CNS: April 2012

You can manage your asthma!

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

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

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

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

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

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

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

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

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

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

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

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

Fly Single And Sleep Double

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

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

Special on World Health Day

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

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

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