Tuesday, November 30, 2010

An outdated Indian strategy, Infected 18,000 children from HIV

Circulated for public awarness & benefit by Lawyer Asad

Dear Sir/madam,

Before observing this world AIDS day on 1st Dec2010, pls read this mail &
pray for those 18000 HIV positive childrens, who could have been definitely saved.
India's first AIDS awareness campaign has completed 25 years and the AIDS epidemic is in 30th year of its devastating presence on this globe. Though India ranks three in HIV numbers, because of its affordable anti-HIV drugs it plays a savior globally by preventing deaths and ameliorating the sufferings of millions of HIV+ people, much more than the original inventors of these drugs. Ironically we save millions globally but loose thousands to HIV nationally. Admittedly, the National AIDS Control Organisation (NACO) says India recorded 18,000 children getting HIV from 65,000 HIV+ mothers in 2009, where as there are strategies to prevent eachof them. HIV+ women received only single-dose nevirapine, a outdated strategy meant for Africa. Who should be held responsible and hanged for this gross neglect?

Peoples Health Organisation (India)- the first NGO that raised alarm against AIDS in India in 1985 and championing the cause of 'Increasing Access to ART' believes that today India has emerged as an asset and not a liability vis-à-vis HIV. This fact has been grossly ignored by the experts and the powers that be in the melee of the 'number game' December 1 - the World AIDS Day is indeed an opportune time to look at the past, present and future of
this epidemic. United Nations Secretary-General Ban Ki-moon suggested strategy of the "three zeros" - zero new HIV infections, zero discrimination and zero AIDS-related deaths. Let us pledge to work together to realize this
vision for all of the world's people.

To mark this occasion PHO has organized a Press Conference to be addressed by:

*Padmabhusan Dr.R D Lele, *diagnosed the first Indian AIDS case

*Prof. K C Mohanty,* Executive Chairman of PHO and renowned TB/Chest Physician

*Dr. I S Gilada,* Secretary-PHO& AIDS Society of India, crusade against HIV
since 1985

*Ms. Kunika Lall,* PHO Executive Member, Social activist and Cine
personality

*Mr. Rahul Roy,* Cine Personality


Tuesday, 30th Nov. 2010 at 12 noon

Mumbai Marathi Patrakar Sangh, Azad Maidan,

Theme: 25 years of HIV Awareness in India and our future challenges.

The media needs to spread this message as part of its social responsibility.
Being a celebrity with good social image, you can help us to spread it
strongly. We request you to be a part of this PC.

The global AIDS Epidemic is completing 30 years of its devastating presence. India's first AIDS awareness campaign has completed 25 years and the first
AIDS case was diagnosed in 1986, yet all is not hunky-dory in HIV
management. AIDS has always been maddening. The virus moves more slowly than any infective organisms that ride sneezes or coughs or rats or mosquitoes.
HIV permits years of symptom-free infectivity and only kills, like a
sluggish-torturer at leisure. Though India ranks three in HIV numbers,
because of its affordable anti-HIV drugs it plays a savior globally by
preventing deaths and ameliorating the sufferings of millions of HIV+
people, much more than the original inventors of these drugs. Just imagine the world without India vis-à-vis AIDS? Ironically we save millions globally but loose thousands to HIV nationally. Admittedly, the National AIDS Control Organisation (NACO) says India recorded 18,000 children getting HIV from 65,000 HIV+ mothers in 2009, where as there are strategies to prevent each of them. HIV+ women received only single-dose nevirapine in an outdated strategy meant for
Africa. Who should be held responsible and hanged for this gross neglect?

A ghastly-devastating disease of early 1990s has become a chronic manageable disorder now. Treatment for only richer countries and the rich in poorer countries has become affordable to most countries. India is at crossroads
vis-à-vis HIV that it makes imperative to look back in the recent past, take stock of what has been achieved and what has been amiss in order to decide future plan for a better tomorrow. UNAIDS has termed India as the third worst HIV-affected country after South Africa (5.5 million) and Nigeria (2.9
million). How can one compare India to a nation less than the size of one of her states and a 30 times more HIV prevalence? India can never be 'Africa' vis-à-vis HIV and even at highest peak in worst case scenario, HIV rate will not cross 2%.Though the past acts and achievements generally haven't been very impressive, yet the anticipated medico-socio-economic impact for the foreseeable future is certainly not as bleak as we collectively contemplated earlier! What has saved the larger Indian population from HIV is the Indian culture, the responsiveness of its youth, efforts of voluntary NGOs and medical caregivers and yeomen contribution of our pharma lobby. We certainly
have reasons to rejoice and project India as a powerful (not a poor,
gullible 3rd rate) country – at least in relation to HIV/AIDS.

*Treasure India's Asset: *India's clinically oriented, conservative,
comprehensive and holistic care has earned accolades. Its *wait-n-watch
approach* in starting anti-retroviral treatment (ART) is indeed blessing
disguise for HIV patients (as against 'Hit-Early, Hit-Hard'approach of the West). It improves quality of life, increases survival, reduces cost and spares them of impending drug-resistance. *Indian culture* of joint families and lasting marriages with integrity in women folks have been an asset in providing psycho-social support and reduced transmission. The age at the first sex is higher in India.* **Kama-Sutra*- an Indian art and science of making love has a lot to offer - adds sensuality to sexuality and reduces HIV transmission with its prescription 'Many positions with one, better than one with many!'

"One Tablet a Day: Keeps HIV at Bay!" treatment invented in India made ART cheaper, safer and easier. The west copies India! ronically, the MNCs made hue and cry, calling Indian Generics *copy-cats*! When the 'West copies the East' in making 'three-in-one' medicines, why apply different yardsticks?
Indian pharma took a lead and risk of inviting litigations, circumvented
patents by producing generic copies using reverse engineering and brought down the prices to 1%, with 100% bio-equivalence (quality). The yearly cost of three-in-one cheapest first-line combo has come down from US$ 11452/- per patient to $69. Indian Pharma must be lauded for saving millions and keeping
our tri-colour flying high.

*What is amiss?*: Shamefully enough less than 10% of the pregnant women received PPTCT and that too only single-dose nevirapine; only 56% of sex
workers are reached with HIV prevention program and 38% of them identify correct ways of prevention methods. Only 20% of the infections are recorded
at NACO, due to inherent flaws in the reporting system. More than half of
the infected people do not know their HIV status. Our efforts to make the risk-takers understand their vulnerability have been inadequate. Most of the national energy and funds were wastefully spent on 'surveillance' without
'interventions'; while only 30% adults with advanced HIV infection are receiving ART (up from 6% in 2005); while 20% patients at free roll out are dead, 12.5% have lost to follow-up or stopped ART in 2 years. Thanks to the Supreme Court order of 1998, India's total blood supply is HIV screened and is safe.

*What India needs to learn? *Critically evaluate the state-run and NGO programs, replicate best practices and shun the unsuccessful ones, provide three tiered (not free for all) ART with quality care, move from 'Donor-dependence' to 'Self-reliance', reduce vulnerability of women and children, PPTCT as a national emergency with 100% coverage and strong focus
on Youth and de-addiction. If our foreign reserves are over 300 billion US$ and we pre-paid the ADB loans, why should we run our NACP on clutches of foreign aid? If Bill Gates contributed 268 million US$ for India, where is the matching response from Indian giants? High 'political will' is needed to
contain HIV beyond tokenism/lip-service.

We are facing an extremely challenging situation with Multi-drug resistant and extremely drug resistant (MDR/XDR) Tuberculosis and HIV, Immune Reconstitution Inflammatory Syndrome (IRIS) – a serious disease situation caused by regaining the lost immunity following successful ART, HIV+
alliances, jobs for recovered people and medical Insurance for HIV/AIDS
patients. What is not yet discovered is effective Vaccine and vaginal
Microbicide to prevent its transmission.

*BUT Model for India*: *B*razil - role model for state-run ART; *U*ganda and *T*hailand - model for Prevention. Uganda's 15% rates in 1995 is down to <5% - with political will and ABC (Abstinence, Be faithful, Condom) approach.
Thailand – topped Asia in 1993, with >2% HIV rate. Control was achieved with AIDS Ministry concept, high-profile awareness, condom campaigns. Scientists and politicians should make India - lead the show for the next decades in HIV care.

There is no other disease that has triggered such a fast and quality
research in short span of time. As regards to AIDS, we know enough on
pathogenesis and epidemiology front. Knowledge on HIV/AIDS is fast evolving and that necessitates timely update of doctors providing HIV care. United Nations Secretary-General Ban Ki-moon suggested strategy of the "three zeros" - zero new HIV infections, zero discrimination and zero AIDS-related
deaths. Let us pledge to work together to realize this vision for all of the world's people.

*What we have gained?* Whenever any epidemic hits- rarely do we discuss its positive impact.

• Sanity about morality, sexuality and sensuality, Importance of Sex
education, Kamasutra, non-penetrative sex, masturbation etc. Pre-marriage counseling and health checks
• Blood-Blood Products safety: >20 Transfusion-Transmitted Diseases are under scanner
• Safe barber practices - only after HIV arrived; though Barbers can
transmit 15 infections
• Lab./Hospital safety - Universal precautions, exposing indifference of
medical caregivers
• Importance of Safe Pregnancy and preventing Parent to Child Transmission (PPTCT)
• Clean needles practices for Injection Drug Users (IDUs)
• Importance of Indian Pharma saving millions and exposing MNCs with >1000% profits
• Knowledge of prevention and treatment patterns of several Opportunistic Infections
• Role of condom in preventing 22 STDs: colour, flavours, textures; and
Female condom
• Mainstreaming marginalised communities like Sex Workers, Hijras, Men sex with men (MSM)
• No. of sex workers-sinking-all time low,80% in Mumbai, STDs down by 80 to 90%

Dr. I S Gilada,Hon. Secretary, PHO and AIDS Society of India


Dr. I S Gilada,

Consultant in HIV/STDs

Secretary General, AIDS Society of India (ASI)

Unison Medicare & Research Centre,

Maharukh Mansion, Alibhai Premji Marg, Grant Road (E), Mumbai - 400007

Tel +91-22-23061616; Fax: 23000016;

E-mail: gilada@usa.net / ihoaids@vsnl.com;

Website: www.asicon2010.com / www.aidssocietyofindia.com


Deepak Tiwari
deepak@fametrick.com
09321148090
www.fametrick.com

Circulated for public benefit by Lawyer Asad

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