********************************************************** SAATHII Electronic Newsletter HIV NEWS FROM INDIA Source: The Times of India, The Hindu, Livemint.in, New Indian Express and Top News. Posted on: 10/12/2007. 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. Combat HIV stigma The Times of India, December 04, 2007. http://timesofindia.indiatimes.com/Opinion/Editorial/Combat_HIV_stigma/articleshow/2592988.cms 2. AIDS rally (Chennai) The Hindu, December 04, 2007. http://www.hindu.com/2007/12/03/stories/2007120359460500.htm 3. India needs improved regimen of anti-retroviral drugs, says expert The Hindu, December 06, 2007. http://www.hindu.com/2007/12/06/stories/2007120656950500.htm 4. Health groups find second-line AIDS drug plan inadequate Livemint.com, December 06, 2007. http://www.livemint.com/2007/12/06002433/Health-groups-find-secondline.html 5. AIDS welfare activities in jails come to a standstill New Indian Express, December 06, 2007. http://www.newindpress.com/NewsItems.asp?ID=IEO20071204220639&Page=O&Headline=AIDS+welfare+activities+in+jails+come+to+a+standstill&Title=Thiruvananthapuram&Topic=0 6. Thousands of HIV+ persons gather for “Be Bold Campaign” in Hyderabad Topnews, December 08, 2007. http://www.topnews.in/health/thousands-hiv-persons-gather-be-bold-campaign-hyderabad-2119 7. Combating HIV/AIDS head-on The Hindu, December 08, 2007. http://www.hindu.com/2007/12/08/stories/2007120857290400.htm =============================================================== 1. Combat HIV stigma The Times of India, December 04, 2007. http://timesofindia.indiatimes.com/Opinion/Editorial/Combat_HIV_stigma/articleshow/2592988.cms Global AIDS numbers have dropped dramatically, but that is only half the battle won. Stigma towards HIV-positive people needs to be countered if the threat of AIDS is to be overcome. An Indian soldier discovers he is HIV-positive and is forced to deal with the termination of his services. He must now move the courts for justice - a burden in itself. An HIV-positive pregnant woman from West Bengal has a sticker plastered on her forehead by hospital staff, is isolated in the ward and refused the urgent medical attention she needed. A couple is stoned, branded outcast by the only community they know simply because they are HIV-positive. A HIV-positive woman in Kolkata aborts her own foetus because hospital staff refuse to assist her. This intense stigma can be painful to endure. The good news is that the number of people contracting HIV infection is dropping, worldwide. A few days ago, UNAIDS, releasing its AIDS Epidemic Update for 2007, said new data show global HIV prevalence (the percentage of people living with HIV) has levelled off and the number of new infections has fallen, in part as a result of the impact of HIV programmes. The new estimate of 2.47 million persons in India living with HIV (0.36 per cent of the adult population) released through the National Family Health Survey-III (NFHS-III) is less than half the official estimate for the previous year. India now comes third among nations with the largest number of people living with HIV. The optimistic arithmetic apart, the experiences of ordinary people living with HIV tell another story. Stigma and not surveillance, is the biggest problem. A 15-year-old boy from Ahmedabad committed suicide to escape the stigma piled on because his parents, both vegetable sellers, were HIV-positive. Two little children in Kerala roused a nation’s feelings when their grandfather stood up and fought against their expulsion from school because they were HIV-positive. In the 24 Parganas district of West Bengal, an HIV-positive child’s mother was forced to accept a refund of his school fees. Stigma is hard to track and its impact even harder to measure. NFHS-III has generated data on stigma by including surveys on HIV/AIDS know-ledge, attitudes and behaviour. Overall acceptance measured through indicators like willingness to care for a positive person or buy vegetables from a positive person, or have a teacher who is positive continue teaching in the school is low - 34 per cent for women and 37 per cent for men. This corroborates a study by International Labour Organisation which says that two-thirds of positive persons face discrimination. The World Bank points to a study in India that found how 34 per cent of students, faculty and technical staff of the public health services would not associate with people living with HIV and AIDS. Those vulnerable to and experiencing social stigma and discrimination will be puzzled if they were told that awareness and knowledge about HIV/AIDS is higher than before. Between 1998-1999 and 2005-2006, knowledge of AIDS in women (earlier rounds of the NFHS did not interview men) went up by 17 per cent (from 40 per cent to 57 per cent). But NFHS-III has also found how only 30 per cent of women with no education have heard about HIV/AIDS. Almost two-thirds of women and half of men still believe that a mosquito bite can transmit HIV infection. Awareness is not translating into tolerance or a shedding of stigma. Protection against HIV and preventing its spread is certainly a key message, but protection using stigma and alienation will go nowhere. It is always challenging to fight for legislation and better policy outcomes. Kerala has a law against discrimination of HIV-positive children in schools. But laws and policies cannot be substitutes for a humane approach. =============================================================== 2. AIDS rally (Chennai) The Hindu, December 04, 2007. http://www.hindu.com/2007/12/03/stories/2007120359460500.htm CHENNAI: Several hundred people walked down the length of the Marina between Swami Sivananda Salai and the Light House on Sunday evening carrying candles for the victims of AIDS. People living with HIV/AIDS, students, volunteers and social workers were part of the rally organised by Hope Foundation, Family Planning Association of India and Indian Church of Christ. In concise English and Tamil, the pamphlets, distributed at the rally, explain how AIDS spreads and reiterates that it is not spread by shaking hands, sharing the belongings such as clothes and food of the AIDS-affected or mosquito bites. Deputy Mayor R. Sathyabama participated in the event held before the rally, where children from the HIV/AIDS Home of Hope performed a dance. Women with AIDS talked about their stigma and opportunities available to them through NGOs. The Family Planning Association of India provides medical, lab and counselling services in the field of reproductive health and family life. The Association is aiming to ‘mainstream’ HIV, ensuring that addressing this issue is an essential part of such services, said Sujatha Natarajan, vice-president, Family Planning Association of India, Chennai. =============================================================== 3. India needs improved regimen of anti-retroviral drugs, says expert The Hindu, December 06, 2007. http://www.hindu.com/2007/12/06/stories/2007120656950500.htm CHENNAI: India needs to switch to an improved regimen of anti-retroviral drugs to cut down the risk of mother-to-child HIV transmission, says Philippe Van De Perre, an HIV expert of the University of Montpellier, France. The preliminary findings of several ongoing global studies to determine the best possible matrix of drugs indicate that anti-retroviral drugs used in combo can lower the risk of parent-to-child transmission of the virus to between 1 and 2 per cent, Dr. Perre told The Hindu during a recent visit to Chennai. “The major worry with a single dose regimen with just one drug like Nevirapine is the potential for the mother developing resistance when the drug is used at a later stage,” said Dr. Perre, whose specialised work includes parent-to-child transmission. The drug regimen recommended by the World Health Organisation involves AZT, Nevirapine and 3TC. It is effective in neutralising the virus across lifecycles, from 28 weeks into pregnancy to the post-partum phase. “India should seriously consider adopting the WHO-recommended regimen to lower the incidence of parent-to-child HIV transmission,” said Sai Subhasree Raghavan, president of SAATHII (Solidarity and Action Against The HIV Infection in India). (Currently, it is estimated that the parent-to-child transmission is 15-20 per cent if no intervention is provided.) Far from being improbable, adopting the WHO-advised regimen should be a viable proposition in India, as the country accounted for nearly half of the global anti-retroviral drug manufacture and exports anti-HIV medicines to over 100 countries, she said. According to Dr. Subhasree, any fear of non-compliance by those who get started on anti-retroviral drugs should not stand in the way of switching to a combo regimen as the public health system in India has been providing long-duration anti-retroviral therapy to over one lakh patients. However, the big challenge is to make access to these drugs distributive and decentralised in a country where 50 per cent of the deliveries still take place in homes and 25 per cent of live births occur in private hospitals. It was imperative that ART interventions be integrated with the existing, ongoing health programmes such as the National Rural Health Mission. This would require toning up of primary health centre infrastructure and proper sensitisation and training of grassroots healthcare personnel, Dr. Subhasree said. However, the pitfall to be avoided, according to Dr. Perre, was keeping apart prevention programmes and delivery of treatment. =============================================================== 4. Health groups find second-line AIDS drug plan inadequate Livemint.com, December 06, 2007. http://www.livemint.com/2007/12/06002433/Health-groups-find-secondline.html Activists slam government plan to target a mere 2,000 people out of lakhs who need the second-line treatment Amid few manufacturers of these expensive drugs, public health groups are noting that the government’s plan to provide so-called second line of AIDS drugs is far too limited to have any significant impact in India. On 1 December, which was World’s AIDS Day, Union minister for health and family welfare Anbumani Ramadoss had announced that government programmes will include second-line treatment from January. To be administered to those AIDS patients who have developed resistance to first line of drugs, these drugs will be given out only to below poverty line (BPL) patients from Chennai and Mumbai to begin with, and cover 2,000 people in 2008. In April, the number of centres will be extended to 10. India is estimated to have 2.5 million HIV-infected people, of which 400,000 require treatment. The government, through National AIDS Control Organization (Naco), provides first-line drug regimen such as zidovudine, lamivudine, statuvudine and efavirenz to 110,000 ­people. “Covering 2,000 (people) is like a joke in the face of 2.5 million infected people. There is a need to scale it up and provide universal access to these drugs,” said Chinkholal Thangsing, Asia-Pacific bureau chief of AIDS Healthcare Foundation, which provides second-line regimen to 30 patients. Thangsing estimates that drug cocktails that involve second regimen, cost Rs60,000-80,000 every year per patient compared with first-line drugs that cost Rs8,400-Rs24,000 each year. According to Dennis Brown, UNaids country coordination for India, about 2-5% of the AIDS patient population develops resistance to the initial line of drugs and need the next level of stronger, more effective drugs. This means up to 20,000 people could be requiring second-line drugs such as tenofovir, atazanavir, indinavir, ritonavir and lopinavir, which are up to 10 times costlier. These drugs are made mostly by multinational drug makers such as Bristol-Myers Squibb Co. and Abbott Lab. Inc., with just three Indian companies—Cipla Ltd, Emcure Pharmaceuticals Ltd, and Ranbaxy Lab. Ltd—making them. This makes the drugs much more expensive than if many manufacturers were producing them. Chan Park, policy adviser to legal activists, Lawyers’ Collective HIV/AIDS unit, said: “It is a long-awaited welcome announcement, but the coverage is limited and not nearly enough. Our survey shows that most families on government ARVs (anti-retrovirals, a class of drugs) earn Rs2,000-3,000 a month. So, it is not just the BPL families who will find it unaffordable.” Park added India needs more makers of non-patented drugs in the fray to drive down prices, but also noted “these drugs are newer and many have pending patent applications on them.” Damodar Bachani, joint director, ARV therapy in Naco, while noting there is a shortage of makers of second line drugs in India, said the initial 2,000 target is “just the beginning,” and it could be reviewed and increased. He recalls how Naco’s entry into first line ARVs brought prices crashing to $1 (Rs39.40) a day and, over time, he expects the same to happen in second-line drugs. The only other way, said Bachani, is “to increase procurement so that rates as low as $500 per patient per year, can be negotiated.” =============================================================== 5. AIDS welfare activities in jails come to a standstill New Indian Express, December 06, 2007. http://www.newindpress.com/NewsItems.asp?ID=IEO20071204220639&Page=O&Headline=AIDS+welfare+activities+in+jails+come+to+a+standstill&Title=Thiruvananthapuram&Topic=0 T’PURAM: AIDS welfare activities in the 23 prisons across the state have come to a standstill as the National AIDS Control Organisation (NACO) has stopped funding. A change in the policy of NACO not to provide funds for AIDS welfare activities in prisons from November had resulted in the untimely death of the project which was started in February, it is learnt. Kerala State AIDS Control Society (KSACS), which was implementing the project, said that it had not fully backtracked from the activities in prisons, but only decided to tone down the activities. A contract was signed between KSACS and the jail authorities in February for implementing the ‘Suraksha Prison Intervention Programme’ of NACO with a total outlay of Rs 40 lakh. Twenty-six coordinators, including two state-level coordinators, were also appointed. ‘‘The project was being implemented effectively. It was also identified that there were 32 HIV positive patients in the jails,’’ said a prison official. The project was aimed at creating awareness among prisoners, especially those who are prone to unsafe sex, on the ways by which the disease is infected. Making them aware of the ill effects of unsafe sexual practices and conducting counselling among AIDS patients were also part of the project. Blood tests were conducted on all the jail inmates as well as those who were being newly admitted. Medicines were also supplied to the AIDS- infected inmates, he said. Out of the Rs 40 lakh earmarked for the project, Rs 11.7 lakh was already allotted, of which nearly Rs 9 lakh was spent. Remuneration to the coordinators were also met from the funds. On October 30, the jail authorities had received a letter from KSAC stating that the contract with the prison authorities would stand cancelled by November end. Jail authorities said that the project would have to be terminated since KSAC has cancelled the contract. ‘‘ The project is terminated as NACO has stopped funding. There is no other option before us to pursue the project, ’’ said ADGP Prisons K P Somarajan. KSACS project director Usha Titus said that a fresh project with some basic activities would be introduced in the prisons within a couple of months. ‘‘In order to utilise surplus funds, we have asked the jail authorities to continue the Suraksha project in December also, ’’ she said. With regard to the fate of the project coordinators, she said that they would be accommodated in other projects of KSACS. =============================================================== 6. Thousands of HIV+ persons gather for “Be Bold Campaign” in Hyderabad Topnews, December 08, 2007. http://www.topnews.in/health/thousands-hiv-persons-gather-be-bold-campaign-hyderabad-2119 Hyderabad: Around 7000 AIDS and HIV positive people gathered here for a mega-event to mark World AIDS week. Women, men and children affected by the fatal disease came together for the "Be Bold Campaign", which is a follow up of last year's programme organised by the state's Aids Control Society. G. Ashok Kumar, Project Director of the Andhra Pradesh AIDS Control Society (APACS) said such events boost the people's confidence. “We had a big campaign called "Be Bold". This was primarily intended to transform the awareness generated into action. Last year we had a get together of about 3800 positive people in this very same place, and we found that after they left this place they had a tremendous self-confidence boost, which they got from here, " he added. Knowledge about the illness is still scant, and most Indians who test positive for the virus do not know about the pitfalls that lead to contracting the disease, its incidence and cure. Bhanu Kumar, a counsellor, said: "There are games for children and they are telling us what we do not know about AIDS". Lack of awareness and a widespread stigma have contributed to the paranoia surrounding the virus in India. HIV patients are meted out rude treatment and are often looked down upon. AIDS has acquired the status of endemic in India -- where over 2.5 million people are thought to be living with HIV/AIDS -- and putting millions of more lives at risk. According to the latest UN figures on AIDS, the global prevalence of HIV AIDS has levelled off in part due to effective HIV programs. Still, in 2007, there are 33.2 million people infected with the disease -- about 30.8 million adults and 2.5 million children. Latest figures show 2.5 million people have become newly infected and 2.1 million people will die of AIDS related causes in 2007. =============================================================== 7. Combating HIV/AIDS head-on The Hindu, December 08, 2007. http://www.hindu.com/2007/12/08/stories/2007120857290400.htm HYDERABAD: Union Labour Minister Oscar Fernandes was impressed by the large turnout of HIV/AIDS patients at an event here which has become an annual feature of the A.P. State AIDS Control Society (APSACS) for the last three years. The size of the congregation drew a spontaneous reaction from Mr. Fernandes as he said this was the first time that he was witnessing such a large crowd of HIV/AIDS patients anywhere in the country. He appealed to the media to play up the show at the national-level to spread awareness. He said he had travelled widely to address meetings of HIV/AIDS patients in India and found them shy and unwilling to identify themselves. The APSACS has been organising a day-long event since 2005 with a view to bring together People Living with HIV/AIDS (PLHAs). They take part in games, entertainment and cultural competitions. It was held this year under the slogan “take the lead” at Shilparamam where the crowd was mobilised from various parts of the State by RTC buses. The Union Minister, who is the convenor of the Parliamentary Forum on HIV/AIDS, expressed anguish that Andhra Pradesh accounts for nearly 20 per cent of HIV/AIDS patients in the country. About 22,000 of the one lakh patients undergoing Anti-Retroviral Treatment (ART) in the country are from the State. Institutional deliveries While complementing the State Government for ensuring 80 per cent institutional deliveries, Mr. Fernandes said it is a matter of concern that the coverage is only 10 to 12 per cent in some other States. Institutional deliveries, he said, are an effective mechanism to prevent mother-to-child infection of HIV. J.D. Seelam, Rajya Sabha member and co-convenor of the parliamentary forum, appealed to patients to take drugs regularly. State Labour Minister G. Vinod, S. Sailajanath, convenor of legislators forum on HIV/AIDS, and G. Asok Kumar, project director of APSACS, also spoke. =============================================================== Disclaimer: Opinions expressed in the above articles are those of the respective newspapers, not those of SAATHII.