********************************************************** SAATHII Electronic Newsletter HIV NEWS FROM INDIA Source: Thaindian.com, Express India, The Hindustan Times, Kangla Online, DNA, The Business Standard and News Post India Posted on: 28/01/2008 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. Transgenders conduct AIDS campaign in Coimbatore Thaindian.com, January 28, 2008. http://www.thaindian.com/newsportal/india-news/transgenders-conduct-aids-campaign-in-coimbatore_10014299.html 2. Second line ART drugs for five at J J Hospital Express India, January 24, 2008. http://www.expressindia.com/latest-news/Second-line-ART-drugs-for-five-at-J-J-Hospital/265362/ 3. Global AIDS epidemic still spreading: UN The Hindustan Times, January 24, 2008. http://www.hindustantimes.com/StoryPage/StoryPage.aspx?id=40d78b3e-340c-4bb2-889b-4af1e73fe2af&ParentID=627499d7-ef21-4280-900c-aa5dc3a04abb&MatchID1=4628&TeamID1=1&TeamID2=6&MatchType1=1&SeriesID1=1165&PrimaryID=4628&Headline=Epidemic+still+spreading%3a+UN 4. Enabling positive children to grow up positively Kangla Online, January 25, 2008. http://www.kanglaonline.com/index.php?template=headline&newsid=40920&typeid=1 5. Probe ordered into WB projects DNA, January 25, 2008. http://www.dnaindia.com/report.asp?newsid=1147409 6. US body denies Gilead HIV drug patent The Business Standard, January 26, 2008. http://www.business-standard.com/common/news_article.php?leftnm=1&subLeft=1&chklogin=N&autono=311752&tab=r 7. Cipla mulls launching generic AIDS drug in US The Business Standard, January 26, 2008. http://www.business-standard.com/common/news_article.php?leftnm=1&subLeft=1&chklogin=N&autono=311753&tab=r 8. AIDS Orphans Across India To Get New Homes News Post India, January 27, 2008. http://newspostindia.com/report-33644 =============================================================== 1. Transgenders conduct AIDS campaign in Coimbatore Thaindian.com, January 28, 2008. http://www.thaindian.com/newsportal/india-news/transgenders-conduct-aids-campaign-in-coimbatore_10014299.html Coimbatore: A group of transgenders in Kinathukadavu village near Coimbatore have recently conducted a campaign through cultural programme to spread awareness about HIV and AIDS. “We intend to make people aware about safe sex and ways to protect themselves from the disease. We also want to educate people about cancer, need to have a girl child, female education and infanticide,” said Thenmozhi, a campaigner. A large number of people thronged the roadside to watch this unique cultural programme. “People have a lot of misconceptions about transgenders. But, now they have come up with the campaign. It is really nice and all of us should support their campaign, said Hussain, a spectator. With the number of HIV and AIDS patients increasing each day in India, such awareness campaigns are a common feature in the country. Although the Government has launched a nation-wide programme to educate the people about the disease, the stigma is still widely prevalent. India has roughly 2.5 million people infected with HIV, less than half the number of cases that previous studies estimated. An earlier U.N. study had estimated 5.7 million HIV cases, which would have been the highest total in the world. But as per the latest available data, India, which has a population of 1.1 billion, has fewer HIV cases than South Africa and Nigeria. =============================================================== 2. Second line ART drugs for five at J J Hospital Express India, January 24, 2008. http://www.expressindia.com/latest-news/Second-line-ART-drugs-for-five-at-J-J-Hospital/265362/ Mumbai: Five persons who have developed resistance to the first line of drugs given through Antiretroviral Therapy were on Thursday selected by a panel to start the second line of drugs at the JJ Hospital in Mumbai. “I have no choice but to take these medicines. Even if they ask me to take 10 medicines, I will take because that is the only way I can survive,” says a 38-year-old HIV positive man. He was admitted to the JJ Hospital two years ago when he was detected with HIV. Though he has been taking the first line of drugs ever since, he has developed resistance to them. “I could not stop taking the drugs, but it wasn’t making any difference. My CD-4 count kept dropping.” Selected from the 18 persons screened for clinical eligibility by State AIDS Clinical Expert Panel-the special panel of experts constituted by NACO-the 38-year-old along with four others was handed over the packets of seven drugs to be consumed on a daily basis by them from now on. The criteria is patient whose CD4 count falls below the baseline after a high or persistently remains less than 100 is eligible, besides those who develop opportunistic infections and whose viral load count is 1,000 copies/ml. The SACEP will meet every Tuesday at JJ Hospital to review the records of patients failing on first line and will decide on second line drugs for these patients. The panel will also ensure strict adherence from patients on second-line ART and will monitor them closely for adverse effects. “Eighteen patients have been screened and five of them were reviewed by the panel. They have been given the seven tablet regime for the second line of drugs,” said Dr B B Rewari, National Programme Officer (ART), NACO. A team from NACO comprising Dr Rewari, Dr Po-Lin Chan, WHO India office, Pradnya, M&E officer, NACO visited J J HOSPITAL to brief the members of SACEP on various technical and operational issues related to the rollout of the second-line of drugs. Experts from Clinton Foundation and other organisations also attended this orientation session. The rollout has to be very careful and systematic as there are no third-line drugs available in case patients fail on second-line drugs. Currently, the Clinton Foundation is providing the drugs. The drugs cost Rs 8,000 per month. “We started work on the rollout more than two years ago with national consultations on the need and feasibility of introducing second-line drugs in view of the very high costs involved and building the capacities of institutions and related laboratories on second-line drugs and tests,” said Dr Rewari, adding, “This was followed by the formation of a Technical Resource Group (TRG) on ART at NACO which deliberated on various issues related to the provision of second line in the national programme” The National AIDS Control Organisation (NACO) began giving free Antiretroviral Therapy (ART) in 2004, wherein JJ Hospital was one of the first centres selected. The ART programme, which began in eight institutions, has now scaled up to 137 ART centres across 31 states. Nearly 1.2 lakh patients are currently receiving free ART treatment at these centres. Of these, 20,000 are from Maharashtra. NACO estimates that despite very good adherence levels, nearly 3 to 5 per cent of patients become resistant to antiretroviral drugs in about three years after the treatment begins. It estimates close to 3,000 persons having ART treatment have developed resistance and need to be moved on the second line of regime. The current phase of will be tried out till June before being replicated at other centres and the rollout will be expanded to 10 proposed “centres of excellence” across the country. These centres will have diagnostic facilities, trained manpower and adequate research facilities in HIV/AIDS. =============================================================== 3. Global AIDS epidemic still spreading: UN The Hindustan Times, January 24, 2008. http://www.hindustantimes.com/StoryPage/StoryPage.aspx?id=40d78b3e-340c-4bb2-889b-4af1e73fe2af&ParentID=627499d7-ef21-4280-900c-aa5dc3a04abb&MatchID1=4628&TeamID1=1&TeamID2=6&MatchType1=1&SeriesID1=1165&PrimaryID=4628&Headline=Epidemic+still+spreading%3a+UN The HIV/AIDS epidemic continues to march across the globe, with more deaths and more infections this year than ever before, according to the latest U.N. report. The report by UNAIDS, the U.N. agency responsible for coordinating global efforts to fight the disease, said the worldwide epidemic killed more than 3 million people in 2003. Around 5 million more acquired the human immunodeficiency virus, or HIV, bringing the number of people living with the virus to between 34 and 46 million. "This is an epidemic that at the start was a white middle-class gay man's disease. Today, if you use a stereotype, the face of AIDS is a young woman from Africa," Dr. Peter Piot, executive director of UNAIDS, told a news conference in London. The report said the epidemic in sub-Saharan Africa remains rampant - an estimated 26.6 million of the continent's people are now living with HIV - and a new wave of epidemics is threatening China, Indonesia and Russia because of transmission through injecting drug use and unsafe sex. UNAIDS said the global response to the crisis had expanded significantly in the past two to three years, with spending on anti-retroviral medication and education increasing in many countries. "However, it is quite clear that our current global efforts remain entirely inadequate for an epidemic that is continuing to spiral out of control," said Piot. "AIDS is tightening its grip on southern Africa and threatening other regions of the world." The report said that anti-retroviral treatment coverage remains dismal in sub-Saharan Africa, and basic knowledge of HIV/AIDS is still disturbingly low in many countries, especially among women. Voluntary counseling and testing services are all but absent in many countries and only 1 per cent of pregnant women in heavily affected countries have access to services aimed at preventing mother-to-child HIV transmission, the report said. A report by the Washington-based International Center for Research on Women said that stigma and discrimination continues to impede testing, prevention and treatment for women in Africa. =============================================================== 4. Enabling positive children to grow up positively Kangla Online, January 25, 2008. http://www.kanglaonline.com/index.php?template=headline&newsid=40920&typeid=1 IMPHAL: For some children adulthood comes too early, as early as right after infancy. When adulthood is imposed on children with certain conditions like HIV, growing up is not easy. Since Anti-Retroviral Therapy made it possible for the people, including children, living with HIV to live longer it is more likely that most of the children orphaned by HIV and AIDS would outlive their grandparents and many of the older caregivers. Are the services being provided by the handful of donors through the NGOs enough to ensure quality and meaningful living for these children? *Noor gets medicinal, educational and nutritional support from the different NGOs she was taken to by her kaka. Though she is happy with all the supports, like other eight years old, Noor wants dolls and toys too. Fourteen years old Bem* is on ART. She knows her HIV status yet she avoids any talk on HIV. When her counselor asked about the opportunistic infections she suffered, she answered happily. But the moment the topic of HIV is taken up, she would say irritatingly said ‘ush, I don’t know anything’. Bem is already menstruating. Like any teenager her age, she has developed interest in boys and blushed each time the topic of boyfriend is brought up. She lives with her grandmother who is also looking after three more children and a positive son, Bem’s uncle. Boi*is very articulate and smart. At thirteen, he knows his HIV status and said with complete ease, “Being HIV positive means I will die of a single disease, it can even be common cold.” His comfort left this writer stunned. Boi knows more names of NGOs than probably his friends or relatives. Boi lives with his elder brother who is fifteen years old. Both brothers live each day as it comes. Boi is completely blank on the question of tomorrow. He makes yongkhot, jharap, meirou chegap, etc in his free time at the nearby blacksmith’s workshop and sometimes gets Rs 100 in two days. All these children are orphans. They are going to get educational, nutritional and other supports. But there are other invisible needs which would be required to be fulfilled or addressed in some way. Many children are growing up without parents in parts of Manipur. One of the major difficulties faced by the counselors dealing with children is ‘how to tell them their status and how to talk to them about safe sex when they are themselves in denial’. Shabana, who is working with the Imphal East Network of Positive People said, “Even the counselors dealing with children are clueless. If one of the parents is alive, he or she can tell. But even parents refuse to do it out of the fear. So what do we do?” The Project Director of Manipur State AIDS Control Society, Dr Pramod said, “There is no NACO protocol for child counselor at present. But NACO is in the process of developing guideline on who to counsel – counselor or care taker.” If this process is finalized, some of the issues and concerns of the children and teenagers living with HIV might be effectively addressed and help them grow with a positive attitude. (*name changed to protect identity) =============================================================== 5. Probe ordered into WB projects DNA, January 25, 2008. http://www.dnaindia.com/report.asp?newsid=1147409 NEW DELHI: The Union health ministry has ordered an inquiry into the functioning of five projects funded by the World Bank following charges of corruption and systemic deficiencies. The probe committee will submit its report by February 10. The Bank had found the fraud during a detailed implementation review in 2006-07 of the National AIDS Control Project II, the Malaria Control Project, the Tuberculosis Control Project, the Food and Drug Capacity Building Project, and the Orissa Health System Development Project. The Review pertained to the implementation of these projects, which are valued at $568.6 billion, during 1997-2006. “We have sent teams to investigate the World Bank’s claim,” the National AIDS Control Organisation’s director-general K. Sujatha Rao said. “The inquiry regarding target intervention programmes which involve a large number of NGOs is very critical.” “Our teams are zeroing on who is doing what and action is being taken to see only correct agencies are funded.” NACO says it has already started taking action against non-performing and erring NGOs. It claims safety measures were in place prior to the launch of NACP III in July last year, for which the World Bank had provided $250 million. “Even though the World Bank has not specifically pinpointed many erring NGOs or specified instances of corruption, the NACO has put in place stringent measures in place to prevent corrupt practices in future. Prior to the launch of NACP III, we conducted a detailed self appraisal and a 100 per cent evaluation of all NGOs involved in target intervention programmes,” the NACO chief told DNA. Evaluation was conducted during April to June last year following which the number of NGOs receiving government funding was reduced from 958 to 790. “These surviving NGOs had to pass the standardised evaluation on the parameters set by NACO. Those scoring less than a particular margin were kicked out. The NACO is now going to evaluate all these NGOs annually. This evaluation gave us a clear picture of who is working and who is not. We were able to check fraudulent claims and weed out of corrupt, non-performing and inefficient NGOs,” Rao said. The NGOs were evaluated on their HR policies, financial transparency, quality of services, documentation and reporting, procurement system, and outcomes. The NACO has also circulated detailed guidelines to the State AIDS Control Societies (SACS) for oversight and selection of NGOs. A separate cell of 20 people headed by a new Joint Secretary is being set up at the NACO headquarters to monitor implementation of programmes and check financial irregularities. “Managing of targeted interventions is important for NACO and SACS. Oversight of NGOs will be far more vigorous now. Every year in the 11th month a three-member committee will inspect the SARCs and the NGOs for their eligibility for continuation of support or termination. In case they are good they can continue but the poor performers will have no place,” Rao said. NGOs and people from the civil society will be encouraged to file their complaints directly to this team of NACO. While whistleblowers are welcome, the NACO is also toying with the idea of having a prominent person as an ombudsman who can coordinate with whistleblowers. “Transparency is the first step to weed out corruption. The same NGOs who helped WB in conducted inquiry could have come to us also. We want people from civil society to bring it to our notice if they find any corrupt practices, officials demanding bribe or any other irregularity,” Rao added. However, the NACO chief on the issue of faulty HIV/AIDS testing kits, the NACO chief refused to accept problems. “There was no question of inferior quality material being supplied to the states. More than 10 million kits were procured and I agree there could be a failure rate of .28 per cent,” she said. She acknowledged problems in the Zhongshan kits but dismissed the Bank’s charge that a Chinese food joint, Golden Dragon, functioned at the address given by Zhongshan’s local distributor in Mumbai, Spectra Pharma and Health Products. Rao said the bank’s team did not conduct a proper inquiry as “there are about 30 shops below the Golden Dragon restaurant”. =============================================================== 6. US body denies Gilead HIV drug patent The Business Standard, January 26, 2008. http://www.business-standard.com/common/news_article.php?leftnm=1&subLeft=1&chklogin=N&autono=311752&tab=r US-based drug maker Gilead Sciences has found four of its US patents on Viread being turned down by the US Patent and Trademark Office (USPTO). The company entered into non-exclusive license agreements with Indian drug companies such as Ranbaxy and Hetero for supply of the generic versions of its patent-protected AIDS medicine Viread (tenofovir) in over 90 developing countries. The rejection of patents, a decision that can be appealed against, was based on the post-grant opposition filed by a US-based NGO Public Patent Foundation (PUBPAT). The initial set back to Gilead has strengthened the case of Indian patient groups and health NGOs who have filed pre-grant oppositions against similar patent applications of Gilead in the Indian patent office. If the US decision is to have an impact on Indian patent office's verdict, the license agreements, which called for restricted supply of the medicines on a royalty basis may turn redundant, experts feel. It was in 2006, that the Indian Network for People Living with HIV/AIDS (INP+) filed pre-grant oppositions to several patent applications on Gilead's Viread on the ground that they did not meet the Indian patentability criteria. Months later, PUBPAT approached the US patent office challenging the patent grants on the medicine. Both oppositions were based on the premise that the patents granted in the US and the ones sought in India are not patentable. According to a PUBAT announcement on January 24, the USPTO has rejected all four patents on the drug. The decision, subject to challenge by Gilead, is likely to have an international impact on Gilead's patents on tenofovir in other countries, PUBAT stated. Indian patient groups said that Gilead will now have to share the US patent office decisions with the Indian patent office. Interestingly, Gilead had almost succeeded in stalling probable patent oppositions from Indian generic companies such as Ranbaxy, Strides Acrolab, Emcure, Hetero Drugs and Matrix Laboratories by entering into licensing pacts with them in August 2006. The agreement allows its partners to manufacture and sell these products in over 90 developing countries, which accounts for 95 per cent of AIDS population, on payment of a nominal royalty. However, INP+ went ahead with the patent opposition as it felt that if patents on tenofovir are granted in India, it will affect the access to affordable generic versions of the medicine in the country. =============================================================== 7. Cipla mulls launching generic AIDS drug in US The Business Standard, January 26, 2008. http://www.business-standard.com/common/news_article.php?leftnm=1&subLeft=1&chklogin=N&autono=311753&tab=r Cipla on Thursday said it would "definitely" consider launching generic tenofovir disoproxil fumarate, an HIV/AIDS drug, if Gilead Sciences does not challenge the US Patent & Trademark Office's (PTO) decision to overturn its patent on the drug. Gilead holds the patent for TDF in most developed markets, including its home country the US. The company sells it under the brand Viread in the US. The US patent office Wednesday overturned Gilead?s patent on the drug, after various petitions argued TDF was not an innovation but a 'prodrug' of an earlier known molecule. "We are studying the impact of the US PTO?s decision in other markets where Gilead holds the patent. Then, we will look at which markets to enter," Amar Lulla, managing director, Cipla, said. "We will definitely try to launch the product in the US market, if Gilead doesn?t challenge the decision," he said. The Mumbai-based drug maker sells generic TDF in India, and some markets in Africa and Latin America, where the drug is off-patent. There are over 40 million HIV/AIDS patients across the world, including over 1.2 million in the US. Lulla said he 'always believed' the patent on Viread was invalid. Cipla shares remained indifferent to the news. =============================================================== 8. AIDS Orphans Across India To Get New Homes News Post India, January 27, 2008. http://newspostindia.com/report-33644 Albina du Boisrouvray dreams big. The head of the only international NGO that works in all 35 states and union territories in India now wants to set up five villages across the country, where 2,000 children orphaned by AIDS will find shelter. The NGO Francois-Xavier Bagnoud (FXB) was set up in memory of Boisrouvray's son, a helicopter pilot who died during a rescue mission. 'In that spirit of rescue, we're stitching together a safety net for AIDS orphans around the world,' Alvina told IANS Saturday. Boisrouvray was in the national capital as part of French President Nicolas Sarkozy's delegation and gushed about the 'wonderful Republic Day parade' she had seen Saturday morning. Straight from the parade, she rushed to Sanjay Colony, a slum in a corner of the capital's diplomatic enclave Chanakyapuri, where FXB runs one of its earliest projects in India. A small computer centre that the NGO set up there has led to some of the slum children getting jobs. Boisrouvray was just as admiring of them as she was of the parade. Since starting in Goa in 1990, FXB works in many areas in India, but helping orphans, especially those orphaned by the AIDS epidemic, is closest to Boisrouvray's heart. 'We work at the grassroots,' Boisrouvray said. 'So we know the problems. And the worst problem is the situation faced by those orphaned due to AIDS. Many of them are HIV positive themselves. 'All of them face huge discrimination, as the stigma associated with AIDS is still very prevalent in this country. Very few of them get a chance to go to school. These are the children we try to help.' The NGO does that through a model developed by Boisrouvray in Uganda. 'We set up FXB houses,' she explained. 'Each house has (foster) parents, maybe grandparents and some orphans they take in with our help. 'Then we extend this into an FXB village. We help start income-generating activities. We set up some education programmes so that the children are able to get into schools. We provide healthcare support and access to basic needs for the first three years. We have found that in 86 percent cases, people are able to look after themselves by the fourth year.' In each 'FXB village' in India, about 80 families would look after an average of five AIDS orphans each, Boisrouvray said. That would mean 2,000 orphans would live in five villages. The India office of FXB has not yet finalised the states in which the five villages would be set up, but Boisrouvray said they were likely to include West Bengal, Andhra Pradesh, Mizoram and Manipur. 'Then in the second phase, we shall set up villages in Jharkhand, Maharashtra, Gujarat, Bihar and at Noida in Uttar Pradesh,' she added. The NGO's India budget for the 2008 calendar year is $1.3 million, and much more will be needed to transform this dream into reality. But lack of money has never deterred the FXB head. Apart from starting the organisation with her own money, she has raised funds from all over the world, including Indian corporate houses. Taking advantage of being part of the Sarkozy delegation, Boisrouvray was busy telling fellow delegates from French industry that they should help this project as soon as they sign contracts with their Indian counterparts. 'I keep pointing out how it will be good public relations for them.' =============================================================== Disclaimer: Opinions expressed in the above articles are those of the respective newspapers, not those of SAATHII.