CNS: November 2014

'Studies underway for possible ebola treatment option '

Diana Wangari, Special Correspondent, Kenya

(First published in The Star News, Kenya)
Recently, on a flight in Europe, I was seated next to a charming French lady who was all smiles and ‘Bonjour’ when taking her seat. Satisfied that the old lady was all charm and good manners, I took my nap. You can imagine my surprise when I woke up, only to find that the lady was now wearing a facemask.

When will we overcome gender injustice?

Shobha Shukla, Citizen News Service - CNS

The Beijing Declaration and Platform for Action (BPFA) is 20 years old now. It was adopted by consensus in 1995 by 189 countries during the Fourth World Conference on Women, in Beijing, China. Although not a binding treaty, it affirms that issues of women’s rights and equality must be part of any government’s agenda. The 20th anniversary of BPFA has opened new opportunities to regenerate commitment, charge up political will and mobilize the public.

Reaching the unreached: ENGAGE TB initiative

Shobha Shukla, Citizen News Service - CNS


(CNS image library, Mandalay 2013) Leaflets on reproductive, maternal, neonatal & child health, HIV/AIDS and TB in a clinic in Myanmar

Despite great strides made in TB care and control over the last few years, the latest data shows that 1/3 of all TB cases are still either not detected or not reported to public health systems. These are people who either seek treatment in the private sector and are not notified to the National TB programmes (NTPs) or have not been diagnosed at all. Some of them would die and all of them would continue to spread TB to others, unless treated. Communities affected by TB are often marginalized--poor people, migrants, injecting drug users, prisoners, refugees, sex workers—and face challenges in securing TB services from public healthcare facilities. Then there are women and children, for whom also it is not easy to access healthcare.

Chhatra Karki, CNS Correspondent, Nepal
Developing countries have a major share in the number of deaths of children due to pneumonia which is considered the most dangerous and infectious disease in children below five years of age. Even though pneumonia affects the children in most of the countries in the world, child mortality rate is negligible in the developed countries due to the effective prevention and treatment procedures.

Pneumonia: 'If only I knew better'

Alice Tembe, CNS Correspondent, Swaziland

Photo credit: CNS: citizen-news.org

“Only if I knew better, my child will still be alive”, these were the words of a weeping mother of two years old *Buhle Matsenjwa who had left for another world. She told me, “Buhle started getting sick- coughing, losing weight and was not eating well. Buhle was taking some kind of medicine that I would get from the local clinic or pharmacy most of the time. Friends and family looked at me with accusing eyes and I did not understand at first until a friend from church asked if I had him tested for HIV and screened for TB.

Aileen Familara, CNS Columnist
Young women from civil society called on governments attending the United Nations High Level Ministerial Meeting to fulfill their promises to advance women’s rights and gender equality. The governments were gathering from 17 to 21 November to report and review the implementation of the Beijing Platform for Action (BPFA) that came into being 20 years ago. The BPFA is a document agreed upon in 1995 for governments to develop and ensure policies on 12 critical areas: Women and Poverty, Education and Training of Women, Women and Health, Violence against Women, Women and Armed Conflict, Women and the Economy, Women in Power and Decision Making, Institutional Mechanisms for the Advancement of Women, Human Rights of Women, Women and the Media, Women and Environment, The Girl Child.

Promise of gender justice is not enough: Make governments accountable

Shobha Shukla, Citizen News Service - CNS

Photo source: Flickr

More than 500 women of the Asia Pacific region gathered in Bangkok from 14 to 16 November 2014 for an Asia Pacific Civil Society Forum on Beijing Plus 20, (organized by 14 civil society organizations with Asia Pacific Forum on Women, Law and Development--APWLD as co-secretariat), preceding the high-level intergovernmental meeting to review and take stock of the progress made in the region for implementing the Beijing Platform for Action (BPFA), a landmark agreement made in 1995 to promote and advance the status of women.

Erwiana, Indonesia
Photo credit: Shobha S/CNS

Shobha Shukla, Citizen News Service - CNS
In her opening address at the Asia Pacific Civil Society Forum on Beijing+20, being held in Bangkok, Kate Lappin, Regional Coordinator, Asia Pacific Forum on Women, Law and Development (APWLD) mentioned that, "Migration into exploitative work is continually on the rise, living wages and decent work conditions are being denied and with deadly consequences. The cheap, exploitable labour of women is underwriting the so-called 'Asian Century' and is used to attract investors to the region."

Beijing to Bangkok: 20 years journey of triumphs and defeats

Shobha Shukla, Citizen News Service - CNS

There are political, economic and cultural constructs that have marred the realisation of the promises made 20 years ago in Beijing around gender justice. The tall tree of injustice and oppression that shades gender justice and equality, has thick foliage and deep roots according to Kamala Chandrakirana of Asia Pacific Women's Alliance For Peace And Security. But there are warm, though feeble, rays of hope, thawing the ice of extraordinary barriers that women face in full enjoyment of their human rights.

Photo credit: APLMA

[हिन्दी] Leaders of the 18 East Asia Summit countries have committed to an ambitious goal of eliminating malaria from the entire Asia Pacific region in the next 15 years. The bold move shows strong leadership on health security and responds head-on to concerns about growing resistance to the drug artemisinin, the mainstay of worldwide treatment for the most dangerous form of the disease.

Women in politics should help women in adversity

Shobha Shukla, Citizen News Service - CNS

Almost twenty years ago, the Beijing Declaration and Platform For Action (BPFA) was adopted by consensus by 189 countries during the Fourth World Conference on Women, in Beijing. Although not a binding treaty, it calls for strong commitments on the part of the governments and other institutions to fully realise women's human rights and gender equality through the implementation of the roadmap set by the BPFA. The 20th anniversary of BPFA opens new opportunities to regenerate commitment and charge up political will and mobilize action.

Diabetes and tuberculosis: Partners in crime?

Chhatra Karki, CNS Correspondent, Nepal

Diabetes is now no longer constrained to the domain of riches and upper class only. Recent trends reveal that both the regal and the plebeian are joining the club of those living with diabetes. Diabetes is gaining its foothold especially in the countries with low and medium Per Capita Income (PCI). Diabetes was for a long time treated as non-communicable disease (NCD) but now the experts opine that diabetes is now turning out to be a 'launch pad' for a disease usually not classified as a NCD: Tuberculosis (TB).

Integrating TB-HIV services with maternal and child healthcare

Nenet L Ortega, CNS Special Correspondent

TB is the third leading cause of death for women worldwide in their childbearing years. Maternal TB leads to poor outcome for the mother and child, especially when the mother is infected with HIV. Intensified case finding, isoniazid preventive therapy (IPT), and infection control ("3 Is") remain the cornerstones of TB-HIV collaborative activities, but have not been systematically integrated into maternal and child healthcare (MCH) settings.

Photo credit: CNS: citizen-news.org

Paidamoyo Chipunza, CNS Correspondent
(first published in The Herald, Zimbabwe)
“HIV destroys the immune system. When this happens, the capsule containing the TB germs weakens and breaks. The germs spill out and multiply. The person becomes sick with tuberculosis, transmitting the germs to others through a tell tale cough,” were the words of Nobel Peace Prize Laureate Archbishop Desmond Tutu, himself a TB survivor, sometime in 2012. However, health experts say diabetes has the same effect on the immune system like HIV.

Responding to MDR-TB from the ground

Nenet L Ortega, CNS Special Correspondent

Photo credit: CNS: citizen-news.org

Community participation indeed play a major role in bringing TB care and control services to populations that are geographically isolated, marginalized, and/or belong to disadvantaged groups. Community based non government organizations bring together key players from government, private sectors, faith based groups, TB patients, their families and survivors to work through partnership and inclusive collaboration–-these are key to effective and low cost TB services in the communities. Examples of creative, effective and low-cost solutions to improving MDR-TB treatment outcomes, supported by the Lilly MDR-TB Partnership and implemented in several high burden countries, were shared during the 45th Union World Conference on Lung Health in Barcelona.

TB-HIV: Better late than never

Shobha Shukla, Citizen News Service - CNS

Photo credit:
CNS: citizen-news.org

There were interesting presentations at the TB-HIV late-breaker session at the 45th Union World Conference on Lung Health held in Barcelona. They ranged from whole genome sequencing, to impact of GeneXpert MTB/Rif, to developing new biomarkers, to private public partnerships - all with the purpose of finding better solutions for care of people dealing with TB and HIV. A study was done in a large population based cohort in Karonga district of Malawi with high HIV prevalence (60%of all TB patients are HIV positive) on whole genome sequencing (WGS) approach and active follow up for recurrence of TB due to relapse or reinfection.

Caring for HIV-TB in adolescents needs a different approach

Diana Esther Wangari, CNS Special Correspondent

Photo credit: Diana EW/CNS

Do you remember the time when you had just passed thirteen years of age but were still below eighteen? You were technically not an adult but neither were you a child. Your parents and relatives probably told you how 'now' you had become an adult and if you were a boy, that came with a certain sense of pride-- "You are now a man", but if you were a girl, the message was laced with caution-- "You are now a woman, you have to be more careful." Being a teenager has never been easy and is probably more difficult if you are a girl because the rules that apply to boys are not necessarily the same standard by which girls are judged.

Innovative solutions when dealing with TB in adolescents

Diana E Wangari, CNS Special Correspondent

Photo credit: Diana E Wangari/CNS

Have you ever been to a hotel or a restaurant and there is a family seated opposite you-- the father with his laptop, the mother on a tablet, the daughter on her phone and the son with his headphones connected to the iPod? They might put their gadgets away to eat, only to pick them up after every five minutes or so, perhaps just to check if there is a message that came through or to check if the world has suddenly gone to war...in the past five minutes. It is a fact that people today cannot survive without electronic devices and the constant need to ensure that they are up-to-date with what is happening in the world-- be in it the political, economical or even social arena. Why then can we not take advantage of this fact in the fight against TB, especially amongst adolescents whose worlds often centre around their mobile devices?

TB control in times of trouble

Babs Verblackt, CNS Special Correspondent

Photo credit: CNS: citizen-news.org

Challenging enough already, TB control gets even more complicated in times of conflict. Anything from social unrest to civil war can disrupt basic TB services, affecting groups at special risk of the infectious disease. Because of fear and chaos, reaching and engaging communities becomes increasingly difficult in conflict situations--though not impossible.

Community speak: Take TB out of the medical box

Shobha Shukla, Citizen News Service - CNS

Photo credit: CNS: citizen-news.org

The last plenary at the 45th Union World Conference on Lung Health, where the panelists were former TB patients, provided a grand finale to the theme of the conference around community driven solutions to tackle TB and associated co-infections like HIV. Narrating their personal experiences, community representatives from Fiji, DR Congo, Ukraine, Nigeria and Moldavia voiced their gratitude for this great initiative of bringing more of the community/patient voices to be heard loud at an international conference, perhaps fro the first time.

Giving voice to the voiceless: engaging community

Babs Verblackt, CNS Special Correspondent

Community engagement is a critical component in reducing stigma, raising awareness, and facilitating access to services for people living with HIV (PLHIV) and TB. From disease control and reaching health services to decision making and drug development--in every element of combating these diseases affected communities should have their say. Several initiatives around the globe are making efforts to ensure that weak voices are not only getting stronger but are also getting heard.

International trade impacts tobacco control

Shobha Shukla, Citizen News Service - CNS

The tobacco industry has a history of using international trade agreements to force open new markets in low and middle income countries, greatly increasing tobacco use and the consequent death/disease it causes. Tobacco companies are also challenging measures to reduce tobacco use as violations of trade and investment agreements, threatening the authority of nations to protect the health and well-being of their citizens.

Community demands shorter and safer treatment for drug-resistant TB

Nenet L Ortega, CNS Special Correspondent

Photo credit: CNS: citizen-news.org

According to WHO's Global Tuberculosis Report 2014, an estimated 480,000 people developed multidrug-resistant TB (MDR-TB) worldwide in 2013 and an estimated 210,000 died from it. However only 136,000 were diagnosed and only 97,000 patients (one out of five) could be started on MDR-TB treatment in 2013, with the gap between diagnosis and treatment widening between 2012 and 2013 in several countries. On an average, an estimated 9% of people with MDR-TB had extensively drug resistant TB (XDR-TB).

Photo credit: CNS: citizen-news.org

The International Union Against Tuberculosis and Lung Disease (The Union) announced plans for new clinical research that will evaluate the effectiveness of two new treatment regimens for multidrug-resistant tuberculosis (MDR-TB). If successful, the study will provide robust new evidence on the effectiveness of both an all-oral and a six-month treatment regimen for MDR-TB. The current standard treatment regimen for MDR-TB lasts up to 24 months and requires frequent injections, which pose a significant burden both for patients and for health systems tasked with administering treatment.

Shobha Shukla, Citizen News Service - CNS
The World Health Assembly's Palliative Care resolution of May 2014 calls for strengthening of palliative care as a component of comprehensive care throughout the life course. An integrated patient-centred model of care and prevention is a pillar of the new post 2015 global TB strategy of the World Health Organization (WHO). Deliberations at the 45th Union World Conference on Lung Health in Barcelona brought out that 'integration of palliative care into mainstream MDR-TB services is enhanced though increased community participation'.

Diagnosing TB in children is no child's play

Diana Esther Wangari, CNS Special Correspondent

Photo credit: Rahul D/CNS

All of us have surely been witness to or personally experienced the sight of a kid throwing tantrums and wailing in a super market or a mall for that extra chocolate bar or candy. The child refuses to pay heed to the protestations/ implorings of the harried parent. As far as she/he is concerned she saw a sweet, liked it and should have it. Words like health issues, or financial constraints are not part of the kindergarten vocabulary sessions. Standing behind the parent, you cannot help but feel sorry as you watch her struggle with the child who might as well be lying on the floor after throwing all the sweets to the ground.

Stepping up development of child-friendly TB drugs

Babs Verblackt, CNS Special Correspondent

The development of drugs for pediatric TB is still in its infancy. But important steps are being made towards formulations that are more child-friendly. Now is the time to go the extra mile, bringing medicines to the market that serve those traditionally neglected in TB research: children suffering from the infectious disease. Pediatric TB is one of the main causes of death in children worldwide.

Double burden of TB-diabetes: Are we ready?

Carolyn Kavita Tauro, CNS Special Correspondent

Diabetes has been long seen as a disease of the rich. Today, however, it is clear that the disease is also prevalent in low- and middle-income countries, affecting the rich and the poor alike. Like malnutrition and HIV infection that compromise a person’s immunity, chronic conditions like diabetes, have also shown to impair a person’s defense system against tuberculosis (TB).

Care for counselling, counselling for care

Babs Verblackt, CNS Special Correspondent

TB patients more often than not struggle to understand their diagnosis and their medication regimen. At the same time they are dealing with fear, doubts and despair over their disease. Yet little attention is given to these issues in TB treatment. Patient counselling is key to TB treatment and care and should get better implemented, felt the experts at the ongoing 45th Union World Conference on Lung Health in Barcelona. Psychological support has been shown to improve treatment adherence and outcomes, yet TB programmes underemphasize patient counselling.

m-Health helping in TB control

Babs Verblackt, CNS Special Correspondent

Photo credit: Babs Verblackt/CNS

Getting diagnosed, getting treatment and adherence to treatment are all well known challenges in TB care and control. In this age of information technology, mobile phone devices around the world are being used to help address these challenges. From SMS alerts for patients to fully integrated systems, the possibilities for incorporating m-Health in TB treatment, care and control seem endless, as several presentations at the 45th Union World Conference on Lung Health in Barcelona showed.

Presumptive TB treatment for people living with HIV: better safe than sorry?

Babs Verblackt, CNS Special Correspondent

Photo credit: Babs Verblackt/CNS

As tuberculosis (TB) remains a major cause of death among people living with HIV (PLHIV), starting TB treatment without bacteriological confirmation is widely practiced in them as in the case of PLHIV traditional TB diagnostic tests have inadequate sensitivity. But this empirical or presumptive TB treatment is not without risks. At the 45th Union World Conference on Lung Health in Barcelona researchers discussed their investigations into who should get the treatment, and when and how.