CNS: March 2014

Civil society participation vital for public health programming

Rahul Dwivedi, CNS Special Correspondent

KS Roy Hospital (CNS photo)

“We have always known that alongside scaling up diagnostic and treatment services, engaging communities is vital for the success of disease control efforts. This is especially the case for tuberculosis (TB) – an ancient disease surrounded by stigma, discrimination, and misconceptions. The Knowledge-Attitude-Practice (KAP) survey results underline the payoffs of civil society participation in public health programming” said Dr Sarabjit Chadha, Project Director of ‘Axshya’ at the International Union Against Tuberculosis and Lung Disease (The Union). The KAP midline survey results were released on 27th March 2014 in New Delhi.

Dr Madhukar Pai

Bobby Ramakant, CNS Special Correspondent
Tuberculosis (TB) care and control does not end with an accurate and confirmed diagnosis, but that is a good start point. It needs to be followed with initiating standard and effective anti-TB treatment (without delay), supporting the person with TB to adhere to the treatment regimen and get cured. Dr Madhukar Pai, Associate Director of McGill International TB Centre, addressed private TB healthcare providers including physicians and laboratory experts in New Delhi before the World TB Day 2014.

Dr Madhukar Pai

Rahul Kumar Dwivedi, CNS Special Correspondent
Data suggests up to 40-50 per cent of tuberculosis (TB) patients are likely to be accessing healthcare services in private sector. A study done in Lucknow by Dr Rajendra Prasad, former Professor and Head of Pulmonary Medicine, King George’s Medical University (KGMU) showed 44 different prescriptions from physicians for the same TB patient – this is when TB treatment should have been the same in private and public sector both because International Standards for TB care (ISTC) guidelines have been there since 2005 onwards.

[Hindi] Research published on 24 March 2014 provides critical new insight on the harmful links between smoking tobacco and developing tuberculosis (TB). Regular tobacco smoking doubles the risk that people who have been successfully treated for TB will develop TB again—a condition known as "recurrent" TB. The study is the most robust-ever conducted into how smoking tobacco increases the risk of recurrent TB. This study has been published in the April 2014 issue of the International Journal of Tuberculosis and Lung Disease which went online today.

[Hindi] A major focus of this World TB Day is the 3 million TB cases that the World Health Organization (WHO) estimates are “missed” each year - that is, cases that go undetected, undiagnosed and untreated. Clearly, this must change if global TB control is to be achieved. “The Forum of International Respiratory Societies (FIRS) is committed to mobilizing all its members to help reach the ‘missing’ 3 million tuberculosis cases”, said Dr Maria Montes de Oca, chair of FIRS. “FIRS members represent 70,000 health professionals working in almost every country of the world, so the capacity to increase case finding and provide TB care that meets the International Standards of TB Care is there.”

Tuberculosis control needs a complete and patient-centric solution

Dr Madhukar Pai, Prashant Yadav and Ravi Anupindi

Whether it is mobile phone service or vacation travel, good businesses know that success depends on providing a complete and customer-centric solution. Should patients with tuberculosis not be offered a complete solution that is patient-centred? After all, millions are affected and a large market at the base-of-the-pyramid (BoP) remains unserved.

Hara Mihalea, CNS Correspondent, Thailand
There is a debate whether providing food packages to TB patients motivates them to stay and successfully complete their treatment and so far there is no evidence to fully support this theory. However, people like me who for years have worked at the patient level, can say with confidence that when families do not know when their next meal will come from, they will not seek care when they are sick because they neither want to lose their daily income nor spend the little money they have at the health centre or hospital.

Rose Koenders, APA

Shobha Shukla, CNS Columnist
At the last sixth Asia Pacific Population Conference (APPC), held in September 2013 in Bangkok, member States and civil society discussed the status and progress on population and development and to highlight the most urgent needs of the region. The meeting was part of the regional review of the International Conference on Population and Development (ICPD) Programme of Action (PoA). The article below is based upon an interview Citizen News Service (CNS) did with Rose Koenders, Executive Director at Asia Pacific Alliance for Sexual and Reproductive Health and Rights (APA).

Dr Ajith Kumar Varma

Shobha Shukla, CNS Columnist
The Global Diabetic Foot Conference (DFcon 2014) concluded earlier this week in Los Angeles US. Citizen News Service (CNS) had an opportunity to interact with one of the key faculties and experts on Indian approach to saving the limb for people who are living with diabetes. Dr Ajith Kumar Varma is a Professor and Diabetic Lower Limb and Foot and Ankle Reconstructive Surgeon, in the Department of Endocrinology, Diabetic Lower Limb and Podiatric Surgery, at Amrita Institute of Medical Sciences and Research Centre, Kochi.

In the run-up to World TB Day on 24 March, the REACH Lilly MDR-TB Partnership Media Awards 2014 were presented in New Delhi, to recognize outstanding and responsible reporting on tuberculosis (TB). The awards were presented by Dr RS Gupta, Deputy Director General (TB), Ministry of Health and Family Welfare, Government of India.

World TB Day, 24th March
The theme for World TB Day 2014 is 'Reach the 3 million.' Of the nine million people who get sick with TB every year, one third or three million of them are ‘missed’ by health systems. Reaching them and then treating and curing them is an essential step towards achieving Zero TB Deaths and also to halve TB deaths by 2015.

(First published by Irish Forum for Global Health - IFGH)
On Thursday 6th March, the Royal College of Physicians of Ireland saw a gathering of clinicians, nurses, scientists, public health experts and more, to attend an event focusing on development of new medications to treat drug-resistant TB.

Rahul Dwivedi, CNS Correspondent
The government of India’s notification which came into effect on 1st March 2014 aims to arrest irrational sale and use of anti-tuberculosis drugs (and other 45 third and fourth generation antibiotics). “The Union Health Ministry has notified amendments to the Drugs and Cosmetic Act, 1940, in which a Schedule H1 has been included. 1st March 2014 onwards these 46 antibiotics that include anti-TB medicines too will only be sold upon presenting a valid prescription from a medical professional. Government needs to be congratulated for this long overdue measure which will curb irrational sale and use of drugs” said Professor (Dr) Surya Kant, Chairman of UP State Task Force for TB Care and Control and Vice President of Indian Chest Society.

Voices from the ground: Stories of people affected by tuberculosis

Hara Mihalea, CNS Correspondent, Thailand

42 years old Khun Mouk (name changed) comes from a small village of Chiang Rai in North Thailand and does odd construction jobs for a living. When I met him he looked very ill. His wife said that he had been like this for some time now--not eating and losing weight, coughing, feeling very hot, and feeling very tired. Initially he took several herbal medicines to get better. But when they did not relieve his symptoms he went to a pharmacy as well as two private clinics for help. He was given different kinds of cough syrups, antipyretic medicines for the fever and mucolytic tablets to release his cough.

Swapna Majumdar, CNS Special Correspondent
Is there a cure for HIV? The success stories of Timothy Brown and the two Boston patients, who rid themselves of the HIV cells through bone marrow transplants, led to hopes that a cure had finally been found. This was further boosted by the fact that the transplants received by them were diametrically different; Brown a transplant with cells that were resistant to HIV and the Boston patients with non-resistant cells. They remained virus-free for months after stopping treatment. However, in December last year, the virus recurred in both the Boston patients.

'2by4', a communications' campaign hosted by Citizen News Service - CNS, a partner of Stop TB Partnership, along with other partners, was first launched in 2013. Over five hundred key informant interviews with people who had either completed treatment for tuberculosis (TB), including drug-resistant TB, or were then on treatment, their family members, other care providers and stakeholders, were done as part of the campaign in 2013. In 2014, the campaign is re-launched before World TB Day, 24th March, as issues it addresses have only gained relevance and urgency over the last year.

Shobha Shukla, CNS Columnist
I apologize for missing out on the celebrations of Women's Day this year as I was too engrossed with changing nappies of my 10 month old adorable granddaughter in London, despite her part time nanny - who is a graduate, and charges a frightful £10 an hour. It was only the tedium of dish washer and washing machine which reminded me of women's plight (whether in UK or in India) in a strange sort of way.

No More Holding Back Women

Swapna Majumdar, CNS Special Correspondent

Two thirds of countries globally now have laws against domestic violence with several significant transformations in legal frameworks in Asia and the Pacific. This significant shift over the last decade has not only led 15 countries in East Asia and the Pacific to enact domestic violence laws but six Asian countries have taken the important step of outlawing rape within marriage.

Socialist Party (India) leaders said to Citizen News Service (CNS) that recent decision of Election Commission of India to raise the ceiling on election spending in Lok Sabha polls to Rs 70 lakhs is anti-people as it will only make it easier for the rich candidates and political parties to spend money in elections. Similarly raising the deposit amount from Rs 10,000 to Rs 25,000 will make it furthermore difficult for poor people to contest polls.

Dr Sandeep Pandey, Magsaysay Awardee and CNS Columnist
Narayan Desai, at the age of 90 years, gave the 115th rendition of his Gandhi Katha in Varanasi at Kashi Vidyapeeth from 21st to 25th February, 2014. When most people at his age would be counting their last days or would be incapacitated, he is moving around and narrating Gandhi’s story in a popular format, usually used by religious people.

Dr Ram Puniyani, CNS Columnist
Banning or attacking the books in current times has been aplenty. There have been many reasons given for this intolerant attitude by different social-political groups. The cases of Satanic Verses by Salman Rushdie, Taslima Nasreen’s Lajja, book on Sonia Gandhi Red Saree, A.K. Ramanujan’s Three Hundred Ramayans are some of the major examples. There is a tight rope walk between freedom of expression and hurting ‘others’ sensibilities, which keeps fluctuating for same political groups.