********************************************************** SAATHII Electronic Newsletter HIV NEWS FROM INDIA Source: Kangla Online, Indian Catholic, The Nation, Zeenews.com, The Rising Nepal, Business Standard and The Economic Times. Posted on: 13/12/2007. 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. Link ART for Bishenpur and Senapati Kangla Online, December 08, 2007. http://www.kanglaonline.com/index.php?template=headline&newsid=40352&typeid=2 2. India’s first AIDS school coming up in Nagpur The Indian Catholic, December 08, 2007. http://www.theindiancatholic.com/report.asp?nid=9549 3. Delaying 2nd line ART for Manipur amounts to lack of concern: TEAM Kangla Online, December 08, 2007. http://www.kanglaonline.com/index.php?template=headline&newsid=40351&typeid=1 4. Teenage girls are particularly vulnerable to HIV/STDs infection The Nation, December 09, 2007. http://nation.ittefaq.com/issues/2007/12/06/news0946.htm 5. AIDS: Ignorance is not bliss Zeenews, December 09, 2007. http://www.zeenews.com/znnew/articles.asp?aid=410569&sid=ZNS&sname= 6. Normal life possible for HIV-patients The Rising Nepal, December 10, 2007. http://www.gorkhapatra.org.np/content.php?nid=31901 7. Pfizer first MNC to get HIV drug patent in India Business Standard, December 11, 2007. http://www.business-standard.com/common/storypage.php?autono=307171&leftnm=1&subLeft=0&chkFlg= 8. HIV drugs to cost more as cos rush for patents The Economic Times, December 12, 2007. http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/HIV_drugs_to_cost_more_as_cos_rush_for_patents/articleshow/2615823.cms =============================================================== 1. Link ART for Bishenpur and Senapati Kangla Online, December 08, 2007. http://www.kanglaonline.com/index.php?template=headline&newsid=40352&typeid=2 IMPHAL: By 31st December 2007, two link ART centres will be set up at Bishenpur and Senapati district hospitals. Speaking to IFP, Dr Premchand, ART in-charge, Manipur State AIDS Control Society said that in this regard MSACS received a written order on 6th December from National AIDS Control Organisation to do the needful training of staffs for setting up the two link ART centres at the two districts within 31st December. As told by Dr Premchand, those HIV positive people who are eligible for starting ART from these two districts will have to undergo a thorough investigation at the nearest ART centres at Imphal and after that they can start taking ART drugs from their respective district link centres for six months. Dr Premchand said that after the initial six months, the client is required to come to the ART centres at Imphal and only after assessment of his/her condition, ART intake from the link centres can be continued. The setting up of link centres will greatly benefit the PLHA of the two districts since they would no longer be required to travel all the way to Imphal for getting ART drugs, said the doctor. He said that training of the doctors and staffs will begin soon and after that the link centres can be set up. Free ARV roll-out began in 2004 in Manipur at RIMS. Now free ART drugs are available at 6 centres under NACO and one under MSF at Churachandpur. =============================================================== 2. India’s first AIDS school coming up in Nagpur The Indian Catholic, December 08, 2007. http://www.theindiancatholic.com/report.asp?nid=9549 NAGPUR: Children with HIV or AIDS, facing discrimination in general and particularly in schools, have some hope now. India’s first AIDS school, which as the name suggests is exclusively for children living with the disease and the stigma, is coming up soon in Nagpur, Maharashtra. There have been instances recently where children living with AIDS or infected with HIV have been turned by the mainstream schools. According to a news report, they will now have dedicated education facility. Nagpur Municipal Corporation with the help of social workers and AIDS cousellors is taking a step to educate HIV -infected children. The first AIDS school with 25 infected children is starting in a North Nagpur area and a few more branches will be opened in the near future. According to Atul Patne, additional municipal commissioner, "It will be a transitional schooling to begin with, but students here will be taken care of in every aspect. From school dress to meals, they'll get everything here". In a recent survey, the civic officials have found a growing graph of HIV infected kids living a hated life. The plight of school-age children prompted the authorities to take a decision to start a school, which will be a slowly converted into a boarding school. And the goal is to accommodate them into the society. The NMC is recruiting a teacher from its staff for the new school. It also plans to set up self help group for their HIV infected parents of these children. =============================================================== 3. Delaying 2nd line ART for Manipur amounts to lack of concern: TEAM Kangla Online, December 08, 2007. http://www.kanglaonline.com/index.php?template=headline&newsid=40351&typeid=1 IMPHAL: Second line ART will be introduced in Maharashtra and Tamil Nadu in January 2008 while the rest of the country, including Manipur, will get it in April. This announcement was made by the union health minister on World AIDS Day. Speaking today to media at Lifeline Foundation, the convener of TEAM (Taskforce to Empower in Addressing Medical Issues) Vikram Nepram said, "As persons living with HIV, we would like equality in access to treatment. Why are we given step-motherly treatment? TEAM is very unhappy with this lack of concern and our appeal is that all the PLHA should be looked at equally." RK Tiken, joint secretary SASO, said, "If the differential timing is due to the number factor, at least start at the same time with limited roll out in Manipur. This is discriminatory treatment. Are the PLHAs in Northeast secondary PLHAs?" It may be mentioned that second line ART is the only option for those who develop resistance to the first line ART, which is being given at present. When contacted, Dr K Priyokumar, ART in-charge JN Hospital said, "The cost of second line ART ranges between 8-10 thousand. Sometimes more also. To my knowledge, at present there are around 30 PLHAs who are already on second line ART in Manipur." Bobby, general secretary MNP+ is at present taking second line ART. "Not able to get easy access is the major hurdle. I had to get my drugs from Delhi. There are many who, after starting second line fall back to first line since they cannot afford. Delaying the introduction of second line ART to this poor state is most unfortunate and discriminatory." TEAM also expressed disappointment at that the new policy of providing OI (opportunistic infections) drugs only at ART centres and health centres. TEAM convener Vikram said, "The guiding principles of providing ART should be pragmatic, practical and easily accessible to the patients. We need a client-friendly approach. How can those PHC with no doctor, staffs and basic infrastructure prescribe OI drugs to the patients?" When contacted by IFP, Dr Premchand, ART in-charge MSACS said that OI medicines are being kept at ART centres and district hospitals so that any HIV positive person who comes to get OI medicines can be linked up to ART. He said, "Having OI is a sign that a person`s CD4 count is low. So if those with OI come to the ART centres or district hospitals, they can be enrolled to ART if necessary. This will help more people to come out and access treatment." Another issue that TEAM highlighted was the unavailability of PEP (Post Exposure Prophylaxis) to those who have accidental exposure to HIV. Sukumar of Care Foundation said, "Till now, under NACO guidelines, PEP is administered to accidental needle prick in hospital and health settings. With HIV transmission through sexual route increasing, there is a need to expand the provision of PEP to accidental exposure to HIV I other settings too so that HIV spread could be effectively controlled." TEAM is a taskforce formed by MNP+, SASO, Lifeline Foundation, Care Foundation, Kripa Society and NEIHRN to address the various medical issues in the state. =============================================================== 4. Teenage girls are particularly vulnerable to HIV/STDs infection The Nation, December 09, 2007. http://nation.ittefaq.com/issues/2007/12/06/news0946.htm Nepal: Teenage girls are particularly vulnerable to HIV/STDs infection in all regions, it is thought that teen age is a period of multiple, rapid, and profound changes and transitions. Such concerns are particularly important for teenage girls: Teenage girls today are much more oppressed. They are coming of age in a more dangerous, sexualized, and media-saturated culture. They face incredible pressures to be beautiful and sophisticated, by chemicals which mean to encourage them to be sexual. As they navigate a more dangerous world, girls are less protected. On the other hand, the low social status of women in many poor countries encourages gender discrimination, domestic and sexual violence and psychological abuse, so that they have no control to negotiate safe sex. Teenage girls in poor families in developing countries often do not have the option to make real choices about their sexual and reproductive lives, such as when and whom to marry, whether and when to have children and how many to have, and whether to use contraceptives. Women tend to marry very young: nearly two thirds of teens in most South Asian countries marry before 18 years of age, and many even before 15 years, despite laws prohibiting such early marriage. Biologically, young women are more susceptible to HIV infection than older women. Because they make up a large proportion of the sexually active population of developing countries, a large proportion of new infections occur in this age group. A survey conduct by Rainbow Nari O Shishu Kallyan Foundation of three brothels in southwest region in Bangladesh, this study did point out that almost 16% of sex workers enter the profession before the age of 18 years, and 30% enter between 18 to 24 years of age. Approximately 10% of prostitutes belong to the scheduled castes minority people. The HIV/AIDS programme specialist Mohammad Khairul Alam said, "several social norms and immature behavior fueled of this disease to scatter rapidly. There are several social components link to develop this harmful situation. Poverty-behind to force it, Gender discrimination plays a vital role; Frustration & risk behavior help to sink humanity resulting infection. The link between poverty & gender discrimination are help to decline socio economic prosperity. This link creates several anti social poisonous issues also. Such as trafficking to prostitute, sell sex for earn or living, break down family norm to create frustration and driven drug point. We notice easily that Illiteracy is the main watchword of all circumstance. So it is not easy to remove it from the society, several programs & strategy are needed to gain sustainable position". In some cultures, young women are sexually abused by older men in the belief that they are less likely to be infected with HIV or even that sex with a young woman who is a virgin is a cure for HIV/AIDS. Moreover, young people are often less likely to have access to the information and means to protect themselves from HIV infection. For all of these reasons, UNFPA is right to make young people a focus of HIV/AIDS prevention programmes. In some countries, adolescents aged 10 to 15 should be a priority, as these are the years when sexual initiation occurs and sexual attitudes and behaviours are established. In these countries, HIV/AIDS prevention messages should focus on younger youth to be effective. Programmes of sex education and safe sex promotion for pre-teens and young teenagers have been successfully implemented in countries as diverse as Uganda and Sweden. However in Asian region, the epidemic is not contained within these at-risk populations. HIV is spreading rapidly to sex industry clients (including sex tourists) and to the sexual partners of both sex workers and IDUs. Evidence that the virus is reaching general populations can be found in the neonatal clinics of the Indian states of Andhra Pradesh, Karnataka, Maharashtra, Manipur, and Nagaland, where more than one percent of pregnant young mother are HIV positive. The responses and capacity required to address the identified vulnerabilities in Asia lie within the region itself. Although, capacities, commitment and resources within countries are varied, a diverse range of successful responses exist within Asia. These include examples of early responses that have successfully reduced the impact of the epidemic in countries such as Thailand and Cambodia as well as examples from countries like India and China which have demonstrated the effectiveness of leadership and commitment at the highest level. As a result of continued and concerted advocacy, all national governments in the region have developed national strategic plans -- most of which recognize the need for multi-sectoral approaches. =============================================================== 5. AIDS: Ignorance is not bliss Zeenews, December 09, 2007. http://www.zeenews.com/znnew/articles.asp?aid=410569&sid=ZNS&sname= On World AIDS Day today, it is important to cite two shocking truths. First, one in three people in the world`s major industrialised countries "know little or nothing" about the deadly HIV/AIDS pandemic and second 25%believe that the problem has been "greatly exaggerated" by the media, a poll said. The survey conducted by global polling firm IPSOS, however, found that 44% respondents, including 50%in the US, are prepared to pay more taxes to combat the disease. The disease is estimated to have killed 28 million people in the last 26 years. The Global AIDS Attitudes survey, published by the non-governmental organization World Vision, reveals the awareness and attitudes of population in Canada, France, Germany, Italy, Japan, the UK and the US, all members of the "Group of Eight" industrialized nations, towards those affected by HIV and AIDS globally. Speaking at the launch of the survey on Thursday, the director of the joint UN programme on HIV/AIDS (UNAIDS), Bunmi Makinwa underlined that "the more we understand the epidemic, the better we can make policies." Among the main findings of the survey is that the more people know about HIV and AIDS globally, the more concerned they are about the issue and the more compassionate they are towards those directly affected by it. The World Vision "index of concern," a tool for understanding the level of concern each country feels towards the issue, finds that Canada leads the seven nations surveyed for the highest level of empathy its residents feel toward those affected by HIV and AIDS globally, with Japan ranking last. The others in order are France, Germany, US, Italy and UK. 59% Indians think AIDS is curable: Study New Delhi: As the world observes Saturday as World AIDS Day, India continues to be plagued by paradoxical and half-baked information on the 21st century`s gravest health hazard, making the disease deadlier, says a new study. Paradoxical though it might appear, a new global study says: "While 79 percent of Indians understand AIDS is always fatal, 59 percent still wrongly believe there is a cure for it available today." The study was conducted by the MAC AIDS Fund, the philanthropic arm of Estée Lauder-owned pharmaceutical major MAC Cosmetics in September 2007 in nine countries, including the US and Britain. As per the study, although Indians generally recognise HIV/AIDS as the most serious health problem facing the country today, confusion and misperceptions about the disease reign here. The study said that Indians generally complained of lack of access to information on various aspects of the disease, including how it is spread. As per the study, 65 percent of Indians attach a sense of shame and stigma with the disease, which contributes to the threat of it acquiring an epidemic proportion. "This is a wake-up call that not only do we need to improve basic education about the realities of the disease - including how it is contracted and how it is treated - we also need to do some serious on-the-ground work to alleviate the sense of shame and stigma that surrounds the disease and prevents people from being safe and seeking treatment," he added. US lauds India`s success in fighting AIDS Washington: As US President George W. Bush renewed a pledge to fight the global HIV/AIDS pandemic, the White House commended "some very successful programmes in India" with a significant increase in resources. "The pandemic of HIV/AIDS can be defeated" through international cooperative efforts such as his President`s Emergency Plan for AIDS Relief (PEPFAR), said Bush on the eve of World AIDS Day. HIV is still the leading cause of death in sub-Saharan Africa, he said, citing Bush`s statement that the Americans are supporting 1.36 million people receiving antiretroviral therapy, and care for 6.7 million people, including 2.7 million orphans and vulnerable children. =============================================================== 6. Normal life possible for HIV-patients The Rising Nepal, December 10, 2007. http://www.gorkhapatra.org.np/content.php?nid=31901 Surkhet: Bal Kumar Shakya of Uttarganga VDC of Surkhet district is an example that HIV does not kill immediately, and people with HIV can still lead a normal and active life for years. He was the first person in the district to disclose of him being HIV-positive in 2061. He said he had contracted the virus nine years ago. Now, he has full-blown AIDS with CD-4 count of less than 200. Despite this, he is working on creating awareness on HIV among youths in the district. Shakya said he used to work as security guard at a private house and later he worked in a hotel. "I used to visit commercial sex workers and practise unsafe sex," he said. ?I used to refuse even when the CSW asked me to put on condoms." He came home on vacations and was married. After about six months of marriage, he became very sick and the family took him to Lucknow. He was already infected by then, but the doctor did not tell it directly. "He only told me to quit smoking and drinking and take good diet and prescribed some medicines." Then he quit them and came back and became well. After his return home his family forced him to go for foreign employment. It was only after his blood test in Kathmandu, he was found to be HIV-positive. That was in 2055 B.S. He and the family knew it but had hidden it from others. "My family thought I would transmit the virus to others in the family and they expelled me." Then he went to Nepalgunj and lived there. "My wife was very supportive in those days," he said. After a lot of awareness programmes run by different NGOs including NRCS, his family called them back. But the family wanted a child to continue the family lineage, as he was the only son. Even after several years my wife did not beget a child, then they began accusing her of being barren and started pestering me for second marriage. When they could not convince the family, they decided to have a child. Under the supervision of the doctors in Nepalgunj, he took medicine that had to be taken 28 days before the contact and conception. He now has a three-year-old daughter and she is negative. In 2001, he came out in the open and declared that he was HIV-positive and started working against HIV/AIDS. The same year, the Nepal Red Cross Society (NRCS) and National Association of People Living with HIV Nepal (NAP+N) provided him the 'challenge fund' to run programmes in prevention, care and support to people living with HIV in Surkhet. "The fund was meant for five months but with the money I ran the programme for 11 months," he said. It has been almost 9 years since he was infected and his CD-4 count is below 200, still he is leading an active life. He is still not taking anti-retroviral treatment (ART). He says he focuses on balance diet and physical exercise and leads an active life doing social work. "I never think that I have HIV." He, in a way, broke the taboo of HIV in a society like that in Surkhet. It was after him about 100 people also came out in the open. They now work together raising awareness among the people. They are running Voluntary Counselling and Testing Programme at the local level and peer education where children and youths counsel amongst themselves against HIV. However, according to NRCS, there could be at least 500-600 people living with HIV but hiding their situation in Surkhet alone. In recent years, with so many people like Bal Kumar Shakya going to India for employment the prevalence of HIV in many districts of Mid-West and Far-West Nepal could be much more severe than estimated. The problem is to find them and bring them into the mainstream society, and convince them and the society that those with HIV can still lead an active life. =============================================================== 7. Pfizer first MNC to get HIV drug patent in India Business Standard, December 11, 2007. http://www.business-standard.com/common/storypage.php?autono=307171&leftnm=1&subLeft=0&chkFlg= Global drug major Pfizer's new HIV/AIDS drug Celzentry (generic name: Maraviroc) has become the first known HIV/AIDS treatment drug to get a patent in India, in a significant development against the backdrop of the patent battle between multinational drug companies and patient groups in India. Maraviroc, the first in a new class of oral HIV medicines developed in the last ten years and expected to become a major blockbuster HIV/AIDS drug globally, was granted a patent in India under the Patent Number 204132, based on the patent application 885/BOM/1999 filed with the Bombay patent office, informed sources said. Discovered and developed by Pfizer scientists since 1997, Maraviroc, which works by blocking the entry of the virus into human cells, received approval from the US Food and Drug Administration (FDA) only in August 2007, through an accelerated regulatory approval process. One month later, the European Commission gave marketing approval for Maraviroc in Europe. Interestingly, the European Patent Office (EPO) is yet to grant a patent for Maraviroc, citing insufficient data, sources said. These were the main reasons cited by the Indian Patent Office for rejecting the patent for the cancer drug Gleevec, which snowballed into a global patent battle between the Swiss drug major Novartis and the Indian government. Leaders with the public interest groups expressed surprise at the decision of the Indian Patent Office. "This is a major development and is a harbinger of the availability and prices of crucial new drugs. We have to evaluate the importance of this drug for HIV patients in India and will decide on the course of action soon," said Leena Menghaney of Medicines Sans Frontiers (MSF), part of the activists’ group. So far the Indian patient groups have filed about 15 pre-grant oppositions for about seven HIV/AIDS drugs of multinational drug companies. A Pfizer India spokesperson confirmed that Maraviroc has received a patent in India and said Pfizer is in the process of complying with necessary regulations for registering Maraviroc in India. "We are committed to bringing meaningful improvement to the lives of people living with and those at risk of HIV/AIDS through outreach programmes that will enable access of innovative medicines to patients," a statement from the company said. =============================================================== 8. HIV drugs to cost more as cos rush for patents The Economic Times, December 12, 2007. http://economictimes.indiatimes.com/News/News_By_Industry/Healthcare__Biotech/HIV_drugs_to_cost_more_as_cos_rush_for_patents/articleshow/2615823.cms NEW DELHI: Treatment of HIV patients in India could get costlier as global pharmaceutical companies have started securing patents for drugs used to treat AIDS and related diseases. Global major Pfizer received the patent for Maraviroc in June this year. Roche has also received patents for its two drugs used to treat Hepatitis C and cytomegalovirus retinitis (blindness), diseases which are common with HIV patients. There are around 2.5 million HIV patients in India and once companies’ gets patents for their drugs, government, HIV organisations and individuals will not have an affordable option of generic drugs. Pfizer drug Maraviroc is a second line anti-retroviral drug used to treat patients who have developed resistance to first line of medications. At present, there are no generic equivalents for the drug worldwide. However, patients groups are likely to challenge the patent for Maraviroc. “The Indian patent office has given approval even though the European regulator has withheld its decision for lack of sufficient details. The company has not even registered the drug in India after getting marketing approval in the US in August. We will have to check the medical benefits of this drug and its market before deciding on the future course of action, ” says an NGO official. Network of people living with HIV, an NGO, has already made a post grant opposition for Roche’s drug Pen-interferon, which is used to treat Hepatitis C. According to some estimates, the cost of pen-interferon for six months is around $5000. Another drug of Roche, Valganciclovir, used to treat blindness in HIV patients has also got patent approval. This could cost around $10,273 for 3 months. Cipla has moved a post grant opposition against Valganciclovir patent. Pfizer on its part said that it will make available affordable drugs in India. “We are in the process of complying with necessary regulations for registering Maraviroc in India. Therefore it is too premature to comment on launch details. However we are committed to bringing meaningful improvement to the lives of people living with and those at risk of HIV/AIDS through outreach programs that will enable access of innovative medicines to patients.” =============================================================== Disclaimer: Opinions expressed in the above articles are those of the respective newspapers, not those of SAATHII.