CNS: December 2012

Tribute to Braveheart

As her violent demise stuns us into silence, and as we hang our head in shame, it also awakens our dead instincts into a quiet but determined uprising, demanding what should have been rightfully ours—a respectable place in society where the dignity of women is not violated day in and day out. We do not want lip sympathy from our impotent leaders, but concrete actions. What happened with the doughty woman (and continues to happen to scores of women every day in some part of the country or the other) must end once for all.

[हिंदी] Gender-sensitive judiciary and police administration, stronger laws, faster legal process to give judgement within six months, protection and social support for those sexually violated, were among some of the key demands getting the mandate of key discussants at the open forum on 'what needs to change in our laws in cases of sexual violence' organized at Ambedkar Mahasabha, opposite Lucknow Vidhan Sabha, by Humsafar - Support Centre for Women, National Alliance of People's Movements (NAPM), Asha Parivar, Lok Rajniti Manch and Socialist Party.

It is said that women who are addicted to cigarettes and other tobacco products are at increased health risks by reason of their biology. Since women biologically conceive and produce children, a coating of tar on their lungs, poisoning due to carbon monoxide or arsenic, or the chemicals that go into the making of a cigarette or a bidi, are more dangerous for them than for men. Pregnant women, who smoke, pass the carbon monoxide in their own blood directly into their unborn babies. Mothers who breastfeed their babies directly pass the nicotine and carbon monoxide to their suckling infants.

[हिंदी] The indefinite fast and demonstration in support of demands of farmers-labourers organized by Socialist Party jointly with National Alliance of People's Movements (NAPM), Lok Rajniti Manch, Hind Mazdoor Sabha, Rihai Manch, Special Teachers and Guardians Association, entered its fourth day today. Two social activists are on an indefinite fast: Dr Sandeep Pandey, Magsaysay Awardee and Vice President of Socialist Party; and Anil Mishra, social activist.

Photo credit: Rajeev Yadav

[हिंदी] Noted social activist and Magsaysay Awardee Dr Sandeep Pandey began an indefinite fast in support of demands of farmers and labourers of unorganized sector and underprivileged children on Sunday, 23rd December 2012 in Lucknow opposite Vidhan Sabha. One of the key demands is: Rs 440 daily minimum wage for labourers of unorganized sector. In last 20 years, although the wage of service class has gone up by twenty times, the wage of labourers of unorganized sector has hardly risen by three times. Just like the labourer is unable to get reasonable wage, the farmers too are unable to get the minimum support price for their crop.

A consultation, to draft a policy to correct the trend of declining sex ratio for the Indian state of Uttar Pradesh was organized by ActionAid and Saajhi Duniya. UP has a dismal sex ratio of 908 and a child sex ratio of 899, which is even worse than the corresponding national average of 940 and 914 respectively. "In UP the child sex ratio is continuously declining. There is a 17 point fall in the child sex ratio in the decade 2001-2011," said Professor (Dr) Roop Rekha Verma from Saajhi Duniya, who is also the former Vice Chancellor of Lucknow University. The main driver is undoubtedly deeply entrenched gender-based inequalities, and obvious culprit seem to be the healthcare personnel who perform sex selective abortions, in gross violation of the Pre conception and Pre Natal Diagnostic Techniques (Prohibition of Sex selection) Act (PCPNDT Act), and yet remain scot-free.

Tuberculosis (TB) is a leading killer of children, particularly in resource-poor settings, though the true size of the problem is unknown. Estimates of the number of children who contract TB annually range from 300,000 up to 1 million; more than 60,000 die each year but many deaths go unreported, especially in high-burden TB countries. Yet the the current TB drug regimens to treat them are inadequate. In 2010, the World Health Organization (WHO) revised its recommended dosages for first-line pediatric TB drugs. However, till today there are no TB drugs for children in the correct dosage forms. With a view to reshape market forces, and catalyze development to improve treatment and reduce mortality among children with TB, UNITAID has provided the Global Alliance for TB Drug Development (TB Alliance) a three-year grant to accelerate the availability of properly formulated pediatric TB regimens.

Even as the Delhi gang rape victim—a 23-year-old paramedical student--who was gang raped, tortured and thrown out from inside a moving bus on the night of 18th December, 2012--- lies in a critical condition on a ventilator support system and battles for her life at the Safdarjung hospital:
- TV channels vie with each other in crying hoarse over the condemnable incident;
- Member of Parliament Jaya Bachchan sheds tears in the Rajya Sabha for the girl;

In 2004, when the International Union Against Tuberculosis and Lung Disease (The Union) launched the Programme of Integrated HIV Care for TB Patients Living with HIV/AIDS (IHC), TB was already a leading killer of people with HIV, but antiretroviral treatment (ART) had just started to become available through the public health system in sub-Saharan Africa. The implementation of coordinated care was therefore in its infancy, and the opportunities for and challenges of treating the ‘two diseases, one patient’ within one health system were still being explored.

The Global Stop-TB eForum facilitated by Citizen News Service - CNS looked back at its archives to enlist key issues raised related to tuberculosis (TB) and online consultations it hosted in the year 2012. Over 1600 members from over 40 countries were part of this online information exchange with over 200 of them having their say in form of commentaries, in-depth articles, case studies, or other input.

During the last three decades, the World Health Assembly (WHA) agreed upon two interventions, which can have far reaching and lasting impacts on global health, if implemented (and not merely endorsed) in their true spirit and letter by the member states. The first one is The International Code of Marketing of Breastmilk Substitutes (The Code), which is an international public health recommendation to regulate the marketing of breastmilk substitutes.

This is one of the main findings of the Global Burden of Disease Study 2010 (GBD 2010) - a collaborative project conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington to quantify the trends in the world’s health problems. The report will be formally released at the Royal Society in London on Dec. 14 and published in The Lancet, which has dedicated an entire triple issue to this massive systematic scientific study which was conducted by 486 authors from 50 countries, including 26 low- and middle-income countries.

Globally, nearly 7 million children under the age of 5 years die every year--two thirds of them before celebrating even their first birthday. Most of these deaths are due to preventable causes like pneumonia, diarrhea and new born respiratory infections and one third of all the under 5 deaths are related to maternal and child under nutrition. A simple intervention comprising early initiation (within the first hour of birth) of breastfeeding, that is continued exclusively for the first six months of life, and later supplemented by complementary feeding, can reduce neonatal mortality by as much as 20%. Yet more than 60% of the world’s infants are deprived of exclusive breastfeeding.

….to protect every feeding mother and her infant from man-made milk as babies need only the Mom-made one. This was the theme of the 1st World breastfeeding Conference 2012 which was hosted jointly in Delhi by the Breastfeeding Promotion Network of India (BPNI), International Baby Food Action Network (IBFAN), and World Alliance for Breastfeeding Action (WABA), in partnership with the Ministry of Women and Child Development, and the Ministry of Health and Family Welfare.

"Getting to zero: Zero new HIV infections. Zero discrimination. Zero AIDS related deaths," is the theme for World AIDS Days between 2011 and 2015, in line with a new global vision being spearheaded by UNAIDS. Whether all countries, regardless of the size of their epidemic and level of development, will achieve this target is another issue all together. However, countries around the world are trying to work out ways of achieving the UNAIDS vision.

To increase issue-focussed reporting on tuberculosis, HIV and lung health in lead up to, during and post 43rd Union World Conference on Lung Health in Kuala Lumpur, Malaysia, the Citizen News Service - CNS was engaged in a range of communication initiatives around this event. Voices of affected communities were in the centre of what CNS did around this conference.

A lot has been bloated about Gujarat’s outstanding economic performance during Narendra Modi’s Chief Minister-ship. Many educated people believe in it too. By looking at the growth of the Net Domestic Product in the past five years, I show that this is a myth rather than reality. Several other states like Bihar, Haryana, Andhra Pradesh and Maharashtra have performed better than Gujarat. By looking at the whole picture, Gujarat’s performance on economic growth relative to other states can only be labeled as above-average. It cannot be called outstanding or spectacular by any yardstick.

As the rich countries are still recovering from the economic depression, health financing is surely one of the casualties. Everyone rightly wants most value for every penny spent and tuberculosis care and control is one of the smart investments countries can make when purse strings tighten. That is why perhaps the Stop TB Partnership has come up with an Operational Strategy for next three years (2013-2015) on how to implement the Global Plan to Stop TB by 2015 end with given human and financial resources.

Dr Manoon Leechawengwong, is the chairman of the Drug Resistant TB Research Fund at Thailand's Siriraj Foundation and is also the Immediate Past President of Thai AIDS Society-- His foundation is under the patronage of the King’s sister--The Royal Highness Princess Galyani Vadhana Krom Luang Naradhiwas Rajanagarindra. He recently spoke to Citizen News Service (CNS) in Bangkok about the rising problem of multidrug-resistant TB (MDR-TB) in Thailand.

An unregulated and greedy private sector and an inefficient and under- funded public sector in India generously allows its patients to choose between the devil and the deep seas. According to the National Family Health Survey-3, nearly two-thirds of all households (70% in urban and 63% in rural areas) in India generally seek health care from the private medical sector, while only one-third of households use the public medical sector. The most common reason given for not using public sector health care facilities is poor quality of the service, followed by non-availability of a facility nearby, long waiting time, and inconvenient hours of operation. This is a clear indication that India's public health delivery infrastructure fails to protect the interests of vulnerable groups.

Well, perhaps yes. While talking to Citizen News Service - CNS at the 43rd Union World Conference on Lung Health in Kuala Lumpur Mark Harrington, Executive Director of Treatment Action Group (TAG), wondered why we are doing better in responding to HIV, which was discovered only in 1981 and for which there was no effective treatment until 1996, while we are losing the battle against TB which was discovered in 1882 and the first drugs for it came in 1948. He rued the fact that we are falling short of meeting the targets for controlling TB and reducing mortality from TB by 50% by 2015 as compared to 1990.”

A world without asthma is the ultimate vision of the Global Asthma Network (GAN), launched last week at the University of Auckland. The network aims to improve care for people with asthma around the world. Its work will range from research into the causes of asthma to improving access to essential medicines.

(First Published in Deccan Herald)
Anti -TB activists at the recently concluded 43rd Union World Conference on Lung Health held in Kuala Lumpur made strident demands for getting to zero. For a post 2015 (MDG goals) strategy, they demanded zero new infections of TB, zero deaths from TB and zero stigma. At the other end of the scale were the doctors, scientists and academicians, who made very cautious commitments and advocated for the setting of realistic targets for TB control post 2015. The situation raises questions. Is asking for zero an unreasonable demand, especially for a disease such as TB which has been among us for as long as civilisation itself? There’s been very little progress down the years on new prevention and diagnosis tools, and treatment options.