CNS: 2015

Well, the answer seems to be NO, as was made out in the deliberations at the 46th Union World Conference on Lung Health held in Cape Town recently. WHO had introduced the MPOWER measures in 2008 to assist in the country-level implementation of effective interventions for tobacco control as contained in the global tobacco treaty (formally called the WHO Framework Convention on Tobacco Control (FCTC).

MDR-TB care: Where do we go when health systems are overburdened?

In any situation of health crisis, it is normally assumed that care of the sick, especially infectious patients, is designated to clinically trained nurses and doctors in hospital settings. Today, as the world battles with the epidemic of infectious diseases like TB and multidrug-resistant TB (MDR-TB), many settings are faced with limited bed-capacity to hospitalize and care for patients till they can be integrated back into the community.

MDR-TB treatment: Comprehensive health system response is needed

Marian Loveday of the South African Medical Research Council (MRC), presented a real life interesting case study at the 46th Union World Conference on Lung Health, held in Cape Town recently, which illustrated the typical treatment journey of a multidrug-resistant TB (MDR-TB) patient in South Africa. South Africa, where a decentralized model of treatment is being adapted in most facilities, has one of the largest MDR-TB epidemics in the world found in its Kwa Zulu-Natal Province, with approximately 75% of the MDR-TB patients being co-infected with HIV.

m-Health solutions for TB care: A moment to ponder

Dr Richa Sharma, CNS Correspondent, India

Dr Evan Lee (R)

In a world where the use of information and communication technology is on a constant rise, the mobile phone, in particular, has permeated to low-income nations where, even in the remotest of areas, it is becoming a form of a necessity. It then seems logical that we utilize this gadget, as much as we can, in seeking health solutions. During the 46th Union World Conference on Lung Health held in Cape Town, results of some of the m-health projects for TB care and control piloted in different countries were shared in a lively session.

To breathe is to live : Call for action to tackle pneumonia

A walk in a clinic in an urban slum or rural setting is invariably associated with one coming across a parent sitting with their child helping them to breathe through the mouthpiece of a nebulizer machine. Such is the presence of pneumonia cases in developing countries and resource constraint settings.

Dr Raghav Gattani, CNS Medical Correspondent

[हिंदी] Dr Ishwar Gilada, President of AIDS Society of India (ASI), who was among the first clinicians to come forward when first HIV case got diagnosed in India in 1985, was the guest keynote speaker at a seminar on “30 years of HIV in India” organized by Department of Microbiology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS), ASI, People’s Health Organization and CNS in SGPGIMS on Tuesday, 15th December 2015.

Pneumonia: An outcome of preventable mistakes

Dr Amitava Acharyya, CNS Correspondent, India

Photo credit: CNS

“That men do not learn very much from the lessons of history is the most important of all the lessons of history”--Aldous Huxley
During the early 1900s, pneumonia was the third leading cause of death. Still now it is in endemic condition among under 5 years old children (responsible for 15% of all deaths in children < 5 years old) and geriatric population. The preventive and curative aspects of pneumonia are well established. But, the failure of implementation of proper health care structure, inadequate health promotion and health education among the masses and inadequate supply of anti-biotics remain the causes of this preventable burden.

[Webinar recording] We welcome you to register for an exclusive media webinar on 'Half the battle won with new child-friendly TB drugs. What is the other half?' As we know, the world's first appropriate, child-friendly fixed dose combination (FDC) medicines to treat children suffering from drug-sensitive TB were announced just ahead of the 46th Union World Conference on Lung Health in Cape Town, South Africa. Get connected with noted experts from lead agencies such as the International Union Against Tuberculosis and Lung Disease (The Union), TB Alliance, Stop TB Partnership and its Global Drug Facility, who will present and respond to questions live!

Inhaled drug therapy for TB treatment

In the light of the outcry of the high pill burden, severe toxicity and high treatment non-adherence rates, and many more challenges associated with the treatment of TB, in particular of multidrug-resistant tuberculosis (MDR-TB), innovative drug therapies are beginning to be explored. One of them - inhaled TB drugs - were presented at the 46th Union World Conference on Lung Health held recently in Cape Town.

Connecting the dots: Mental health and tuberculosis

Dr Annika Sweetland

As I get totally swathed by the very inspiring and tiring 46th Union World Conference on Lung Health, a serious thought that came to my mind was the connect between mental health and TB. This was a question also posed by Dr Annika Sweetland, a Research Scientist in the Department of Psychology from Columbia University, also tried to answer a similar question in one of the sessions: Does TB predispose patients to mental health disorders, and, are mental health disorders a risk factor to developing active TB?

TB-HIV in pregnant women: Does drug metabolism change?

Photo credit: CNS: citizen-news.org

In a global conference where lung health is addressed in different tracks through parallel and equally stimulating sessions, with emphasis on TB, one often finds oneself struggling about what session to attend and which one to forego on behalf of the other. I was often faced with a similar dilemma while attending the 46th Union World Conference on Lung Health. Therefore, when I came across the session 'Maternal and Infant TB: Advancing our understanding of pathogenesis, treatment and prevention', I had to pause.

Will 2030 Global Goals help accelerate progress towards ending TB?

[CNS video] This article is based upon an exclusive interview with Dr Mario Raviglione, Director of the WHO's Global TB Programme. Dr Raviglione spoke with CNS (Citizen News Service) at the 46th Union World Conference on Lung Health in Cape Town, South Africa. As we know, the Global Goals for Sustainable Development 2030 adopted by the governments at the 70th United Nations General Assembly in September 2015, present an integrated development agenda.

Lesson from the frontlines: Decentralized care and treatment for MDR-TB

During the 46th Union World Conference on Lung Health, that just concluded in Cape Town, I had the opportunity of visiting the close-by township of Khayelitsha, where Medecins Sans Frontieres (MSF), more commonly known as Doctors Without Borders, has, since 2007, implemented a decentralized model of multidrug-resistant TB (MDR-TB) care.

TB Chronicles: A leading example of community-driven approach in Eastern Cape South Africa

Learners from Masakhe Primary School
in Duncan village, East London

In Kenya, there is a phrase ‘serikali saidia’ which translates to ‘government help us’ and it is often that you will find that this phrase appear in conversations of victims of disaster situations. Therefore, if a bridge is swept away during a flood, you are bound to hear the villagers explaining how fundamental the bridge is to their day-to-day activities and their plea to the government is that it builds a stronger and wider bridge next time.

Patient-centred approach for MDR-TB treatment: Are we ready?

Dr Jennifer Furin (L), Alice Tembe (R)

As the world gears up for ‘The New Agenda: Lung health beyond 2015’ - the inspired theme of the 46th Union World Conference on Lung Health taking place in Cape Town, South Africa, a new buzz word doing the rounds is about keeping patients central to all treatment approaches and not merely a number in data.

Turning the tide on drug-resistant TB

Photo credit: CNS: citizen-news.org

There is a quote often attributed to Albert Einstein, “If you always do what you always did you will always get what you always got.” The point being that if you want to change the end results, you need to change the way you do things. The escalation of multidrug resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), with approximately 480,000 new cases of MDR-TB reported in 2014 globally, has challenged the principles of care for TB patients.

Half the battle won: Need to accelerate roll-out of child-friendly anti-TB drugs

Monique Davids (R)
with her son Jaden (in her lap)

Monique Davids, mother of 4 children, lives in Cape Town, the venue of the ongoing 46th Union World Conference on Lung Health (conference theme is 'A new agenda: Lung health beyond 2015'). She is a living example of what it is to be the caregiver for children suffering with TB. The past one year seems to have aged her a lot making her look much older than her 32 years. Her fiance and father of her four children contracted TB which he passed on to his two children - his youngest son Jaden was diagnosed with TB in 2014 at the age of two months, along with his 3 years old sister.

End TB agenda: Have we done enough?

As the world was commemorating the World AIDS Day on the 1st of December 2015, it came to fore that tremendous progress has been made in the past three decades-- from ‘no name for the wasting disease, no antiretroviral treatment (ART) for adults or children, no special trained doctors/nurses/laboratory specialists, no diagnostic equipment’, to ‘patient friendly treatment for both adults and children, state of the art equipment for diagnosis and continued care, elimination of mother to child transmission of HIV, specialized health care professionals and significant improvement of the quality of life for persons living with HIV’.

Photo credit: CNS

Alice Tembe, CNS Special Correspondent, Swaziland
Pneumonia has been noted as one of the most deadly infectious illness for children worldwide, with an estimated 900,000 children dying of pneumonia this year. Dr Amita Pandey, a Professor in the Department of Obstetrics and Gynecology at K G Medical University, India, presented statistical data showing the incidence of pneumonia in children under five to be approximately 156 million new episodes each year and WHO estimates that death due to pneumonia occurs in 1 in 3 cases. The Director of Policy, Advocacy and Communication at IVAC, Lois Privor-Dumm further indicates that every minute, six children die from pneumonia or diarrhea. The burden of pneumonia screams for attention.

TB Chronicles: An MDR/ XDR-TB champion

How many people find it hard to complete an antibiotic dose that is probably one tablet a day for 5 days? Do you remember the last time the doctor said you needed to get an injection and you thought to yourself, surely there must be some other way and so you tried negotiating with the doctor? Now imagine having to take twenty-seven pills a day for not just 5 days but 2 years and on top of that a painful daily injection for 6 months? Take a moment and let that sink in.

MDR-TB: A generation of survivors

Being a public health specialist in the field of TB and HIV, there are always aspects that tend to fall through the cracks, only to be realized when the effects start showing and then another intervention is designed-- the cycle seems to be never ending. As a member of the engagement tour organized by the Lilly MDR TB Partnership at the King Dinuzulu Hospital, I walked through a path of awakening.

A milestone in global health: Child friendly TB medicines become a reality

Thanks to the untiring efforts of TB Alliance (Global Alliance for TB Drug Development), and its partners: World Health Organization (WHO), UNITAID and US Agency for International Development (USAID) - the world's first appropriate, child-friendly fixed dose combination (FDC) medicines to treat children suffering from drug-sensitive TB were announced today, just ahead of the 46th Union World Conference on Lung Health in Cape Town, South Africa.

A school with a difference!

Located on the grounds of the King George Hospital Complex (now known as the King Dinuzulu Hospital Complex- KDHC) in Durban, ‘King George V Primary School’ is indeed a school with a difference, catering to the special educational and social needs of a unique class of children.

The fight against AIDS has definitely made considerable progress but formidable challenges confront the path to ending AIDS by 2030, as committed by the countries globally at 70th UN General Assembly in September 2015. The brutal irony is that despite knowing 'what works in helping us progress towards AIDS' the uptake of these evidence-based strategies is abysmally low, and some countries like India, have slashed health budgets by 20%.

What APEC means to poor people in Asia

Cherian Mathews, Regional Director, Asia office of Oxfam

Recently Manila hosted the 23rd Asia-Pacific Economic Cooperation (APEC) Leaders’ Meeting—under the theme of Building Inclusive Economies, Building a Better World: A Vision for an Asia-Pacific Community- that was attended by prominent world leaders.

Addressing pneumonia: The deadly childhood illness

Dr Richa Sharma, CNS Correspondent, India

Photo credit: CNS: citizen-news.org

Despite being preventable, pneumonia continues to be a top killer of children under five. It also wreaks 'breath-taking’ havoc in the lives of adults, particularly the elderly, and people living with HIV. According to the 2015 Pneumonia and Diarrhea Progress Report released recently by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health, a projected 5.9 million children around the world will die in 2015 before reaching their 5th birthday.

Dr Rahul Pandey, CNS Columnist
I wrote these personal thoughts immediately after the 26/11 terror attacks in Mumbai in 2008 but never sent it to a publication. On the heels of terrible terror attacks in Paris, in the midst of equally horrifying attacks going on in parts of the Arab world, and on the anniversary of 26/11, as similar thoughts come to my mind I decided to dig it out. So here it goes ..

Lessons to be learned from intolerance debate

Dr Rahul Pandey and Dr Sandeep Pandey

Photo credit: CNS: citizen-news.org

A good outcome of so many writers, poets, artists, historians and scientists returning awards or writing letters in protest against growing intolerance in Indian society is that a debate has been set off in the public domain. However the arguments and counterarguments have often become bitter. In this debate most of the bitterness has been displayed by some of those who do not agree that intolerance is on a rise.

Prime Minister Narendra Modi has joined other Asia Pacific Leaders in taking a concrete step closer to defeating malaria. Along with the 17 other East Asia Summit (EAS) Leaders meeting in Malaysia this past weekend, he endorsed a detailed plan to eliminate the disease throughout the region by 2030.

Can global peace and harmony be a reality?

Dr Ajit Kumar Verma

Dr Ajit Kumar Varma, CNS Columnist
I am writing this as I am deeply pained by all the atrocities, killings, aggression and war rampant in different parts of the world. All this mad frenzy of violence and killing, which is going on all around us, has been present there in varying degrees since civilization began. Recent acts of terrorism have escalated it to new despicable heights. Nations are now discussing ways and means of countering the nefarious acts of terrorism. But most discussions on peace centre around ways of subjugation and suppression of the 'enemy'. Now there are talks of waging a war on terror.

Action against TB-Diabetes co-epidemic: If not now, then when?

Photo credit: CNS: citizen-news.org

The world is threatened by yet another big looming co-epidemic of TB and diabetes. And no, it has not happened overnight-- it has taken its own time to evolve and emerge as a public health emergency. The situation is so very similar to the TB-HIV epidemic and the late response that was meted to it that it scares the policymakers, public health professionals and people across all strata of society to think about the impact that this combination of deadly diseases will have, once it strikes with full force.

[Call to register] Webinar for media: Every breath counts: Stop pneumonia now!

[Webinar recording] We welcome you to register for an exclusive media webinar on one of the biggest cause of death for children under 5 years of age, Pneumonia. Pneumonia also effects adults, particularly the elderly. Top reason for people living with HIV ending up in intensive care units of hospitals is not heart disease or accident, but pneumonia! Get connected with noted experts from lead agencies such as the International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, International Union Against Tuberculosis and Lung Disease (The Union), King George's Medical University (KGMU), among others, who will present and respond to questions live!

ICD 10: Adoption and patient care

Dr Raghav Gattani, CNS Medical Correspondent

International Classification of Diseases (ICD) is a method of integrating disease diagnosis and medical and surgical procedures into codes; codes of patient’s state of health. These codes primarily allow electronic documentation of patient conditions which help physicians revisit, transfer or share unambiguous data within the health care system. Extensive debates on the need to update the ICD from its 9^th edition to the 10^th, have led to adoption of ICD-10 CM/PCS from October 1^st, 2015 throughout United States. Surprisingly though, the update has come after 35 years and has expectedly brought with it diversity and specificity that will ultimately refine and revolutionise the medical system in the United States of America.

Diabetes mellitus and TB: Can we avert a looming co-epidemic?

Catherine Mwauyakufa, CNS Correspondent, Zimbabwe

Photo credit: CNS: citizen-news.org

Diabetes mellitus (DM) and tuberculosis (TB) have a link, even though many people have not really taken time to see that this co-infection is on the increase. In 2013 4% of the global DM burden was in Africa. In the same year, the continent reported 29% of the TB burden. As per the Diabetes Atlas, worldwide 387 million people have DM today and this figure could rise to 552 million in 2030.

TB & Diabetes: How will I live?

Alice Tembe, CNS Correspondent, Swaziland

It seemed like the sun will not set, as Thandiwe Tsabedze (name changed), a 38 year old mother sat by the doorstep of her home in Msunduza while her children played with laughter in the backyard. Thandiwe had developed diabetes as a side effect of antiretroviral treatment (ART) that she started on a few years ago. At that time she was also diagnosed, and was successfully treated, TB as well.

The Bali Declaration aims to prevent diabetes from fuelling TB

Dr Amitava Acharyya, CNS Correspondent, India

Photo credit: CNS: citizen-news.org

The duel problem of TB and diabetes mellitus (DM) is a major public health dilemma today. Like in the case of TB-HIV, it has taken several years to focus the attention of the public health community and others on this crucial issue. According to estimates, 6 of the 10 high-TB-burden countries are also expected to have the highest numbers of people living with diabetes by 2035.

[Focus] UNAIDS India Director reflects on fight against HIV: Ending AIDS is possible if...

[Focus] Caring for the elderly living with HIV

New funding boosts research for effective control of TB, malaria, dengue and leishmaniasis

Dr BT Slingsby, GHIT Fund
Photo courtesy: GHIT Fund

[हिंदी] An additional investment of US$ 10.7 million has been announced by Global Health Innovative Technology Fund (GHIT Fund) to find more effective tools to control and eliminate TB, malaria, dengue and leishmaniasis. Dr BT Slingsby, CEO of GHIT Fund spoke with CNS (Citizen News Service) before this announcement: "We have been investing in these diseases for over 2 years now. Antimicrobial resistance has been creeping up, particularly in Asia, making drugs used to treat TB and malaria ineffective. If we look at dengue, after a gap of 70 years, Japan had a major spread of dengue 2 years ago. Controlling and eliminating these diseases is very important for global health. Without right interventions and right innovations in place it will be very difficult to effectively eliminate, and in some cases, eradicate these diseases."

Deadly connections: Diabetes, junk food, tobacco use and TB

The 2030 Global Goals for sustainable development have an important focus on health, and rightly so. The world has pledged, amongst other things, to end HIV/AIDS, malaria and TB by 2030 and also to reduce mortality from non-communicable diseases (NCDs) by 33%. Today, 387 million people are affected by diabetes mellitus (DM), with 77% of the cases in low- and middle-income countries (LMICs) where TB is highly prevalent. It is also interesting to note that the high TB and DM burden countries have a high burden of tobacco consumption too.

Which is the bigger culprit: Diabetes or TB?

Bi-directional screening at Lok Nayak
TB Hospital, Delhi (CNS photo)

In so far as disease prevention and control is concerned, diabetes mellitus (DM) seems to be a more difficult nut to crack, believe the experts. During the just concluded world’s first International Summit on TB and diabetes, that was jointly organized by the International Union Against Tuberculosis and Lung Disease (The Union) and World Diabetes Foundation (WDF), CNS (Citizen News Service) spoke with some of the stalwarts in the field.

What will it take to avert the looming TB-Diabetes co-epidemic?

As per latest data, 9.6 million people fell ill with TB and 387 million people were living with diabetes mellitus (DM) in 2014. One person dies of TB every 22 seconds, while diabetes takes a toll of one life every 7 seconds. Six of the 10 countries projected to have the greatest numbers of people living with diabetes by the year 2035 - China, India, Brazil, Indonesia, Pakistan and the Russian Federation—are also classified as high TB-burden countries by the World Health Organization.

After convening a two-day summit this week in Bali, the Indonesian Ministry of Health, together with the International Union Against Tuberculosis and Lung Disease (The Union) and the World Diabetes Foundation, today signed the Bali Declaration, uniting more than 100 global health officials and experts behind a global campaign to fight the twin scourge of TB and diabetes. Bi-directional screening is a key component of the Bali Declaration, which aims to bring the co-epidemic to the attention of governments across the globe.

Avert the looming TB-diabetes co-epidemic before it gets too late