Health and Development Initiative-India, (www.healthinitiative.org), publishes TB News from India' once every two months. The objective of newsletter is to highlight issues related to Tuberculosis and HIV/AIDS control in India and enlist political, public, professional and administrative support for its cause. Health and Development Initiative-India is a not-for-profit organization and the news items have been quoted from various sources for fair use and in public interest. Reproduction of the material published is welcome provided a reference is made to the original source of the news item and TB News from India.

Editorial note:  

AIDS-Care-Watch campaign launched in India

The new AIDS-Care-Watch Campaign aims to raise awareness about AIDS care options available in India, and hold institutions and organisations in the country accountable for their explicit commitments to provide appropriate care to those in need. This campaign was launched at the International AIDS Community Care and Support Conference held at Mumbai on December 7, 2004.

"In the next few years, hundreds of thousands of Indians will die needlessly from AIDS-related conditions because specific drugs to treat HIV/AIDS cannot be made available fast enough and other options for keeping them alive are being seriously neglected. However many of these deaths could be postponed using readily available, affordable and time-tested treatment approaches," says Bobby Ramakant, AIDS-Care-Watch Campaign India Coordinator for Health and Development Networks (HDN). HDN is a Thailand
based international NGO engaged in generating and supporting a global response to the AIDS pandemic.

The Campaign document cites the figures just published by the United Nations, which show that HIV is well entrenched in some parts of India with serious epidemics underway in several states. The country is now home to over five million people living with HIV and according to the World Health Organization (WHO), roughly 710,000 people are in need of the 'gold standard' of AIDS treatment- antiretroviral (ARV) drugs. At present, however, only 21,000 people are receiving these life saving medicines. This is far below the WHO treatment target of providing ARVs to 355,000 people by the end of 2005 and the country's pledge in April 2004 to provide 100,000 people living in six high prevalence states.

"And it is likely to be years before the remaining people living with HIV in India have access to affordable ARV treatment. Thousands will die while they wait for ARV programmes to deliver on their promise. But they don't need to. AIDS deaths can be postponed without ARV drugs," says the Campaign Coordinator.

Some of the cost-effective and not-so-difficult-to-implement approaches advocated by the Campaign include, voluntary counselling and testing for HIV as the entry point for access to all health care services and self management, prevention and treatment of tuberculosis (TB) in people living with HIV, provision of drugs to treat/prevent other opportunistic infections (e.g., cotrimoxazole, fluconazole etc), home- and community-based care approaches, tackling HIV-related stigma especially in a health care setting which often keeps people away from heath services , pharmacotherapy (e.g., methadone) for recovering injectable drug users and promoting food security and micronutrients.

"These non-ARV care options are vital elements to addressing the HIV/AIDS crisis that is engulfing India's poor and yet, as we enter 2005 they are not being given adequate attention," says Bobby.

We in Health and Development Initiative-India consider the key elements propagated by AIDS Care Watch Campaign as highly relevant to ground realities in the country. We are confident that this campaign will go a long way in ameliorating the sufferings of people living with HIV/AIDS and their families in India

For more information about the campaign in India, please go to www.aidscarewatch.org 
Or email join-aidscarewatch@eforums.healthdev.org 

 

National Consultation on Nutritional Security and the Prevention, Treatment
and Mitigation of TB and HIV/AIDS in India held.


"AIDS pandemic is fuelling Tuberculosis, poverty, school dropouts and human trafficking. All TB and HIV control programmes must incorporate nutrition-based interventions," said Manoj Pardesi, Vice President Indian Network of Positive People. He was participating in the first national consultation on Nutritional Security and the Prevention, Treatment and Mitigation of Tuberculosis and HIV/AIDS jointly organised by the United Nations World Food Programme and the National AIDS Control Organisation in New Delhi in December 2004.

Mike Tonsing of Delhi Network of Positive People told the elite audience present in the plush Conference Hall of Teen Murti House, "most people getting anti-retroviral drugs from government clinic in Delhi cannot afford nutritious food. Our members rely on local Gurudwaras (Sikh temples) for their daily meals."

According to Dr. S.Y. Quraishi, Director General National AIDS Control Organisation, India is witnessing a changing face of the AIDS pandemic. HIV, which was earlier confined to high-risk-behaviour-groups, has now moved to general population. Another warning sign is the swift feminisation of the epidemic, he said. India currently reports 5.1 million HIV positive cases and more than 50% of them will develop tuberculosis in the years head. The country already has 90,000 full-blown AIDS cases.

Participating in the first plenary session, Dr. Stuart Gillespie, Senior Research Fellow, International Food Policy Research Institute stated that food and nutrition are fundamentally intertwined with HIV transmission and the impact of AIDS. The response to HIV/AIDS is conventionally disaggregated into the four pillars of prevention, care, treatment and mitigation. Food and nutrition security are fundamentally relevant all the four strategies. Food assistance is essential for vulnerable group well being, for strengthening human capital, as well as preserving livelihoods.

Here Professor Amitabh Kundu of School of Social Sciences, Jawaharlal Nehru University New Delhi sounded a note of caution. "If we try to identify people infected with TB and HIV using physical tests, social exclusion process will begin immediately," he said.

He called for a need to identify the current food and nutrition linked programmes, which can be expanded and modified as we approach the people with TB and HIV affection and infection. "An analysis of present nutrition and food linked programmes reveals that programmes which, reach targeted selection using an economic criterion have a higher degree of efficiency. Some of the examples of such programmes are Integrated Child development Services and Annpoorna Yojna. The involvement of community based organisations and NGOs also adds to the efficiency of such services," he opined.

However if we try to identify people infected with TB and HIV using physical tests, social exclusion process begins immediately and it becomes worse due to social stigma. "So how do we design nutrition programmes for people living with TB or HIV/AIDS without inviting their social exclusion?" he asked.

He informed the participants that the per capita calorie consumption has been consistently declining in the country and is going down even in further in lower thirty percent population. The microenvironment of living in the country has worsened over the decades. There is lack of sanitation, number of persons living in one-room units has gone up and there is social and economic exploitation at work places. These factors were silently making our people vulnerable to the twin epidemics of AIDS and TB.

He proposed that nutrition programmes for people living with TB or HIV/AIDS should have a sharper focus. In view of the large target group, even the present Rupees 30,000 crore food subsidies may prove insufficient. Initially the programme may focus on critically ill patients, orphans or widows.

In his remarks at the end of first plenary Mr. David Fletcher said that available scientific evidence suggested that nutritional
supplementation improves quality of life of TB patients and people living with HIV/AIDS. Good nutritional status slows the progress to AIDS, reduces vulnerability to opportunistic infections such as TB and increases effectiveness of anti-retroviral drugs.

The challenges in front of the India include incorporation of nutrition related messages in related IEC activities, community
participation and development of a mechanism for distribution of food amongst the targeted groups.

Related stories:

One in every five Indians undernourished: Food and Agricultural Organisation

According to FAO estimates, 21 percent of India's total population of 1.03 billion are undernourished. According to the UN body, India is the only country with the number of undernourished people exceeding 200 million.

Read the full text at:
http://news.newkerala.com/world-news/?action=fullnews&id=46866


Focus on nutrition
http://www.hinduonnet.com/thehindu/thscrip/print.pl?file=20041231001709200.htm&date=fl2126/&prd=fline&


World Food Programme, India Build New Alliance To End Hunger, Fight HIV/AIDS
http://www.wfp.org/newsroom/subsections/preview.asp?content_item_id=2062&item_id=1141&section=13

http://www.123bharath.com/news/index.php?action=fullnews&id=24978

Man dies of starvation

A man died in a Bihar village after allegedly starving for days together. Jhapsi Manjhi, a Dalit belonging to the poor Musahar
community, died of starvation in Majhiari village in Jehanabad district, 60 km from state capital Patna.

"Manjhi died due to starvation after struggling with hunger for over five to six days," a police official said. Officials said Manjhi had nothing to eat for days and his family members confirmed that he died due to lack of food.

But the district administration denied that Manjhi died due to starvation. "He died of tuberculosis," a district official said.

Read the full story at:
http://www.newkerala.com/news-daily/news/features.php?action=fullnews&id=49785

Music enlisted to convey TB message : The evening of soft classical music was for a cause - the fight against tuberculosis.  


Organised by the Research Group for Education and Advocacy for Community Health (REACH), an NGO working for control of tuberculosis (TB), music became the medium to spread awareness on creating a TB-free society. The proceeds of the concert and the REACH Diwali Party hosted at a hotel in Chennai following the concert were donated to the REACH TB Patient Support Fund.

A brochure `TB Free: Join the Drive,' distributed to the visitors at the concert said that one person died of TB every minute in India which carried one-third of the global TB burden. The warning was that the HIV epidemic would increase and hasten the spread of TB to unmanageable numbers.

REACH conducts programmes for slum dwellers through street theatre, pamphlets, posters and screening of films and slides. Programmes are conducted in Chennai's Corporation and private schools such as quiz, talk shows and slide shows on TB.

Read the full story at:
http://www.hindu.com/lf/2004/11/09/stories/2004110913430200.htm

SAARC region near attaining TB patients cure rate target

The South Asian Association for Regional Cooperation (SAARC) region is near to attaining the World Health Organization's target of 85 percent cure rate of new smear positive cases of Tuberculosis (TB), according to the SAARC TB Center, Kathmandu.

A four-day SAARC Conference on TB, HIV/AIDS and Respiratory Diseases, health experts held at Kathmandu in third week of December 2004 recommended the effective implementation of the new technology of "Directly Observed Treatment, Short Course" (DOTS) to eradicate TB from the region.

The experts also proposed to include the DOTS strategy in the curriculum of schools and colleges to educate the youths who are more vulnerable to the disease.

They suggested SAARC member countries to provide extra inputs to take care of the constraints of urban TB control programs and draw strategies to address cross-border and gender epidemic.

Read the full story at:
http://news.xinhuanet.com/english/2004-12/19/content_2354041.htm

Poor kids get free dud TB capsules Johnson T A

Times News Network, December 23, 2004

Empty capsules - that's what children suffering from tuberculosis have been swallowing in government hospitals in Bangalore. Capsules given to children under the Karnataka government's free medicine for the poor scheme seem to have been duds.

Hundreds of the Rifampicin 150 mg capsules provided free of cost across the state could be just the plastic casings with no drug inside. Over 100 of the Rifampicin 150 mg capsules from 15 sealed strips obtained by Times Of India during an investigation had no drug inside them.

The samples obtained are from Batch No. 570024 of the public sector Karnataka Antibiotics and Pharmaceuticals Ltd. The suspect batch was manufactured in January and has an expiry date of August 2006.

Read the full story at:
http://timesofindia.indiatimes.com/articleshow/968484.cms

Web-based resource centre for TB control programme launched

Revised National Tuberculosis Control Programme has launched a web-based resource centre www.tbcindia.org, the first ever of its kind for any disease in the world.

The website has information in nine regional languages besides English, Hindi and Urdu, to facilitate information spread even in the remote areas, according to Director General Health Services Dr S P Agarwal.

"The information on the web is easy to understand and is prepared for a wide range of different target groups. Through a search option embedded in the web-site anybody could access authentic information about the disease," he said.

Read the full story at:
http://www.123bharath.com/india-news/index.php?action=fullnews&id=44670

News from India's neighbours

No News items in this category for this edition.

TBNI Editorial Team

Dr. Dinesh Kumar,
dinesh_kumar@vsnl.com 

Dr. Jatinder Singh,
jatindersingh@vsnl.com