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TB News from India: January-February 2004 Issue
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:
TB is a workplace issue too!
One may wonder why should employers be interested in TB - and
specifically interested in taking steps to contribute to TB control?
The answers are straightforward:
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TB interrupts workflow, lowers productivity and
raises both
direct cost related to treatment and care and indirect costs such as
the replacement and retraining of workers.
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Without effective treatment, employees sick with TB
will often
spend three to four months off work.
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But given effective treatment, many employees can
return to work
within two to four weeks without the risk of infecting others.
TB is a workplace issue because health is essential
not only to the well being of individuals but the functioning of
economies. Employers can play a vital role in promoting and undertaking
TB control
activities in the workplace and in the neighboring community. Workers'
organizations can collaborate in these activities and advocate for the
needs of employees, including health care.
The advantages of the workplace for TB control activities are that
workers attend on a regular basis, communication systems are in place,
and existing structures, services, and facilities can be used
for prevention, care, and support. Most employers can contribute towards
the following key components of TB control, identifying TB suspects and
referring them for diagnosis; helping TB patients to complete their
treatment. Some large-scale employers with a significant number of TB
cases among their workforce may wish to set up a workplace DOTS program.
World Economic Forum's Global Health Initiative has commenced its
activities in India to enlist support of businesses for Revised National
Tuberculosis Control Programme (RNTCP). This indeed is a
well-timed move because an isolated health sector cannot alone stop TB
and new partnerships must be forged across sectoral boundaries.
After all TB is everyone's business.
New guidance for TB
management in the workplace launched at the India Economic Summit
(A set of guidelines for managing TB in the workplace, published by
Global Health Initiative of World Economic Forum were launched at India
Economic Summit held at New Delhi during last week of November 2003.)
"TB Management in the Workplace: An Introduction for Businesses in
India" provides guidance for managers to tackle TB in the workplace. The
document lays down ten key principles that can guide a workplace TB
policy and program. It identifies TB as a workplace issue. Case studies
have shown that treating TB in high prevalence settings makes business
sense, and workplace is often the ideal place to identify cases and
administer treatment. The document cautions against discriminating with
individuals because of their real or perceived TB status, as
discrimination and stigmatization of people with TB causes delays in
diagnosis and makes it more difficult to cure patients. It calls upon
workplace managers to work together with Revised National TB Control
Program [RNTCP] for providing DOTS services. Often daily contact with
workers makes the workplace an ideal setting for
implementing DOTS program, it says.
Read the complete story at:
http://www.weforum.org/pdf/Initiatives/GHI_Guidelines_WHO_TB_India.pdf
Private sector
participation crucial in fighting AIDS
(Bachi Karkaria, Times of India, December 16,2003)
Richard Feacham, executive director of Global Fund to Fight AIDS, TB and
Malaria (GFTAM) believes strongly in the private sector offensive in
global war on AIDS. He refers to the latest meeting of the Global
Business Coalition (GBC) in Nairobi in early December 2003. Seven MNCs
with operations in developing world announced the expansion of their own
HIV/AIDS programmes into the larger community.
Tata Steel was the Indian major in this GBC initiative. The Tata Steel
hoped to scale their 21 community clinics currently engaged in testing
and treatment for 14000 people in Jamshedpur. Feacham said that Ratan
Tata is a leading member of this coalition and has thrown his personal
commitment behind the war against AIDS.
Feacham said we welcome private sector endeavors because it is our
experience that they move faster and more successfully.
TB cases on the rise in
Punjab
(Times of India, New Delhi/Chandigarh; December 13, 2003)
Even as Punjab government continues to pour in large sums of money to
control tuberculosis in the state, the disease seems to have a life of
its own. with hundreds of people losing their life to it every year.
Statistics for the last many years show that the disease has not been
tamed in the state, a situation similar to one prevailing in other
states of the country where also disease is on the rise. This year
disease is on the rise in border district of Gurdaspur and Jalandhar.
During the two years between 2001-2003 some 13,460 cases were reported
from Ludhiana, the hub of industry in the state, alone. This is in spite
of the fact that health department is running a special campaign in nine
of the seventeen districts of the state under the Revised National TB
Control Programme [RNTCP]. Part of the problem, health officials say is
that of the resistant strains of tuberculosis bacillus infecting people.
These are not amenable to treatment by usual drugs prescribed for the
disease. Another problem is that many people diagnosed with the disease
do not complete the regime of medicines given to them leading to
emergence of [drug] resistant strains
Evening OPDs for TB
patients soon in Chandigarh
(Sourav Sanyal, Times Of India, November 29, 2003)
To cater to the needs of patients suffering from TB evening OPD is
returning to hospitals in Union Territory of Chandigarh. Though the
exact dates for launching the evening Out Patient Departments (OPDs)
have not been finalized, these are expected to become functional by
March 2004. Speaking of evening OPDs Dr. Pradeep Kapoor. WHO-RNTCP
Consultant says," We thought of starting evening Directly Observed
Treatment Short-course [DOTS] centres since patients undergoing
treatment are often forced to forego their daily wages as they have to
report to DOTS centres during morning hours and this might act as a
deterrent.
Dr. Kapoor also spoke about a pilot project aimed at fostering
public-private partnership in controlling TB, WHO is running at 15 sites
across the country including Delhi, Bangalore, Pune, Lucknow, Chennai
and Chandigarh. An all-round approach is being followed in Chandigarh to
achieve participation of NGOs, Private Practitioners (PPs) and Corporate
sector. Fifty-five PPs have already signed a memorandum of understanding
with Chandigarh District TB Control Society. The success of evening OPD
plan will depend on active participation of PPs, feels Dr. Kapoor.
A "task force" comprising of local area representatives, ex-servicemen
and cured patients is also proposed to be setup to spread the message
that treatment for TB is now available free of cost and
that any person having cough for three weeks or more needs sputum
examination at a DOTS centre.
Read the complete story at:
http://timesofindia.indiatimes.com/articleshow/329136.cms
Non-Compliance, A
Crucial Obstacle in Tuberculosis In Control: A Gujrat Study
Non-compliance of treatment by patients continues to be one of the major
hurdles in control of tuberculosis, according to a study conducted in
Anand district of Gujarat. Anand is one of the 25 districts of Gujarat
implementing Revised national Tuberculosis Control Programme (RNTCP). It
is a major tobacco cultivating district of Gujarat. The RNTCP was
launched in Anand district in April 2000.
The district has been divided into four Tuberculosis Units (TU). All the
TB patients registered under RNTCP during last quarter of year 2002 from
two randomly selected TU were interviewed. Some DOTS providers were also
interviewed.
The study found a default rate of 7.3%. One principal reason for
defaulting was side effects of anti-TB drugs. The default rate was also
found to be higher amongst patients who were observed by Government
staff as compared to those observed by volunteers. This could be due to
the reason that cash incentives given to volunteers are not admissible
to Government staff. These important findings
point to the difficulties in practice of DOTS at the cutting edge.
(Contributed by Dr Niraj Pandit
Assistant Professor, Department of community medicine, P. S. Medical
College Karamsad Gujarat).
India's AIDS epidemic could
grow to African levels: activists
(Agence France Presse, Thursday, November 13, 2003)
India could see an AIDS epidemic similar to that in some African countries
where the disease is the leading cause of death, according to a study funded
by Microsoft head Bill Gates. The study cited figures from the Indian
National AIDS Control Organisation (NACO), which said 4.58 million Indians,
were living with HIV/AIDS at the end of 2002, a significant leap from the
figure of 3.97 million given the previous year.
"HIV/AIDS is now spreading to the general populace in India and if knowledge
of the disease, preventive measures and counseling is not made universal then
India could see an epidemic similar to that of some of the African
countries," said a release by the Washington- based Population Reference
Bureau (PRB) which co-authored the study with the Population Foundation of
India (PFI).
India, with a population of more than one billion, has the second largest
number of people living with HIV/AIDS after South Africa. The total increase
in HIV/AIDS cases worldwide in 2002 was five million of which India accounted
for about 12 percent.
Study co-author A.R. Nanda, who heads the PFI, said the "problem would have
been worse" if the Indian government had not addressed the issue as soon as
the first AIDS case was detected in the southern city of Madras [Chennai] in
1986.
"But the trends still indicate the need to remove the social stigma currently
associated with HIV/AIDS and ramp up efforts to fight the disease," said
Nanda.
He pointed out that general awareness levels of HIV/AIDS in India were skewed
with villagers displaying "colossal ignorance" about the disease." Three out
of four rural women living in the populated states of Bihar, Gujarat and
Uttar Pradesh said they had never heard of HIV/AIDS. And three out of 10 men
were not aware of the condom's protective value," said Nanda. The study said
that while 90 percent people living in urban areas had heard of HIV/AIDS only
72 percent of people in the rural areas had done so.
Read the complete story at:
http://massiveeffort.org/showstory.asp?id=653
Country's first TB
hospital to be shut down
(Kolkata, Times News Network, November 03, 2003)
Ignoring the rising number of TB cases in state as well as throughout
the country, the West Bengal government has decided to sell off and
close down South Asia's first and the state's only specialized TB
hospital - the K.S Ray TB Hospital adjacent to Jadavpur University.
Set up in 1923 by pioneering thoracic surgeon Kumud Sankar Ray as a
four-bed sanatorium, it became a 750-bed centre with money donated by a
landed aristocrat called Provash Ghosh, who died from the disease and
willed his entire fortune to Ray to acquire the 65-acre location and set
up the hospital.
According to health secretary Asim Burman, the decision was taken on two
counts. "The hospital is located in a congested area, where treating a
contagious disease may become a problem. Moreover, TB is no longer such
a big threat in this region."
Read the full text of the story at:
http://timesofindia.indiatimes.com/articleshow/264160.cms
Web Call: A visit to
Global Health Initiative's Best Practice Guidelines page
The World Economic Forum's Global Health Initiative (GHI)
is designed to foster greater business engagement in the global battle
against HIV/AIDS, tuberculosis (TB) and malaria. It works in partnership
with various international organizations to develop and communicate
corporate best practices in these areas. The documents available on this
page are part of the GHI's efforts to improve the quality as well as the
quantity of the private sector's efforts to combat these diseases. A
number of useful documents are available on this page, which include:
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Guidelines for Workplace TB Control Activities
prepared by the World Health Organization (WHO) and the International
Labour Organization with the goal of harnessing the contribution of
employers and workers towards the control of tuberculosis (TB)
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TB Management in the Workplace: An Introduction for
Businesses in India and Africa provide guidance for managers to tackle
TB in the workplace.
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Statement on the Role of the Corporate Sector in
Global TB Control, prepared by Programme in Infectious Disease and
Social Change, Harvard Medical School.
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This page is a useful reference point for those working to engage
businesses to support National Tuberculosis Programmes (NTPs) or
interested in developing workplace programmes and policies for
tuberculosis control.
Visit the Home Page at :
http://www.weforum.org
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