportunistic infections in infancy. It also means there is a gap with regard to PPTCT (prevention of parent to child transmission) as an entry point for diagnosis and access to treatment. Even the 21,000 children that are born with HIV each year through mother-to-child transmission is due to lack of services including access to preventive medication. Without treatment, these newborns stand an estimated thirty percent chance of becoming infected during the mother’s pregnancy, labor or through breastfeeding after six months. There is effective treatment available, but this is not reaching all women and children who need it. Dr Vaswani, consultant UNICEF, MDACS (Mumbai District AIDS Society), states that even for those children accessing treatment difficulties exist for the caregivers in getting transport to the ART centres across the city for treatment and care.
HIV positive children face discrimination in their everyday life. This stigma and discrimination practiced by the general public against the HIV positive children denies their access to education, health and many other crucial government provided services. Caregivers at the Ashray center for children in Mumbai mentioned that stigma and discrimination continue to be the major challenge in obtaining school admissions for HIV infected and affected children. It is clear from various studies in India, that HIV positive children who are being denied an education based on their HIV status are due to lack of knowledge or awareness about how HIV/AIDS spreads in the general population.
The number of children who are positive and affected by HIV and AIDS, including those who have to head households, care for infected parents and siblings and lose their childhood, is increasing. With every passing day the number of street children and those sold into the sex trade is also increasing, making these children more susceptible to HIV. Now with a large number of perinatally infected children approaching adolescence, issues of adherence, substance use, sexuality, secrecy, peer relationships, vocational training and guidance and planning for the future have become increasingly important.
Children have the right to love, care, affection and protection against exploitation. Providing care and support for those who are infected results in realization of protecting their rights – which is enshrined in India’s ratification of the UN Convention on the Rights of the Child. HIV/AIDS affected children have many of the same needs as other children – good nutrition, exercise, education, love and affection. Beyond these, affected children whether orphaned or not, may have special needs such as counseling, medical treatment, vocational training and encouragement of self-reliance. Legal support may be required in fighting discrimination in schools and medical care settings, also to help with guardianship issues and inheritance disputes. A child’s development is dependent on all of these needs and each must be adequately addressed.
What we need to understand is that -- HIV is a problem for the whole society and the solutions must have the involvement, support and effort of the whole community. Children affected by AIDS need adults (each and every one of us) to voice and protect their rights. Multiple partnerships and collaborations are needed at all levels, with Governments and NGOs, to International Agencies and Donors working together with Health care providers, Nurses, Pediatricians, Religious leaders, Faith communities, Pharmaceutical companies, Industrial houses, Child Advocates, Academic and Research institutions, Media, and legal and human rights activists. Coordination and cooperation through an Intersectoral approach with government commitment at the highest level.
For Children affected and infected by HIV/AIDS the approach is of an emergency. We must put care and protection of these children high on the national HIV/AIDS agenda.
Ishdeep Kohli-CNS
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