********************************************************** SAATHII Electronic Newsletter HIV NEWS FROM INDIA Source: The New Nation, New Indian Express, DNA India, NewKerala.com, The Times of India and The Hindu. Posted on: 24/01/2008 COMPILED BY: Jacob Boopalan, and L. Ramakrishnan SAATHII Chennai Office. Note: this compilation contains news items about HIV/AIDS published in the Indian media, as well as articles relevant to HIV/AIDS in India published internationally. Articles in this and previous newsletters may also be accessed at http://www.saathii.org/orc/elibrary =============================================================== 1. Media can help Govt, NGOs fight against HIV/AIDS The New Nation, January 22, 2008. http://nation.ittefaq.com/issues/2008/01/22/news0736.htm 2. Counsellors boycott screening test New Indian Express, January 22, 2008. http://www.newindpress.com/NewsItems.asp?ID=IEK20080122010302&Page=K&Title=Southern+News+-+Karnataka&Topic=0 3. State in denial after World Bank exposé DNA India, January 22, 2008. http://www.dnaindia.com/report.asp?newsid=1146712 4. Tamil Nadu rolls out second-line AIDS treatment NewKerala.com, January 23, 2008. http://www.newkerala.com/one.php?action=fullnews&id=16293 5. Fresh hope for HIV+: 2nd line of treatment begins The Times of India, January 24, 2008. http://timesofindia.indiatimes.com/India/Fresh_hope_for_HIV_2nd_line_of_treatment_begins/articleshow/2726005.cms 6. AIDS vaccine: Chennai trial results encouraging The Hindu, January 24, 2008. http://www.thehindu.com/seta/2008/01/24/stories/2008012450031600.htm =============================================================== 1. Media can help Govt, NGOs fight against HIV/AIDS The New Nation, January 22, 2008. http://nation.ittefaq.com/issues/2008/01/22/news0736.htm Media could play an important role simultaneously with the government and NGOs to fight against HIV/AIDS. HIV and AIDS situation is the worst in India among the South Asian countries. Though the prevalence rate of HIV/AIDS patients is slow in Bangladesh, but it is under risk factor. This was disclosed at the inauguration of two-day long workshop on 'Dhaka Dialogue on HIV and AIDS' jointly organised by National Media Forum on HIV and AIDS, Panos Bangladesh and ActionAid International in support with USAID at a city hotel yesterday. Jamil Osman, Secretary for Ministry for Information, Ramesh Venkataraman, Coordinator of Asia HIV and AIDS, Iqbal Sobhan Chowdhury, Convener of National Media Forum on HIV and AIDS, Farid Hossain, Bureau Chief of Associated Press (AP), spoke at the inaugural session. Rahul Dev from India was the facilitator at the working session. Besides, Sanjay Dev, journalist from India were also present on the occasion. People living with HIV and AIDS in Bangladesh still face stigma and discrimination in their daily lives. Media could play as informer as their ethical responsibility to create awareness among the people, the speakers said. The workshop will conclude today. =============================================================== 2. Counsellors boycott screening test New Indian Express, January 22, 2008. http://www.newindpress.com/NewsItems.asp?ID=IEK20080122010302&Page=K&Title=Southern+News+-+Karnataka&Topic=0 MANGALORE: Over 450 counsellors from seven districts attached to Integrated Clinical Testing Centre (ICTC) opposed the grading system by boycotting a screening test held in Roshini Nilaya School of Social Work on Monday. Tests conducted in other centres including Gulburga, Bellary and Bangalore by National Aids Control Organisation (NACO) and Aids Prevention Society of India (APSI) were also boycotted, sources told this website?s newspaper. The counsellors appearing in the test would receive grades "A" "B" "C", based on their performance in the test. The counsellors charged that the test was actually a ploy to retain a few and eliminate most of the counsellors appointed by them. "When we have already been appointed based on the qualifications, what is the need of such a test", the candidates asked. Raising slogans against APSI and NACO, the counsellors demanded the withdrawal of the test. The counsellors from Mandya, Channarayapatna, Shimoga, Chitradurga, Kodagu, Dakshina Kannada and Udupi districts also charged that counselling centres set up in state lacked infrastructure. They also denounced the practice of setting targets of HIV patients. "Asking us to meet the target on number of patients counselled every month is not practical and unethical", they stressed. =============================================================== 3. State in denial after World Bank exposé DNA India, January 22, 2008. http://www.dnaindia.com/report.asp?newsid=1146712 MUMBAI: After the World Bank’s exposure of large-scale misuse of funds meant for HIV/AIDS projects in the state, officials are still in a state of denial. DNA had reported on Monday how the review of the World Bank exposed glaring discrepancies in the National Aids control programme-II in Mumbai and Maharashtra. The review revealed lack of financial control over the money given to the NGOs, improper selection of NGOs and rampant demand for bribe. Even kits for testing HIV/AIDS were found to be of substandard quality providing poor quality of tests and false results. Health minister Vimlatai Mundada said she is in Kerala attending a health seminar and was unaware about the issue. The Maharashtra state AIDS control society (MSACS) that was established to implement the Aids control programmes was found violating the guidelines of the national aids control organisation (Naco). When questioned, Dr Prakash Sabde, project director of MSACS refused to talk on the issue. “I am in Delhi right now and not in a position to comment,” he said. When this reporter insisted on his comment, he said that he has not yet received the report. Even the Mumbai districts Aids control society (MDACS) that was started by the Brihanmumbai Municipal Corporation (BMC) for the implementation of HIV/Aids programme in Mumbai received flak from the World Bank. The MDACS did not have any expenditure documentation for NGOs funded by it. When asked, project director of MDACS, refused to comment. However, the principal secretary, health Chandra Iyengar said that she was looking at whatever reports the media had published. “We have not received the World bank report so we are referring to whatever has come out in the media,” she said. “If discrepancies are proved, the state has powers to initiate an inquiry,” added Iyengar. =============================================================== 4. Tamil Nadu rolls out second-line AIDS treatment NewKerala.com, January 23, 2008. http://www.newkerala.com/one.php?action=fullnews&id=16293 New Delhi: Nineteen of 21 HIV/AIDS patients in Tamil Nadu were found to have developed resistance to first-line drugs in a first of its kind screening, thus requiring second-line drug treatment, which was rolled out in the state Wednesday. "Today we rolled out the second line Anti Retroviral Therapy (ART) for AIDS patients," Supriya Sahu, project director of Tamil Nadu State Aids Control Society (TNSACS), told IANS over phone from Tambaram, 20 km from Chennai. "Of the 21 people screened, 19 were found to have developed resistance to first-line drugs. They underwent Viral Load Tests and 19 have been found eligible for the second-line therapy," Sahu added. There are 2.5 million HIV/AIDS patients in India. Tamil Nadu is home to nearly 170,000 patients, of which 26,000 are under first-line drug treatment. Sahu said a weekly assessment would be conducted at the Government Hospital for Thoracic Medicine (GHTM), Tambaram, to decide on those HIV positive people who are on ART and have developed resistance to first-line treatment. On Dec 1, 2007, Health Minister Anbumani Ramadoss had announced that second-line drugs would be rolled out in two hospitals - J.J. Hospital (Mumbai) and GHTM (Tamil Nadu). Sahu said second line ART would cost at least Rs.8,000 per month per patient. "But the government is providing it free". Initially only patients in Mumbai and Chennai will have access to the free treatment. But the government is planning to reach out to more people by April 1 when it launches 10 more centres across the country. These centres of excellence are being developed by NACO and will have state-of-the-art diagnostic facilities, trained manpower and adequate research facilities in HIV/AIDS, TNSACS officials explained. A special panel of experts set up by NACO would conduct the patient selection for second line treatment. The panel shall ensure that a very strict adherence to protocol is maintained for patients on second line ART and shall monitor them closely to record its effects, officials said. =============================================================== 5. Fresh hope for HIV+: 2nd line of treatment begins The Times of India, January 24, 2008. http://timesofindia.indiatimes.com/India/Fresh_hope_for_HIV_2nd_line_of_treatment_begins/articleshow/2726005.cms NEW DELHI: Life-saving free second-line Anti-Retroviral Therapy (ART) has finally been rolled out for HIV patients, who had become resistant to first-line drugs. Five patients were administered second-line ART for the first time under India's National Aids Control Programme on Wednesday at Chennai's Tambaram ART Centre. Sixteen others will follow on Thursday. According to Dr B B Rewari, national programme officer (ART), 21 persons will be put on the treatment in Mumbai's J J Hospital on Thursday. TOI had first reported in November that the National Aids Control Organisation (NACO) had decided to roll out second-line from January, starting with J J Hospital and Tambaram ART Centre. The treatment will then be available at 10 proposed centres of excellence across the country, including Maulana Azad Medical College (Delhi), PGI (Chandigarh) and ART centres in Kolkata, Manipur and Nagaland by April 2008. Union health minister A Ramadoss then made this announcement on World Aids Day on December 1. However, health secretary Naresh Dayal had categorically told TOI only those patients, who have been on first-line drugs in NACO's ART centres and have become resistant, will be eligible for free second-line therapy. "Every week, we will put 21 patients, who have become resistant to first-line therapy on second-line drugs, in Chennai and Mumbai. We estimate nearly 3,000 patients currently on ART may have become resistant to first-line drugs. All of them will be put on second-line by December 2008,” Dr Rewari told TOI. He added: "The patient selection for second-line is being done by a special panel of experts constituted by NACO. A state AIDS clinical expert panel will meet periodically to review the records of patients failing on first-line. The panel will ensure that a very strict adherence protocol is maintained for patients on second-line ART and will monitor them closely for adverse effects." Till now, NACO only provided free first-line drugs to over 1.05 lakh HIV patients in its 135 ART centres. NACO estimates that at least 3% of these patients have become resistant to first-line drugs. Ten doctors from the centres of excellence visited Thailand to study operational issues relating to second-line therapy in December 2007. UNITAID, an international drug purchasing facility, will donate the drugs to India. Naco will then tie up with India's generic drug makers to provide them after two years. While first-line drugs cost NACO Rs 8,000 per patient on ART per year, second-line drugs will cost it Rs 8,000 per patient per month. UNAIDS India chief Dr Dennis Broun told TOI: "Second-line treatment is very expensive and requires high adherence rates. Brazil at present spends 60% of its national AIDS budget to buy second-line drugs required for only 10% of its HIV population." Dayal said: "We had planned to introduce second-line treatment only after one lakh HIV patients were put on first-line drugs. Now that we have crossed that mark, second-line has been introduced." ART is the known treatment that inhibits HIV. The drugs slow down the replication of HIV and immune deterioration is delayed leading to an improvement in the survival and quality of life. =============================================================== 6. AIDS vaccine: Chennai trial results encouraging The Hindu, January 24, 2008. http://www.thehindu.com/seta/2008/01/24/stories/2008012450031600.htm All in the high-dose group who got the vaccine showed immune response The vaccine tested contains six HIV genes inserted into the MVA vector The MVA vaccine construct used in the trial was developed by a Kolkata based scientist There appears to be a greater possibility of finding an efficacious AIDS vaccine. The preliminary results of the Phase I trial of the AIDS vaccine undertaken in Chennai have been largely encouraging. The trial undertaken at the Tuberculosis Research Centre (TRC), using the Modified Vaccine Ankara (MVA) vector has shown the ability to elicit immune response. Unlike the three doses used at the National AIDS Research Institute (NARI) trial, Pune, the Phase I trial at TRC involved just two doses — a high dose (2.5x10{+8}) and a low dose (5x10{+7}). Vaccine safety Much like the AAV vaccine tested at NARI, the vaccine tested at TRC has been found to be safe at both the doses. But where the MVA has probably scored better compared with AAV, at this stage, is the number of volunteers who received the vaccine recording an immune response. “We have seen 75 per cent immune response [9 out of 12 volunteers] with the low dose and 100 per cent with the high dose [all the 12 volunteers] after three injections,” said Dr. V.D. Ramanathan, Deputy Director (Department of Clinical Pathology) at TRC and the Principal Investigator of the vaccine trial. The level of immune response seen, among other details, will be known only after the final analysis of the data. The immune response seen after just two injections were given to the volunteers was good. According to Dr. Ramanathan, 66 per cent immune response (8 out of 12 volunteers) was seen in the low dose group and 92 per cent (11 out of 12 volunteers) in the case of high dose group. It may be recalled that vaccine trial at Chennai was started in February 2006 (The Hindu, February 9, 2006) and involved 32 volunteers who were split into two groups of 16 each. Of the 16 in each group, 12 received the vaccine and four received a placebo (dummy). Final results While the 18 months follow-up of the volunteers belonging to the low dose category has been completed, the required follow-up of those in the high dose group will be completed in the first week of February 2008. The first volunteer to be given the high dose was in the first week of August 2006. The preliminary immunogenicity (immune response) result was presented during the AIDS vaccine conference at Seattle. The final results will be available only in mid-2008. So will there be a surprise in the final results? “How the immunogenicity will translate into actual protection remains to be seen,” said Dr. Ramanathan. Dr. Patricia Fast, Executive Director (Medical Affairs) of the International AIDS Vaccine Initiative, New York in an email communication to this Correspondent noted, “…We expect that the [interim data result] is close to the final responses.” Only Phase II and Phase III trials involving larger number of people would help in knowing this crucial issue. “The results of the first trial suggest that further clinical research is warranted,” Dr. Fast noted. She also indicated that the conduct of further clinical research will depend on the Indian Government. The man behind If the MVA vaccine has shown encouraging results in the Phase I trial, the full credit should go to the person who was responsible for producing the MVA vaccine construct — Dr. Sekar Chakraborty, Deputy Director of the National Institute of Cholera and Enteric Diseases, Kolkata. Unlike the vaccine tested in Pune (AAV) that contained only three HIV genes put into the vector, the MVA has six genes. But it is not just the number of genes that has probably resulted in better immune responses. The six genes have been put in two different positions of the MVA genome. This is unique and thus different from the other MVA constructs developed by people abroad. Dr. Chakraborty had also modified the natural amino acids of three of the six genes to enhance the immune response. Dr. Fast noted that it is “…not yet possible to conclusively identify the reasons” for the good showing of the MVA construct. High stability While the earlier MVA construct suffered from instability problems, the construct developed by him has been shown to have 96 per cent stability. This increased stability has been achieved by putting the six HIV genes in two different positions of the MVA genome. =============================================================== Disclaimer: Opinions expressed in the above articles are those of the respective newspapers, not those of SAATHII.