CNS: April 2013

Are we doing enough to protect right to clean air?

Bobby Ramakant - CNS
Despite overwhelming evidence from around the world on positive health benefits of enforcing smoke-free policies, countries in South and South-East Asia are yet to achieve desired enforcement of smoke-free laws. More political will and strategic programming are key elements of good smoke-free programmes. At the recently concluded 4th Union Asia Pacific Region Conference on Lung Health (APRC 2013) in Hanoi, Viet Nam, countries were appealed to strictly enforce smoke-free laws on the ground and maximize potential public health outcomes.

Kulsum Mustafa
Nautanwa (Maharajganj district in Uttar Pradesh): Statistics never lie - they only help unravel some harsh truths. Like many social indicators in Maharajganj district only confirm that this district is one of the most undesired places for girls to live in. While 73.6 per cent of females here marry before the legal age of 18 years, the female literacy rate is a mere 28 per cent. One can find a child bride in almost every second home. While poverty, human trafficking, low birth registrations are some of the other major issues which the residents are battling with, child marriage undoubtedly tops all these concerns.

Dr AK Varma, AIMS, Kochi

Shobha Shukla - CNS
Today, in India, there are more than 63 million people living with diabetes, second only to China, as per the latest 5th Diabetes Atlas statistics. Being a disease of the blood vessels diabetes affects all organs. An estimated 50,000 amputations occur every year in India due to diabetes related foot problems. By the time the blood supply to the foot has been compromised due to peripheral obstructive vascular disease, the heart is also involved. The use of prosthesis in a patient living with diabetes increases the cardiac strain to over 15%, leading to cardiac failure over a period of time. World statistics show that when walking even with the best of prosthesis, mortality at 5 years after unilateral below knee amputation is 50%, and there is 50% mortality after above knee amputation in 3 years, due to cardiac failure.

Socialist Party (India) demands ending imports from China

In wake of Chinese intrusion into 19kms of Indian territory, the Socialist Party demands that the Government of India must stop all imports of Chinese goods into India. Banares Sarees, Holi 'pichkaaris, woolen clothes, religious statues, various kind of electronic goods, etc are some examples where our markets are flooded with Chinese products. We do not support direct military action at this stage and believe that the dispute should be resolved through bilateral negotiations. But we do support and demand policies which should protect our local markets of small and middle scale industries and local craft artisans across the country. Such a decision will strengthen our economic power. Banning imports from China and promoting domestically produced products will give double boost to our economy and put more pressure on China to respect international borders including India’s.

Moses Wasamu, Kenya
(First published in The Star, Kenya on 15th April 2013): Malaria control strategies must keep up with the rapidly changing patterns of malaria infection in low transmission settings, the authors of a new review published in The Lancet say. Sir Richard Feachem, director of the Global Health Group at the University of California, San Francisco, USA, and senior author of the study, says the malaria control strategies implemented over the last decade have been highly successful in reducing malaria worldwide. “However, these strategies must evolve to respond effectively to the changing patterns of infection in low transmission areas,” he says.

Bobby Ramakant - CNS
Tuberculosis (TB) rates are coming down, but not dropping fast enough to keep the world on track to meet the target of Stop TB Partnership: to eliminate TB by 2050 (less than 1 percent TB in population is referred to as elimination). "The current decline in TB rate is 2 percent globally every year" said Dr Christian Lienhardt of WHO Stop TB Department at the 4th Union Asia Pacific Region Conference on Lung Health (APRC 2013) which recently concluded in Hanoi, Viet Nam.

Dr Nguyen Viet Nhung,APRC 2013
Photo credit: CNS

Bobby Ramakant - CNS
There is an overwhelming evidence linking lung cancer to tobacco smoking. Tobacco smoking continues to remain a major risk factor for lung cancer. Among cancers, most deaths every year are attributed to lung cancer, followed by stomach, liver, colon and breast cancers globally. Close to 1.4 million people die every year due to lung cancer. Centre for Disease Control and Prevention (CDC) warns that tobacco smoking causes about 90% of lung cancers. People who smoke are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. "Tobacco smoking is biggest risk factor for lung cancer" stressed Dr Nguyen Viet Nhung, Deputy Manager of Viet Nam’s National TB Programme and Vice President of Viet Nam Association Against Tuberculosis and Lung Disease (VATLD).

World TB Day Commemoration in Swaziland

Business sector marching on TB Day

Alice M Tembe, Swaziland
The Kingdom of Swaziland joined the world to commemorate the Tuberculosis Day on the 27th of March 2013 in Manzini. The event was preceded by a High Level meeting on the 22nd -23rd March 2013 at the Happy Valley Hotel in Ezulwini, where influential delegates gathered for the first time in one place to dialogue on the Tuberculosis matter, an initiative led by the Honorable Minister of Health, Mr. Benedict Xaba in collaboration with the South African Minister of Health Mr. Aaron Motsoaledi.

Xpert MTB/RIF in Delhi
Photo credit: CNS

Bobby Ramakant - CNS
One golden wish in TB care and control is surely around early diagnosis of all forms of TB. New rapid diagnostic tools have come on board over the past years such as Liquid Culture, Line Probe Assay (LPA), and Xpert MTB/RIF among others in addition to conventional gold standard solid culture and drug susceptibility testing (DST). At the 4th Union Asia Pacific Region Conference on Lung Health in Hanoi, Viet Nam, national TB programmes of different countries shared their experience of using WHO - recommended Xpert MTB/RIF in Programmatic Management of Drug-resistant TB (PMDT) over the past few years.

Dr Gilles Cesari, The Union
Photo credit: CNS

Bobby Ramakant - CNS
The 4th Union Asia Pacific Region Conference on Lung Health (APRC 2013) opened in Hanoi, Viet Nam, with a powerful and thought-provoking session on TB and migrants. There are scores of known structural drivers that put people at risk of TB such as poverty, but other less-spoken factors, such as immigration laws, International relations between countries, legal status of migrants, labour laws, and politics of borders where some countries deport expats who develop TB, need more attention too. According to International Organization for Migration (IOM), there are 215 million international and 740 million internal migrants. Migrants in many parts of the world are known to have reduced access to TB diagnosis and treatment, affecting the global fight against the disease. A range of policy measures have been taken at different levels including global, yet implementation is indeed lacking in most countries. The countries where migrants originate from, as well as the countries receiving migrants, have the responsibility to establish partnerships to ensure continuity of care.

Dr Hoang Thanh Thuy
Photo credit: CNS

According to the World Health Organization (WHO), Viet Nam ranks 12th among 22 high burden tuberculosis (TB) countries, and 14th among 27 high burden multidrug-resistant TB (MDR-TB) countries in the world. "2.7% of new TB cases, and 19% of previously treated cases have MDR-TB in Viet Nam" said Dr Hoang Thanh Thuy of Viet Nam's national TB Programme (NTP). She was speaking with Citizen News Service – CNS at the 4th Union Asia Pacific Region Conference on Lung Health in Hanoi, Viet Nam. Viet Nam has 3,700 MDR-TB cases annually. Although evidence is weak due to lack of data but people living with HIV (PLHIV) are more likely to get drug-resistant TB, said Dr Thuy basing her observation on higher MDR-TB rates in places where TB-HIV co-infection was reported more in Viet Nam.

Ministry of Health, WHO urges on blood pressure tests

Sam Banda Jnr, Malawi
(First published in The Daily Times, Malawi on 10th April 2013): THE Ministry of Health and World Health Organisation (WHO) have called on adults in the country to check their blood pressure and adhere to medical advice when found with high blood pressure. The advice follows this year's World Health Day theme which is focusing on high blood pressure. In a statement released on Saturday, Secretary for Health Charles Mwansambo and WHO Resident Representative Felicitas Zawaira also advise people to practice healthy lifestyles to prevent and control high blood pressure and its complications.

Hoang Ha (photo: CNS)

Bobby Ramakant - CNS
Hoang Ha, Secretary to the 4th Union Asia Pacific Region Conference on Lung Health (APRC 2013) which opened today in Hanoi, Viet Nam, told Citizen News Service – CNS that APRC 2013 will address key issues related to lung health such as tuberculosis (TB) and drug-resistant TB, tobacco control, asthma, chronic obstructive pulmonary disease (COPD), pneumonia, acute respiratory infections (ARIs), diabetes and TB, childhood TB, research and development for new TB vaccines, diagnostics and drugs, TB-HIV co-infection, among others. Hoang Ha said to CNS that APRC 2013 is on the theme of “Optimal use of new technology and approach” and is organized by the Viet Nam Association against Tuberculosis and Lung Diseases (VATLD) and International Union Against Tuberculosis and Lung Disease (The Union) from 10-13 April 2013. It brings together more than a 1000 stakeholders in lung health from 32 countries.

Millions of women (and men) are still unable to protect themselves from sexually transmitted infections (STIs) and prevent unintended pregnancies. Despite major thrust on research and development of new options to prevent STIs and unintended pregnancies, and efforts to expand access to existing prevention technologies, unmet need of contraception and tools to protect from STIs, is alarming.

Shobha Shukla - CNS
Could you ever imagine that a string of beads can act as a contraceptive device to avoid unintended pregnancies? Well CycleBeads just does that by helping women to follow the Standard Days Method (SDM)—a natural fertility awareness method of family planning. It consists of a string of 32 colour coded beads, provided with a rubber ring that can move over the beads. Even illiterate women can use this tool to keep track of their menstrual cycle to know when they are fertile and to monitor their cycle length and thus avoid unintended pregnancy.

Socialist Party (India) strongly supported the Supreme Court decision to uphold access to essential medicines and deny patent protection to dummy innovations as claimed by Novartis. Justice (retd) Rajinder Sachchar also extended his support to Socialist Party's position. Novartis had sought a patent for Imatinib (brand name Gleevac or Glivac) which noted lawyer and UN Human Rights Commissioner Anand Grover said was the same molecule with little ‘tweaking’. The cost of this drug is INR 120,000 per month for blood cancer (leukemia) patients. After Supreme Court ruling the price of drug may fall steeply from INR 120,000 to perhaps INR 8000 – this is a huge step forward in terms of advancing access to essential medicines and also in protecting public health from interference from profit-driven corporations and markets.

Monicah Mwangi and Henry Kibira, Kenya
(First published in The Star, Kenya on 3rd April 2013): When Jane Mwende noticed a swollen gland under the armpit of her 10-month-old baby, she never took it seriously. She thought it was a boil which would eventually clear. “I took him for a check up and the doctor at a private hospital in Nairobi gave us some ointment to apply and said the infection should clear in a few days,” Mwende said. This was however not to be. For about five months, Mwende moved from different hospitals trying to seek help for her son who was now beginning to lose weight. “I went to about six doctors and none of them seemed to get to the bottom of the problem.” She visited a facility where she requested the doctor to conduct different check-ups on her son. The medic carried out multiple tests among them HIV, cancer, liver, kidney and chronic ailment examinations. “That was a shocking moment for me.

Despite government notification dated 27th September 2012 to rotate new effective and powerful pictorial health warnings on ALL tobacco products from 1st April 2013, the tobacco industry has once again not acted upon in timely manner. In the past, our government has held the dubious distinction of deferring and/or diluting these warnings, not once but several times under immense lobbying/pressure from the tobacco industry. The Health Ministry said to the Central Information Commission in November 2008 that it is tobacco industry pressure that is not letting it implement tobacco control health policies effectively.

Gugulethu Nyazema, Zimbabwe
(First published in Daily News, Zimbabwe on 25th March 2013): People with diabetes are 2,5 times more likely to develop tuberculosis (TB), according to an international study. The International Diabetes Federation revealed there was a study that showed that people with diabetes are at higher risk of developing TB than those without diabetes. According to the Zimbabwe Diabetes Associations, close to 40 percent of the Zimbabwean population is diabetic.

Photo credit: Aliwassa - CNS

Gugulethu Nyazema, Zimbabwe
(First published in Daily News, Zimbabwe on 24th March 2013): HARARE - Leonard*(not his real name), only had an appetite for alcohol and cigarettes. As he wasted away, he continued going to the bar, with his sagging pants threatening to expose his rear. A man in his late 30s, Leonard called binge drinking his career. He continued to drink even after being diagnosed with Tuberculosis (TB) in 2005. “Drinking is my career and I love my alcohol but I had to quit my career, in order to regain my health,” he said.