NEWS YOU CAN USE HIV/AIDS MAY 2001
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- NEWS YOU CAN USE HIV/AIDS MAY 2001
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HISMIBS - News.'W Can Use - HIV/AIDS ■ WW You Can Use -HO
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News You Can Use - HIV/AIDS
(NYCU) is a specially formulated
monthly mediascan on issues related to
HIV/AIDS compiled to meet the
specific information needs of NGOs
Directed to meet the urgent need for
As a part of a regional initiative to
information and awareness building on
Wild awareness oh HIV/AIDS,
HIV/AIDS, this special publication
several
efforts
have
been
presents a compilation of news clippings
undertaken by PLAN International
on the issue We hope that the contents
(Bangalore Zone) in partnership
will provide readers with relevant,
with Madhyam. Dissemination of
useful and topical information to
information to NGOs is a key
facilitate grassroot work on prevention,
component of this campaign. This
care and networking.
publication is aimed to strengthen
This edition has been
ongoing
compiled from
The publication includes a selection of
newsitems/features/articles/editorials/
letters
from
leading
national
newspapers Each newsitem carries the
efforts
through
information processes as well as
serve as a regular reminder of the
urgency to addressing the issue.
name and date of publication and is
This publication is supported by
placed under appropriate categories for
PLAN
easy reference.
Madhyam.
International
Team:
Shortgun Das Gupta
Jiji Abraham
Shobha C
Janet Lazurus
News You Can Use is compiled and
published by Communication for
Development and Learning,
Bangalore
INTERNATIONAL
and
X The Times of India
X Hindustan Times
X The Hindu
X The Statesman
X The Pioneer
X The New Indian Express
X Deccan Herald
X Deccan Chronicle
X The Economic Times
X The Asian Age
X UN Newsletter
Communication for
Development and Learning
ll/A, 7“ Cross, 17
* Main. Koramangala
6 Block, Bangalore 560 095
*
Ph. (080) 5524192.
e-mail: cdlblr@bgl.vsnl.net.in
URL www.cdlbir.org
Introducing NYCV-HlV/jllcDS .................
Dear readers
Nkosi Johnson a name that many will recall easily. For others, it will be ad
equate to introduce him as the 12 year old activist, spokesperson and public
face of AIDS at the recent Durban Conference. Nkosi died, a victim to AIDS,
on 1 June this year.
Till not so long ago, HIV/AIDS was a relatively unknown term. In fact, as re
cently as 20 years ago, it was practically unheard of. Today it has almost
assumed the status of an epidemic with the highest number of HIV-positive
people. Given the high infection rate, this spread has serious implications.
With no cure in sight, prevention is the only cure. An environment needs to be
created where the implications of the issue is recognised in its gravity and this
receives the attention it needs for control of the spread. It would indeed be
unfortunate if ignorance is allowed to grow into a factor for the spread of HIV/
AIDS.
This publication is the result of a thought process that started over three years
ago at CDL. As a part of our media research activity, coverage to the issue in
the printed media has been monitore&and noted to be increasing regularly.
Yet, contradictions were evident. On toe one hand, was the increase in tan
gible space in the media to issues related to, HIV/AIDS. We are not referring
here to the quality of coverage, but to the actual column space for projecting
the issue through the media. Our data showed that as compared to 798
newsitems on HIV/AIDS in 1998-99, there were 1036 newsitems in the same
period in next year.
However on the other hand, was the alarming increase in the number of HIV
positive cases and the spread of the virus. In an environment where ‘preven
tion is the only cure’, awareness building is a key factor. While several
components contribute to this, the use of the media emerges as an obvious
key component. In addition to ensuring media coverage is the importance to
ensure dissemination of information and networking between NGOs to share
resources, information, and even sustenance.
To our minds, a peculiar contradiction existed. Despite the growing media
coverage, lack of information and ignorance was an obvious problem. Infor
mation was obviously not reaching the masses. Given the information boom
across the globe, it was a sad comment in our country that several rural based
NGOs did not have access to basic information - even in the form of the daily
newspaper.
X
It was to meet this need for direct, topical and credible information that this
compilation has been put together. The objective here is to keep NGOs in
formed of developments and news on issues related to HIV/AIDS. While the
status of this demands immediate attention, the scope of the issue has been
expanded to include population, reproductive health and sexuality in order to
make the compilation more exhaustive. The contents have been drawn from
the print media from a diverse range of publications. However, we have been
careful to steer clear of publications that are purely medical and research ori
ented, important as these are. Focus has been given to include coverage that
is recent, important and information that can strengthen the work of NGOs in
the field.
The contents are reproduced in the form that it appears in the original publica
tion. The source and date of publication has also been included. Classified
information such as advertisements, publications, workshops and programmes,
announcements, will also be included in our subsequent editions.
We hope that this publication will be of use to NGOs working on the issue,
activists, media as well as serve as a tool for advocacy. It is our hope that a
regular reminder of the gravity of the issue will reinforce and strengthen ongo
ing efforts in prevention and care and indirectly motivate a strengthening of
activities. We also hope to inform and encourage NGOs not working on the
issue to appreciate the need to include this as a part of their work. Building
advocacy and networking between groups is another important objective of
this publication.
While we at CDL, have embarked on this effort with our own specific under
standing of the situation, we do believe that this will be substantiated only when
the information compiled is used to strengthen direct intervention. It is our ear
nest hope that this publication will serve the objectives for which it is intended.
We welcome your feedback and comments and will gladly incorporate sug
gestions made. If you know of other groups who would like to receive this
publication, please do not hesitate to forward these addresses to us.
This publication has been brought out in partnership with Madhyam and sup
port has been received from PLAN International as a part of an awareness
building campaign on HIV/AIDS.
Shangon Das Gupta
May 2001
TABLE OF CONTENTS
MAY - 2001
Analysis
When ignorance is not bliss
The myth of the population bomb
Muslim success in birth control
The right to choose
The pill fits the bill
Universal and free AIDS care
Drugged by patents
Data
NACO disputes Swiss NGOs figures
Panel disagrees on AIDS source
Little known facts about neuro AIDS
Experts criticise India’s population control
targets
Population up, but number of girls
plummets in India
10 per cent of world’s HIV cases in India
NACO cooked up AIDS data, alleges NGO
08
16
21
25
26
27
38
02
08
14
15
15
40
40
Editorial
Reveal the truth
43
Event
Plans for AIDS meet
40
Feature
A lifeline for children with HIV
For HIV Children, A Positive Step
The poor and the ignorant fall victim
09
12
22
Global
Is AIDS ruling in S.Africa really a victory?
US trade action threatens Brazilian AIDS
programme
San Francisco’s HIV infection rate doubles
HIV infections hit a record high in United
Kingdom
1 in 4 pregnant women in
South Africa has HIV
AIDS: S-G Welcomes withdrawal of Case
Against South Africa
06
45
46
46
47
48
Information
Origin of HIV
Anti-AIDS proposal
Flirting with death
Unicef gives $450,000 more to Vietnam
Growing killer
Industry
• Defence drug industry fuels fight
over patents
. Drug gaints run into AIDS
counter-offensive
City based firm launches Hepatitis-C
detection kit
Aurobindo Pharma division to fight AIDS
• Cipla to bring down prices of
AIDS drugs with cocktail pill
18
31
33
43
45
11
13
19
23
23
• Hetero Drugs to supply anti-AIDS drug to
Kenya
23
• AIDS drugs mkt set for major price war
24
Ranbaxy enters domestic anti-AIDS
24
j Pharma cos. Bet on African market for their
anti-AIDS drugs
29
Restrictions make Viagra s^le go limp
35
Try the Cipla therapy
42
Ranbaxy Drugs to supply 4 more anti-AIDS
drugs
43
. Drug company to sell AIDS drugs at
less than cost price
48
Media
Puppet shows, folk songs to spread
message against AIDS
FM programme on AIDS
Many HIV drug ads are misleading: US
A rare day for sex workers with a
message on AIDS
Hijras to spread awareness
Soaps for social change
Fund to fight AIDS
01
07
17
17
18
20
20
AIDS awareness drive next month
When family is small in size Dreams come
true. As per choice
40
44
News
Injectable contraceptive for males
to hit market
AIDS spreading ominously
HIV detection kit launched
01
03
03
‘Ringing the contraceptive bell
It's the people's pill
04
05
Sex educators get new ‘street-smart’
classroom survival kit
Bonda tribes have unique population
control method
05
07
Indian scientist gets award for
Aids research
07
High HIV incidence among city migrants
13
HIV virus makes the journey from Mumbai
brothels to Satara ....
14
Crores go down the drain, 125 test HIV
positive
21
Cadila to hit S. Africa with HIV detection kit 28
Rapid HIV detected kit launched
Indigenous 3-minute AIDS detection kit
launched
28
30
‘AIDS awareness campaign a success'
30
Govt wakes up to people’s role in AIDS
prevention
NSS meeting held
31
31
Condoms free with liquor to fight AIDS
32
AIDS control: PM will review
steps with CMs
Candlelight tribute to Aids victims
33
34
Centre joins States on AIDS
35
Jihad in Kashmir Valley against
dreaded AIDS
36
PM asks affected States to wage
36
37
37
war against AIDS
New Delhi: Prime Minister Atal...
Wage war on AIDS, urges Vajpayee
‘Religious groups can spread AIDS
awareness’
39
Talks on funding battle against AIDS
41
Newsbriefs
Footnote
AIDS hitting housewives
Indigenous oral contraceptive
01
02
02
Question and Answer
Aids Alert
Towards a New Horizon
Girl Interrupted
Understanding AIDS
19
32
34
41
Research
Cheap AIDS drugs cheap enough?
17
Plants may someday deliver HIV vaccine
43
Scientists isolate HIV blocker in placenta
46
International effort to find AIDS vaccine for
India
47
Schemes
More births and deaths being registered
under new format
Govt to supply free drugs to HIV-hit
pregnant women
33
37
Study
Caste-based prostitution report causes stir 04
AIDS unkown to Gaya sex workers: Study 31
In brief
47
Puppet shows,
folk songs to
spread message
against AIDS
“We based the programme on
the folk forms and traditions of
Uttaranchal because the people
SONGS BASED on various folk here arc traditional and do not like
forms of Uttaranchal will be used direct reference to using condoms
by the local artists to communicate etc. which is being done by the
to the people the message of Aids- electronic media in the name of
awareness in the remote areas of publicising the AIDS-awareness
programme,” Dr Kapoor said.
Uttaranchal.
The folk forms on which the
.Around five troupes of total 70
artists will present their-fortnight- songs related to the AIDS-aware
long musical AIDS-awareness pro ness programme arc based include
gramme in five districts of Chapli Jagar and Bhagnol etc.
Noted environmentalist and cul
Uttaranchal from February 1. The
artists will also communicate the tural activist, Dr Ajaya Rawat, also
message through puppet shows justified the SDD's efforts to com
municate its message on AIDSand street plays.
awareness
The five dis
through
songs
tricts where this
based on the
programme will
The
six
local folk forms
be
presented
and traditions.
before the rural
this
“Despite being
audience include
a part of an
A 1 m o r a ,
gramme
will
be
essentially liberal
Pithoragarh,
society, the hill
N a i n i t a I ,
include
people here still
U d h a msingh
consider the sexNagar in the
Almora,
related topics as
Kumaon division
**
taboo,
Dr Ajaya
and Dehra Dun
Rawat said.
in the Garhwal
According to
division. .
him, the message
AM
the 70
of Aids-awarcartists are cur Udhamsingh
ness based on
rently gearing up
local folk forms
for the proposed
Dehra
and
traditions
programme in a
would go down
two-day work
shop on prevention of AIDS, well with the people because
which was inaugurated by the Uttaranchal has rich folk and oral
District
Magistrate,
Mrs traditions.
“This is a sound strategy consid
Aradhana Shukla here today.
“The entire programme is being ering the fact that in Uttaranchal
jointly undertaken by the National cultural patterns change from vil
AIDS
Control
Organisation lage to village and valley to valley
(NACO) and the Song and Drama due to the local geographical con
Division (SDD) of the Information ditions,” Dr Rawat observed.
He said that in the past also the
and Broadcasting Ministry,” SDD
assistant director Ashok Kapoor Song and Drama Division success
fully used the same strategy of
told The Hindustan Times.
Dr Ashok Kapoor said the whole using programmes based on folk
idea behind choosing the local folk songs and traditions in creating
forms and traditions as a base for awareness among the hill people
the programme, was to help vil with regard to the schemes like
lagers comprehend the message in water harvesting, water manage
ment and child and mother care.
its entirety.
Deep Joshi
Namital, January 30
districts
where
pro
presented
Pithoragarh,
Nainital,
Nagar
and
Dun.
HERALDING THE SWANSONG OF VASECTOMY?.
Injectable contraceptive
for males to hit market
NEW DELHI: A first-of-its-kind Cosmetic Rules.
A standard 60 mg of the com
male contraceptive developed
indigenously by the Indian pound was enough for people of
Institute of Technology and AU different physical build and there
India Institute of Medical Sciences fore there was no need to test it on
is in its final stage of clinical trials.
larger number of individuals as the
“The phase-III clinical trials of contraceptive is quite safe, Guha
the injectable male contraceptive added.
started in May 2000”, said S.K.
Risug, a combination of two com
Guha, biomedical engineer from pounds, styrene maleic anhydride
11T, Delhi at the ongoing science (SMA) and dimethyl sulphoxide
congress here.
(DMSO). is injected into the vas
The contraceptive — Risug, an deferens, a vessel that carries sperm
acronym for reversible inhibition cells.
of sperm under guidance — is the
The compound interacts with the
result of 25 years of research com water molecules present and gener
bining biomedicine and engineer ates a set of electrical charges, both
ing. It offers several advantages positive and negative.
over conventional vasectomy.
The membrane covering the
“Intellectual property rights are negatively charged sperm cells
protected by process and product breaks on corning in contact with
patents in India, Bangladesh, US these charges resulting in the
and China. Some more patents are release of trapped enzymes which
pending including an international are necessary for penetration of
patent under PCT,” said Guha.
the sperm into the ovum, thereby
The contraceptive has been suc leaving the sperm incapable of fer
cessfully tried on 100 males till now tilisation.
and scientists plan to test it on
One time injection of Risug
more than 500 individuals in the remains effective till 15-20 years.
third and final stage of experimen Guha said. But the most remark
tation before marketing it
able characteristic of this contra
The toxicology safety of the con ceptive is that it can be withdrawn
traceptive has been approved by from the body, thus reversing its
Central Drug Research Institute effect.
Risug is also being tested for its
(CDRI), Lucknow and the subjects
use as a spermicide, which will
have shown no side effects.
The test on 500 people was make it an effective female-contra
enough to gauge the efficacy of the ceptive, and for its anti-microbial
contraceptive and the number was effects, which will make it preven
in consonance with the Drug and tive against AIDS too. -ph
The Times of India
08 January 2001
FOOTNOTE: People with sexually transmit
ted diseases (STD) are infected with HIV
faster than others, a survey on AIDS in
Tamil Nadu concluded. The survey was con
ducted recently on 16,200 women in Tamil
Nadu.
The Telegraph
07 February 2001
The Hindustan Times
31 January 2001
NYCU - HIV/AIDS ® j
NACO disputes Swiss
NGO’s figures
for this alarming figure. “The rates are similar among men ence in the past two years has
FXB figures are for a skewed and women, which shows that shown that Government mess
New Delhi
*
Feb 18: AIDS infe sample and not an index of the disease had moved from ages are not reaching the
ction averages a high 8.2 per AIDS prevalence in the gene the high-risk group to the gene people as AIDS awareness in
bent in some pockets of rural ral population be
the region was
Rajasthan, largely in areas cause those going.
completely lac
from where workers have mig to voluntary test
king before we
rated .to Mumbai. These are ing centres and
started workthe findings of Francois-Xav
"Most
people
look
for
cure
in
mixtures
and
^th?Te>
ier Bagnoud (FXB), a Swiss tadSged tn Mgh- powders doled out by quads who know as little sa£X
NGO that has been testing and
about AIDS US their patients"
anyway has a
counselling people in the rural risk activity and
districts • of Jaipur and suspect being .inf. poor awaren
Jodhpur for the past two years. ected," says * J V R Prasada ral population. “Many people ess record. While the. National
“Infection has touched 13.1 Rao, Director, National AIDS infected in villages are missed Family Health Survey-2 relea
per cent in some areas, and Control Organisation (NACO). as most of the Government’s sed last year said 40 per cent
what makes these statistics “It’s like going
*
to a cardiology AIDS surveillance, detection women in India had heard of
even more worrying is that clinic and saying 50 per cent of and counselling sites are in AIDS, the Rajasthan average
they come from a region where the Indian population have a urban areas," says Anil Puro- was just over 20 per cent, half
AIDS prevalence is supposed heart .disorder." NACO’s figu hit, Executive Director, FXB. • of the national average. Pri
to be low," says Countess res for Rajasthan are 1.72
Ninety-eight per cent of mary. Health Centres play no
Albina
du
Boisrouvray, among rural men and 0.021 those infected were people role in spreading awareness be
among rural women.
founder of FXB.
who had migrated to Mumbai cause they are not accessed by
FXB found that infection in search of work. "Our experi villagers.
But there aren’t many fakers
*
“A major hurdle is
the popularity bf quacks, and
most people look for cure in
mixtures and powders doled
out by quacks who know as
AIDS hitting housewives
little about AIDS as their pati
ents," says Dr K. C. Joshi, Out
© The AIDS scourge is percolating down from high risk groups
reach Programme Site Direc
such as the commercial sex workers to affect the low risk popula
tion including housewives, says a report, according to PTI.
tor. Jodhpur^.
Surveillance data collected by the National Aids Control
The FXB Foundation has a
Organisation from ante-natal clinics in seven metro cities also
budget of US $ 425,tX)O for its In
shows that HIV infection has crossed two per cent in Mumbai,
dia programme. The Bill and
more than one per cent in Hyderabad, Bangalore and Chennai and
Belinda Gates Foundation has
below one per cent in Kolkata, Ahmedabad and Delhi.
further donated USS 800,000 for
Deccan Herald
a three-year project in Rajasthan for training volunteers, cou
22 January 2001
nselling people with AIDS.
•“It’s time to intervene so that
India can contain the disease
like Thailand and Uganda and
does not have a fate similar to
Indigenous oral contraceptive
that of Africa, where 50 per
cent of the population is count
With scientists succeeding in isolating compounds from papaya.
ries like Rwanda are infected.
**
which has contraceptive properties, India may become one of the
says Countess Albina.
first countries to produce a plant-based oral contraceptive for men.
By Sachita Sharma
AIDS1NFECTION RATE
"Four compounds have been isolated from Papaya seeds, which *
have been found to be suitable for use as oral contraceptive", Dr N
K Lohiya, Director of the School of Life Sciences of Rajasthan
University said at a conference on 'Challenges in Reproductive
Health for the Millennium
,
*
according to PTI from New Delhi.
The Indian Express
19 February 2001
Deccan Herald
11 Januaiy 2001
2
NYCU - HIV/AIDS
Q
AIDS spreading ominously
PH New
*
Sendee
IEW DELHI. Jan 31
lid you know that three lakh peo
ple died of AIDS in India in 1999?
'hat SO lakh people in the country
tre afflicted with the dreaded dis•ase, or that Maharashtra and
kndhra Pradesh are the worst
iffected by AIDS (if you imagine
or a second they are independent
jountries), next only to Thailand
ind Kampuchea? That Karnataka
s one of the most affected states in
India? Difficult to believe, but the
shilling facts are a commentary on
the extent the killer disease has
spread across the country.
These and scores of several
other facets of AIDS are part of the
book "Sex, Lies and Aids" written
by Mr Siddarth Dube, a researcher
working for the School of
International and Public Affairs,
Columbia University, USA. Mr
Dube, a health policy researcher,
who has worked on AIDS in India
for several years, is amazed at the
lack of seriousness of the authori
ties over the rapid spread of the
disease.
“By end-1995, India was estimat
ed to have the largest number of
HIV-positive people of any country. population in Mumbai and Pune
By end-1998, about 35 lakh Indians are afflicted with AIDS. Other
were infected, and over three lakh parts of India are not far behind.
died of AIDS in that year alone. At Mr Dube says these figures are
the very beginning of 2000, the best part of the UNAIDS records
estimate is that 50 lakh Indians are although Indian government
infected with HIV virus—about 10 rarely reveals these startling sta
times the number of end-1991. Of tistics.
the 16,000 people contracting HIV
He, however, is distraught that
every day across the world, 3500 the Union government, or the
are Indians," says Mr Dube. About states, while being nearly ignorant
25 lakh people have died in India of of the extent of the disease, are
AIDS since late 1980s and about 1.5 doing precious little to take pre
lakh children have contracted HIV ventive action.
from their infected mothers.
What are the causes for this
Talking to Deccan Herald, Mr rapid spread of the disease in
Dube, who presented a paper at India? Mr Dube says that igno
the
recently
concluded rance of people about the life
International Press Institute con threatening sexually transmitted
ference here, said Maharashtra diseases, lack of access to basic
and Andhra Pradesh are in the health care, great scale of illitera
thick of the epidemic, with over cy and poverty, flood of migration
two out of every 100 adults infected of single men from rural to urban
with HIV. Several other states — areas etc are the main factors
Tamil Nadu, Karnataka, Nagaland behind the alarming spread of the
and Manipur — follow close on the dreaded disease.
heels.
Mr Dube says AIDS is no more a
The worst affected areas poor man’s or poor woman’s dis
include Mumbai, Kolhapur, Pune. ease and it has started engulfing
Satara,
and
Thane
in all sections of society, be it middle
Maharashtra, Namakkal in TN, class or rich.
Hyderabad and Guntur in AP etc.
“The elite can no longer take the
A shocking 2.5 to 5 per cent of the threat easy
,
**
he says.
Deccan Herald
01 February 2001
HIV detection kit launched
PH News Sendee
NEW DELHI. March 12
An Indigenous human Immunode
ficiency virus (HIV) detection kit
which costs about 13 times less
than the imported version, has
been
launched
today
by
Department of Biotechnology
(djb$;
The indigenous kit was re
searched by Mumbai-based Cancer
Research Institute (CRD in a DBTfunded project for seven years and
manufactured by Delhi-based J
Mitra and Co Ltd with assistance
from Biotech Consortium India
Ltd in Delhi.
It is the first of its kind from
SAARC countries and is expected
to have a global market.
The kit, launched jointly by the
Health Minister Dr C P Thakur
and Minister of State for Science
and Technology B S Rawat. has
been certified by the World Health
Organisation (WHO) and the
Drugs Controller of India.
The indigenous Western Blot
kit, considered to be the confir
matory test for AIDS, could
identify both HIV-1 and HIV-2 types
as well as HIV-1 sub-type C • the
commonest form of HIV found in
India, Dr Robin Mukhopadhyaya
from CRI said. HIV-1 is more
common in India with almost
three fourth of AIDS patients are
being infected with this virus.
The Rs 3,000 pack is capable of
testing the viral load in five pa
tients. On the contrary, the im
ported kit carrying diagnostic
equipment for 12 patients costs
about Rs 40,000, said Lalit
Mahajan, managing director of
the company A 20-strip pack is also
available.
The pack contains five test
strips. When a drop of the sample
fluid taken from the patient is
placed on the strip appearance nf
coloured bands indicates the
status of the sample subjected to
evaluation.
The easy-to-use kit which can
be handled by technicians at small
labs or at public health centres
would be made introduced in all
district centres, Dr Thakur said.
adding 41 per cent deaths aue to
AIDS have been reported from
South East Asia. The prevalence m
India is rising too. he warned.
It is to be noted that an enzyme
linked immunosorbent assay
(ELISA) kh for preliminary diag
nosis of HIV in AIDS patients was
developed by National Institute nf
Immunology (Nil) under a DB T
fund ed p reject. *
Though the kit was cummer
cialised, it has not gained much
popularity in the medical circle
•vet.
Deccan Herald
13 March 2001
NYCU - HIV/AIDS
0 3
Ring’ing the contraceptive bell
Reuters
London
A REVOLUTIONARY contraceptive
ring, due to go on sale in the
United Stales this year. Is as
effective as the pill, despite deliv
ering substantially less hormone.
a leading scientist said.
The flexible plastic device,
which is inserted into the vagina
each month, fits around the cervix
and releases a steady flow of both
progestogen and oestrogen to
prevent conception.
“The results are very promising
indeedsaid Frans Roumen on
Wednesday, a gynaecologist al the
Atrium Medisch Centrum in
Hrcrlcn in The Netherlands, who
conducted a yearlong study on the
ring made by Organon, a unit of
Akzu Nobel.
Roumen found only six
pregnancies among 1,145 women
who used the ring over ono year,
a failure rate of well under one
per cent, making it as effective as
oral contraceptives.
Results of his research were
published in the journal Human
Reproduction.
The ring, which is around five
centimetres (two inches) in
diameter and is folded before use,
can be inserted and removed by
women themselves.
It is designed to be kept in for
three weeks followed by a oneweek ring-free menstruation pe
riod. although it is possible in fu
ture it might be used continuous
ly to stop periods altogether.
Organon plans to launch its
nuvaring product in the US
market this year with Europe fol
lowing later, once marketing
approval Is received.
It is not the first contraceptive
ring to be developed but it offers
a significant advantage over
previous versions which only
released progestogen, resulting in
abnormal bleeding.
Vaginal rings are also being
developed for other treatments.
Northern Ireland drug company
Galen Holdings plans to launch a
ring for delivering hormone
replacement therapy in Britain
within the next couple of months.
in addition to convenience.
Roumen said Nuvaring’s low dos>
*
would be a major plus for women
worried about high hormon<»
levels In the pill.
“The ring releases hormones
continuously through the vaginal
mucus, which is complete!}
different from using a pill which
produces an initial increase in
hormones and then a decrease."
he said.
“It leads to less complaints
better bleeding patterns and th
**
total daily dose is less than when
using the pill."
That may be good news for
women at risk of thrombosis
since oestrogen has been
associated with an increased risk
of the condition.
The Pioneer
16 March 2001
Caste-based prostitution report causes stir
UNICEF and inspired by inter being stigmatised by‘the soci- prepared to marry girls from
national concern for the preval- ety.
there,"he said.
New. Delhi, March 2: A report ’ence of prostitution in the
As for the HIV tests, it-is aga- . -The report, which is claimed
by the Madhya Pradesh Hu state, according to a preface by Inst the norms set by the to be based oh “detailed and auman Rights Commission is set the CWrman of the Commlss- World Health Organisation thentic Information and .is the
- and the Health Ministry to ide- result of a serious and compre
to raise a controversy over the ion, Justice Gulab Gupta.
insensitive manner, in which it . The report does not reveal ntify persons or groups tested hensive study of the subject”,
discussed "caste based prostit .figures ;_______________ :________ ______ _ HIV posit- uses' insensitive language and
ution”' in the state.
retort to sweeping generalisatabout the WHO regional advisor, South lye.
*
idns
while detailing the hist:The report - Caste taped Pro number of
AsiaJal Narayan said that
stitution in Madhya Pradesh ory df the castes under study.
a.aen/rvepd.mor.Mrm
without giving'specific-details
One of the‘groups included
. thon good.
Asia
Jal -to the study is reported as “criabout the survey conducted, the
says there is rampant prostitu survey or ■■■■ ■
*
■
■ ■■■■■■■■'■ fiaTayan minals from the beginning1'.
tion among three caste groups people indulging in prostitut- said -that these surveys do “Male are even now criminals
in the stqte. The report also de ion and pimping.
more harm thhb good by turn and engage in several offences,
clares that 50 per cent of one of
Despite the good intentions ing people against all attempts mare particularly' thefts. Nowthe three castes discussed' in behind the Survey, the pubiica- to prevent HIV/AIDS. “Reme- a-days, many of them also act
the report have been tested tion of the report and i^ gener- mber what happened in Hary- as pimps and procure customHIV positive. . .
• .» allsed conclusions may only ana? Once a village was bran- era for female prostitutes," the
The study was funded by lead to members of the castes ded HIV infected, nd one was. ’ report goes on tp say.
By Smeelatha Menon
*-.
Eff
The Indian Express
03 March 2001
4
NYCU - HIV/AIDS
9
Sex educators get new ‘street-smart’
classroom survival kit
By A Staff Reporter
MUMBAI: hi an effort to pull a
cringing genie out of the shadows,
the community outreach and video
production departments of the
Xavier Institute of Communication
have created a comprehensive sex
uality education resource kit.
Anjirbag.
Tlie manual, which begins from
the basics and addresses a range of
frequently asked questions, takes a
prospective trainer through issues
that evoke bewilderment and often
activists involved in the project,
“Any girl coming out on the
streets cannot live for more than 24
hours without being sexually
abused,” says Mansoor Qadri, co
founder of Saathi, a voluntary
grassroots workers come into direct
contact with vulnerable children,
but they are not trained to handle
issues like sexuality. Besides, the
manual puts information in a se
quence.’*
trauma in a child’s life. Masturba
tion, relationship with the opposite
sex. ridicule on the streets, homo
sexuality, sexual abuse by peer
group arid people in positions of
power—it talks about the zoo out
there in the. child’s’ mind, say
organisation working with street
youth and children which coordi
nated with the XIC group in the
making of the manual.
He adds,“No serious attempt had
been made before
*
this to create a
training, manual. Al present.
Apart from theoretical informa
tion. the kit gives tips to NGOs
workers on how to elicit responses.
;
Tlie first video film—Badhte
Badhte Kuch Kuch Hold Hat—follows a dramatic narrative in a real- £
istic slum set-up, showing children q
Tlie material is aimed al non-gov
ernmental organisation (NGO)
workers involved with a margin
alised younger population, includ
ing streetchildren, urchins, child
workers in lea stalls and dhabas,
slum children and domestics.
Apart from ircadiimon this ex
treme! v sensitive and dilficull
knowk-dr.c dissemination area, the
effort casts lii'.ht on issues like Child
sexual abuse again.
Incidentallv, XIC has also come
up with a skill development kit in
Marathi lor rural non loinial edu
cators called Vikas Kaushalyancha.
Ilic sexuality education manual,
named •Sahajcevan’.contains nine
booklets and two video films, all in
Hindi. Written by t’rceli Tclang,
I’eruzi Anjirbai’.. Dccpa Hari and
Vasudha Ainhiyc.the booklets con
tain extensive illustrations by
Deep;: Balsavar. who specialises in
illustrations on community devel
opment.
“We have been asking NGOs
what kind of media material they
need. We have based the resource
kit on their requirements.” says Ms
Monthly pill sales in these cities have gone
up by almost 24 per cent in the last two years,
said Dr Leavell. Leading gynaecologists were
selected to provide free counselling in support
In a population of over a billion where an esti- success. Interestingly, among the modem con- of the pill, literature about the pill sent to
mated 51.7 per cent don’t use any cdntracep- traccptivc choices available, the pill has shown 30,000 doctors, training programmes held for
five methods, a private sector initiative has tlie greatest increase — from 1.2 per cent (Na- 23.000 chemists and follow-up programmes
come as a ray of light
tional Family Health Service 1 survey — 1993- done for 12,500 neighbourhood doctors
The Goli Ki Hamjoli project, a joint venture 94) to 2.1 per cent (NFHS 2 — 199&-99).This»
It wasn’t easy to dispel preconceived notions
between ICICI and Commercial Market though, is low compared to its use worldwide about the safety of the pill, said Dr Leavell. But
Strategies (CMS) — a USAID-funded project —15 to 25 per cent. Female sterilisations ac- she insists these are unfounded. The support of
*
— to promote the use of low-dose oral contra count for 34 per cent and condbm use three per the
mass media, doctors and....
chemists has
aiw
_
ceptive pills and started in 1998 has shown how cent inIndia.
helped
remove some of the biases. Also, the
(U
thai'tii«e“w7re‘i'ow^Mc
Jberethe involvement of the commercial sector in The project is aimed at the urban markets of
family planning could be another way to stem thesc states because it was found that the use of foret hlve fewcr .idc-cffecu made a difference.
modem family planning methods here wasjis ■ ’The advantage of oral contraceptives is that
CM our ballooning numbers.
a jig project
piujcci is targeted
uugciGu at the
uic xjjjviruw
The
BIMARU low as in rural areas, said Dr Rita Leavell, there are various branch at >11 price levels r?ngO
£ states of Bihar, Madhya Pradesh, Rajasthan country head of CMS. Besides, urban areas fag from a unit ptice of Rs 2 to Rs 56. Besides,
(0
0) P and Uttar Pradesh which constitute over 44 per have all the ingredients for a successful cam- they are reversible and most of them can be
i- cent of the population. It has drawn within its paign — use of mass media, doctors, chemists, sold over the counter. They also have other
E •g
ambit 30,000 allopathic doctors, 23,000 availability of medicines. "We need to try urban benefits — reduces anaemia, the risk of certain
U- chemists and 10,000 traditional practitioners in areas before venturing into rural ones where types of cancers, osteoporosis, pelvic faflammam 25 cities.Though originally slated for two years, the approach will be different and the re- tory diseases and ectopic pregnancies.
— Shobha John
CM the project has been extended because of its sources needed, more:”
It’s the people’s pill
NYCU-HIV/AIDS
©
5
Is AIDS ruling in S. Africa
really a victory?
By Mkiiaei. Bmala
Stietfilrufsche 7.citiii^/(J.VNS
Nairobi, April 20: h may seem
like a major victory but it is not.
When on 'llmrsday the pharma
*
ceiilicals indiistiy di opped its case
against the South African govern
*
menl. singing, dancing and jubilanon broke mil in the public galleiy
<>l the Pretoria courtroom.
AIPS activists and aid organise
*
linns interpreted the drug compa
nies’ action as an admission that a
human life is wrath more than
lights tn a patent. Now. (hey said.
the Inins would not he able to
profit from the AIDS disaster in
Africa. It will take a few days
before the jubilation gives way to
disappointment — because in the
id the 39 drug companies have
a on. They brought proceedings
against the government in an
attempt to block a law enabling
the manufacture or import of
r
*
chea|x.
versions of * patented
AIDS medications. Hie charge
claimed that the law violated
international patent law. In the
mit-ol-court settlement with the
government. the word is that both
sides will now negotiate to work
out how best the law. which was
passed in 1997. can be implement
*
cd.
The most important clause in the
agreement said that South Africa
would not violate international'
patent law. This means that (he
interests of the pharmaceutical
firms are safeguarded. The case.
of course, tarnished the image of
the companies.
In Africa, AIDS flourishes like
nowhere else in the world. Alone
in Kenya, according to govern
ment figures. 500 people a day die
MEWS ANALYSIS
of the illness. In South Africa.
Zimbabwe,
Botswana
and
Malawi, almost entire generations
are threatened by AIDS. Very few
people there can understand how
manufacturers want to profit from
the suffering.
But (he moral indignation should
Contd...
involved in a workshop.
interactions with the children.” she
The second video—Men Sehat says.
Mera Nimay—is about HIV/AIDS
Ms Balsavar, who has spent the
and projects an middlc/upper mid last 12 years on childrcn-relalcd
dle class milieu.
projects, says she had to use a lot of
“People can go through the ma humour in her illustrations to light
terial. and create their own mod en the grimness of the issues.
ules,” says Ms Anjirbag, adding,
“The illustrations had to depict
“Although the kit is primarily the rebel in the children, their
aimed at NGOs, it can also be high mood swings etc..picturcs make the
ly useful to BMC for its municipal issues slightly more tangible than
schools.”
«
when one merely talks about
She says Sahajeevan encourages them” she says.
trainers and children to talk more
With more than 45 organisations
and more about sexuality, making it working with vulnerable children,
easy to handle tonics that normally and a juvenile board set up recent
make one go red in the face. “It is ly, the kit comes as fresh ammuni
also important that trainers do not tion to combat the child sexualitylet personal biases and rigidities on related problems.
issues like masturbation taint their
be levelled at the South African
government rather than the manu
facturers. The government should
have declared an emergency years
ago. This would have enabled it to
dispense with (he patent law.
Importing cheap versions of
brand-name medication from, for
example. India, is permitted in
eases of emergency.
But the government has not
acted appropriately: more than It)
per cent of the population of South
Africa is infected with AIDS.
Instead of declaring a catastrophe
and intensifying the education
campaign. President Thabo Mbeki
has persistently denied any direct
link between the Hl-Virus and
AIDS
Now he has stopped saying any
thing at all about the disaster. Peo
ple still treat infected victims like
lepers. Condoms are frowned on
as items only needed by adulterers
or the promiscuous.
The most advantageous outcome
of the case on Thursday will be
that patented AIDS drugs will
become much cheaper. This has
already happened in Uganda and
Rwanda. In those countries, gov
ernments reached agreement with
the manufacturers that patent laws
would be respected but. at the
same time, cheap medication
would be made available.
Treatment for AIDS here costs a
tenth of the 10.000 dollars a year
that it costs in jiurope.
The Asian Age
21 April 2001
The Times of India
05 April 2001
6
NYCU - HIV/AIDS
Bonda tribes have unique population
control method
Both male and female Bonthe men marrying women Govaradhan Panda, who has
many years older to them.
been living with the tribes for das are addicted to different
Skuru Sisa, a 12-year-old tri the last twenty years.
forms of liquor, creating freq
Malkangiri, April 22: The
Ashok Mishra, Bonda film uent social disorders within
Bonda tribe, spread over thi bal bpy married Rumu Sisa, a
rty villages under Khiroput 21 year old woman from Bada- maker and noted tribal resea the community.
block in Malkangiri region, f>ada village.
rcher agrees.
According to reports, every
By the time, the boy develo‘The typical marriage sys- year about twenty Bondas
will soon be on the verge of ex
tinction if they do not alter ped conjugal relations with
their marriage customs.
his wife, she had crossed thi
'By the time they can have sexual relations, the
But how can they be incited rty.
■
biological
dock has caught up with the wife and this
The huge age gap in marr
to do so? This is the question
checks the birth rate,' says researcher Covafadhan
that haunts tribal research ied couples, among more than
ers and Government agencies ninety per cent of the populat
Panda, who has been with the tribes for 20 years.
following the significant decl ion, is a major barrier in proine in Bonda population in creation of children and has tern and high age gap is solely die, fifty get injured and thi
the last two decades.
contributed to the decline of responsible for the decreas rty are taken into police cust
The number of Bonda tri the tribes.
ing population,” he emphasi ody because of liqour-related
bes has stagnated at around
“By the time they can have ses.
violence.
5,500 for the past several sexual relations, the biologi
This apart, violence within
Efforts by the Government
years and old-timers attrib cal clock has caught up with tlie Bonda community also and Non Government Organi
ute tills to their unique marr the wife and this checks the has an adverse impact on the sations to develop the Bonda
iage system which involves birth rate,” says researcher population.
tribes over the past two deca
des has elicited little or no response among the tribals.
This due to the Bondas' ada
mant rejection oTmodem me
dicine and health care from
outsiders.
STATESMAN NEWS SERVICE
The tribes believe in using
.traditional herbs and roots
KOLKATA, April 8. - A weekly
even for serious ailments and
Bengali episode, “Gyaner Aalo
.this contributes to the high
Zindabad", aimed at generating
* death rate.
awareness on issues related to
Meanwhile, gravely conce
HIV/AIDS among the young,
rned over the sluggish popuwas
broadcasted
from
7
p.m.
to
NEW DEI.HI, Mar I (UNI)
•lation growth of the Bondas^
7.30 p.mu today on the radio's
A US-based doctor of Indian or.
the Orissa Health Departm
FM
channel
gin. Dr Sunil K Ahuja. has bagged
ent has stopped all family pla
The programme will be broad
the prestigious Elizabeth Glase<
nning measures in Bonda tri
casted on 12 consecutive Sun
Award for his contribution to Aids
bal villages.
days. It will also include a coun
research. Dr Ahuja succeeded in
All sterilisation program
selling session, with a helpline
typifying genetic mutations in the
asking for questions on repro
mes and distribution of birth
OCRS chemokine receptor, a key
ductive health, HIV/AIDS, and
control devices have been
receptor for HIV virus, that can
other problems that teenagers
curbed in these areas.
determine whether or not an irjdi
may.have, which will be an
virtual will be susceptible to HIV.
The Indian Express
swered by a psychotherapist
Studies by Dr Ahuja and his wifi
*
23 April 2001
The
programme
is
conceived
Seema S Ahuja, determined tha:
and produced by Thoughtahop
there is a significant difference in
Foundation,.a city-based NGO,
the’susceptibility of different indi
and supported by the State
viduals to contract AIDS.
AIDS Prevention and Control
Deccan Herald
Society and the Department for
02 March 2001
International Development,
By Akhaya Kumar Mishra
FM programme
on AIDS
Indian scientist
gets award for
Aids research
UK
The Statesman
09 April 2001
NYCU - HIV/AIDS
7
When ignorance is not bliss
cent in Bihar te 93. per .c^4$itanipur,
and Mizorank AIDS awarfehe^have gone
X 3>betvreen afew months and a -decade
Up significantly (from 1992-93 to 1998-99)
only in Tamil Nadu, Delhi, Maharashtra
or morewHehthere.may be.no apparent
and Goa.
symptoms of apy; illness tjLll the -on^etpf
even heard of AIDS up to 1998-99.
AIDS.
Tolovisiun wuu the mowl import tint
cTM>Td'uiiber'of people living with Education and standard of living had a source of information (70 per cent) among
HIV/AlDS ip India was already as large aa positive association with knowledge of women, both urban and rural. Other
3'.6 million at the end-of 1990. Since ..the AIDS, which ranged from only 18 per cent important sources were radio. (42 per
•stabifrhmcnt of the National AIDS among , illiterate women to 9? pei cent cent), friends or relatives <32 per cent).and
Control, QrgphiiaUoh. in 1989,. various among women who’ve nt least completed newspapers or magazines (27 par cent).
efforts to prevent HIV transmission, such high school. Similarly. AIDS awareness
It is disappointing to learn that among
as'.pnl^. health Jd^you’ tl^igh’ ;.the increased from 20 per cent among women women who had heard about AIDS, 33.per
*
:modla • and i nhn-govmimenial- orgaiiisa- in households with .a low standard of liv
cent did not know any way of avoiding it.
tiaps, havebeenri^e.Bu£^Bfruits of ing to 74 par cent among ^oiuc-n with a As expected, this percentage was higher
l.iniaa. nites v:«n
*
this labour ware far from oncounigihg az high stand'Ud of
a mung rural than urban women, and
knowledge of increased x^aiply with decreasing levels
revealed in the rooeintly.published report considerubi.. .
of the National Family Health Survey AIDS. It ranged from k low of only 12 per uf education and standards1 of living.
Among women who auid that suinolhing
could be done to prevent AIDS, the most
commonly mentioned ways were to have
only one adx
*
partner (40 per cent) and
avoiding injections or using clean needles
(30 per cent). Avoiding sex with sex work
ers, using condoms, and avoiding blond
transfusion were also mentioned by 25 per
cent, 20 per cent and 19 pei cent of the
women ruHpoclitoly
The lack of knowledge about AIDS, its
need for further research and
Chris McGreal
modes of transmission and ways to avoid
Johannesburg
discussion.
infection are still the greatest challenges
The dissidents recommended
to efforts towards prevention and control
A PANEL of international scien an end to the "hysteria" around
of AIDS in India. Since even basic infor
tists convened by the South AIDS by suspending "the dissem
mation about AIDS is seriously deficient,
African president, Tliabo Mbeki, ination of the psychologically
:o resolve the issue of whether destructive and false message
at least among the women in our country,
HIV causes AIDS has failed to that. HIV infection is invariably
AIDS. prevention organisations need to
-each agreement after nearly a fatal".
give highest priority to the educational
/ear of debate
South Africa win not be disap
programmes
among the rip-ji. |xw»r »>ud
An interim report produced pointed by the lack of consensus.
disadvantaged communities.
-•onflicting sets of recommenda- The report neither embarrasses
— Moni Nag
ions becau-se of divisions Mbeki by concluding he was
:
’
A
FTEKtimim^
varying
(NFHS-2) conducted among about 90,000
married Women in the age-group of 15
tbl9 years. A few examples of the findings:
i As many as 70 per cent rural women
and 30 por cent urban women had never
Panel disagrees on
AIDS source
between the mainstream scien wrong to question the cause of
tists, who believe HIV is the AIDS, nor does it say he was
cause of AIDS, and a "dissident" right when his government qui
faction that claims the disease is etly reversed its original AIDS
the result of social factors like policy
drug use and poverty
Guardian News Service
The panelagreed only on the The Hindustan Times
06 April 2001
The Statesman
04 March 2001
A lifeline for children
with HIV
By Ashish Sen
the state to even question the implications
A case in point is education. It took Rau
that
these statistics
throw up. and the Freedom Foundation team exactly
MITA and Rashmi argue about Notwithstanding the sharp rise in the a year and eight months to get the children
who will wear the dupatta. quantum of people who are HIV positive admitted into schools. “I don’t know how
Ashok, Riyaz and Chinku are the official policy continues to be over many schools we went through before a
immersed in discussing India’s whelmingly biased in favour of prevention school said ok . Today, we have two
fortunes against Australia in railwr than ran
*
and support. Itm admis schools that admit our children..." Rau is
the .Kolkata Test match. that the growth in statistics has perhaps upbeat about the fact that the children
-Nandini takes my hand and demands a brought about some degree of change. But have not been admitted on a confidentiality
ride in the car. Energetic shouts and laugh- the crucTal question is: whether thus is too basis. "The schools know that these are
ter front the other children resonate in the little and too late? "The government did hot positive children. Despite this, they have
*
and supjxa t in the first come forward."
background while 1 defer to Nandini's rv«’H loOk al can
wishes — a shade too quickly. As I walk to phase (in th-e nineties) .Now ,illrr consider
While Freedom Foundation is grateful to
*r)
the World Bank these schools, it hasn’t been a cakewalk.
the car, hand in hand with the animated •ilile pushing and (alt«
*,
said that ran
*
and supjxirt is a good
six year old, I can’t help but feel that ha
"In one school somebody noticed the
thing. 20
<-<»nt of lhe budget has l»vn autorickshaw which brought these chil
appearances are deceptive.
The increase in the number of HIV
Amita, Rashmi, Ashok, Bairam, Chinku
dren to school and which had our name
and Nandini are six of the '14 H1V/AIDS positive children who required support
..We got a call from the school asking us
led
to
the
formation
of
the
residential
positive children who are a part of the
not to send the children, because the par
Freedom Foundation community living on care centre in 2000. Today, ^.the
ents of some children were objecting ... It
he outskirts of Bangalore. They are also Foundation in .Bangalore houses 14
was a very disappointing day for us. But
orphans and have lost their parents (in children ranging from 18 months to 14
the entire team met. and (initiated) a meet
many cases their siblings as well) to the years. If Hyderabad' and Bellary are
ing between parents and teachers to dis
brought into the picture the figure will
AIDS scourge.
cuss the issue. The next day the children
"When we talk of children with almost double by the end of March,
went back to the same school. To us that
HIV/AIDS (he fundamental flaw is that .’ says Rau. But he clarifies that in terms
was a major achievement. We are so grate
*
then
is no voice. What makes the flaw of support the number is 136 children.
ful to those parents and teachers..”
even greater is that there doesn’t even In doing so, he categorically affirms
.win to be the identification of a need.". that Freedom Foundation is not a one
NOTHER issue of concern was com
The concern is voiced by Ashok Rau. stop shop' and that HIV/AIDS must be
munication within the group. The
Executive Trustee of Freedom Foundation. viewed as a societal issue. “However.
children come from different parts
a front line HIV/AIDS care and support poor the environment may be from
of the country. “They had lived
NGO. Il is also perhaps the only group where the child comes, fundamentally
children came up and said we want-to
come to the cemetery. From a societal
which pnivides residential care to children we have no right to disturb’ it (So) we *
try and hold a dialogue with
*
the par-'
who an
* HIV ixisitive.
point of view it is not done. But when you
if Rau’s concern is legitimate, it is also ent. Is there someone in the family
see a family within a family demanding a
an eye opener into the double speak and who can help and who can be contact
fundamental right, you need to acknowl
the hypocrisy that characterises much of ed. But when there are definite gaps,
edge it."
r .
•
the ostensible crusade against the disease. when comes forward, the Foundation
In such a scenario, counselling assumes
While millions of dollars have come into steps in." he says.
additional significance. There is a tremen
"It has never been easy for Freedom
the country under the garb of HIV/AIDS
dous amount of therapeutic work which
*
is
assistance. there has lieen hardly a whim- Foundation to address this issue from
carried out. .But even here Rau’s experi
*r.
•x
let alone gesture, for children living a practical and financial point of
ences substantiate that in mort^ways them
with HIV/AIDS. A recent UN AIDS study view." But then, as Rau points out, there is one the child is the father of the man.
carried out in Octobcr/November 2000 •also an emotional perspective. "It really "When a child recently passed away, thdre
pointed out that children with HIV/AIDS boils down to seeing this child and trying were various things the children got themin India could be anywhere between 2 and to imagine what he/she is going through..." selves into therapeutically — as apart
of
*
2.5 lakhs. A "gross understatement,"
The centre for HIV positive children lias their own grieving process. Besides these
according to Rau.
brought with it many challenges. "We still children display a maturity far beyc
”Wc are looking at very alarming figures don’t have societal acceptance and permis their years. Many of them taiow they t(re
and trends." says Rau. Unfortunately, there sibility in saying that it is all right to nor affected..."
seems to bo no inclination on the part of. malise these children’s lives."
- ' There is more good news. Rau points out
C ontd..
A
NYCU - HIV/AIDS || I
which includes a 10-bed hospice to house children of society and are a part of soci
ety. This started a process of identifying
that 6 families from different parts of the and care for terminally ill patients".
country, some of them with ’normal’ chil
The Foundation has also grown in other other avenues. It is amazing to see that
dren', have adopted HIV positive children. ways. Based on a demand driven model. today these children go to dance classes
The process was easier said than
done.
*
It branches have opened in Hyderabad and with other children, enjoy outings with
took about two years of intense discussions Bellary. Mangaloi^ will shortly have anoth other children..."
Freedom Foundation is also on the
and meetings before it went through. The er centre. The National Aids Control
guardians also have an assurance from the Organisation (Naco) has recognised the verge of starting a children’s learning cen
Freedom Foundation that they will be Freedom Foundation model of Care, as "the tre which will offer HTV positive children
"the very best of Information Technology.
ready to step in at any stage. None the less. ideal, low cost, community based model.
**
new ground has been broken.
Reportedly, it is the first HIV/AIDS home NUT has come up with a computer package
While the Freedom Foundation model in the country.
very specifically for these children.
his tangibly demonstrated the need for a
Significantly, the centre will “open its
care centred model where children play a
HESE, however are not enough for doors to other, so called normal children."
crucial role, there seems to be no dent
Side by side with the efforts to join the
the Freedom Foundation team. As
made at tlie policy lex-el. As Rau says. this
Rau points out, there are no more mainstream are other fundamental quuscalls for a drastic change in how the
than eight to ten centres across the . tjons. How do these children come to terms
HIV/AJDS issue is perceived in the coup- country which provide residential care to with their illness and the possibility of
try. AIDS needs to lx; viewed ax a dcvehip- people with HIV/AJDS. Put differently, this death? Should children be exposed to such
ment issue and not as “somebody vise’s moans that only about a thousand affected trauma? While there are no easy answers,
business.-Consider his arguments:
___ _ can avail of these facilities. This is Rau describes a "very real side" to the
people
—the increase in the numbTof. shocking, given the fact that the ordinary issue." “When the first child was in hospithing. 20
cent of the budget has been
citizen is constantly being bombarded by till, I had three children come up and say
allocated for care .and support...but it is
the fact that India is sitting on an AIDS we want to go to the hospital. When (one of
still only 2u per cent.’
the children) recently passed away, the
time bomb.
The accent on prevention rather than
Moreover, despite Naco's blessings, care H1V positive children will result in i!ic
care and support has, not surprisingly,
and support continue to remain outside the inability of traditional models <»t 'urro|’.it«‘
evoked brickbats from several quarters.
centre of the HIV/AIDS strategy. This is support care in accommodate them.
The millions of dollars that flood the coun
where the rub lies. There is no tangible Freedom Foundation's experience with
try would seem to have provoked a mush
move by tlie State to undertake responsibil- children has already exemplified the
of N’GOs working
field ui
of
*4rooming ih
ruom:n
wurning in
ui the
ure uuiu
', , . .
. ..,
,
“inability of poor communities to absorb
HIV/AIDS prevention, but riot achieved
'
'•
HIV/AJDS children into an informal set up
HIV positive.
much else. In fact, many of these NGOs
The children’s issue came up almost in without formal supixjrt. ’*
have reportedly, "only existed on paper."
At the same time, unless strategies to
the same way as how we got into care am
Others have been unable to utilise a sub
support.We had the first child who was ensure the rights .of children with
stantial quantum of the funds which they
bom here (in 1997) to a mother who was HIV/AIDS are developed, these children
were allocated. This has. in turn, raised
HIV
positive ...The child did not make it, wall be forced into poverty and high risk
questions about professionalism andand died after six months. During those six activities like prostitution etc. In tlie cur
accountability. But underlying the gross
months we went tried hard to figure out if rent context, an infected orphaned child is
lack of transparency, there is a human
this child was HIV positive, how and where unlikely to inherit his or her parents’
component which demands reckoning with.
and when we could process things to assets. More like he/she will be vulnerable
As Rau asks. "What is the point of hammer
ensure that the child’s needs are met to homelessness.
,
ing away at prevention when we do not
...There was nothing to be found.
b. The family structure is likely to
have systems in place?” Moreover, "care
"We ran from pillar to pofft to try and change with the spread of HIV AIDS. A
and support will complement any kind of
find an organisation which would address generation is likely to be wij/.-u out. and as
prevention effort you are going to make."
the issue. There w-asn't a single one in the the Northeast has witnessed the burden
Care and Support has remained the corerslone of the Freedom Foundation wing country. We realised then that we were will fall on the grandparents. Or there will
ommitted to HTV/AIDS infected people going to have many more people coming to be more child headed households. Both sce
us... *
narios are more prone to poverty.
since its inception in 1996. "We got into
Sim? enough we soon had the first family
This co-relation between AIDS and
care and support when people said we were
poverty is daunting. From a vulnertL
crazy to...," reminisces Rau. "My entire coming to us where both parents and chil
child to a vulnerable family to a vulnerable
(motivation) came after I did my first dren were affected..**
within acertain kind cl xp.ur, hull jln-ath community — the vicious circle v. ill clear
awareness programme... three men came to
devclnjxd certain beliefs.” In order to part ly place an inordinate pressure both on
me and admitted that they were vulnera
ly overcome this barrier all the children society and tlie government. A c.'u
*e
centn-d
ble. They nskcxl me where they should go...
have learnt Kannada and Hindi. At the model could make the crucial (hflercncn.
I did not know where to send them or what
same time, the Foundation started an infor But for this to hapixm we need tn get Ixick
to do."
mal education component which prepares io Ixisics. The State needs to lake the fn-sl
Started by Karl Sequeira and Ashok Rau
the "child for a formal school"
$t<-p by acknowledging and demonstrating,
in 1993 as a centre to provide intensive and.
It also answers a related question, "how its responsibility and supjxirt to the iq-ow
*
effective treatment fur chemical depen
does a Marathi speaking child study in a ing number of HIV/AIDS children and
dents, Freedom Foundation has come a
Kannada medium school?
**
adults in the country. Will* 'Jgv? .
long way- In November 1996. it initiated a
(^rhe names nJ children
25-bed, short/Iong stay, day care centre for" The quest to provide normalcy raised
other challenges. Apart from education, we __
_ _
have Ikvh cfitnmed)
HIV positive people. Today there are more
need to "ensure that these children don’t
than 500 clients using its services, while
The Indian Express
really become the HIV positive children of
the Care centre combines "out-patient ser
15 April 2001
Freedom Foundation^but are HTV positive
vices with a 45-bed residential care unit •
Contd...
r
10
NYCU-HIV/AIDS
Defensive drug industry fuels
fight over patents
HEBIG'pbarmaceudcal com-, and Kenya in their efforts to gain access ments for tropical diseases. But others
say what deters companies from devel
panics; march to the beat of a_ to lower- priced AIDS drugs.
steady chant.that pateht'pro-i
Until recendy, the industry worried oping those drugs is the small market
tectionfor drugs is essential fpf.. that erosion of patent rights or prices in size.
Patents award an inventor exclusive
innovation^.At.tbes urgin^pf.. (he drug one country could lead to similar ac
companies,’tH^Uhit^5fates govern tions elsewhere, particularly in the rights to make or st-F • product for a set
ment has pressed
^jany
*
nations to United States, where the industry gets period. In countries nat adheie to the
honour patents bn'medications.. ■
Trips agreement, patents run for 20
much of its profit.
'But now, it seems,/the industry may
“There was a feeling that if a country years from the filing of the application.
have overplayed its hand. Drug patents deliberately went against TRIPS, there Patents provide an incentive for inno
are under attack, blamed for high AIDS would be a castlu-of-cards effect,” said vation. and in return, the invention is
drug prices that
*
deny, life-saving ther?' Mr. Jean- Pierre Garnier, chief execu publicly disclosed so others can learn
apy to millions of people in developing tive of GlaxoSmithKline, a major sup from it.
countries. And some analysts say the plier of AIDS drugs. "Without patents,
Drug companies argue that they
industry itself fuelled the' backlash.fry the industry ceases to exist.”
need patents because it can take more
staunchly defending ' its‘ intellectual * But now. judging from their actions, than a decade and hundreds of mil
property in the face of a pandemic that
• :<? companies have decided to sacri- lions of dollars to develop and test a
could claim more lives.than. the Black
p . •. s in some poor countries in drug, which can be copied relatively
Death of the Middle Ajges>(
* order to argue that generic manufac easily once it is on the market. Many
The latest clash over patents'on AIDS turers are not needed and to relieve die countries have viewed drugs as mer
drugs came to a boil in South Africa last pressure on the patent system. In Bra- iting exceptions to patent law because
week, when 39 drug companies drop- - zil, for example, Merck recently agreed of dieir importance to public health.
ped a suit trying to'block a: law’”the
to big price cuts for two AIDS drugs to But with trade agreements like TRIPS,
companies asserted would, make it too
prevent the government from allow ing countries have tightened their patent
easy for the government ,to abrogate' a local generic manufacturer to make a protection.
their patents.
copy of one of them.
TRIPS does not go as far as drug
The debate.' has' erupted >4n > other ’• * Some AIDS activists, however, say it companies would like, and it includes
countries as welt Brazil has threatened is better to rely on competition from some exceptions to patent protection.
to grant licences to local manufacture
generic manufacturers than on volun For example, countries can force pat
ers on patents for'AIDS drugs' held by
tary actions by big drug companies. ent holders to licence their patents to
Merck and Hoffman-La Roche. InThai
They say drug companies
*
recent dis others, like generic manufacturers. Bur
land, AIDS patients and '.activists' -are
counting was only in response to an so far. no country has.
planning a legal challenge to the val
Some activists say the countries have
offer of low-priced AIDS drugs by a ge
idity of a Bristol-tMyers Squibb patent
neric-manufacturer in India. But under not used licensing because of pressure
on an AIDS drug.*'•■.' - ‘
' V .7?,
TRIPS, India and other countries will from drug companies and Washington.
The uproar over AIDS drugs is threat have to enforce patents bv 2005 or But the United States has partly re
ening moves toward, more globalisaversed its policy and is no longer rais
2006.
tion, eight years after
*
most nations
ing objections to compulsory licensing
"If
we
don't
deal
with
the
problem
approved the Agreement .op Trade^Re?
in (he case of health crises in devel
now,
5
to
10
years
from
now
we'll
have
la ted Aspects of Intellectual. Property
no possibility of bringing prices lower oping countries.
Rights, or Trips,.which commits them
and we'll be completely at the mercy of The country with the most experi
to enforce drug patents. Activists are the big drug companies," said Ellen T
ence with compulsory’ licensing, albeit
campaigning * against "the proposed Hoen, an attorney with Doctors With
before TRIPS took effect, is Canada. For
Free Trade Area of theAmericas, saying out Borders.
decades Canada allowed any company
the United States wants more patent
Drug company executives argue that to apply for a licence to make a patent
*
protections.
’ . Ui-3*.- -SsV-I
patents are not a barrier to treatment of ed drug their.
"The TRIPS agreement was probably AIDS. Even generic drugs arc out of re
In 1969. it allowed copies of patented
the
greatest
political- economic
ach for countries that spend less than
achievement that the pharmaceutical $10 a year per person on public health drugs to be imported, and a generic in
*
began to thrive. The compulsory’
industry ever had," said Mr. Jim Keon, and lack doctors and clinics to deliver dustry
licensing system was weakened in 1987
president of a trade group representing
the medications. Moreover, in many and then abandoned in 1993.
generic drug companies in Canada.
Since then, spending on research
"Now it’s coming home
*
to roost, countries of Africa besides South Afri
and development by drug companies
though. Can the world afford it? Is it ca, AIDS drugs are not patented.
ethical?"
*
"At least for AIDS drugs, patents have in Canada has zoomed, to about $900
Even some supporters of patents are been a barrier only as an exception million in 1999 from $166 million in
pulling back somewhat. Washington rather than the rule in Africa," said Mr. 1988. I he Canadian experience sug
says it will no longer pressure poor Amir Attaran, director of international gests that protecting intellectual prop
countries that allow production of health research at Harvard University's erly may prompt greater investments
cheaper versions of patented drugs for Centre for International Development. by ding companies and even the devel
major health problems, provided they Drug companies and some expert.
**
ar opment of a homegrown industry.
adhere to Trips guidelines. The Eu gue further that if developing countries
But it is not clear if African countries
ropean Parliament has expressed "soli honour patents, drug companies will have the scientific expertise for a redarity and support" for South Africa have more incentive <0 develop treat search-oriented drug industry. More- Contd...
T
NYCU - HIV/AIDS
fi 11
A
For HIV Children,
A Positive Step
As IIISH SEN
care for terminally ill patients
,
**
children ranging from 18 month?
-------------------- -..............
Foundation has also to 14 years. If Hyderabad and
mita and Rnshmi argue grown in other ways. Based on a Bellary are brought into the picabout who will wear the demand driven model, branches ture the figure will almost double.
jupatix Ashok. Niyaz and have opened in Hyderabad and $ayS Rau. But he clarifies that in
A
Chinku are immersed in dis- Bellary. Mangalore will shortly terms of support the number is
cussing India's fortunes against have another centre. lhe Na- 136 children.
Australia in the Kolkata Test tional Aids Control Organisation
The centre for HIV positive
match. Nandini lakes my hand (Naco) has recognised the Free- children has brought with it
and demands a ride in the car. dom Foundation model of Care, many challenges. "We still don
*:
Energetic shouts and laughter as the ideal, low cost, commu- have societal acceptance and
from lhe other children resonate nity based model.
*
These, how- permissibility in saying that it K
in the background while I defer
uro not enough for the Free- a]| right to normalise these chil
li* N.inJini- wishes
<i shade dom Foundation team. As Rau dren's lives." A case in point is
too qtikkly. As 1 walk to the car, points. out, there are no more education. It took Rau and the
hand in hand with (he animated
eight to ten centres across Freedom Foundation team exsix year old. I can’t help hut feel l*,c country which provide rcsi- act]y a yCar ancj cight months tc
that appearances are deceptive, d^arc to people with get the children admitted ink.Amita. Rashmi. Ashok. BairAIDS. I ut differently, this schools. "I don't know how mam
am. Chinku and Nandim are six means that only about a thou- schools we went through before
of the 14 HlV/zMDS positive sa°d affected people can avail of a school said ok. Today, we have
children who are a part «j| the these facilities. This is shocking, two schools that admit our chilFrecdoin Foundation commu- ghen the fact that the ordinary dren..." Rau is upbeat about the
nity living on (he outskirts ol ^jh^yn is constantly being bom- faC[
(he children have not
Bangalore. They are also or- barded by the fact that India is been admitted on a confidentialphans and have lost their parents sitting on an AIDS time bomb, jjy basis. 'The schools know that
(in many cases (heir siblings as
"The children's issue came up these are positive children. Dewell) to the AIDS scourge.
almost in the same/way as how spite this, they have come for"When we talk ofBiildren" we got into care and support.We ward."_
■
with H1V/A1DS the fundamcn- had the first child who was bom “ Th©Indian FxnrAQC
tai flaw is that there is no voice, here (in 1997) to a mother who
onn-i
What makes lhe flaw greater is was HIV positive ...Tlie child did 1 ® April 20U1
that there doesn't even seem to not make it, and died after six
be the identification of a need." months. During those six months
The concern is voiced by Ashok we went tried hard to figure out
Rau. Executive Trustee of Free- if this child was HIV positive,
dom Foundation, a frontline how and where and when we
HIV/A1DS care and support could process things to ensure
NGO. Il is also perhaps the only that the child's needs are met
group which provides residential ...There was nothing to be found.
care to IIIV positive children. .
"Wc ran from pillar to post to
Started by Karl Sequeira and try and find an organisation
Ashok Rau in 1095 as a centre which would address the issue.
to provide intensive and effective There wasn’t a single one in the
treatment for chemical depen- country. We realised then that
dents, Freedom Foundation has we were going to have many
come a long way. In November more people coming to us...
1996, it initiated a - 25-bed,«
Sure enough we soon had the
short/long stay, day care centre first family coming to us where
for HIV positive people. Today both parent^and children were
there are more than 500 clients affected
The increase in the
using its services, while the Care number of HIV positive children
centre combines “out-patient who required support led to th.
scrriccs with a 45-bed residen- formation of the residential care
tial care unit which includes a centre in 2000. Today, the Fouhqspice_to house and ndation in Bangalore houses l 4
Contd...
over, some experts say the drug
companies promised in advance to in
crease spending in Canada if (he law
was changed.
The precedent that most worries
drug companies now is (hat weakened
patent protection in developing coun
tries will lead to pressure to weaken
patents and in the process, their lai*
itude to set prices in the United States.
The Consumer Project on Technol
ogy. a Washington group fou.nded by
Ralph Nader, has asked the govern
ment to let it make a low- priced ver
sion of d4T. the Bristol-Myers AIDS
drug. The National Instiiiites of Health
has in the past rejected such requests.
Even without (he AIDS crisis, there is
pressure on patents as a result of high
drug prices in the United Stales. While
innovation should be rewarded, some
drug industry critics say. the drug in
dustry' is the most profitable in the na
tion. Moreover, many drugs are
initially developed with government
money.
Dr. Gail Wilensky, a senior fellow at
the international health education or
ganisation Project Hope who tan Medi
care under former President George
Bush, has proposed shortening the life
of drug patents to let competition low
er drug ju ices, as an alternative to regu
latory options that are sometimes
discussed. A report issued last year by
the National Institute for Health (?nie
Management l-'oundalion. an organisa
tion supported by health insurers, said
the elfeclive patent life for some ding'has grown from 8 years in the early
1980s to 14 or 15 years now.
"Wc have moved more toward in
creasing market power of pharmaceu
tical companies than we wished to."
Dr. Wilensky said.
Andrew Pollack
Seirjjt/k’ Tinier
The Hindu
26 Aoril 2001
NYCU-HIV/AIDS
High HIV incidence among city migrants
Smlta Doshmukh
Pegged as a major hub of migrant pop
ulation. Mumbai is now witnessing an
alarming riso in the number of sexually
transmitted infections (STIs) and
HIWA1DS amongst single men and tho
g.iy community.
Migrants cornpriso ovor 40 por cent
of Mumbai's industrial worker popula
tion. This being predominantly mate,
perpetuates a serious gendor imbal
ance (700 women for 1000 mon) com
pared to the national avorago (940
women for 1.000 mon). Tho profile of
these migrants include truck drivers.
workers in small restaurants and
labourers, a lot of whom are forced to
stay in small rooms and found to have
sexual relationships with each other.
Tho Humsafar Trust, a cooperative
ol single men in Mumbai, recently
undertook a major project, for MSMs
(men having sex with men), which will
cover around 15,000 such men in the
city. This effort is backed by the
Mumbai District AIDS Control Society
(MDACS),
the
Brihanmumbai
Municipal Corporation's health depart
ment, the National AIDS Control
Organisation (NACO) and various cor
porate bodies like
Glaxo. The results
showeo a high rate of
STIs and HIVXAIDS amongst such
mon.
"Wo have made a serious effort
towards advising these mon, who are
situational homosexuals, to seek help
regarding their health condition. A con
stant and prompt treatment for STIs is
a must," says Ashok Row Kavi. a gay
activist and founder of the Trust.
In fact, Humsafar runs one of
India's few health facilities for homo
sexual males. Pre-test and post-test
counselling is also offered for any men
before they are tested for HIV.
"Many of these men are married so
their sexual behaviour puts their
spouse and children in danger of con
tracting STIs and HIV. Our study
shows that more
than 20 per cent of
MSMs have relation
ships with women, hence linking up
with Sion hospital's skin and derma
tology department also encourages
partner notification and treatment,’’
explains Row Kavi.
The Trust completed a major base
line study of the knowledge, attitudes.
behaviours and practices (KABP)
among the city's gay and MSM popu
lation.
The SOWs reached out to a little
over 8,000 men al various cruising
sites, bars, pubs and discos frequent
ed by the former. The organisation's
outreach has been extended to Thane
and Vashi in the eastern and Borivali in
the western suburbs. The SOWs aro
now operating at major railway sta
tions, bus stations and along tho
beach fronts.
•The Trust is also working with tho
BMC's. Asha project, located in
Kamathipura. where other NGOs like
Prema work with women in prostitu
tion. They have with them Dr Mahindra
Watsa. Dr Raj Brahmabhatt. Dr Hansh
Shorty and the OPD departments of
various public hospitals for rapid treat
ment at affordable rates.
smita.doshmukh ©timesgroijp.com
The Times of India
05 April 2001
Drug giants run into
AIDS counter-offensive
FROM STEVEN SWINDELLS
Johannesburg,
'April
11
(Rdulers): A leading South
African AIDS advocacy group
filed court papers against the
world’s most powerfill drug firms
today, charging them with failing
to ‘act in .the face of the.country’s
AIDS crisis.
‘ ‘
.
The Treatment Action Cam
paign (TAC) lodged its 800-page af
fidavit ahead of the resumption of
a landmark case at the Pretoria
high court on April 18 which will
pit 39 of the world’s biggest drugs
firms against the South African
government.
The Pharmaceutical Manufac
turers Association ofSouth Africa
(PMA) is seeking to strike down
South African legislation which it
argues would violate its highly
cherished patent rights on medi
cines, including AIDS drugs.
The outcome of the case is ex
pected to be a key test ofthe ability
of developing countries to import
generic drugs in the face of a
health crisis caused by AIDS
which affects more than 25 mil
lion in Africa alone according to
UN estimates.
South Africa has more people
living with the disease than any
other country in the world, with
an estimated 4.7 million people or
one In nine of the population af
fected.
TAC national secretary Mark
Heywood said their legal deam
will argue that the South African
government was within its rights
to import generic drugs under in
ternational trade laws, including
the TRIPS agreement which cov
ers patents.
The affidavit also attempts to
dismiss arguments by drug firms
that they have offered a series of
price discounts on their anti-AIDS
drugs which Pretoria has failed to
take up.
“Drug firms want South Africa
to be a beggar. The offers are con
ditional and only made under pub
lic pressure and could be just as
easily taken away.” Heywood told
Reuters. “South Africa cannot
give away its rights to compulsory
licence and parallel import on
these offers,” Heywood said.
PMA’s position that patents
were vital to fund drug research
were countered by TAC which
said that drug firms got tax breaks
for their research from public cof
fers and that key compounds in
patented drugs were discovered
by publicly funded scientists.
AIDS activists and aid organi
sm Ions have slammed the drug
firms for putting profits ahead of
lives by earning excessive profits
from their patented medicines.
The PMA will argue in court
that the act will give the health
minister unfettered power to im
port generic or copy-cat versions
of medicines in violation of their
patent rights.
PMA’s legal team is also ex
pected to argue that the South
African government has failed to
take up a series of offers on dis
counted AIDS drugs because it
still has doubts over the safety and
ethics of the distribution of anti
retroviral drugs. President Thabi
Mbeki has caused a storm of inter
national criticism by questioning
the causal link between HIV and
AIDS.
Glaxo SmithKline (GSK) yes
terday said that Mali had become
the sixth African country
*
to strike
a deal with Western drug firms to
ensure cheaper access to drugs.
GSK has offered its combination
AZT 3TC antiretroviral drug The Telegraph
Combivir to Pretoria at $56 for a
12 April 2001
month’s treatment.
NYCU | HIV/AIDS
13
THKvii•us .makes thejourneyfrom Mumbai
brothels to Satoru homes
By Kalpana Jain
Tho tlmos of India Nows Sorvlco
SH IND1
\V/\DI
*
(Maharashtra):
*I1k* narrow road that snakes into
this Milage cuts through steep
mountains. One wrong step could
inc.m the end of the journey. With
careful and cautious manoeuvring,
(he driver lakes me inside the vil
lage However. HIV entered this
vtll.igc much more easily.
there is a row of houses al the
end of (his narrow road./Ml houses
are built in a similar manner, encl
*.
with an open coin (yard outside and
a roof made of brick tiles.
A young couple infected with
the virus lives in one of these hous
es al the end of this road.’Hie cou
ple, in their mid-2()s. is just return
ing from the place of the woman’s
parents where their four-year-old
daughter has now been left. A mat-
tress. hanging on a line there, is
pulled down and spread on the
mi. ' ' icred floor. I am invited
to sit v .1 while the couple squats
on the floor.
I lanuinant, who used to sell veg
etables in Mumbai, learnt about his
infection six months ago. He still
has not come to terms with it.
Though he looks healthy, a stream
ol infections has started invading
his body. 1 le developed tuberculo
sis three years ago. But it was only
recently that he was tested and
found to lie HIV-positive.
Hanumanl seems to be deeply
disturbed. I k does tell us that he is
trying to build a positive attitude
and says aloud."I need to live well
to live longer.” But he swiftly
launches into a monologue of how
he has ruined his life. He can no
longer look anyone in _the eye.
“There is this deep sense of guilt in
side me. Every time I talk to some
one who knows about my condi
tion, I wonder what he might be
thinking about me.”
This is obviously a reference to
his visit to a sex worker, perhaps
somewhere in Mumbai, hi all the
households in the villages, the virus
"LIVING WITH AIDS^j
has travelled from Pune or Mum
bai, where the men of the house
holds had gone to work. After
word leaked out to his family, his
mother fell ill. he says, just worrying about him. His brothers told
him to stay away. A bitter Hanu
manl recalls, “I was told:’Stay at a
government centre. Al leasl you'll
get food and medicines. Do nol
come back to us’.”
see much of dementia in India al
though it can occur any time after
a year of HIV infection. We sec
more of neurological opportunis
tic diseases than dementia." said
Dr. Ravi.
obvious ones like loss of memory.
By R- Prasad
"The neurological problems
loss of consciousness, loss of mo caused by AIDS can be treated if
-. t
CHENNAI, APRIL 1. Opportunistic in tor function, seizures and even they are diagnosed early,” Dr. Ra
fections like tuberculosis of the dementia. ‘Nearly 10 per cent of vi said. Diagnosis and treatment
chest in AIDS patients have re HIV infected patients develop de are crucial in the case of neuro
ceived more attention in India. mentia," said Dr. Kumaraswamy
.
*
AIDS primarily because the
However, many are totally igno based on his observational data. blood-brain barrier in the human
rant of dementia and other neur Dr. Ra\i mentions a much smaller body prevents many drugs from
ological problems that could figure of 2 per cent. HIV caused reaching rhe biain. Even when
afflict AIDS patients. This is intri dementia incidence is as high as they do reach the brain, they arc
guing as a large percentage of 30-40 per cent of the cases in the insufficient in quantity to keep
AIDS patients in the country will West. Various reasons are given the virus under check.
suffer from such problems. "Ob for the low occurrence in India as
'Only two or three untiletroviservational data at our centre sug compared to the West but noth ral dnigs are able to go past the
gest that nearly 30-40 per cent ing has been proved conclusive'!1,. blood-brain barrier. Hence cor
would suffer from AIDS related
The HIV virus is carried to the rect treatment using these drugs
neurological problem at some
is vital." Dr. Kumaraswamy
point of time in their life," said brain in the first four weeks after
Dr. N. Kumaraswamy, Chief Med infection by the macrophages. stressed. In the absence of correct
ical Officer, YRG CARE at the VHS Once inside the brain, the HIV in treatment, there lies a possibility
Hospital, Chennai. It is nearly 70 fects die microglial cells — the of the virus developing drug re
brain’s macrophages. "The lime sistance and the brain becoming
per cent in the West.
a major reservoir of vims. Disease
More than the high likelihood span for developing some neur
of developing a neurological ological problem here is 2-5 years management in such cases will
while it is 8-10 years in the West,” become all the more difficult.
problem, nearly 10 per cent of
Dr. Ran said.
AIDS patients first come to know
The Hindu
The damage to the microglial
of their disease (AIDS) status only
cells can cause meningitis. Simi
02 April 2001
through neurological problems,
larly, damage to nerve fibres can
according to Dr. V. Ravi, Head of occur. It can also cause a host of
rhe Neuro Virology department at (neurological) opportunistic dis
the National Institute of Mental eases due to immune suppres
Health & Neuro Sciences (NI.M- sion. Dementia that results due to
HANS), Bangalore.
injury or death of neurons can oc
The symptoms of neuro AIDS' cur in the early to middle as well
can range from lethargy' to more as in tite late stages. "We don’t
Little known facts
about, neuro AIDS
14
Now their only support is his
wife’s parents. Not that they have
accepted Hanumanl. At least they
are willing to take care of their
daughter and the granddaughter.
Mis wife. Ranjana, had developed
Herpes Zoster, a skin infection in
which large, red, extremely painful
blisters crop up.
This was the time when her infec
tion was delected. She looks very
thin and is suffering from acute
anaemia as well. She lost her eightmonth-old boy. I le became sick and
died because he wasn't tested and
even the couple didn't know at that
time that they had 11IV.
Ranjana wants to keep her
daughter till the lime she lives, but
says that she has little strength. Bui
this depresses her further. And as
she fights off her tears, the ques
tions come pouring out.“How will I
work and support myself through
my remaining days. If one of us
were to fall seriously ill, how are we
to be transported to a health cen
tre,” she says, considering the irack
which leads to their home is so
treacherous? And finally, in a tone
which conveys her hopelessness,
she says, “Why can’t a centre just
accept us and provide us medicines
till the lime wc Jive?”
In village after village lhai I went
lo in Salam district of Maharashtra.
there had been several recent
deaths. All the villages arc small —
clusters of I (X) lo 200 houses.
Most of the villages were very
poor and no one seemed lo know
anything about HIV, till they got in
fected. In all the villages, the
mobili
*
ty of men had brought HIV,-con
fined to some parts of the cities,
right into their homes.
The Times of India
09 May 2001
NYCU - HIV/AIDS
0
Population up, but number
of girls plummets in India
B. Pradeop Nair
BANGALORE: Hidden within
the provisional figures of census re
*
leased last month is a distressing
trend. In the age group of under
*
six, for every 1,000 boys, there are
only 927 girls. This figure was 945
ten years ago. In Karnataka, the
child sex ratio, has dropped from
960 to 949: a decline that has made
policy planners and health workers
sit up and take notice.
This drop looks all the more
alarming when viewed against two
other figures. One, the sex ratio for
the total population has gone up
during the last 10 years — 927 to
933. (In Karnataka from 960 to
964.) T\vo, in the seven-and-above
age group, the number of females
has gone up — 923 to 935. (In Kar
nataka from 960 to 966.)
This means the decrease in the
number of females has been only in
the age group of below six. And
provisional figures for Karnataka
show that it is in the relativeiy-affluent districts that the number of
girls has dropped over the past
decade.
Sex ratio is considered an impor
tant indicator of a society's well
being. According to UN figures:“In
countries with adequate health
care, there is an average of 105 fe
males to every 100 males". India is
one among the countries that has a
low sex ratio.
According to the United Na-
: Number OF GIRI^IOREVERYz;-;
1,000 BOYS IN THE.0-6AGE GROUP
• Dinrcr A
BtLCMJ'1
: &1BWGA
1991
955
959
MamOxa'1 - • 959
•Tumkur
970
BamgmjORE (Rurm) . 957
v
~
2001
924
937
937
952 ‘
941
tions Population Fund. Indian
mortality rate for girls is 40 per
cent higher than for boys. The 2001
census shows that out of 35 states
and Union territories, only five
have registered an increase in child
sex ratio. They arc Sikkim. Mizo
ram, Tripura, Lakshadweep and
Kerala.
Sabu George, who has done ex
tensive research in female infanti
cide in Tamil Nadu, and who
works with the Community
Health Cell, Koramangala, attrib
utes this to the mushrooming of
sex-determination clinics. "The
figures arc a confirmation of our
prediction. When the first clinics
appeared we had warned of ad
verse consequences. The figures
speak of a deliberate act of vio
lence against women."
In Karnataka, the biggest drop in
child sex ratio is in Bclgauin — 955
to 924. In Gulbarga and Mandya. it
came down from 959 to 937; in
Tumkur from 970 to 952 and in
Bangalore Rural from 957 to 941.
H. Sudarshan. chaimuyi. health
and family welfare task force, says,
“This drop could be because of the
neglect of the girl child, and high
girl mortality. Another factor could
Ik* sex determination and selective
female abortion. In Mandya town.
for example, there arc a number of
clinics and arc spreading to the vil
lages."
Donna Fernandes of Vimochana
says: "It is a reaffirmation of the
age-old prejudice against females.
who are seen increasingly as a lia
bility. Boys arc seen as bringing in
money whereas girls arc seen as
taking out money. Sadly, educated
and affluent people ask for more
dowry."
Gita Sen. professor, economics
and social sciences. UM. Bangalore.
also attributes this to the "system
atic inroads made by selective
abortion”.
“lhe fact that the decline is more
steep in the forward districts of
Karnataka is disturbing. It is per
haps an indication of easier accessi
bility to clinics there.” she adds.
Sabu George is quick to clarify..
"We arc not against abortion. Wc
are against killing of females be
cause of their sex. Violence can’t be
an answer to violence.” Gila Sen
stresses the need for a campaign.
particularly against the practice of
dowry, which she feels is the major
reason for girls being perceived as
a liability.
The Times of India
29 April 2001
Experts criticise India ’s population
control targets
her oi deaths by 2045.
force. Wc arc positive that a mixlcrn
"Are wc are living in a dreamland?” asked approach will help us achieve our targets.”
census commissioner *J.K. Bhanlia. "To ’Tor this wc have asked the district admin
achieve the targets set by the government. istrators of 133 problem districts to get back
By Piuyanka Khanna ”
wc ate asking for a miracle from northern to us with area specific policies to control
stairs.
----- population." she said.
New Delhi. April 28: India's target of “Wc arc expecting states like Bihar and The latest census .'hows that India has
putting a cap on the burgeoning population Uttar Pradesh to attain the status that took become the second most populous country
growth within lhe next decade is unachiev- southern states like Kerala. Tamil Nadu and aftcr China to cross’ the one billion mark.
able, say demographers.
Andhra Pradesh 40 years to reach." Mr Currently, every sixth person in lhe world is
The government's National Population Bhantiasaid.
an Indian. India's population officially
Policy has set a target of reaching replace- But Krishna Singh, a member of the docked at 1.027,015,247 on March 1.
mcni feitilily levels by 2010 when each National Commission on Population which India added about 181 million people
woman gives birth to at least one daughter is headed by Prime Minister Atal Behari between 1991 and 2001. which is more than
and not more than two children.
Vajpayee, said: “Our targets seem optimistic the estimated population of Brazil, the fifth
This in turn will lead to a stage where lhe as far as some slates go. Wc do nut want to most populous country.
births gradually come on par with lhe num- revise the targets as they are our driving
~
Contd...
NYCU - HIV/AIDS
0 E
The myth of the population bomb
. Devaki Jain
NDIAN census counted 1,027 mil
lion inhabitants in 2001. This popu
lation is expected to grow to over 1.6
billion by the middle of the 21st century,
making India the most populous nation
in the world. This population growth is
worrying parliamentarians so much ilia t
there ;ire currently more than 20 private
member bills and resolutions asking for
urgent action.
They .suggest that the New Imputa
tion Policy, which has been announced
liy the Central government in 2(XX) and which adopts a target free ap
proach - is lex) mild since it is pltrased as
a collection of incentives and disincen
tives. Instead, they would like with
drawal of scvenil rights from people, if
they do not adopt the two family norm.
'I'liese include debarring individuals
from standing- for elections for local
government and rendering them ineli
gible for government jobs.
The urgency for action conveyed in
these bills assumes that without strong
government action population growth
will continue unchecked. 1 lowevcr In
dia’s population growth rate has de
clined significantly in tire past two
decades with total fertility rate dropping
from 6 children per couple in 1951 to 33
children perample in 1997. taking India
nearly70 per cent towards the goal ofre
placement fertility.
While the frustration with the
prospect of high population growth is
I
this period is altrilfu table to "unwanted
understandable, this fear of population
bomb leads to actions that are likely to
fertility”, i.e. unplanned and unwanted
lx: ineffectual and cocreive. While In
births to women who would like toslop
dian fertility has been declining signifi
having more children. This portion of
cantly. as a result of high fertility in the
future growth can be reduced by pro
viding high quality contraceptive ser
*
past
our population consists of a large
vices in an ethical and sensitive manner.
number ofyoung people, just entering
The desire for large families accounts
reproductive ages. Even if they were to
strictly adhere to the two child norm, for
for only 20 per cent of tlie future
growth. Thus, the bills referred to
the next few decades, births in India will
above. address only a small portion of
exceed deaths, resulting in net growth
the expected population growth.
of the population.
; It is far from dear that these mea
This phenomenon, known as "Pop
sures can effectively control even this
ulation Momentum” is estimated by
small fraction of tlie expected popula
the demographers in the National Pop
tion growth. Moreover, this legislation
ulation Commission to account for 58
could have a strong inadvertent effect of
per cent of the population growth be
excluding some groups from the political
tween 1991 and 2016. Public policy is
likely to have only marginal impact on * process. The data from National Family
this portion of the population growth. ■ Health Survey document that SQST in
A further 20 per cent of the growth in_ dividuals bear nearly half a child more
than tlie non SQST population. Also
less educated and poor families have
mdre children titan the better off sec
tions. Thus, this provision will lead to the
exclusion of tribals, dalits and the poor
from the political process.
This could be particularly oppres
sive for the membereof the SQST pop
ulations who face high infant mortality
and child malnutrition rates. Of the
1000 newly bom children, nearly 126
SC children are likely to die before
reacliing age 5 as opposed to 82 for the
higher castes. Until better guarantee of
child survival and high quality health
care ran lx: given to the population as a
whole, and the marginalised groups in
particular, expecting strict adherence to
tlie two child norm seems unrealistic as
well as oppressive.
• As these arguments suggest, the
bills pending before the parliament as
well as those in progress in state legis
latures (including Maharashtra. Ra
jasthan. Andhra Pradesh. UP and
MP), arc not only unlikely to be effec
tive in curbing the population growth.
but they also contain dangerous and
undeniable consequences for the
panchayati raj institutions and the
marginalised groups. Thus, it is imper
ative that these Bills not be allowed to
proceed any further.
TJieivruerisaBa/igcilorc-ba^'d
development ccotion list
The Indian Express
02 May 2001
Contd...
Uttar Pradesh's. 166 million is more than ment levels will be achieved by 2020 and
stabilisation will occur only by 2060.“
(he estimated population of Pakistan.
India's share in the world population is Demographers who project a doubling of
16.7 per cent while it makes up for just the country's population by 2038 feel every
slightly more (han two per cent of the earth fourth person in the world will be an Indian
’s land surface. Tlte population is growing al in 37 years.
1.9 percent annually and will surpass Chi Commissioner Banthia said the country’s
na’s in 25 years if (he current (rend contin percentage growth in population has
declined from 23.86 in 1981-91 to 21.34
ues.
The government, however, feels (hat (he during 1991-2001, which is the sharpest fall
country can stabilise its.populalion when (he since independence. “But the 1.93 per cent
net growth rate becomes zero by 2045. Pop- an,n,‘d growth rate is still higher than (he
ulation experts rubbish the claim.
earlier projections that placed it at I.8 per
Well-known demographer Mari Bhatt said,ccnl*
sa^Abroad News Service
‘‘It is impossible to achieve the targets set by
Th© Asian Age
the government. Wc .suggest that replace2g /\ppj| 2001
16
NYCU - HIV/AIDS
CHEAP AIDS DRUGS
CHEAP ENOUGH?
/
IR, — Three Indian generic
Sdrug manufacturers’ (Cipla,
Hetero and Aurobindo) offer of
selling a cocktail of three anti
AIDS drugs at considerably
lower prices ( $350, $347, $297
respectively per year per per
son) than those of multinational companies in intern
ational markets (ranging from
$1,000 to 15,000) reflects a
remarkable achievement by
Indian drug industry (21 April,
“Drug-maker pricks MNC
arrogance” by Seema Kamdar).
But is it really “great news for
an Aids-scarred world, espe
cially in South Africa”, as
commented by the author?
South Africa currently spends
less than $10 a year per person
on public health. How can its
government provide these
drugs even at the drastically
reduced price offered by Indian
drug makers to its over four
million people living with
HTV/Aids?
It is much more difficult —
almost impossible — for many
developing countries like India
with considerably less per capi
ta expenditure on public health
and per capita income to take
advantage of the reduced price.
The number of people living
with HIV/Aids is about four
million in India and about 34
million in the Third World.
The reduction of anti-Aids
drugs is, of course, highly
desirable. It would at least
alleviate the suffering of a
fraction, however small of
those infected with HIV/Aids in
developing countries.
But too much focus on the
treatment drug cocktails that
would make living with
HIV/Aids tolerable should not
in any way divert attention
from the real issue in devel
oping countries — stemming
the spread of the disease
through not so expensive but
expanded« and increasingly
effective prevention program
mes carried out by government
and non-govemment agencies.
— Yours, etc., MONI NAG.
New York, 28 April.
The Statesman
01 May 2001
A rare day for sex workers
with a message on AIDS
Express News Service
Mumbai, April 30: Swirling
skirts and smiling faces — it
was a fitting memorial to two
life-loving, spirited • women
who had succumbed to AIDS.
The dizzy tune of Bhumro Bhumro buzzed through the aftern
oon air at the Khetwadi Munic
ipal School in Mumbai on Satu
rday, as 100 commercial sex
workers (CSWs) and their dau
ghters came together to pay tri
bute to Gauri and Sushila who
passed away last week.
Their laughing eyes and
wholehearted enjoyment of the pum actress Dlvya Dutta hugs the daughter of a commercial
event was a far cry from their
worker. at Khetwadi In Mumbai.— Express photo
lives in Kamathipura. Fourby-four rooms, with just a
small opening to call a window, a bed allotted conceived while she was shooting a film on
to them for eight-hour shifts on which they them, which won eleven awards and inspired
have to sleep, tend to the children, and carry people world over. Actress Divya Dutta was
present at the occasion. Currently, Apna Aap
out their ‘business.’
Providing a binding force in that scenario is conducts classes for CSWs to educate them on
NGO Apne Aap, that has worked for the last their rights and the health risks they face. The
six years to improve the lot of the CSWs. Star message was not lost AIDS is deadly, and prec
ted by ex-joumalist Ruchira Gupta, who is cur autions have to be taken. Sex workers are hurently working with the UNICEF, the NGO was ' man beings with a right to life. _
The Indian Express
01 May 2001
The Times of India
02 May 2001
Many HIV drug ads
are misleading: US
WASHINGTON: A review of HIV drug advertising found
that many promotions are misleading because they do not
make clear that the medicines cannot cure infection or re
duce viral transmission, US regulators said.The Food and
Drug Administration said it had changed its position and
now considers it a violation of federal law to run promo
tions that fail to depict medicines
*
limitations or use images
“not generally representative” of HIV-positive patients.
The agency notified eight drug makers of its policy in a
letter. In the letter, the FDA said a review of some directto-consumer marketing found that many ads “do not ade
quately convey that these drugs neither cure HIV infection
nor reduce its transmission”. Also, some ads “may not
clearly reinforce
*
’ that many drugs need to be taken in
combination with other therapies to fight HIV, the virus
that causes AIDS.
NYCU - HIV/AIDS
17
Hijras to spread awareness
•aIiu in turn lakes care of all ihch
icquiiemeins. Kumari. is denoted
to hci husband Prakash whom she
met and fell in love about 12 yems
.
i
r
r
i
.
i
rom R
Rajlakshmi
ajlakshmi T
Trivedi
rivedi
Kumati decided U»
peralcly long for a family and
back. Kumari
in so
e. l«>
From
ago. Prakash's laniily comprisii.g
have devised a system to suffice
Madras for "divine castialiou
Ins wile ami iwo children have
this
need
for
belonging.
prevalent
custom
among
?
*
Hijr<
\ isakhapalnam, May 4: Shunned
accepted hci as prtkkiiihi (aunt)
Whenever
a
new
member
joins
*v>
by family members and disgraced done in front ol a pious IX
Kuiitaii is only happy to iccipio
theii
community,
she
can
join
only
who in turn lauds the sxicnhc r:
by society. 36-year-old Kumari's
Calc then feelings. Living with the
as
kodulu
(daughter-in-law)
or
with feminity
life is a saga of untold miseries.
Jamil', has also given her lhe
kuiitat (daughter), the two groups
However. Today, she heads a Hijra Abandoned ami astray she loti
much needed confidence in going
existing
in
every
community
area
Mumbai lo join the uoiiiniunity >•
leunukh/community which hasabout hci new-found job of coun
Kumaii
ieveals
that
she
has
eight
been butt ut ridicule and humiluV . sex workers al-Gram Road. Ill
selling. she says.
lion, h is unfortunate (hat even the treated and abused by olhei bt<»ih daughters and 16 daughier-in-laws
Deccan Herald
in her family.
el members. Kumaii decided to
government has done little or2
Each
group
is
headed
by
head
of
return
to
Visakhapalnam
to
join
05
May 2001
nothing to enhance its status. No
the family and Kumari is one such
her community back home.
wclfaic or developmental pro
A very close-knit lot, Hijras also matriarchal head.
gramme have been devised for
She ln»\is an elaborate Jiiwui
lhe Hijras thus making them live a* crave for love and sense of
*u
tlci«
lo die community whenever
belonging. Their life is different
ide c.f pciiiii\
Today. Ku man has a purpose, loo. and interesting fur many who arc a lie a mcinbei enters the family.
I lie kuliuu oj kmhihi give their
unaware and indifferent.
lo live for. Thanks io Hoina. a
cntiie earnings lo lhe family head
I he community of eunuchs dcssocial organisation that has taken
the initiative io work with Hijras
HE controversial
1997, Edward Holmes at
io create awareness on sexual
theory
that
the
University
of
health among lhe community on
researchers
Oxford and his col
picveitlion oj IIIV
developing polio vac
leagues conclude that
Kuaiai: j - .i coimsclku wilh
cines in Africa in the
the multiple subtypes
Hoina. She along with Shanti and
1950s
accidentally
triggered to create the OPV tested in the that characterize modern-day HIV
Swapna. who are also Hijras. and
today's global AIDS epidemic has Congo. They also detected neither could not have originated from
Appa Rao i a gay), they work
been dealt what could finally be a HIV nor its primate form and clos contamination with chimpanzee
towards spreading awareness
fatal blow. Three new studies have est ancestor, simian immunodefi tissue in the 1950s. According to
among their community on HIV
found no evidence for the main ciency virus (SR7)- Furthermore, Holmes’ team, the last common
and raker STI K
claims of the theory.
they present evidence that the ancestor of the variants known in
Avcoiding lopiuject in-charge
In his 1999 book "The River: A virus emerged in human popula- the Congo today was present in a
R.»vi Chandra. S I Ds and HIV arc
Journey to the Source of HIV and tions before the Congo vaccine human host and was not, as
very common among Hijras as sex
has become ilicii main .source of
AIDS," journalist Edward Hooper trial. The researchers admit that Hooper alleges, transferred from a
ii‘.elil;v“d
promulgated a disturbing theory their findings cannot disprove primate.
lheh. is cvviy need lo locus alien
about the origins of AIDS. Hooper's theory. “It’s the old prob
The genetic history of HIV-1
bon ol lhe suv lal wcllarv
Hooper’s assertions threatened to lem of proving a negative," says strains. Holmes says, “fits a classic
dejiarthienu- lo ihc.se needy souls.
capture the public's imagination Neil Berry of the National exponential
epidemiological
AikcJ uK<ui ihv work as a conn
until they were largely discredited Institute for Biological Standards spread and says nothing at all
'csk»:. Kumari. ponders loi long
by preliminary investigations pre and Control (NISBC) in Potters about multiple transfer" from vac
before saying. “Yes definitely. Al
sented at the Royal Society in Bar, UK. Perhaps the most com cination with a contaminated oral
least I'm doing something woiih
September last year. At the time. pelling evidence against Hooper's polio vaccine. "It may be a natural.
while in helping my communiu
Hooper dismissed the results theory comes from Berry’s group. ecological process, which is what 1
Otherwise. who will give-me :i
as”irrelevanf to his hypothesis.
They analyzed a vial of the same believe it is,” Holmes adds.
job. will you ?’* she asks.
Hooper claimed that by using vaccine stock as was used to treat
Edward Hooper was not avail
*
Kumari's
father who worked al lhe
chimpanzee kidney tissues infect people in the Congo and is directly able for comment but has so far
sub-col leulof s office al
ed with human immunodeficiency blamed in “The River" for the out stood firmly in support of his the
Nursipainam bi ought her up like a
virus (HIV) when developing an break of HIV in humans. When ory. He has said that the only evi
son w’ith his:ether foui children.
oral
polio
vaccine
(OPV), “The River" was published, the dence he will accept is proof that
Wilh iwo deter brothers and two
researchers at the Wistar Institute Wistar Institute could not produce HIV existed in humans before 1957.
sisters. Kumari always fell like a
in Philadelphia, Pa. inadvertently a sample of that vaccine. The one “He’s going to fight until someone
woman in hci manly aline, she
contaminated their vaccine stocks that has now been tested was later finds a blood sample from the 1940s
says. She wasrscnl lo school like
with tlte virus. He alleges that found in a freezer at the NISBC.
her siblings. tVhilc in (. lass VII •»!
that's HIV-positive," Holmes says.
a<g.Qy.enjiBgnJL'Schuol, her widow ci
when these vaccines were tested in
Berry’s team did not detect HIV Simon Wain-Hobson, a member of
.scbpolieavhiR luicd hei to woik ai
as many as one million people in
or S1V in the suspect vaccine. the Blancou team at the Pasteur
the Congo between 1957 and. 1959 What's more, the only tissue iden Institute
sympathizes
with
CAMPAIGNthey seeded the human population tified was from macaque monkeys Hooper's "compelling" theory.
with HIV-1 - the strain that most - which Wistar researchers insist “Such an outrageous thing as HIV
his house. He abused her for two
commonly causes AIDS. Three ed that they had used - and not requires an outrageous explana
years and one day vanished leav
independent research groups have from chimpanzees. "We used a sen tion.” But, he argues, the scientific
ing her abandoned. Kumari spent
now found no trace of chimpanzee sitive assay for both tissues and evidence for the origins of HIV tel
her days on lhe Vijay awada tail
tissue in any of the remaining only one was positive," Berry says. a less dramatic tale.
way platlomi. begging and cat in
stocks of the original vaccine, Finally, having examined samples
TOM CLARK!
(is commercial sex worker. I In
*.
including-a vial of the stock used of HIV collected in the Congo in
Nature
News Service
was when she gave up dressing up
T
as a male and'started wearing a
sari. When she tried lo Luhlaci h> t
family, they declined lo acccpf he
18
Origin of HIV
Deccan Herald
01 May 2001
NYCU - HIV/AIDS 0
OtacQ
Baby might
be infected
(This week, we introduce a new colurqn
where Dr Neeru Bhatia, Deputy Director,
Delhi State Aids Control Society, answers
your queries about AIDS.)
ince there is no known cure for
AIDS, prevention remains the most
effective way of controlling the
spread of the disease. This can be done
by taking precautions while indulging in
high risk behaviour that can spread the
infection. The main routes of transmis
sions are:
□Unprotected sex with an infected part
ner. HIV/AIDS can spread through any
from of unprotected sex, be it anal, oral
or vaginal. Those who have multiple
partners are at higher risk.
□Using HIV infected blood' and blood
products, or through organ transplants
from an infected donor.Through infect
ed needles or syringes.From an infected
mother to her new bom child.
S
PRECAUTIONS:
Avoid multiple partners and use condoms
while having sex with an unknown per
son. Since the presence of STDs increase
frisk of contacting AIDS, get STDs treated
immediatelyAlways use disposable/autoclave syringes' and never share sy
ringes. Ensure that blood or blood prod
uct being used for transfusion have been
tested for HIV. Same is true for trans
planted organs
READERS WRITE IN:
Ques: We are a middle-aged childless cou
ple who have been offered a two month old
babyfor adoption. The baby has been suf
fering from fever and pneumonia for the
past one month. There has been no in
crease in his weight since birth. Is it pos
sible fora baby to have AIDS?
Ans: A new bom can get infected with
HIV/AIDS during the delivery birth or in
the womb of an infected mother. A child
should be tested for AIDS if he/she has
some of these symptoms:
★Unexplained weight loss or abnor
mally slow growth.
★Chronic diarrhoea, for a month or
more, which does not respond to medi
cine.
★Prolonged fever for more than a
month that doesn't respond to treat
ment
★Repeated ulcers in the moudpi.
★Persistent cough.
4
‘ v .
★Repeated CQmmon'inffectiofl
★Enlargement of the lymph nodes in
differentparts of the bndv.
. ’
Since the child has some of the above
symptoms, it is advisable to get him test
ed for HIV to rule out any possibility of
infection. Tests can be done at:
' *'
★Microbiology Department, Mao! ana
Azad Medical College
★Microbiology Department, Lady
Harding Medical College
★Microbiology Department, AIIMS
★Microbiology Department, University
College of Medical Sciences
★Armed Forces TYansfusion Centre,
Delhi Cantonment
★Indian Red Cross Society
Ques: For seven years I’ve been workingas
a helper at a doctor’s clinic.My work in
volves disposing all the waste including
used syringes and needles. A number of
times I’ve been pricked by needles I throw
away. I read thatHIVinfected needle pricks
can cause AIDS. Do I need to get myself
testedfor HIV.
Ans: HIV infected syringes, needles are an
important mode of transmission of
HIV/AIDS.Syringe and needle cutters or
destroyers should be used in every clin
ic. They should be disposed off in punc
ture proof bags. You should also wear pro
tective gloves while handling bio-medical
waste being generated in the clinic. It ap
pears that your centre has not being ob
serving these precautions. It would be ad
visable to get yourself tested for HIV.
Ques: I work as an executive in Delhi and
have been staying awayfrom myfamilyfor
the lastfouryears. When Ifeel lonely I vis
itprostitutes. I have always used a condom
while havingsex, but last time when I had
sex with a prostitute I realised the condom
got torn. Now I am scared about having
contacted AIDS. Please advise what I
should do?
Ans: Condoms are a good protective
method of preventing the spread ofAIDS,
but in your' case there is a doubt that the
condom could have been tom while
having sex, so the possibility of contact
ing the disease cannot be ruled outGet
yourself tested for HIV. You will have to
wait 3 months from the last contact be
fore getting yourself tested. I would also
advise you to stop visiting prostitutes.
Ques: We are a group of five fidends.
Visiting a festival in a Rajasthani village
we all got small tattoos on our thighs as
a mark ofourfriendship Later we realised
that the person engraving tattoos had used
the same needle ’ without cleaning for
everyone. We have heard infected needles
can cause HIV. What do we do?
Ans: You are absolutely right in saying that
HIV infected needles can cause HIV in
fection if used immediately. In your case
if the needle was used immediately pri
or to engraving tattoo on your body then
their can be a risk because the previous
persons on whom the needle was used
could have been HIV+ve. You should get
an HIV test done three months after the
date.of tattooing.
Address mail to Aids Alert, Vivacity, Link
House, 3 BSZ Marg, NewDelhi 2.
e-mail: www.pioneer@deI2.vsnl.net.in
The Pioneer
’ 03 May 2001
City based firm launches
Hepatitis-C detection kit
DH News Service
BANGALORE, April 30
HEP-CheX C, the country’s first
indigenous kit for detection of
Hepatitis-C,
produced
by
Bangalore-based
Xcyton
Diagnostics Limited, was today
■launched
here
by
Dr
G
Padmanabhan,
Emeritus
Professor of the Indian Institute of
Science.
The Drug Control Department
of India is making screening of
blood for Hepatitis C compulsory
from June 1, 2001. Earlier, screen
ing of blood was a must only for
HIV, Hepatitis-B, Malaria and veneral diseases. Hepatitis-C, trans
mitted through blood, is a form of
virus which causes live cirrhosis.
There are 11 types of this virus.
The Hepatitis-C detection kit
has been developed in collabora
tion with the International Centre
for Genetic Engineering and
Biotechnology, Delhi
Earlier, Xcyton Diagnostics also
developed HIV-CheX, the first
indigenous kit for detection of HIV
1 and 2. The company has plans to
produce detection
kits for
Hepatitis-B, pulmonary tuberculo
sis,
tuberculosis meningitis,
malaria and typhoid fever in the
future.
Speaking to reporters here, Dr
Padmanabhan said clinical trials
are on at Indian Institute of
Science for rabies vaccine in col
laboration
with
Indian
Immunologicals, Hyderabad, and
rota virus in children, which is the
cause of 40 per cent of diahorreal
deaths in children.
Deccan Herald
03 May 2001
NYCU - HIV/AIDS J |
very start that the messages embedded in
the dramas were contributing to benefi
cial change, Andrews says.
' developing nations, he notes, with
PCI hopes a soap opera now in its
AN sub-Saharan Africans slow
. extended families gathering each night
third season in China will resolve a
the spread of AIDS if the stars of around whatever sets are available and
reproductive problem - in this case the
their favourite TV melodramas
often discussing the plots and predica
marked preference for male babies
practice safe sex? Will Chinese families ments after the programme is over.
among couples allowed to have only one
coping with the country's one-child poli
"Viewers trust TV characters more
child.
cy stop valuing boys over girls because
than their gov
Despite the opportunities television
the heroine of the most-watched televi
ernments, so
and radio offer in educating people in
sion drama is as successful and dutiful as
it's important
developing nations, bureaucratic and ide
any son a parent could imagine? Is the
for the enter
ological obstacles remain. The St Lucia
answer to Brazil's bloody struggle
tainment media
. government bans the use of the word
between wealthy barons and landless
to take up
peasants the sympathy generated for the
issues that will "condom" in the PCI-assisted serials it
otherwise welcomes. To get around the
destitute squatters by a wildly popular
enlighten audi
technicality,
writers aiming to educate
prime-time series? Tune in for a daily
ences and lead
dose of encouragement for the behav
to resolution of listeners about family planning simply
substituted the word "catapult" for "con
ioural changes that these shows' produc
social prob
dom." "It took people no time at all to
ers believe will create a better world.
lems," says
realise what was meant when the girl
Soap Operas for Social Change Is a
Benedito Ruy
would ask her boyfriend if he remem
multinational mission aimed at lacing
Barbosa, a
bered
the catapults, or if he knew how to
entertainment with role models whose
Brazilian
trials and tribulations mirror the every
writer of soap put one on. The result is that today there
isn't a single person in St Lucia who
day lives of listeners and viewers in
operas and
doesn't know what a catapult is," says
developing nations. It's an international
prime-time dra
Andrews.
cross-breeding of philanthropy develop
mas for the last
The 40-odd countries now receiving
ment aid and local media talent
30 years.
development aid via soap operas and
Germany, as one of the top media powers
Barbosa's
other entertainment vehicles are mostly
in the developed world, has become an
hugely popular
poor states with too few resources and
incubator for ideas on how to spread
*
"OReido
production skills to undertake such pro
democratic values via entertainment
Gado" (The
gramming tasks on their own.
From teenage pregnancy to pollution,
Cattle King),
domestic violence to school dropout
which aired in
^Lo$ Angeles Times
rates, education masked as dramatic
the late 1990s,
diversion reaches a far broader audience
Deccan Herald
was credited
via the airwaves than it ever could on a
with instigating land reform because it
03 May 2001
face-to-face basis, says Hans Flelsch,
brought home the suffering and Injustice
head of the German Foundation for
of the landless to 80 million Brazilian
World Population.
viewers.
"With hundreds of
"Even before the end of the series, the
millions of people in the government was forced to impose a tax
world living in trauma - on land left fallow to pressure the 'fat
forced (female) circum
bellies' to allow the landless to farm it,"
fight AIDS
cisions, war, discrimina says the writer.
tion against women,
At a recent seminar to brainstorm
THE SEVEN wealthiest nations
AIDS - there will never
broadcast interventions into the world's
may establishing a fund to com
be enough resources to
most pressing problems, the German
bat AIDS and other diseases,
provide individual ther
activists and the US-based Population
Italy's finance minister said.
apies, which is why tele Communications International (PCI)
At an upcoming summit of the
vision presents such a
were approached by Primus Guenou, a
industrial giants, Italy will pro
great opportunity to
production, executive from Togo, who was
pose that the 1,000 largest corpo
convey an Important
rations in the world contribute at
seeking collaboration on a soap opera to
message," he says.
least $ 500,000 each — and that
educate Africans about the causes and
"Television in the
the industrialised nations match
prevention of AIDS.
each contribution dollar for dol
developing world isn't
"This is the only way to do it People
lar, "with the view to achieving a
only for entertainment,
won’t read brochures or listen to lec
starting overall target of $1 bil
and it's not regarded as
tures. They want to be entertained," says
lion," Vincenzo Visco said.
a waste of time. It's seen Guenou, the director of Primus
AE.United Nations
as an engine for social
Entertainment Production.
The Hindustan Times
change and develop
PCI President David J Andrews con
ment," says Dietrich
firms that Africa's AIDS crisis is his
04 May 2001
Berwanger, head of the
organisation's next big priority and that
television training divi
the New York-based operation, funded by
sion of Germany’s inter private donors, hopes to partner with
national broadcast serv
local broadcast producers throughout
ice, ifeutsche Welle.
Africa. PCI began supporting radio and
TV watching remains
television serial productions a decade
a communal affair in
ago and had empirical evidence from the
Soaps for social Change
C
Fund to
20
NYCU - HIV/AIDS
Muslim success in birth control
Quick estimates from the latest
census show that India’s rate of
population growth has moderated
somewhat. Religion-wise figures
for population growth have not
yet been tabulated. When they
are, they will doubtless show the
Muslim population growing much
faster than the Hindu population
— that has been the pattern ever
since censuses began a century
ago.
The RSS will doubtless blame
the nature of Islam and mullahs
for this sad state of affairs. Many
secular Hindus will also conclude
that Muslims regard birth control
as unlslamic.
Really? Among the ten coun
tries that achieved the fastest re
duction in the total fertility rate
(number of births per woman) be
tween 1980 and 1999. No less than
eight of the ten are Islamic coun
tries. Indeed, those who are quick
to jump to conclusions may even
.conclude from the data that Islam
is the surest way of reducing fertil
ity! Now, it has long been known
that some Muslim countries are
willing practitioners of birth con
trol. Indonesia has long boasted
an enviable record in population
control.
In
recent
years,
Bangladesh has made rapid
strides in reducing fertility.
But such examples do not im
press most Indians. They believe
that Islam as practised in coun
tries
like
Indonesia
and
Bangladesh is a toned-down ver
sion of the real thing. After all, In
donesians Muslims dance the Ramayana, and Bangladeshis sing
Rabindra sangeet. Such “soft”
Muslims may adopt family plan-
Miff
Swaminathan S. Anklesaria Aiyar
tually the lowest fertility rate in
the world, just 1.2 births per
woman, well below replacement
rate.
ers ' started from a
ning, but what about
If religion does not matter, what
much higher level
the “kattar” Muslims
accounts for the persistently high
than .India, and this
of the Middle East?
rate of population growth of Mus.made reduction easier
Most Indians equate
lims in India? There are many rea
once
they
got
going.
Islamic culture and re
sons.
Still,
India
’
s
two
Is
ligious practice with
First,traditional Hindus do not
lamic
neighbours,
that of the Middle
East.
Pakistan
and allow the remarriage of widows,
Bangladesh,
have • while Muslimsencourage it. Sec
Well, in the last two
both reduced fertility ond, a disproportionate number
decades, Muslim coun
tries of the Middle
by a bigger amount of migrant labourers are Hindus,
East have been world
than India. This will and their long absences from
champions in fertility reduction. surely surprise those who believe home tend to reduce births per
Many Indians believe that social that Muslims are fundamentally woman. Third, literacy is lower
among Muslims, especially Mus
ist Arab states may promote birth against contraception.
control, but not traditional ones
In absolute terms, India’s fertili lim women. Low female literacy is
dominated by Sheikhs and mul ty rate (3.1 births per woman) is associated globally associated
lahs. This too is a mistaken notion. lower than that of Pakistan (4.8) with higher birth rates.
First in the fertility reduction or Bangladesh (3.3). But even by
But the most important reason
championship is Oman, a tradi this yardstick, India is a poorer of all may be the failure of the
tional sheikhdom. Number two is performer than Islamic countries state. The world over, government
Iran, where the mullahs rule. Jor like Indonesia (2.6 births per efforts have been important in
dan, Kuwait and Morocco are woman), Iran (2.7), Kuwait (2.7) persuading people to adopt con
other Arab states ruled by kings or Morocco (2.9).
traception. The state has been
and sheikhs.
These numbers make it abun able to persuade Muslims to use
Saudi Arabia, the most conserv dantly clear that acceptance or re contraception in Iran, Libya,
ative of all Muslim states, is not jection of family planning has Bangladesh and many other coun
among the fastest reducers of fer nothing to do with religion. Some tries. But state has not been able
tility, but even in that country fer mullahs may oppose family plan to carry conviction with Muslims
tility declined from 7.3 to 5.5 ning, but mullahs disagree among in India.
births per woman in 1980-99.
themselves on this issue, just as
Do not blame this on the cul
India’s fertility rate declined by priests of other religions do. And ture and religion of Muslims. Our
1.9 births per woman in this peri ordinary folk ultimately decide data show this is a misconception.
od, a positive achievement. Yet what to do, regardless of what
The fault is mainly that of the In
this is barely half the decline priests may say.
dian state, which is able to per
achieved by some Islamic coun
The best proof of this comes suade Hindus up to a point but
tries. Even Pakistan, which is no
from Italy. This is the home of the not Muslims.
torious for neglecting its social du
A successful state is one which
Pope, revered as God’s own repre
ties, reduced births per woman by
sentative on earth. The Pope has earns the respect of all communi
2.2 in this period, more than India
always lambasted birth control. ties, and carries conviction with all
did.
Yet Italian Catholics have decided of them. Judged by this yardstick,
Pakistan, Oman and many oth to ignored him. Italy today has vir the Indian state has failed.
The Times of India
06 May 2001
in the number of such patients is
Twelve patients which were
not only worrying the medical detected HTV positive during the
J experts but has also created, a last- three months, included four
panic among the public.
women. It is a matter of concern
Prof. Abida Malik the chair- that a large number of women
person of Microbiology depart- have also come in the grip of this
HT Correspondent
spreading fast in India has creat- ment of J. N. Medical College of disease.
Aligarh Muslim University told
Sources said that amongst the
Aligarh, May 5
fed a panic in this city too.
------------------- ----------------------------- j Although in Uttar Pradesh the the Hindustan Times that sur- HIV positive cases, 50 per cent
NOTWITHSTANDING THE Gov- AIDS awareness fortnightly pre veillance centre was established found in Aligarh are suffering
eminent order and despite gramme is going on but it has not in Aligarh J. N. Medical College from Tuberculosis. The first HTV
Spending crores of rupees on the proved successful in Aligarh by National AIDS Control Organ- positive case was detected here
prevention of AIDS, District because in Jawahar Lal Nehru isation in 1987. It has played an when the blood of a child was
Health Department has failed to Medical College the surveillance important role in detecting HIV tested some eight years ago.
Dr M U Rabbani of J.N. Medcheck the increasing pace of this centre of Aligarh Muslim Uni positive cases. Dr Malik further
disease in Aligarh. More than 125 yersity has detected twelve HIV said that last year. 38 persons ical College told the Hindustan
bersons were tested HIV positive positive cases within a period of were found to be HIV positive Times that along with the transIn Aligarh. AIDS which is last three months. The increase which included fourteen women, fusion of blood, use of syringe
NYCU - HIV/AIDS
0 21
Contd..
Crores go down the drain.
125 test HIV positive
The poor and the ignorant fall victim
By Sahana Chanin
bangalore, may 6. It was a scrape with death
for 21-year
old
*
Chanda (not her real name)
at the hands of a quack.
Chanda and her husband, who live in
the Anandapura slum near Airport Road,
relied on the local quack for an abortion.
His suspect methods for termination of
pregnancy proved almost fatal for her. She
barely survived the ordeal, while severe
stomach aches and trauma haunt her even
now.
There are more such ghastly tales in the
bylanes of Bangalore, where quacks charge
a premium for their dubious services. Mr.
Prem Kumar, an engineer, was duped by
one of them of thousands of rupees for
"curing” a slight ailment. He approached
the Indian Medical Association DMA), and
a complaint was lodged with the Ayurveda
Board, the-regulating body, but action was
not taken against die accused.
The quacks1 victim-list does not end.
According to the Anti-Quackery Cell of the
Indian Medical Association (Bangalore
Branch), die City accounts for a shocking
number of over 30 illegal abortions a day.
There are around 15,000 quacks operating
in the City, and more than 80,000 in the
State. They claim to do everything from
medical termination of pregnancy (MTP) to
curing HIV/AIDS.
“These quacks advertise their services
openly at important locations and crowded
places in the City, though medical
practitioners are prohibited from doing so,
according to the Drugs and Magic
Remedies (Objectionable Advertisements)
Act, 1954," said Dr. P.Janardhana Rao,
Convener of the cell.
Dr. Rao told The Hindu that the
association's complaints against quacks
provoked no action from the authorities
concerned. “There are around 1.5 lakh
Pamphlets advertising medical services, which are In violation of the law, are
rampant In the City. — Photo: K.Bhagya Prakash
cases of illegal abortions in the State.
There are many more that go unreported
because the issue of illegal abortion is
always shrouded in secrecy. The IMA
requested the State Government to check
the quack menace and suggested that an
Anti-Quackery Bill be enacted. But the
Government did not respond. Even the
circular issued to identify quacks in the
State has been withdrawn," he said.
A report jointly brought out by the IMA
and the United Nations International
Children’s Education Fund (UNICEF) in
March 2000 revealed that India figured first
in. the list of countries where illegal
abortions are rampant. Out of the 1.5 crore
illegal abortions carried out in the world,
India alone accounted for around 40 lakhs.
Ninety per cent of these were cases o'female foeticide.
When The Hindu visited the
aforementioned quack, his wife said her
“gynaecologist husband" would carry out
an abortion for Rs. 1,000, though she was
told that the patient was 16 weeks
pregnant and not married. The "clinic"
does not have a doctor’s name board, and
abortions are conducted in a dingy room,
which is a violation of the MTP Act, 1971.
The Act states that abortion should be
done by a registered medical practitioner,
authorised by the District Health Officer,
and in hygienic conditions using specific
instruments. The doctor is also supposed
to have his name, designation and degree
clearly displayed on the name board.
"The poor approach quacks sometimes
for female foeticide. They go to unqualified
persons, who raise no questions," Dr.
Sheela Bhanumathi, President, IMA
(Chennakeshavanagar Branch), told The
Hindu. "The quack’s wrong methods cause
infection, injury to the uterus, infertility
and severe blood loss which may even lead
to death," she said.
The Hindu
07 May 2001
Contd...
(needle) and unsafe sex there are sitive for HIV positive disease.
two more factors which are spe Secondly many foreign students
cially responsible for increase in are studying in various institu
HIV positive cases in Aligarh.
tions of Aligarh.
The first.is that several per
Sources said that according to
sons including women frequent norms prescribed by the Govern
ly visit foreign countries like ment of India, the blood test for
Thailand, Singapore, Pakistan jnv wgs carried out on all‘for
and other Asian countries for eign students admitted in educa
business or employment purpos- tional institution just after their.
es.-These countries are more sen admission.
The Hindustan Tinies
06 May 2001
22
NYCU - HIV/AIDS
Hetero Drugs to supply
anti-AIDS drug to Kenya
phI2mTd°
Jl ndrilld
By Ramnath Subbu
MUMBAI, may 6. The Hyderabad-based Hetero Drugs
(HDL) has received the compulsory license to supply
its anti-AIDS drugs to Kenya. “The license is current
ly in the process of being registered", said Mr. Dharmesh Shah, director, Business Development, Hetero
Drugs. “The registration procedure is expected to be
completed in the next few weeks and we will begin
supply of the drugs from July." said Mr. Shah.
HDL manufactures the triple AIDS cocktail of La
mivudine, Nevirapine and Stavudine besides other
anti-AIDS drugs comprising the basket including In
dinavir, Zidovudine and the recently launched Nelfinavir.
Further, the company is in the final stages of regis
tration in Colombia and west Asia. HDL was in dis
cussions with Mexico also but it is currently studying
the patent situation there. Regarding the supply of
the triple AIDS cocktail to South Africa, Mr. Shah
said, “The court verdict in South Africa in favour of
supplying life supporting drugs to AIDS patients
there has set a precedent. We met officials from
South Africa last week and they have decided to go in
for ‘fast track’ registration. As per a legislation under
TRIPS (Trade Related Intellectual Property Rights),
an international tender would be floated in the last
quarter of the current year.”
After Kenya, HDL plans to supply its drugs to Con
go and has already lined up other African countries
with which discussions are underway or are to com
mence. “We are currently in talks with the Nigerian
and Zimbabwean governments. A more definite pic
ture will emerge in the next few months." said Mr.
Shah.
As per an understanding with Aspen Pharmacare
(APL) of South Africa, HDL will supply the drugs to
the SADC region through APL. The SADC region in
cludes Angola, Botswana, Lesotho, Malawi, Maur
itius, Mozambique, Namibia, the Seychelles,
Swaziland, Tanzania, Zambia and Zimbabwe. Aspen
Pharmacare is a 1.1 billion SA Rand company and
HDL has already made a technology transfer to it
HDL has, according to Mr. Shah, also had dis
cussions with Medicins Sans Frontiers (MSF) for
supply of anti-AIDS drugs. HDL had earlier offered
to supply the anti-AIDS cocktail of Lamivudine, Ne
virapine and Stavudine to MSF at $ 347 per patient
per annum as against the Mumbai-based Cipla’s of
fer of $ 350 per patient per annum. “Bio-equivalency
tests were required to be carried out on the drugs
and we are expecting the results at the end of this
month. Thereafter we will discuss the matter further
with MSF.”
In the domestic market, HDL has been talking to
National AIDS Control Organization (NACO) as well
as the World Health Organization (WHO). “Howev
er, at the moment, these organizations are collecting
information and studying the patterns.”
HDL has six manufacturing facilities — five in
Hyderabad and one in Surat besides a Research ft
Development (R&D) centre in Hyderabad.
division to
fight AIDS
From Our Bureau
The Hindu
07 May 2001
Cipla to bring down prices of
AIDS drugs with cocktail pill
Sltaraman Shankar
MUMBAI 8 MAY
rugmaker dlpla, which
D
sparked cuts in global AIDS
drug prices in February, pl£hs
to make an AIDS cocktail pill which
could cause prices to fall even fur
ther, its chairman said on Tuesday.
*We are applying for Indian gov
ernment permissions to launch three
AIDS drugs — stavudine, nevirap
ine and lamivudine in one tablet,
*
said Yusuf Hamied.
Handed jolted the global drug in
dustry with an offer to supply the
three AIDS drugs to international
charity Mededns Sans Frontieres
(MSF) for $350 per patient per year.
or under $1 a day, l/30th the price
in the United States. The new pill
will bp added to tfte offer, he said..
*We win offer the new combina
tion pill to Mededns Sans Frontieres,
other non-govemment bodies and
governments in general for them to
supply free,' he said.
Over time the price will be cut to
below $350 per patient per year,
Hamied added, without giving any
indication qf how soon that may
happen. Cipla’s new product, to be
called Ttiomune-LNS, will be the first
combination pill of the three drugs
anywhere in the world, he said.
Basically that's because patents
for the three drugs are controlled by
different companies. Britain's
GlaxoSmithKline holds the patent
forlamivudinc,
Germany's
Boehringer Ingelheim the patent on
nevirapine arid US drug giant JristolMyers Squibb the patent on stavu
dine.
Cipla is allowed by Indian patent
law to make products that are un
der patent internationally as the law
protects only the processes by which
drugs are made, and not the drugs
themselves. Cipla focuses on finding
different routes to make patented
products and are in the process of
applying for marketing permissions
in some African countries, includ
ing South Africa, in due course,*
Hamied said.-r- Reuters
Hyderabad, May 7: “Il is neces
sary to take care of treatment of
persons who are infected with
Acquired Immuno Deficiency
Syndrome in our country along
with carry ing out the awareness
campaigns," said former director
of Health Services Nand Raj
Singh on Monday.
Speaking during the launch of
Immunus, a division started by
Aurobindo Pharma for research
programmes on AIDS treatment
here, he said availability of medi
cines at a low cost was very essen
tial for the effective treatment of
patients.
“Since llie disease was first diag
nosed in 1986 it has been a great
threat for the entire human popula
tion, all over the world.
But most of the medicines cost
much making it unaffordable for
the patients. There should be
efforts to bring here all drugs
available for this in other coun
tries," he said.
Aurobindo Pharma will concen
trate mainly on research work and
introduction of all kinds of vac
cines which can bring relief to
AIDS patients through the new
division.
The division will make use of the
sendees of hundreds of scientists
already employed in the
Pharmacy.
Immunus will also concentrate on
encouraging HIV positive patients
to lake treatment and will mobilise
funds in association with the vari
ous governmental and non-govemmental agencies which are actively
involved in AIDS control pro
gramme. Manager of Aurobindo
Pradeep Kumar said drugs which
cost around Rs 10.000 a year ago
were now available for Rs 4,000
after the entry of the firm into this
field._
Deccan Chronicle
08 May 2001
The Economic Times
09 May 2001
NYCU - HIV/AIDS
23
Ranbaxy enters domestic anti-AIDS segment
new Delhi, may 7. Joining the bandwagon of
anti
A
*
IDS
drug makers in the country, Ran
baxy Laboratories has introduced three antiAIDS formulations in the domestic market, a
top company official said here.
"We have introduced three formulations in
the market and will add five more to our port
folio in July," Mr. J. M. Khanna, president (re
search
and
development),
Ranbaxy
Laboratories told PTI.
Ranbaxy, which will have a total of eight
drugs in its portfolio of anti-AIDS formula
tions by July, has priced them nearly 5 per cent
lower than market leader Cipla’s version of
drugs to gamer a share of the Rs. 120 crore
market.
Its versions of Zidovudine (Viro-Z), Lamividine (Virolam), Neuriepine (Navipan) and
combination of Lamividine and Zidovudine
(Virocomb) are priced nearly 5 per cent lower
than Cipla, according to sources.
While a 10-tablet strip of Cipla’s Lamividine
and Zidovudine (Tiiovir) costs Rs. 510, Ran
baxy’s Virocomb is priced Rs. 500. Its version
of Zidovudine (Zydovir) costs Rs. 300 for a
strip of 10 tablets, Ranbaxy’s Viro-Z is priced
at Rs. 260.
Ranbaxy would be marketing its cocktail of
anti-AIDS drugs through its division Cross
lands, he said.
Even as the company has entered into the
anti-AIDS market it has also firmed up plans
to foray into the herbal generics segment
Mr. Khanna said the traditional medicine
segment had an immense potential and the
company would utilise its expertise in R and D
to bring out research-based herbal medicines.
He said the company which currently
spends nearly 5 per cent of its turnover on R
and D activity, is in the process of setting up
another research laboratory near its existing
facility.
It has also developed a new once-a-day for
mulation of ofloxacin on a patented technol
ogy platform which will be launched in the
fourth quarter of 2001, according to. company
sources.
The products in various strengths of 400,
600 and 800 mg were in phase-ill clinical trials
which were expected to be over by the third
quarter of this year.
The global market of ofloxacin, an anti-bac
terial used in the treatment of bacterial in
fection of the urinary and respiratory tract is
estimated at $260 million. The pharma major
would initiate brand marketing in key devel
oped markets and further strengthen its
branded product portfolio in developing mar
kets. — PTI
The Hindu
08 May 2001
AIDS drugs mkt setfor major price war
_
a t
-
___
y
~
___
~
/i
.
k
THE ANTI-AIDS (Acquired
Immuno Deficiency Syndrome)
drug market in India is set to wit
ness a major price war with sev
eral companies, both domestic as
well as multinationals, waiting
to enter this segment of the phar
maceutical sector in the country.
The domestic anti-AIDS drug
market which is currently domi
nated by Cipla, has recently wit
nessed the entry of five more
local players including Ranbaxy
Latjoratories Ltd, Aurobindo
Pharmaceuticals Ltd, Zydus
Cadiila, Ambalal Sarabhai and
tiie Hyderabad based Ginix Phar
maceuticals.
Other domestic pharma com
panies including Sun Pharma,
Torrent, etc, are also likely to
enter the market with their
respective versions of the drug,
but; the anticipated price war
could create entry barriers,
sources told Hindustan Times.
Amongst
multinationals,
Glaxo-SmithKline has already
made a foray in the domestic
AIDS drug market and others
like E. Merck and Pfizer are like
ly to follow soon, sources added.
Glaxo is currently importing
are currently sold at around Rs.
390 for a strip of ten tablets.
• Comparative prices of AiDS drugs
Sources say that, if accepted,
(Mi prictsare in?.: for a strip of fatten) •
the Cipla move would allow the
company to establish its brands
•Drug
Glaxo
.
Cipla
Ranbaxy ]
in this segment of the Indian
pharmaceuticals market.
| Lamivudine
4i0
285
230
This, in turn, would also pres
‘ (I50 mg)
(Epivir)
(Lamivir)
(Virolam)
surize other pharma companies
to substantially cut prices of
Zidovudine
600
300
260 ;
their AIDS drug in the months
i (300 mg)
(Retrovir)
(Zydovir)
(Viicr-Z)
ahead.
According to Manoj Kalra, a
leading pharmaceutical distribu
■ Lamivudine * 820
560
500
tor in Delhi, the new entrants in
, Zidovudine
(CombMr)
(Duovir)
(Virocomb) i
the AIDS drug market have
already started resorting to an
Nevirapine
~
.
390
375 .
aggressive marketing strategy
(200 mg)
(Nevimune) (Navipan)
While Ranbaxy has recently
introduced four anti-AIDS for
(flames in. bracker are the respective bnundO
mulations in the Indian market
its formulations and selling it in
early this year had also put phar with a 5 per cent lower price tag,
Aurobindo Pharma has launched
the Indian market for a price ma MNCs under tremendous
five such formulations priced
ranging between Rs. 200 to Rs. 820
pressure to reduce their AIDS
around 10 per cent lower than the
drug prices internationally.
per strip of 10 tablets.
The rising competition in the
Cipla’s latest initiative of competition.
Both these companies are
domestic AIDS drug market has
offering free supply of AIDS
planning to expand their AIDS
already led to Cipla, leader in the drugs for two years to various
drug portfolio by adding 5-7 new
nongovernment organizations
segment, resorting to a steep
price cut in its various products.
(NGOs) will further intensify the products by August 2001.
Analysts feel that despite the
In the last three years, the com price war in the domestic mar
entry of a large number of play
pany has cut its AIDS drug prices
ket, sources claimed.
ers, the domestic market for antifive to six times in the domestic
The company has offered these
market.
NGOs a free supply of Nevirap AIDS drugs will continue to grow
The company’s move to reduce
ine tablets which prevent moth- by at least 15 to 20 per cent per
its prices globally by 35 per cent er-to-child HIV transmission and annum.
F
Girish Singhal
New Delhi, May 10
The Hindustan Times
11 May 2001
24
NYCU - HIV/AIDS
The right to choose
—
flft FTER THE tremendous setback suf
*
/ 0 \ fered by the country’s family plan
*
Ml ning programme during the emer
gency, the government has been extreme
ly cautious about every step taken on the
population stabilisation front. That is
why we did not even have a population
policy till last year. Though one of the
first countries to launch a national fami
ly planning programme in the Fifties,
the contraceptive choice is still limited
to the condom, the oral pill, the IUCD
(intra-uterine contraceptive device).
Sterilisation is an option only for those
who have completed their family.
Smaller developing countries like
Indonesia and Bangladesh, despite their
stricter Muslim regimen, have been more
progressive and offer implants and
injectables among the array of contra
ceptive choices. In India, women's groups
have made such a hue and cry about them
that the government has steered clear of
introducing them in its welfare services.
Recently, the Supreme Court set aside a
writ petition against the use of the
injectable net en (Norsiterat) and there is
hope it may be introduced soon. But like
a scalded cat the government is still being
extremely cautious. After a spate of meet
ings with the Indian Council of Medical
Research and the All India Institute of
Medical Sciences, the government has
decided to involve 12 medical colleges in a
pilot study of net en.
While it is true that in a country where
basic health facilities are lacking, it is
difficult to push the injectables, which
requires monitoring and counselling of
those using them, with India's population
having crossed a billion, can the govern
ment just sit back twiddling its thumbs?
Should it not play a more proactive role?
More and more women are resorting to
abortions when they find they are preg
nant. It is estimated that 11 million abor
tions occur in India annually killing
20,000 women. Modern technologies like
ultrasound are being used in small towns
and villages to determine the sex of the
unborn child and get rid of it if it is
female. So why are we being so queasy
about the latest technologies and contra
ceptives to have spacing between chil
dren? Is it not better than foeticide?
While the government is still edging
along cautiously on injectables, several
private doctors and NGOs like DKT in
Mumbai, Janani in Patna and the Family
Planning Association of India are mar
keting and prescribing injectables. Just
one NGO has motivated 50,000 women in
-
ByUshaRai
Female freedom and family values
Maharashtra, Gujarat, Madhya Pradesh,
Andhra Pradesh, Uttar Pradesh and the
North-east to try out the injectables. In
Mumbai, the Muslim women opt for
injectables to prevent conception rather
than resort to sterilisation.
DKT is marketing injectables in Mum
bai for over five years. Others have tried
it and rejected it because it did not agree
with them. The important thing is they
had a choice. Yasmin Sheikh, 28, mother
of two, who has been on net en for five
years is a remarkably confident woman.
Yasmin, who lives in Park Side, Vikroli
West, has induced other young women in
her locality to opt for injectables.
Just seven or eight years when her
mother died, she had to stop attending the
madrasa to look after her younger broth
er. Married at 15, for two years she was on
the pill. At 18, she had her son. After that
she had two abortions. She had a daughter
five years after her son. Ever since, on the
advice of her family doctor, she has been
on injectables. Earlier, she was thin and
had heavy bleeding. Now she is 50 kg and
her periods are regular. Yasmin has the
support of her husband and family elders.
Asked why she did not go in for steril
isation if her family was complete, Yas
min said no one in her family had under
gone a sterilisation and they did not
approve of one. Asked how long she
would be on injectables, she replied, “As
long as I can tolerate them. If I go in for
sterilisation; it will be with the concur
rence of my family."
Nirmala, 35, and mother of four, has
been on net en for two years now. Sterili
sation is taboo in her house too. Soon
after being put on net en, Nirmala said
her periods were irregular, her stomach
felt distended and she had a stomachache.
She bled for a whole month but could do
nothing about it because she was in the
village. On her return to Mumbai, her
doctor gave her medicine to ease the pain
and control the bleeding. Nirmala has
decided to continue with the injectable
till a better contraceptive is available. She
prefers injectables to pills, which have to
be taken every day.
Rita Gupta, 23, was not as upbeat about
the injectable as Yasmin. Mother of one
child after a caesarian operation, Rita
had an induced abortion to avert a second
child. She had three shots of net en in six
months. Initially, she had heavy bleeding
and the chronic pain in her back had
increased. With medicines the heavy
bleeding has been arrested but the back
pain persists.
Sanjeevani Gawde, 28, has been on
injectables since 1995, within two months
of its introduction in Mumbai. She saw the
DKT poster at her doctor's clinic, inquired
about the product, then went in for it
According to Sujata, DKT’s social worker
for the Vikroli area, Sanjeevani, had only
one child when she went in for the injecta
bles. After two years on the injectable, she
stopped it to see if her fertility had been
affected. She got pregnant, had a dean up
job, and went back to the injectable. San
jeevani is a remarkable women because
she personally tested the contraceptive.
Contd...
NYCU - HIV/AIDS
25
The pill fits the bill
Sumita Mehta
Contd...
Behrampada is a predominantly Mus
lim area of Bandra, and families live
There is little doubt that frequent and closely
AST YEAR, India celebrated the birth of its
cheek by jowl Seven doctors in the area
billionth citizen — Baby Astha was born spaced pregnancies are bad for both mother and
dispense injectables along with other
amid the flash of light bulbs and adulation
child. The Population Reference Bureau and WHO
contraceptives. Injectables have been
reserved for celebrities. Today, her highly publi reports show that every five minutes one woman
introduced and women were in their sec
cised birth is recalled with a tinge of fear. For in India dies of a pregnancy-related cause and that
ond and third doses of net en when this
that was the Rubicon India crossed on its way to
15 per cent of deaths in the reproductive age are
correspondent met them. Praveen Abdul
becoming the world's most populous nation.
maternal deaths. Studies have shown that infant
Salam Sheikh, 25, mother of a boy and girl
Despite a decline in population growth, the cur and child mortality decreases by 50 per cent with
aged five and three, however, had six doses
rent census figures show that we are still growing two years of spacing between births.
of net en. Except for amenorrhoea (stop
too fast and India will soon overtake China.
• Even if the mother survives, the high preva
page of periods), she found the injectable
The latest NFHS (National Family Health Sur lence of anaemia — 50 per cent of Indian women
quite suitable. She was thinking of delay
vey, 1998-99) data shows that 30 per cent of women suffer from this — ensures that she will live out
ing her next shot of net en but the social
between 15 and 19 are married. Early childbearing her life in poor health. If she belongs to the 15-19
worker asked her to get in touch with her
seems the norm and births are not adequately age group, she is part of the highest level—56 per
doctor. Praveea’s daughter was only six
spaced. Half of India’s married women have their
cent. Had she chosen to use the oral contraceptive
months when she got pregnant. Earlier,
first child before the age of 20. One out of every
pill as a spacing method, she would be better off.
she was on pills but had problems.
eight births takes place within 18 months of
With the AIDS scare, the condom is the ideal
Praveen’s neighbour was stopped by
the previous one.
spacing method, but the problem here is .that its
her mother-in-law from using the injecta
Given a choice, most married women in this
use is dependent on the male partner. At a slum
bles when she had ’spotting’. Spotting is a
country want to stop at two children. Significant close to Delhi’s Sainik Farm, women complain
side-effect of injectables and even if it is
ly, this includes the majority of rural and unedu that they cannot cope with frequent pregnancies
negligible women stop using the contra
cated women as well. Though the use of contra and five or six children. Economic factors apart,
ceptive because they cannot do pooja or
ceptives has increased from the first survey in 1991
their bodies just can’t take it, they said.
namaz when they have spotting. Coun
— half of those in the 15-49 age group use contra
In most cases, the husband used a condom, but
selling women :hat spotting is different
ception — the best known and most popular
the women said it was a method over which they
from menstruation does encourage some
method is female sterilisation. But this is after the
had no control and its use was a hit and miss affair.
women to continue with the contracep
mandatory two or three chil
Fed up with sickly babies and
tive. There were five, other Muslim
dren — preferably sons — are
no food, many have taken the
women from Behrampada (between 20 to
born. Hardly useful in bring
decision to go in for the IUD or
30) who were on net en.
ing down the numbers.
use the oral contraceptive pill.
The side-effects of injectables are inter
Ideally, the birth of the first
Let’s face it: pregnancy is
mittent. In 25 per cent cases, there is amen
child ought to be delayed, and
usually the woman’s problem
orrhoea. There are more chances of amen
the second should take place
and they prefer a contracep
orrhoea in depo provera, which is a quar
after an interval of several
tive method over which they
terly injectable than in net en, a bi-month
years. This would alter the
have control — which is why
ly injectable. The women tend to worry
picture drastically. Spacing
most opt for the IUD or pill.
that they have got pregnant when they
births through methods like
Dr Rohit Bhatt, former pres
have amenorrohoea. Counselling is vital at
the condom, intra-uterine
ident of the Federation of
this stage or the women give up injecta
device (IUD) and the oral con
Gynaecologists and Obstetri
bles, says Sanjay Mehta, who runs a nurs
traceptive pill is the only
cians Society of India, adds
ing home in Ghatkopar and offers women
answer. However, despite
another dimension when he
who have had babies a choice of IUCD, the
wanting to space births (28 per
advocates the use of the oral
pill and the injectables. He has been selling
cent of married women do not
contraceptive pill. A safe spac
depoprovera for less than a year.
want to have more children,
ASTHA: Join the billionaire’s club
ing method, it has a number of
Though DKT has been supplying net en
and 13 per cent want to wait at
health benefits, like alleviating
at a subsidised rate of Rs 50 a shot, doc
least two years before their next child) the most anaemia, he says. He also points out that 50 per cent
tors charge Rs 100 a shot. For subsequent
frequently discussed method by a health worker is
of women in the reproductive age group have dysconsultations they charge Rs 20 a visit
sterilisation. Just 15 per cent of women are told of menorrhoea (painful periods), 20-30 per cent have
The price of depo is Rs 100 a shot. Fifty
alternative methods.
irregular, heavy periods, 15 to 20 per cent suffer from
per cent of the wdrnen drop out because.
The health worker always follows up more fre pelvic inflammatory disease, 10 per cent have pre
coming from a poor section of society.
quently in the case of sterilisation. The picture
menstrual tension (PMT) or benign breast disease.
they find the price too high. Their hus
worsens when one sees that the average age at ster The pill helps in all these conditions.
bands earn Rs 2,000 to Rs 3,000 a month.
ilisation is less than 26 years. In Andhra Pradesh,
Used by over 100 million women worldwide, the
the average age is only 23.6 years.
trend of pill use has gone up in some Asian coun They prefer Mala D, which costs just Rs 2
a month. If the injectables were cheaper,
With just 30 per cent of the demand for spacing tries. China at 7.6 million tops the global list of pill
being satisfied, it is not surprising that a little over users. In Germany, 6.8 million women are on the there would be greater acceptability; for
if a woman on the pill misses a single
two per cent of married couples use the pill or the pill and Indonesia follows with six million. In
IUD and just three per cent the condom. A stag Bangladesh, pills are the most widely used contra dose she gets pregnant and has to go in
gering 82 per cent of women have never used any
ceptive method — 5.7 million women are on the for medical termination of pregnancy.
Injectables are a surer method of staving
other method before being sterilised.
pill. In 1983, three per cent of married Bangladeshi
This explains the high abortion rate in India.
women opted for the pilL In 1997, this figure went off conception.
An Indian Council of Medical Research bulletin up to 21 per cent. In India, only 2.1 per cent (5.2 mil
The Hindustan Times
puts the unofficial figure at 11 million and almost lion) of married women are on the pill.
11 May 2001
half the maternal deaths in the 15-19 age group are
When asked what was the greatest benefit of
due to unsafe abortions. The number of these
using the pill, a group of women in Delhi said it
deaths could drop dramatically with increased was lack of tension. Through its use, the fears of
contraceptive use. According to a New York Times an unwanted pregnancy and the consequences of
report, in Russia, where pills and other contracep refusing intimate relations were removed. The
tives were made widely available, maternal deaths
women also had a sense of freedom and this The Hindustan Times
caused by abortions declined by 56 per cent enhanced the pleasures of intimacy. Surely, that is
10 May 2001
between 1989 and 1997.
not too much of a tall order for Indian women.
26
Universal and free AIDS care
By C. Rammanohar Reddy
NDIAN PHARMACEUTICAL firms
now offer hope to the millions in the
poor countries of the world who are
infected with the Human Immuno
deficiency Virus (HIV), the disease which
causes the Acquired Immune Deficiency
Syndrome (AIDS). They have offered AIDS
medicines for export at $350 a year for ev
ery patient, compared to western market
prices of as much as $10,000 to $12,000.
Governments in the South can now at least
contemplate providing their HIV-infected
citizens with highly active anti-retroviral
therapy (HAART), the medication which,
■while not a cure, helps patients lead a pro
ductive life. The irony is that India itself
jhas so far shown little initiative in using
'the Indian drug industry's capabilities to
■provide free universal care to the 3.86 mil
llion Indians now infected with the virus.
I Two reasons have been offered for why
(universal care is not possible in India. One
tis that counselling, monitoring and com
pliance are as important as affordability of
drugs. The second and more vocal argu
ment is that even at $350 a year the AIDS
■cocktail is not affordable, in a country
where the per capita annual income is only
$440. (The lowest retail cost of an annual
dosage of drugs in India is presently Rs.
42,000 — $900 — much higher than export
prices mainly because of taxes, packaging
and retail margins.) Even for a developing
country these are not arguments but only
excuses to avoid providing care. Since
1997, Brazil has provided free care for ev
ery HIV-infected Brazilian who seeks it.
The'programme runs on active health care
combined with provision of generic ver
sions of AIDS drugs that Brazil produces
locally. The result is that new infections
have been controlled, HIV transmissions
lowered, AIDS-related deaths brought
down and the HIV population is now less
than half what had been projected for
2000. India's per capita income
*
is only
one-tenth Brazil's while its HIV population
is eight times larger, so the Brazilian expe
rience may not seem very relevant. But
I given the prices Indian Industry has been
able to come up with and the experience of
Indian doctors there is no reason why In
dia cannot administer a similar pro
gramme to cope with its AIDS epidemic. A
careful listing of costs suggests that uni
versal and free HIV therapy is feasible in
India.
(1) Size of programme: Not all of the 3.86
I
The cost offree treatment for India9s 3.86 million
HIV positive people (Rs. 3,400 crores to Rs. 4,300 crores
a year) looks large. But it is as little as 0.28 to 0.35
per cent of the country's GDP.
NYCU - HIV/AIDS
million Indians infected with HIV need
other health concerns? In India the num
HAART immediately. Health personnel
bers in TB, malaria and diabetes are much
such as Dr. N. Kumarasamy of YRG Care in
larger. Here again Brazil offers hope. The
Chennai who have been working with
mass movement that HIV therapy has be
HIV/A1DS patients state that epidemiolog
come there has meant that the people's
ical studies point to 20 to 30 per cent of the
demands in other health areas have also
infected requiring therapy. That would be
increased, leading to a general improve
800,000 to one million people. (2) Cost of ment in the quality of public health ser
drugs: Retail prices are now Rs. 42,000 a
vices. There is no reason why that cannot
year. But bulk purchases for a universal
happen in India as well. And the unique
programme could save on packaging, re
nature of the fatality of HIV/AIDS means
tail margins and perhaps even taxes. Prices
that it does require special attention.
Third, can Indian industiy produce drugs
should then be closer to the rupee equiv
alent of $350. Dr. Y.K. Hamied, Chairman
on the scale that a universal programme
of CIPLA, the company which
would require? Dr. Hamied is
has turned the spotlight on MACROSCOPE confident that with more and
prices, is confident that by 2003
more Indian firms entering
the drug cocktail could cost as little as $200
the business this will not be a problem.
a year. But a conservative estimate of costs
Besides, Indian industry is now already
would be Rs. 16,450 ($350) for each pa
manufacturing up to 14 types of drugs.
tient. (3) Costs of monitoring/testing: As
Moving from the simplest $350 cocktail to
the AIDS cocktail is extremely powerful
another in order to deal with side-effects
patients have to be monitored regularly for
in some patients could also mean more
side-effects. The costs of such tests are
expensive medicines. But the CIPLA chief
considerable. At Rs. 26,000 a year they cost predicts that these costs ($500 to $2000)
more than the medicines. (4) The total cost
should also keep falling. Fourth, the AIDS
cocktails now being produced in India at
then is an annual Rs. 42,450 for each pa
low cost were all patented before 1994 —
tient. A universal AIDS care programme in
India would therefore cost the Govern
prior to the TRIPS agreement of the WTO.
But patents on the next and more effective
ment between Rs. 3,400 crores and Rs.
generation of drugs are likely to be pro
4,300 crores every year.
tected by TRIPS, so local production will
As everyone is aware, there are other is
violate the WTO agreement. The Govern
sues to consider as well. First, adminis
ment will then have to overcome opposi
tration of these medicines on a massive
tion from the patent holders among the
scale will be a challenge In itself. Most im
portant, compliance has to be ensured. If multinational drug firms and issue compulsory licences — provided for in TRIPS
patients do not stick to the complicated
— to Indian firms so that they can produce
regime, they could develop drug- resistant
and sell these drugs at affordable prices.
strains of HIV. But again as Brazil has dem
onstrated it is possible even in a poor
country to devise an innovative compli
ance regime, involve community groups
and motivate health personnel to ensure
adherence rates even among illiterates
that are reportedly no lower than in Cali
fornia. Here in India, Dr. Kumarasamy re
ports rates of up to 90 per cent among
those who are buying the AIDS cocktail.
Second, is it correct to spend so much en
ergy and money on AIDS at the expense of
It all finally comes down to costs. The
Government has indeed considered a lim
ited HAART programme. Mr. J. V. R. Prasada Rao, Director of the National Aids
Control Organisation (NACO), says that
rough estimates—assuming 10 per cent of
the infected need treatment and, of them,
half use private services — point to an an
nual cost ofaround Rs. 1,300 crores which
is considered unaffordable because this
would be more than Central Government
spending on all public health programmes
(Rs. 810 crores in 2001-02). The NACO Di
rector says there is a need to "prioritise"
health concerns in India. The NACO is
hoping instead that India will receive some
assistance from the proposed $7-10 billion
health fund which the U.N. is proposing
for malaria, TB and AIDS, though that fund
would focus on Africa. But India does not
have to wait for foreign aid.
The cost of a universal programme (Rs.
3,400 crores to Rs. 4,300 crores a year)
looks large. But it is as little as 0.28 to 0.35
per cent of India's GDP, which is not a
large burden to cany. And with falling
prices this is likely to be an over-estimate.
In any case, a 5 per cent surcharge on cor
porate and personal income taxes will
yield enough to finance this universal pro
gramme. In the absence of such a pro
gramme, no more than 5 to 10 per cent of
the HIV carriers, those who can afford the
medicines, will be on HAART. The rest will
have to make do with treatment of their
"opportunistic" infections. This would on
ly precede a gradual and wasting death
from AIDS for hundreds of thousands of
Indians. As HAART also contributes to a
reduction in the virus transmission rate, its
inaccessibility for most of the infected will.
only mean that the Indian population af
flicted by HIV/AIDS — already the second
largest in the world — will keep growing.
The only cure for AIDS is its prevention
and India does need to do a lot more in
this respect. Indeed, if India had done bet
ter in prevention it would not now have
had millions of its citizens struck by the
deadly virus. But the 4 million Indians now
infected with HIV cannot be abandoned to
a wasting death when an affordable ther
apy is available. If the numbers about HIV
infections are correct, the countiy is facing
its biggest ever epidemic that in its devas
tation will spare no region or socio-eco
nomic class. In the absence of universal
therapy the tragedy will become a catas
trophe that is likely to
* surpass what is now
unfolding in Africa. The issue has long
since ceased to be one of "violating" pat
ents on drugs. It is one of respecting life.
There is no alternative then to a state-run
universal and free programme that pro
vides HIV therapy to any Indian who needs
•»■
'The Hindu
12 May 2001
Cadila to hit S. Africa with HIV
detection kit
By Our Correspondent
New Delhi, May 11: Close on
the heels of the controversy
over exports of cheaper anti
*
AIDS formulations by drug
makers like Cipla, Ahmedabadbased Cadila Pharmaceuticals
is all set to hit the South
African market with its rapid
human immuno virusdetection
kit.
“We are in the process of get
ting necessary regulatory
approvals and hope to start exporting by the year end,” I.A.
Mody, chairman, Cadila Phar
maceuticals Ltd said and fur
ther added that the company
would export to Southeast Asia,
Europe, South America and
Africa.
Unveiling here on Friday
‘Neva HIV Detection Kit
*
developed in collaboration with
University of Delhi and depart
ment of biotechnology, he said
the company was also in the
process of getting all necessary
approvals for its manufacturing
facility from the United States
food and drug administration
and the United Kingdom medi
cine control agency.
Mr Modi said the company
hoped to gamer a major share
in human immuno virus diag
nostic market estimated to be
$750 miHion by 2002 through
Neva which can detect the
virus in three minutes.
THE BOTTOMl/M
He said company was also in
talks with a Japanese firm for a
possible tie-up for marketing
and research'and development.
Elaborating on the company’s
expansion plans, he said the
company had about 40 prod
Rapid HIV detection
kit launched
While a large number of detec
tion methods have been devel
NEW DELHI, MAY ix The Depart oped and are also commercially
ment of Biotechnology, Delhi available worldwide, these are not
University, and the Ahmedabad- suitable for situations requiring
based pharma major, Cadila quick results. Even the ELISA test
Pharmaceuticals, have developed and the western blot are time
a rapid HIV detection test which consuming, costly and cannot be
is as specific as the currently pop afforded by developing countries
ular ELISA test.
in their respective National Aids
Christened the ‘Naked Eye Vi Control programmes.
sual Agglutination Assay (NEVA)’
Because of the non-availability
test, it utilises the unique recom of immediate results, patients and
binant fusion proteins compris blood donors become untraceaing a monovalent-monoclonal ble. If they are HIV carriers, they
antibody fragment fused with HIV become a continuous, risk for the
proteins of diagnostic impor spread of HIV infection. “The NE
tance. Capable of reacting with VA test is simple and economical
human erythrocytes and anti and even people in remote rural
bodies to HIV antigens in the hu areas can know about the sero
man blood, the test reveals the se- positivity status in just three min
ro-positivity status by reflecting it utes’*. The kit has been extensive
as agglutination. “The NEVA test ly tested on 3,583 blood/sera
offers a number of advantages
The Hindu
and would facilitate easy and rap
id HIV testing in the office of a
12 May 2001
physician and in rural settings
where laboratory facilities are not
available/' claimed Mr. I. R. Modi,
Cadila chairman, at a press con
ference here on Friday.
By Our Staff Reporter
28
ucts in pipeline and would con
sider a listing on the domestic
as well as overseas bourses by
2003 but refused to give any
details.
The over Rs 400 crores Cadila
Pharma which is closely con
trolled by the Modi family will
also introduce an Elisa Test
based human immuno virus
testing kit ‘Elik’ required for a
detailed evaluation for human
immuno virusdetermination.
While the government holds
patent for Neva, Cadila has
Been given the rights to manu
facture and market the product
globally.
The company was also in the
process of introducing a
Hepatitis C testing soon for
which drug controller general
of India's approval was expect
ed soon.
The company was eyeing ‘
biotechnology in a big way, Mr
Mody 9o|d adding it would
foray into therapeutic segments
like diabetes, anti-dnfectives
among others.
*
'
Mr Mody said the company
was also in the process of initi
ating similar technical collabo
rations with other institutes. ’
The Asian age
12 May 2001
NYCU - HIV/AIDS
Pharma cos. bet on African market
for their anti-AIDS drugs
By Ramnath Subbu
mumbai, may 13. Indian pharmaceutical com
panies have trained their sights on the African
continent where acquired immuno-deficiency syndrome (AIDS) has spread at an alarm
ing rate.
There is a huge opportunity in Africa fol
lowing the withdrawal of the patent suit filed
by 39 global pharma companies against the
South African Government which allowed the
sale of cheaper branded generic drugs.
India itself presents a daunting scene with
possibly the second highest HIV positive in
fections after South Africa.
The anti-AIDS retroviral drugs market in In
dia is dominated by Cipla which in many
ways has been the most aggressive player in
this segment and also enjoys the 'first mover'
advantage over others as far as venturing into
the African market is concerned.
The company had created a furore in global
pharma circles when it offered to sell its 'triple
AIDS cocktail’ to a doctor's group Medicines
INDUSTRY FOCUS
Sans Frontiers (MSF), which is working in
Africa and Southeast Asia for the treatment of
AIDS at $350 per patient per year three
months ago.
This was when global pharma companies
were charging between $10,000-15,000 per
patient per annum for the same regimen.
The number of HIV positive cases in SubSaharan Africa alone is estimated to exceed 25
million while in India, it is in the region of
3.5-4 million cases, according to the National
AIDS Control Organization (NACO).
Other players to have announced a foray in
the anti-AIDS segment are Zydus Cadila, Au
robindo Pharma, Ranbaxy, Hetero Drugs and
Kopran.
A company seeking to export drugs from
India requires a compulsory licence from the
importing country. Under compulsory licens:
ing, a manufacturer is allowed to produce a
patented drug in exchange for a licence fee to
the inventor. The fees vary from deal to deal.
Cipla was the first to take the lead in export
ing to the African markets. The company sup
plied MSF a cocktail consisting of
Lamivudine, Stavudine and Nevirapine. Its
first lot was supplied to Cambodia and it re
cently signed an agreement with the Nigerian
government.
Nigeria is buying the drug to treat 10,000
patients per annum and at $350 per patient,
the order is worth $3.5 million. Execution of
the order is to commence soon.
Cipla is in talks with the governments in
Zimbabwe, Cameroon, Ivory Coast and Alge
ria and is also in discussions with AngloAmerican, a South African private sector firm,
for treatment of 20,000 patients at $350-500
per annum.
Zydus Cadila has put up applications to ex
port its cocktails to Kenya, Uganda and South
Africa. According to the company, the appli
cation has been registered in these countries
and clinical trials are on. There are also some
negotiations taking place on the pricing.
Hetero Drugs is in talks to supply its drugs
to Kenya and Congo and its registration is
being processed in Colombia and West Asia.
The company offered to supply its triple drug
cocktail to MSF at $347 per patient per an
num.
* *
It is also in talks with the Nigerian and Zim
babwean governments and expects a more
definite picture to emerge in the next few
months. Aurobindo Pharma has stated that it
is in discussions with MSF.
Today, the triple drug 'cocktail' regimen
typically consists of two nucleoside reverse
transcriptase inhibitors (NRTIs) in combina
tion with either a protease inhibitor (PI) or a
non-nucleoside
transcriptase
inhibitor
(NNRT1).
The compounds Zidovudine, Lamivudine
and Stavudine are NRTIs which form the
backbone of triple therapy. Either Zidovudine
or Stavudine is used in combination with La
mivudine.
Now with the introduction of Didanosine,
the options have widened and patients who
do not respond to the earlier mentioned com
binations can switch to a Stavudine-Didanosine of Zidovudine-Didanosine combination.
Nevirapine belongs to the NNRTI class of
anti-retroviral drugs. These act by inhibiting
reverse transcriptase, which is essential for
the multiplication of the human immunodef
iciencyvirus. NNRTIs inhibit HIV-1 strain but
are not active against HIV-2 strain. Indinavir,
Nelfinavir, Abacavir are protease inhibitors
(PI).
Regarding the domestic market, Mr. Srinivas Lanka, director, Aurobindo Pharma, said,
"There is no clear evidence on the size of the
domestic market for the anti-AIDS drugs but
on the basis of sales at the retail level, it ap
pears to be around Rs. 120 crores in size.
Owing to the stigma attached to AIDS,
numbers can be gleaned only from indirect
sources.-But with the increasing incidence of
the infection, this market is now growing at
200 per cent per annum."
"Most of the drugs in use today have
pre-1995 patents. The fact of the matter is that
there is no product to kill the virus as yet and
all medication is only to retard or prevent the
progress of HIV positive patients to full-blown
AIDS.
Unfortunately in India, the government is
working only on prevention of HIV infection
and not on its treatment," said Mr. Lanka.
Cipla last week announced a cut in the do
mestic prices of its drugs. The company's
price cuts are in the region of 15-17 per cent
for the basket of products including Zidovir,
Lamivir, Duovir, Stavir, Nevirapine and Dinex
100.
Consequently, the price of its triple drug
cocktail, of Stavudine-Nevirapine-Lamivudine, per patient will go down to Rs. 3,495 per
month against the earlier price of Rs. 4.320
per patient per month.
Ranbaxy Laboratories last week launched
Lamivudine, Nevirapine and Zidovudine
products in the Indian market. Virocomb, a
combination of Lamivudine and Zidovudine.
has been priced at Rs. 500 per strip of 10 tab
lets. Its Zidovudine tablets have been priced
at Rs. 260 per 10 strip. The drugs are to be
marketed through its division — Crosslands.
Aurobindo Pharma has set up a new divi
sion — Imunus to offer HIV/AIDS drugs. Imunus last week launched five options for the
treatment of HIV and plans to offer seven
more options in this financial year.
The five options include Zidovex, Lamivox,
Nevirex, Stavex and Zixovex-L. The seven op
tions to be introduced by the end of the fi
nancial year include Didanosine, Efavirenz,
Delavirdine, Indinavir, Ritonavir, Saquinavir
and Nelfinavir.
x Aurobindo has eight bulk drugs and two
formulation plants and has earmarked a Rs.
20 crore fund for Imunus.
The medicines are to be distributed free
through NGOs and government organisations
besides Aurobindo's own centres.
The Hindu
14 May 2001
NYCU - HIV/AIDS
0 29
Indigenous 3-minute AIDS
detection kit launched
I
KamipRi ya Vashisht
. proudly, “This -is;-a thingy very
tnuch oilr own, .no foreign aid, no
J' ’
New Delhi, May 12: If not cure, 'foreign-help.” * •
at least quick detection of AIDS - Neva is a unique fest which
has finally become a possibility. gives its results mthi^fninutes.
Ahmedabad-bascd pharma major, It is simple enough to be carried
Cadila Pharmaceuticals, in col put byjscmi-skilled technicians. It
laboration with the University of - does not‘ require instruments,
Delhi, South * Campus, and the •electricity and can be used in the
Department of Biotechnology, remotest villages in India. ’
government of India, has devel
Neva can detect both HIV-I and
oped a test which can be applied HiV-H infections. It is also very
in a range of situations to detect reasonably priced at Rs 39 per
the HIV virus.
test. Each Neva kit provides for
Neva was launched on May-11, 50 tests.
also being celebrated as National
Says Mr R.V. Bhat, head of
Technology
Day, at Hotel biotechnology, Cadila, “Since
Ashoka in the city. Speaking on A IDs spreading is directly related
the occasion, minister of science to the HIV population of a coun
and technology. Dr Murali try, the only cure can be to find a
Manohar Joshi said, “We must rapid diagnosis.”
have things of our own.” The man
And sure enough diagnosis is
behind the success of Nova, Prof. now a pin prick away. This kit
V.R. Chaudhaiy, announced very can eradicate the spread of AIDS
through blood transfusion. 30
million units of blood passes out
of blood banks each day. Nova
could become invaluable to blood
banks.
This test kit is the result of 5
years of research. “I was in the lab
in Ahmedabad even when the
quake shook Gujarat,” says Prof.
Chaudhary. It has already been
successfully tested in Ahmed
abad, and AI IMS in Delhi.
Very soon Nova will be export
ed to Southeast Asia, Africa,
Europe, and South America. If
Nova proves successful in the
market, it would truly be a giant
leap towards the control of —
“killer AIDS.”
Chairman of Cadila pharmaceu
ticals, Mr LA. Modi, said. “Neva
is a breakthrough in the world of
technology, a first of its kind in
the world.” ’
The Asian Age
13 May 2001
‘AIDS awareness campaign a success’
By Our Staff Reporter
bangalore, may 18. The first phase
of the “Universities talk AIDS”
(UTA) campaign from 1991 to
1997, implemented through the
National Service Scheme in uni
versities and pre-university edu
cational institutions has been a
resounding success in sensitising
the youth, according to Mr. R.K.
Misra, Joint Secretary, Union
Ministry of Youth Affairs and
Sports.
Mr. Misra told presspersons
here on Friday that the objective
was to create an awareness about
AIDS and its prevention among
the student population through
information, education and com
munication. The method had
been adopted by Indonesia and
Malaysia and the SAARC coun
tries.
At the national level, 6,500 NSS
programme officers and 34,000
peer educators implemented the
programme in 4,500 colleges and
institutions and made 40 lakh stu
dents aware about AIDS against
the target of 25 lakhs during the
UTA campaign’s first phase.
As far as Karnataka was con
cerned, 600 NSS programme offi
cers and 6,000 educators were
trained and the campaign was im
plemented in 600 colleges cover
ing eight lakh students.
Mr. Misra said the National
AIDS Control Organisation had
agreed to provide financial assist
ance for the UTA phase II cam
paign from 2001-2004. Based on
the experiences of phase I, some
new thrust areas such as positive
living, lifestyle education, eco
nomic and developmental im
pact, and impact on women and
children had been included in the
second phase.
Mr. Misra said that volunteers
had an added advantage of reac
hing out to the community by
networking with NGOs.
For the first year of the phase II
campaign, Rs. 1.04 crores had
been sanctioned. This time the
emphasis would be on rural areas
and the NSS and the other volun
teers would work along with the
Nehru Yuva Kendra Sanghatan.
As a part of the campaign, a threeday zonal training workshop for
key NSS functionaries from Kar
nataka, Andhra Pradesh, Madhya
Pradesh and Chattisgarh was held
here.
Experts from the National In
stitute of Mental Health and Neu
ro Sciences, the Rajiv Gandhi
Health University and NGOs
shared their experiences and ex
pertise to develop Appropriate
skills and competencies to enable
participants to implement the
programme in their respective ar
eas.
Asked whether the volunteers
had tried to approach sex workers
to educate them about the use of
condoms to protect themselves
from the dreaded disease, Mr.
Misra said it could also be done.
Later, Mr. Misra delivered the
valedictory address at the work
shop. Prof. M. Gourie Devi, Direc
tor
and
Vice-Chancellor,
NIMHANS, presided.
Mr. B. Umapathy, Deputy Pro
gramme Adviser, NSS Regional
Centre, and Prof. C.T. Shivappa
Gowda, NSS State Liaison Officer,
spoke.
The Hindu
19 May 2001
30
NYCU - HIV/AIDS
0
AIDS in India. “India is not a mated at Rs 20 crore, excee
sexually deviant country. ded the target of sensitising
Bangalore, May 18: Joint But we cannot become comp 2;5 million students about
AIDS.
Secretary in the Union Minis lacent either,” Mishra said.
In all, 6,500 NSS progra
The workshop, held over
try of Youth Affairs and Spo
rts R K Mishrg on Friday cal- ’ three'days, was attended by mme officers, 34,000 peer edu
led for greater convergence about 34 NSS functionaries cators, and 4 million stude
of efforts from all stake-hold-- from' Universities from four nts from 4,500 colleges/ insti
tutions were educated in the
*
ers such as NGOs, State States in this zone - Andhra
*
Pradesh, first phase.
AIDS Control organisations Pradesh, Madhya
’Director .and vice-chancel
and the medical community Karnataka : and Chhatti
to raise awareness in rural sgarh. The first phase,, esti- lor of the National Institute
of Mental Health and Neuro
India, where AIDS is fast spr
Sciences
(Nimhans).
M
eading. “AIDS has spread
MEDICAL
SOFTWARE
Gowri Deyi, who was the chi
widely to rural areas - it’s
time to involve the commun Bangalore: pity-b^s^ds CIFT- ef-guest on the occasion, poi
ity in all awareness worksh ech Solutions has come out nted out that while Indians
ops and training program with a software package that had once believed they
can help manage general prac would,never be infected by
mes,” Mishra said.
He was speaking at the val- • titioners’ clinics and primary HIV, they were now having a
edictory function of the sec-, health centres (PHCs). The tough time coming to terms
ond phase of the regional Na software CIFT clinic can help with reality. .“At first, India
tional Service Scheme (NSS) computerise medical and adm denied that AIDS could ever
training workshop conduc inistrative ^p^ts^’dtacs.. spread to this country, that
ted as part of the Rs 10-crore It can; manage ;;p0tiiMit *. data, it was only prevalent in ‘deb
national project ‘Universit staff rops.Mfruglists,Mis and auched’ countries.
But reality showed other
ies Talk AIDS’ (UTA)'campa- accounts. The software pack
ign for AIDS awareness. He age costs Rs. 13,500and.canbe wise and we had to take note
was, howevefr, optimistic provide it:W/^cjHk^fcndl of the rising incidence of
: \ AIDS,” she said.
about curbing the spread of rates for• PHCs • ENS
Express News Service
The Indian Express
19 May 2001
Anti-AIDS
proposal
GENEVA: The World Health
Organisation stopped short of
approving radical Brazilian
proposals for wider
international access to cheap
HIV/AIDS drugs but urged
greater effort toward tackling
the epidemic in a resolution
adopted on Saturday. Brazil
initially called for legislative
protection for local production
of cheaper generic drugs — a
plan criticised by
multinational producers of
branded products. Europe, the
U.S. and some other countries
objected on the grounds that
the WHO didn't have the
authority or resources to take
on such a role, and that trade
and patent issue's were best
handled by the WTO. In
picture, a Kenyan girl with her
father holds a candle and joins
in prayers during the 18th
International AIDS Candlelight
Memorial on Sunday. — AP
The Hindu
21 May 2001
NSS Aids
meeting held
PH News Service
BANGALORE. May 18
The three-day zonal training work
shop for Universities Talk Aids
(UTA) Project Phase n for National
Service Scheme (NSS) officers and
volunteers was held from May 16.
Experts in the field from
Nimhans, Rajiv Gandhi University
for Health Sciences and NGOs
trained more than 50 key NSS per
sonnel from Karnataka, Andhra
Pradesh, Madhya Pradesh and
Chattisgarh during the workshop.
The UTA programme is being
implemented since 1991 all over
the country through the NSS in
universities, pre-university educa
tion institutions. The focal objec
tive of this campaign is to create
awareness about AIDS and its pre
vention among students through
information, education and com
munication.
Mr R K Mishra, Joint Secretary
of Ministry of Youth Affairs and
Sports, which is implementing the
programme with the financial
assistance from National AIDS
Control Organisation (NACO), said
that the Phase II of the project will
be in force from 2001-2004.
_
Deccan Herald
19 May 2001
AIDS unknown
to Gaya sex
workers: Study
Patna, May 20: Most commer
cial sex workers in Bihar are
ignorant of AIDS though State
NGOs have spent Rs 30 crore
to educate them, says a recent
study. Helping Hand Founda
tion, under the awareness and
prevention project of Bihar
State Aids Control Society,
conducted the study in Gaya’s
red light areas. Foundation
director Lalan Choubey said
around 80 per cent of sex wor
kers in Gaya are unaware of
the disease. Though almost
half NGOs in Bihar had star
ted awareness drives and
spent crores, the message has
apparently failed to get
across. For sex workers, AIDS
is nothing more than another
disease«ENS__________
NYCU - HIV/AIDS
The Indian Express
21 May 2001
Govt wakes up to people’s
role in AIDS prevention
9 31
Towards a New Horizon
How many people in India suffer
from the HIV/AIDS virus? Who
are they? How'is India dealing with
this pandemic? Pumlma Mane,
vice-president, Population Council
and director, International
Programmes Division, says that
although a lot has been done to pre
vent the spread ofthis much-feared
virus here, so much more needs to
be done, especially in creating pub
lic awareness about the disease She
tells Mahendra Ved that this is one
health threat that cannot be handled
by the health sector alone:
What is the global update on the
HIV/AIDS epidemic?
When AIDS emerged two
decades ago, few could predict the
monstrous dimensions it would
take on. It was seen largely as a
health problem, which would affect
specific segments of the popula
tion, often on the margins of soci
ety. Perhaps, this very limited prism
from which we viewed AIDS is
partly responsible for the stagger
ing proportions it has taken on to
day. UNAIDS and WHO estimate
that at the end of the year 2000, the
number of people living
with HIV or AIDS stood at
36.1 million. There were 53
million new infections in
2000 alone. HIV is now the
single largest infectious
killer and the fourth leading
cause of death in the world.
That the new infections are
largely among the under-25
age
group,
especially
women, is.most alarming.
Not surprisingly, it is now a
global crisis, demanding a
response that cuts across sectors,
nations and all strata of societies.
Today, it is also a development is
sue — one that wipes out hardearned gains made by societies.
Sub-Saharan Africa has been the
hardest hit. More than 25 million of
the 36 million infections are from
this region alone. But South and
Sduth East Asia also need urgent
attention. While the developing
world is struggling to make
AIDS visible, in other parts of the
world, many believe that the
worst is over. With new anti-retro
viral drugs becoming available at
least to spine, there is complacency
in some pockets.
What is the role of the Population
Council in dealing with AIDS?
The Population Council is one of
the organisations working on de
veloping a microbicide. This is a gel
women can use in the vagina to
protect themselves from HIV.
More needs to be done on develop
ing vaccines. We need more accessi
bility to female condoms, and of
course, male condoms, which are
often available but not used. This
epidemic challenges us to go
32
Condoms
free with
liquor to
fight AIDS
boosts my spirits a little. There are
many more NG Os, including
groups of people living with
HIV/AIDS, working boldly, taking
up sensitive issues which govern
mental agencies cannot handle.
Some are well-resourced but a
majority are not. There are many
wonderful and inspiring Indians
working in this field. Some are pro
From A Srinivasa Rao
fessionals but many who symbolise
the common person, standing up to
Hyderabad, May 19: Buy a
a dreaded problem with courage
bottle of liquor and get a con
and imagination. The government
dom free.
too has shown a commitment to
The AP State AIDS Control
make things happen, even if the
Society has come up with this
resulting change is slow. Adequate
novel idea to check the spread of
internal resources will have to be
AIDS. The idea has already
assigned, especially on making care
been put to practice at 112 select
available to all. In a country with a
retail IMFL shops in the high
range of problems, some argue that
risk areas of coastal Andhra. It
AIDS is not a priority.
will be extended to other parts of
When a development project is
the State in a phased manner.
planned, we need to see how it
“It doesn't matter if a person
would impact on the spread of
throws away the condom once
HIV. For instance, in many devel
he comes out of the liquor outlet.
oping countries, the construction of
But he will definitely recall its
a new highway has meant construc
supply while consuming liquor
tion workers and truckers staying
and talk about it with others.
away from homes for too long. This
Sooner or later, the discussion
fosters the spread of HIV.
will make people think why con
How is India faring com
doms are being supplied free of
pared to other countries?
((There has been a
cost and gradually they will
Many countries acknowl
sea change in the overall
begin to talk about AIDS. And
edged the epidemic faster
Indian climate around
talking AIDS is stopping
than we did. Unfortunately,
AIDS,” Society director K
AIDS. There are many
we lost precious time in the
Chandramouli told Deccan
more NGOs, including
early years of the epidemic.
Chronicle.
We have a tendency to
groups ofpeople living
The campaign is specially
lament
our
weaknesses;
we
m with HIV/AIDS, working
aimed at truck drivers, who are
hardly
ever
acknowledge
s boldly, taking up sensitive
in the high risk category and
small successes. Gov
® issues which governmental our
form the focus of the “Healthy
ernmental openness on
§ agencies cannot handle
Highway” project of the AIDS
AIDS is a plus point as are
Control Society.
the resources which inter
The Society will organise the
We need to address many ques national agencies are placing at our
International AIDS Candlelight
tions. How do we effectively reach disposal. We need to use them judi
Movement all over the State on
the large numbers of people in rur ciously and expeditiously, matching
Sunday to generate awareness
al areas with our messages on them with our own resources. The
among the people.
AIDS prevention? How do we get NGO sector is doing good work.Chandramouli said hundreds
around the cultural taboos sur We have much more openness in
of volunteers, representatives of
rounding open discussion of sex, the media around AIDS than be
NGOs, members of Mythri
despite decades of family planning fore. Pharmaceuticals are coming
groups and people from all
work? How do we highlight the forward to help make affordable
walks of life would hold lighted
dangers of AIDS when people of anti-retroviral drugs available.
candles exactly at 7 pm at dis
A lot is happening towards con
ten live a hand-to-mouth existence,
trict headquarters, mandal head
and the dangers of AIDS seem un trolling the spread of AIDS. But
quarters
and
villages. In
real, even unimportant, vis-a-vis there is so much more we need to
Hyderabad, a rally would be
finding the next meal? How do do. We are not in the category of
taken out from Charminar which
women negotiate condom use with Thailand, Senegal or Uganda,
would be attended by prominent
the men in a gender climate which which are quoted as classic exam
citizens. Chandramouli said the
makes this almost impossible? And ples of what early action, good poli
candlelight movement was
how do we ensure that people with cies and programmes, political will,
being organised for the first time
HIV/AIDS and their loved ones and openness can do in the fight
in the State, though it had been
are treated without discrimination? against AIDS. We have much to
going on in 70 countries all over
The National Aids Control Organi learn so that we can avoid making
the world on the third Sunday of
sation (NACO) has been working the same mistakes.
May every year.
to address these questions. But the
For a large country with tremen
Deccan Chronicle
health sector cannot do it alone.
dous diversity, India's programmes
Are NACO and the NGOs on need to be tailored to local and re
20
May 2001
the right track?
gional needs, to carry different in
There has been a sea change in terest groups. This is not an easy
the overall Indian climate around task. Above all, we need an acceler
AIDS over the seven years I have ated sense of urgency for action — The Times of India
been working outside the country, the longer we take, the more
21 May 2001
and each time I come home, it we place our future at risk.
beyond technological fixes. The
Population Council is working
through Horizons, a project funded
by USAID, to test what works in
this epidemic, in terms of putting
programmes and services in place,
and testing out innovative strate
gies. We know a lot about this epi
demic. Our problem is how to use
what we know, effectively, with
the best results, while preserving
people’s dignity and human rights.
How serious is the AIDS threat
in India?
The estimate of between three to
4.5 million Indians being infected
with HIV may seem limited in
terms of India's one billion-plus
population. But it is the world's sec
ond highest, and is definitely seri
ous. Today, HIV is no longer re
stricted to stigmatised and socially
marginalised populations such as
sex workers, homosexuals or drug
users. Nor is it restricted to a few
urban pockets. In 1990, when I was
studying AIDS in India, it was be
ing referred to as a disease of the
city. Today, it is everywhere. AIDS
has had a devastating impact on the
pace of India's development.
Flirting with death
ACCINES MADE from live but
weakened HIV could wipe out
AIDS in countries such as
Thailand and Zimbabwe with
in fifty years, computer models sug
gest. But there's a big catch: such
vaccines will inevitably kill some of the
people they’re meant to protect.
Live "attenuated” vaccines made
from weakened forms of viruses work
much better than vaccines containing
inactivated viruses. But they are inher
ently risky — sometimes the weakened
virus itself causes disease, or reverts to
the wild-type form.
Tests in monkeys suggest live HIV
vaccines could work in humans, but
their use is controversial. "HIV strikes
at the heart of the immune system. I
don’t think a live attenuated HIV vac
cine is analogous to any other live attentuated vaccine in terms of the
risks,” says Mamie Elizaga of the Uni
versity of Washington’s Vaccine Trials
Unit in Seattle.
So to assess the risks, Sally Blower of
the University of California in Los An
geles and her colleagues modelled the
effects such vaccines would have in
Zimbabwe and Thailand. They as
sumed that live attentuated vaccines
would be between 50 and 95 per cent
effective in blocking the spread of wild
type HIV, and that they would cause
AIDS in between 1 and 10 per cent of
vaccinated people.
Blower’s team found that each of the
V
vaccines could eradicate wild-type HIV
in both countries within 50 years and
the vaccine strains would simply die
out when vaccination stopped. Howev
er, while the model predicted declining
death rates for Zimbawe, in Thailand
most vaccines would initially cuase a
rise in deaths from AIDS. That’s be
cause Thailand has a substantially low
er HIV transmission rate, Blower says.
"The important point is that the
same vaccine would have different ef
fects in different countries,” she says.
"In developing countries where the
transmission rates are very high, you
would have a beneficial effect. But you
would be killing off a certain fraction of
the population. If you had these vac
cines and nothing else, yes, you should
use them. But if you had something
better then go with something better,”
says Blower.
Not everyone agrees. “1 think there is
no justification whatsoever under any
circumstance,” says Max Essex, chair
man of the Harvard AIDS Institute. He
says that it’s virtually impossible to
work out if such vaccines are safe, be
cause they may not cause AIDS for almost 20 years, and safety trials usually
q
only last six to eight months. “The 3 O
most horrible scary scenario with a live
attentuated HIV vaccine is one where it «
does not induced disease or death in
anyone within 15 or 20 years, but after ®
that induces death in everyone.— New .
Scientist
AIDS control: PM will
review steps with CMs
By Sanchita Sharma
New Delhi, May 21: Concer
ned about the rising HIV/
AIDS prevalence in the coun
try, Prime Minister Atal Behari Vajpayee is meeting Uni
on Health Minister C P Tha
kur and Chief Ministers of six
States with high HIV prevala
nce on Tuesday. The PM is
keen to discuss strategies and
steps taken to contain the dis
ease, despite the National
AIDS Control Organisation
(NACO) insisting that there
has been only a miniscule inc
rease in the number of HIV
cases in India, up from 3.7 mil
lion last year to 3.86 this year.
Vajpayee will review exist
ing AIDS control work in the
concerned States with the Chi
More births and
deaths being
registered under
new format
By Our Staff Reporter
bangalore, MAY 21. The revamped Civil Registration
System (of births and deaths) which was introduced
in the State from January 1,2000, has proved to be a
good move, with registrations in both categories
showing an increase, Mr. S.M. Vijayaraghavachar,
Chief Registrar of Births and Deaths, said here today.
Mr. Vijayaraghavachar, who is also the Director,
Department of Economics and Statistics, told press
persons that within the next two years, all bottle
necks would be cleared to ensure 100 per cent
registration.
Until 2000, the registration of births and deaths in
the State was carried out under the provisions of the
Registration of Births and Deaths Act, 1969. The Kar
nataka Registration of Births and Deaths (Amended
Rules), 1999, which revamped the registration sys
tem, was introduced in January 2000, to remove bot
tlenecks and streamline the process of registration,
apart from ensuring speedy transmission of data,
preservation of registers and so on.
On the measures taken to improve registration,
Mr. Vijayaraghavachar said all deputy commission
ers had been requested to ensure that registrars in
rural and urban areas issued certificates free of cost
immediately after registration, under Section 12 of
the Act.
Registration centres had been opened in five gov
ernment hospitals in Bangalore and the 24 maternity
homes run by the Bangalore Mahanagara Palike
(BMP). Permission had also been accorded to open
registration centres at NIMHANS, Kidwai Memorial
Institute of Oncology, Jayadeva Institute of Cardiol
ogy, Command Hospital and the ESI hospitals in
Bangalore. Nine government hospitals in Hubli and
Dharwad and two in Mangalore were now registra
tion centres. Soon there would be centres in Mysore,
Gulbarga and Belgaum city corporations too.
Mr. Vijayaraghavachar said he had requested the
Registrar-General of Census, India, to permit the
opening of centres in major private hospitals too.
Hospitals such as St. John’s, St. Martha’s and other
missionary hospitals could then be included as cen
tres. In order to create awareness about the necessity
of registration, the Directorate had produced a moti
vational film aimed at the rural public titled "Huttu
savina jothege”. It was directed by Mr. N.S. Shankar,
and the 15-minute spot would be telecast on May 31
on Doordarshan at 7.15 p.m. It would be aired again
on June 7 and 14, he said.
Karnataka stood third after Kerala and Tamil Nadu
in the registration of births and deaths. While in
Kerala the registrations came under the purview of
the Department of Panchayat Raj, there were some
States where it came under the Health Department,
Mr. Vijayaraghavachar added.
The Hindu
ef Ministers and discuss new
initiatives in the offing. While
the CMs of Andhra Pradesh,
Karnataka, Nagaland and Ma
nipur
will
meet the PM,
Tamil Nadu
and Mahara
shtra will be
represented
by
their
Health Mini
sters.
The review comes a month
before India sends a ninemember delegation to New
York to participate in the UN
Assembly’s special session on
AIDS. Health Minister Tha
kur will head the AIDS delega
tion' to new York, where he
The Indian Express
■will chair the UNAIDS’ Progr
amme Co ordinating Board.
22 May 2001
22 M
2001
J
NYCU - HIV/AIDS S 1
Girl Interrupted
Will misuse ofadvances in techno
Population management is hap What are the repercussions ofselec
logy only further aggravate gender
pening in some states and people tive breeding? How will it alter
are having fewer children. But in national demographics?
inequalities? In India, mostfami
With
technology
becoming
lies set great store by the male prog many cases and especially in rural
India, because there are fewer chil cheaper and more accessible, it will
eny; it is taken for granted that only
dren being bom, parents want to en impact a large cross section of soci
a son can carryforward the lineage
and the scriptures are freely quoted sure that there are at least two sons ety. While it may only be a few who
in each family. They continue to be can afford it at the moment, imagine
to sanctify this beliefAnd now the
Genetics & IVF Institute in Ameri- • lieve that having a daughter is like gender determination tests being
freely available in states like
watering someone elsc’s fields.
ca offers pre-conceptual gender
And now comes an American Haryana and Punjab that already
selection fora price. Sustained
company offering gender selection * have such low male-female ratios.
gender selection will have serious
x This gains expediency given India’s
at a price.
ramifications in countries like
Well, this is an unholy alliance be preference for first-borns to be
India where the gender ratio is
tween tradition and technology. male. Who is going to send theijr
already tilted in favour ofthe male.
Preference for sons is often quoted only sons into the armed forces dr
Nina Puri, president ofthe Family
as being the root cause for the high for that matter to the police or to
PlanningAssociation ofIndia and
fertility rates in India. Before this other high-risk careers? Fewer girls
chairman ofthe South Asia region
new technology, there used to be fe in society will not alter the natural
ofthe International Planned
male infanticide, and
*
that is still desires in human beings.
Parenthood Federation, talks to
prevalent in some Indian states. DiThis abnormality in gender ratios
PH News Service
Sandhya Mulchandani about the
' agnostic technology and testing fa is going to manifest itself socially as
repercussions of the misuse of
cilities like ultrasound and amnio increase in rape, prostitution, incest,
BANGALORE. May 20
centesis have made huge inroads in homosexuality and other deviations.
this technology:
The Aids Forum Karnataka (AFK)
rural India. Clinics have also mush It will alsQ have a lasting impact on
and the Plan International today
Indians have always had a marked roomed throughout the country social interaction, changing what is
organised the 18th International
which enable people to choose to intrinsically Indian like the family
preferencefor sons. Why is this so?
candlelight march in the city as a
This phenomenon is not restrict abort female fetuses. For example, in structure. For starters, there will be
tribute to those have died from
ed to India, it’s a universal problem a small town like Palwal alone, there fewer marriages. And this is just the
Aids.
and particularly an Asian one. It has, are reportedly over 150 ultrasound beginning. The next step would be
Minister for Health and Family
however, persisted in India despite a clinics.To add to these existing prob- babies with fairer skin, lighter eyes
Welfare A B Maalakareddy re
and higher intelligence. We
growth in living standards. It
leased a bunch of white balloons
are sitting on a volcano. You
cuts through all classes of so
“Population manage
as a symbolic tribute. He said each
can’t even imagine the
ciety, be it the rich or poor—
ment is happening in
moral dilemmas we will
not having a male heir is
balloon represents thousands of
some states and people
have to face.
looked upon as something
lives lost due to Aids. He also
to be ashamed of The pref
are having fewer children. Some believe that sex selec stressed the need to bring about
tion may be a necessary evil
erence for a son is deeply
awareness among people to fight
But especially in rural
embedded in our psyche.
— a preferred path to dowry
against Aids.
India,
parents
continue
to
deaths, female infanticide
Moreover, our scriptures
Aids is the biggest threat to
| believe that having a
endorse this.
and domestic violence that
Are you saying that econom
S daughter is like watering continues to be played out in human race, said Ms Munira Sen
of Madhyam. The disease has in
ic progress, education and a
so manyfamilies in India.
^someone rise's fields »
fected around 36 million men,
general rise in living Stan*
I agree that this may be
women and children living in the
dards have had no impact on
the perception at a micro
world today and 22 million have al
lems, technologies like MicroSort level. There are those who feel that
this preference for male children?
ready lost their lives.
That’s right. The 2001 census en will further upset the balance.
to pre-determine sex may be better
dorses this. In Haryana, for example, How does the new technology work? than the moral trauma of having to
The
Karnataka
State
The clinic is said to have perfected abort a child. But when this contin
the sex ratio has decreased from 865
Prevention Cell also participated
females per 1000 males in 1991 to a technique that is able to separate ues, its context is taken away from
in the march which began from
861 in 2001. In Punjab, it has gone the male from the female sperm by the immediate environs of a family
Vidhana Soudha today evening.
down from 882 females' per 1000 making use of the fundamental dif and takes on larger, macro dimen
People from all age groups from
males in 1991 to 874. But the most ference between male and female sions. On a national level it impacts
different section of the society par
alarming statistic here is in the 0-6 * sperms.The female sperm carries an economic, political, and social devel
ticipated in the march.
‘
*
X
chromosome
and
has
a
larger
year range, where it has gone down
opment Continued over a period of
from 875 females per 1000 males in percentile of DNA that makes it time, these changes can become a
Deccan Herald
1921 to 793 — a marked decrease in possible to distinguish it from the Y . phenomenon changing the very fab
21
May 2001
the number of female children be chromosome carrying male sperm. ric of society. What companies like
ing born. This, despite literacy levels The process first made news in 1998 MicroSort will do is remove the
* rising by almost 11 per cent. People and it has been found to work more guilt that is associated with aborting
have changed, but not dramatically. for girls than for boys. However, an unborn fetus.
It is not that they want to educate . intrauterine insemination may not
their daughters less; they want to ed happen at first shot; most need an Isn’t it ironical that technology
ucate their sons more.
average of three trials before the today is being used to perpetuate
So while education and economic impregnation takes off, pushing up gender bias?
It is absolutely ironical. On the
development are important, these costs further.
factors alone have not been able to What about patents? Can Indian one hand, the whole world is crying
out to correct gender inequality,
change the social mindset. Social clinics use this technology?
While the United States Drug empower women and provide
problems like dowry continue.
There is still a marked preference Administration (USDA) has per them with equal economic opportu
for sons — whether it is the middle mitted this technology to be patent nities. On the other hand, new
classes, businessmen or lower ed in North America, Europe, Aus technology is being misused, to
income groups.
tralia and Japan, countries like India perpetuate gender inequality.
We’ve had population management and South Korea (where there is a Women have been discriminated The Times of India
for the last few decades. What effect cultural preference for boys) are from creation to cremation. It is a
15 May 2001
free to pursue this technology.
complete paradox.
has it had?
Candlelight
tribute to Aids
victims
34
Restrictions make Viagra
sale go limp
From A Srinivas Rao
Hyderabad, May 21: Potency
drug Viagra which registered phe
romonal sales across the globe
has failed to excite consumers in
the city with the Drug Control
Administration Authority playing
killjoy with its restrictions.
The sales of the blue pill have
sure given the shopowners across
the State the blues as users no
longer clamour for it like they
used to.
The initial high over the wonder
drug cooled down within a few
weeks of its launch last January.
The drug, mainly available under
three brand names — Caverta
(Ranbaxy), Edcgra (Sun Pharma)
and Androz (Torrent) — had
many people making a beeline for
chemist shops when it was intro
duced in the market. But when
the DCA, after an emergency
meeting to review the sale of
Viagra and (he side-effects asso
ciated with it in the last week of
January, imposed several restric
tions, the sales began dwindling.
The department asked all whole
sale and retail druggists to main
tain a stock register with updated
statistics of its sale.
The retailers were asked to sell
the drug only against a prescrip
tion given by an endocrinologist
or a urologist or a psychiatrist.
No other doctor would be permit
ted to prescribe it. The retailer
should put a stamp with a date on
the prescription, so that the same
prescription cannot be used to
purchase the drug again and
again. The customers should also
produce two sets of the prescrip
tion, so that the retailer can keep
the duplicate and produce the
same when DCA authorities drop
by to inspect the shop. “All these
measures were intended to check
the indiscriminate use of Viagra,
the use of which has been linked
to dangerous side effects,” DCA
Director A Janaki Reddy told
Deccan Chronicle. The stringent
conditions have forced the whole
sale and retail druggists to cut
down on the sale of Viagra to a
. large extent. “In the beginning.
there used to be a big demand for
these brands of Viagra. But now,
it has come down by 80 per cent.
Centre joins States on AIDS
But PM promises no aid; CM meets Sinha
From Our Bureau
New Delhi, May 22: Describing
the AIDS epidemic as a grave chal
lenge, Prime Minister Atal Behari
Vajpayee called on the affected
States to wage a “joint war” against
it including an intensified preven
tion drive, expansion of youth edu
cation programmes and involve
ment of religious groups.
Stating that India had an estimat
ed 3.86 million people infected
with HIV, Vajpayee said recent sur
veys conducted by the national
AIDS control organisation had
shown a high prevalence of over
one per cent in the states of
Maharashtra, Andhra Pradesh,
Karnataka, Tamil Nadu, Manipur
and Nagaland.
“The prevalence level among
sexually transmitted disease clinics
attendees is even higher. This is
truly a cause of serious concern,”
he said addressing a meeting with
Chief Ministers of the six high
prevalence States on HIV/A IDS.
The Prime Minister said India
still had the opportunity to prevent
the AIDS epidemic from becoming
as widespread and devastating as in
africa. “However, this necessitates.
urgent and concerted action by
both the government and the civil
society."
The AIDS epidemic presented a
grave challenge, he said and urged
the six States to intensify preven
tion activities and focus on aware
ness of the young people who are
the most vulnerable.
“These should include pro
grammes for school children, street
children and other young people to
help them adopt a responsible
lifestyle. We should also actively
involve religious establishments
who can have a strong positive
influence over large sections of the
society,” he said.
Meanwhile, Chief Ministers of
Andhra Pradesh, Karnataka and
Kerala on Tuesday held separate
meetings with Finance Minister
Yashwant Sinha to draw the atten
tion of the centre to their fiscal
problems.
According to sources, Andhra
Pradesh
Chief Minister
N
Chandrababu Naidu asked Sinha to
expedite disbursal of funds for the
State to help meet its financial
problems. Kerala Chief Minister A
K Antony asked Sinha to look into
the fiscal challenges of the State
and not to delay the grant of funds
due to his State.
“The economic crisis in Kerala is
such that the Centre has to help the
State,” Antony is reported to have
told Sinha.
Wc hardly get any indent from
our retailers these days,” says
proprietor of Kamalesh Pharma,
which is the wholesale distributor
for Ranbaxy.
According to him. occasional
queries from customers about the
drug continue to trickle in but the
retailers bluntly reject them
unless they furnish a prescription
from an authorised doctor. “We
will be in trouble if we sell them
without prescription. We cannot
even oblige our regular cus
tomers,” he said.
Giri of Sri Sairam Medical Shop.
Punjagutia, said he had stopped
selling Viagra brands way back in
January itself. “The DCA authori
ties told us to stop selling the
drug. And it is not possible to fol
low their conditions strictly,” he
said. Apollo Pharmacy al
Hydcrguda also gets inquiries
regarding Viagra from customers
once in a while, but says a strict
“no” to the drug. Babu of Jyolhi
Medical Hall, Secunderabad, says
he has registered only 20 per cent
sale in the last five months.
Janaki Reddy says the restrictions
on Viagra were imposed by the
Central Drugs Control
Administration, because of its
side-effects. “So far. wc have not
received any complaints about
violation of rules and no irregu
larities have been found during
our raids. Our inquiries say the
consumption of Viagra in the
twin cities is practically nil.” she
satd_
Deccan Chronicle
22 May 2001
Deccan Chronicle
23 May 2001
NYCU - HIV/AIDS || 35
Jihad in Kashmir FAITH SHOWS THE WAY IN UGANDA
Valley against
dreaded AIDS
cases in JOK was around
15,000 in 1998, which Masoodi
Srinagar, May 21: This is a ji- bills as an "alarming figure".
had everybody is cheering on. Parmar adds that since KasIts warriors are health profes- hmiri society is strait-laced
sionals and Imams. Its end. about sex, health workers strthe defeat of the spread ofuggle to approach AIDS in.a
AIDS in Jammu and Kashmir, more direct manner, such as
And its weapons are dry medi- distributing condoms and specalese and the principles of Is- aking openly about safe sex.
lam.
"When faith gets involved,
The ‘holy war’ against AIDS our AIDS prevention message
kicks off in Jammu and Kash- will be much more credible,"
mir next month, steered by says Parmar.
Prof Muneer Masoodi, who It was Masoodi, a devout belteaches social and preventive iever himself, who persuaded
medicine at the Government a group of top Islamic scholMedlcal College Srinagar, and ars and Imams around the ValAshok Parmar, project direc- ley to step in. "We provided
tor of J-K State AIDS Prevent- them the scientific and technion and Control Society. .
ical information about AIDS,
"Since the prevention of its transmission and the
AIDS corresponds almost exa- means of prevention. An eminctly to the sayings of the Prop- ent Ulema (Islamic scholar) of
het and dictates of the Holy the Valley integrated the releQuran, it is easier for Imams, vant Quranic verses, Hadith
Islamic scholars and mubal- (sayings of the Prophet), Sunigs (preachers) to convey the nah (way of the Prophet’s life)
message of AIDS prevention and Ijmah (consensus) with
to the masses," said Prof Mas- scientific facts and developed
oodi.
a book for the Imams," he
Quoting from the Quran, he says.
said the holy book categorlca- After months of groundwlly orders people to avoid adul- ork, the group is finally ready.
tery, which, he says, is one of An IJttmah (congregation) of
the main transmitters of the eminent Ulemas and Imams
HIV virus.
will soon be conducted to sen"Islam strictly prohibits al- sitise them about the killer
most everything that can be a disease.
cause of HIV transmission. A “We hope to involve around
true Muslim has zero risk for 200 Imams. Each district of
AIDS," feels Masoodi. "He the Valley, especially the
does not attract high risk sex- Jamia mosques, will be repr
isal behaviour because he will esented
in
this
first
never be adulterous, never be workshop," says Masoodi.
a homosexual, never' take After a basic discussion on
drugs whether intravenous or the disease, the Imams will be
oral And when science too given the book so that they
warns about the devastating can preach. Parmar has sugimplications of these practi- gcsted leaders of other religices, changes in behaviour are ous groups also take up the
inevitable."
issue. "No religion approves
According to the National sexual behaviour that is resAIDS Control Organisation, ponsible for HIV transmisthe number of HIV positive sion," he said.
By Muzamil Jaleel
In Uganda, at least one in every 10 persons is HIV posit
ive. Muslims form more than 20 per cent of the country’s
population, and in 1992, the Islamic Medical Association
of Uganda (IMAU) started combating AIDS through relig
ion. His Eminence the Mufti, who heads the Ugandan
Muslim Supreme Council, even called for a ‘jihad
against AIDS’ and asked his 33 district religious leaders
(Khads) to co-operate with IMAU.
Established in 1988 by three medicos, IMAU now has
more than 300 members and has involved over 8,000 rel
igious leaders, including Imams and their teams of volu
nteers. Already, they have made repeated home visits to
over 100,000 families in 11 districts across Uganda~ENS
The Indian Express
22 May 2001
The Pioneer
23 May 2001
PM asks affected
States to wage war
against AIDS
Staff Reporter
New Delhi
THE CENTRAL Government has
decided to provide the drug
'nevrapine prophylaxis' free of cost
to women and children at risk to
prevent the transmission of the
AIDS virus from mother to child.
Speaking to newspersons after
the Prime Minister held a meeting
with the chief ministers of the six
states with the highest incidence
of AIDS, Union Health Minister Dr
C P Thakur said that to implement
the programme, each district
would have one counselling and
testing centre.
Also a direct outcome of the
meeting was the Government's de
cision to introduce AIDS education
for school-children and for those
of school-going age but not in
schools. AIDS education will be
provided till the age of 17.
. Earlier in the meeting with the
chief ministers, Prime Minister
Atal Bihari Vajpayee had called on
the affected states to wage a 'joint
war' against AIDS includ ing an in
tensified prevention drive, ex
pansion of youth education pro
grammes and involvement of re
ligious groups.
Stating that India had an estimated'3.86 million people infect
ed with HIV, the PM said that the
recent surveys conducted by the
National Aids. Control Organisation
had shown a high prevalence of
over one per cent in the states of
Maharashtra, Andhra Pradesh,
Karnataka, Tamil Nadu, Manipur
and Nagaland.
'The prevalence level among
sexually transmitted disease clin
ics attendees is even higher. This
is truly a cause of serious con
cern,” he said addressing a meet
ing with the chief ministers of'the
six high prevalence states on
HIV/AIDS.
The Prime Minister said that
India still had the opportunity
to prevent the AIDS epidemic
from becoming as widespread
and devastating as In Africa.
"However, this necessitates
urgent and concerted action by
both the Government and the civ
il society."
The AIDS epidemic presented a
grave challenge, he said and
urged the six states to intensify
prevention activities and focus on
the awareness of the young peo
ple who are the most vulnerable
to this disease.
"These should include pro
grammes for school children,
street children and other young
people'to help them adopt a re
sponsible lifestyle. We should al
so actively involve religious es
tablishments who can have a
strong positive influence over
large sections of the society." he
said.
NYCU - HIV/AIDS
0
Wage war on AIDS, Govt to supply free
drugs to HIV-hit
urges Vajpayee
pregnant women
By Our Special Correspondent
NEW DELHI, may 22. The Prime Min
those infected and their families
continued to be victims of stigma
and discrimination.'Tt is impor
tant to intensify the awareness
drive based on community partic
ipation.
ister, Mr. Atal Behari Vajpayee, to
day called upon the States which
have a high prevalence of HIV/
AIDS cases to go in for a 'Joint
war” against the deadly disease
STD treatment facilities in both
by launching an intensified drive the Government and the private
involving religious groups. The sector need to be strengthened.”
educational programmes should Intensive programmes for indus
also be expanded for the youth as trial workers, dock workers, slum
they were the most vulnerable population and truck drivers
sections, he said.
should be strengthened, he said.
. The challenge posed by the
Referring to the fact that Tamil
AIDS epidemic must be met effec
Nadu has begun to use Ayurveda
tively sinch it has serious implica
and Siddha drugs in the clinical
tions for the future development care of AIDS-infected persons, he
of their States, Mr. Vajpayee, told said "these studies could provide
a meeting of the Chief Ministers us important feedback on the val
of the six high prevalence States ues of Indian system of medicine
on the control and prevention of in fighting the epidemic. These
the disease. India has an estimat remedies can be low-cost alterna
ed 3.86 million affected people. tives to anti-retroviral drugs.”
The recent surveys conducted by
Stating that "certain social
the National AIDS Control Orga
nisation have shown a high prev evils” contributed to the spread of
alence of over one per cent in AIDS in Karnataka, Mr. Vajpayee
Maharashtra, Andhra Pradesh, said, "these need to be countered
Karnataka, Tamil Nadu, Manipur through concerted action by so
cial groups.”
and Nagaland.
"The prevalence level among
In Manipur and Northeast, a
sexually
transmitted
disease majority of the infection occurred
(STD) clinic-attendees is even due to sharing of infected syring
higher. This is truly a cause of se es and needles by drug users and
rious concern.” Fortunately, In "we need to coordinate with the
dia still had the opportunity to drug de-addiction programmes of
prevent the AIDS epidemic from the Centre and the NGOs.”
becoming as widespread and dev
The Hindu
astating as in Africa. What was
23 May 2001
needed was urgent and concerted
action by both the Government
and the civil society, he said.
Dwelling at length on the im
portance of educational pro
grammes, the Prime Minister said
ew Delhi: Prime Minister
these
should
include
pro
Atal Bihari Vajpayee on
grammes for schoolchildren,
Tuesday called upon the
street children and young people
chief ministers of the six most
to help them adopt a responsible
AIDS-affected states of
lifestyle. "We should also actively
maharashtra, Andhra
involve religious establishments
Pradesh, Karnataka, Tamil
who could have a strong positive
Nadu, Manipur and Naga
influence over large sections of
land to intensify prevention.
the society.” Promising all possi
activities and focus on aware
ble help from the Centre, the
ness of young people who are
Prime Minister said, "Our success
the most vulnerable.
in these six States would greatly
The Asian Age
boost both our ability and confi
dence in fighting the menace
23 May 2001
elsewhere in the country."
Mr. Vajpayee regretted that
N
available with National Aids
Control Organisation (NACO).
NEW DELHI. May 22
India has 3.86 million HIV-infected
In an effort to check transmission people.
of Aids-causing HIV from mother
Expressing serious concern
to child, the Centre has decided to over the growing Aids menace. Mr
distribute free of cost anti-A ids Vajpayee told the chief ministers
drug AZT among HIV-infected to intensify prevention activities
pregnant mothers at an annual and focus on the younger genera
cost of Rs 1,600 crore.
tion who are more vulnerable to
The decision has been taken at the dreaded disease. He also sug
a high-level meeting chaired by gested involving religious groups
Prime Minister Atal Behari in anti-Aids campaign since such
Vajpayee at bis Race Course Road establishments have a positive
residence in the morning which influence over a large section of
was attended by Union Health society.
Minister C P Thakur, chief minis KRISHNA’S DEMAND: Giving a
ters of Karnataka, Andhra clarion call to the six states, Mr
Pradesh and Nagaland, and health Vajpayee said that success in these
ministers of Maharashtra, Tamil states would boost India’s ability in
Nadu and Manipur.
fighting the menace elsewhere in
Briefing the newspersons after the country. However. Kamakata
the meeting, Dr Thakur said coun Chief Minister S M Krishna
tries like Thailand and Philippines demanded supply of free medicine
have achieved success by introduc to all HIV patients and more
ing anti-retroviral drug AZT in Central assistance to check the dis
their national health programme. ease in Karnataka.
The rate of mother to child infec
Mr Krishna suggested that a
tion is also very high in most of bold policy decision should be
the states. In Karnataka, for exam taken to supply the anti-HIV drugs
ple, about 1 per cent of babies are free of cost which would help in
bemg oorn with HIV infection.
the long run a reduction in the
After conducting AZT feasibili high cost of anti-HIV drugs.
ty studies in 11 centres, it has been
Mr Vajpayee also underlined
found that a particular drug, the need to remove some of the
Nevarpin Prophylaxis, is better as social evils in Karnataka that help
only one dose, is required for the in proliferating the disease. In par
mother and child, Dr Thakur said. ticular, the migrant labours from
Among .the six states the number the northern districts needed spe
of HIV-infected pregnant women is cial attention as many of them go
maximum in Maharashtra where to Maharashtra and Gujarat in
about 900 women were found to be search of employment, he said.
HIV positive.
However, the entire scheme of
Two other decisions taken at distributing the medicine free of
the meeting are distributing con cost is a voluntary scheme and the
dom freely and launching coun pregnant HIV-infected women
selling centres at all districts have to come state Aids control
across the length and breadth of societies or NACO offices to pro
the country.
cure the medicine, NACO chief J V
The six states that were repre R Prasada Rao said.
sented at the meeting contribute
Deccan Herald
about 76 per cent of the total esti
23
May 2001
mated HIV infections in the coun
try. According to the latest figures
PH News Sec/ica
NYCU - HIV/AIDS
0 37
Drugged by patents
By Vandana Shiva
HE AIDS epidemic has made evi
dent the fact that the cost of health
care and drugs is becoming prohibi
tive in the entire world as a result of
implementing US-style patent regimes.
Currently, there are approximately 32.3
million cases of HIV/AIDS in develop
ing countries. More than 2.5 million peo
ple die each year from the disease.
While a cocktail of drugs has reduced
mortality by 75 per cent over a three-year
period in the US, the treatment is costly.
Annual treatment costs range between
$ 10,000 and $ 15,000. Even if the UNAIDS
initiative subsidised the price by 85 per
cent, the cost would be approximately
$ 2250 per year. And AIDS is only one
among other killer diseases like malaria
and tuberculosis in the third world.
In poor countries, drug prices are
closely connected to exclusive marketing
rights (EMRs) and product patents.
Patents preventing generic drug produc
tion or cheap imports put drugs beyond
MEDICINE WITH FRONTIERS: Indinavir, one of the ingredients of the 'AIDS cocktail*
the reach of the common people in such
countries where GDP per capita ranges
generic drug production supported under Constitution. After the 1970 Act was
from $ 140 to $ 6,190. People with AIDS in
these countries are thus condemned to
its 1997 Patent Law and making this kind
enacted, the number of registered phar
premature death.
of law a model, the US has taken Brazil to
maceutical producers (small, medium
However, with generic drug produc the WTO dispute panel in order to force and large scale) increased from 5,000 to
tion, drug prices of AIDS drugs in third Brazil to undo its patent laws. If US
24,000 with 250 large/medium and 8,000
world countries are, on the average, 82
patent monopolies are globalised through
small-scale units.
per cent lower than prices in the US. The
TRIPs as a result of being allowed to
The production of pharmaceutical
price of treatment also comes down. For
undo Brazil's patent laws, then millions products also grew 48-fold from Rs 250
example, Flucanazole, a drug used to
of AIDS victims in the third world will be crore in 1971 to over Rs 12,068 crore in
treat AIDS, is not patented in Thailand.
denied affordable treatment.
1997-98. In a short period of less than 10
Pfizer was selling the drug for $ 6.20 while
In 1977, the South African government years, exports increased from Rs 228
the Thai manufacturer priced the drug at also passed a law to provide access to crore in 1987-88 to Rs 4,090 crore in 19960.3,297 times cheaper than Pfizer.
affordable medicines by using the provi 97. The multiplicity of producers has
Brazil is a country that has made the
sions of compulsory licensing and paral been possible because the 1970 Act did not
most progress in producing low cost
lel imports. The aim was to reduce the allow product patents in medicine.
AIDS medicines. Brazil provides AIDS
cost of treating HIV/AIDS by 50 to 90 per
This competitive environment and
therapy for $ 192 per month. Starting in
cent With over 4 million AIDS patients,
exclusion of product patents in medicine
1994, the Brazilian government urged
the government action was a public
has created self-reliance in medicines
local companies to start making drugs
health imperative. Yet, all pharmaceuti and kept the prices of medicine within
to treat AIDS. The government invoked
cal giants mobilised to challenge the reach of the common man. Prices of med
‘national emergency' provisions in its
South African law. They later backed
icines in India are in fact much lower
patent laws to start manufacturing low down from a legal confrontation last
than in other countries.
cost anti-retrovirals such as- AZT.
month signalling a victory for the South
Indian medicines are far cheaper than
Brazil makes eight of the 12 drugs used
African government.
even those in industrialised countries and
in the so-called AIDS cocktail. As a result,
Many countries like India have evolved other developing countries like Pakistan
prices have gone down by more than 70
sovereign patent systems which have and Indonesia. This is primarily because
per sent. The availability of cheaper excluded patents on medicine and food many developing countries like Pakistan
drugs has enabled the Brazilian govern in order to prevent “profiteering from
have continued with the colonial 1911
ment to provide anti-retrovirals to more life and death'
.
*
Only process patents on
Patent Act inherited from the British
than 80,000 citizens by the end of 1999,
methods of production of pharmaceuti which has maintained total dependence on
which has led to a more than 50 per cent
cals have been allowed as product patents
imports with no development in indige
drop in AIDS related mortality between
in sectors such as food and medicine
nous capacity for production.
1996 and 1999. This has also allowed
create monopolies, thereby increasing
The executive director of Pharma
Jhe government to save $ 472 million in
prices in the vital areas of health and
Bureau, an association representing
hospitalisations.
nutrition.
multinationals, was quoted in SCRIP
However, instead of applauding Brazil
(August 9,1996) as saying that multina
In India, the 1970 Patent Act was
for its success in fighting AIDS through
tionals will transfer their investments to
shaped by obligations as laid down in the
38
NYCU - HIV/AIDS
Contd..
T
‘Religious groups can spread
AIDS awareness ’
cent of the 3.86 million HIV tain the killer disease which special session on AIDS.
cases in India. "Intensive pro has infected over 1 per cent of Health Minister Thakur, just
New Delhi, May 23: Innovat grammes for industrial work the population in the States. back from a week long stint in
ive AIDS control programmes ers, dock-workers, slum popu He said high risk groups like Geneva for the WHO’s World
may be on the cards if Prime lation and truck drivers sho migrant labourers who go to Health Assembly, will head
Minister AB Vajpayee has his uld be strengthened,” said Vaj- Maharashtra and Gujarat for the AIDS delegation to New
way. Vajpayee met represent payee at the meeting at his employment needed special at York, where he will chair UN
atives of six high AIDS preval Race Course home. "At the tention, "as there were cert AIDS’ Programme Coordinat
ence states and asked them to same
time,
ing Board.
“actively involve religious est we must exp Those who met the Prime Minister included the
In between
ablishments who have a str and
the
chief ministers of Andhra Pradesh, Karnataka the travel, the
ong positive influence over education
Minister plans
and Nagaland. These states, along with Tamil to. begin trials
large sections of society”.. He programmes
Nadu, Maharashtra and Manipur, account for for
also asked the states to incl for
youth,
nevirap
ude AIDS awareness progra both in and
almost 75 per cent of the 3.86 million
ine, used to
mmes in the school curricula out of sch
prevent mothHIV cases in India.
and organise street plays to re ools,”
he
er-to-child tra
ach street children.
said. Also present were ain social evils in this region nsmission of AIDS. "It’s imp
Those who met the Prime Health Minister CP Thakur which contribute to the ossible to give anti-retroviral
Minister included the chief and National AIDS Control spread of HIV”.
to all AIDS patients in the cou
ministers of Andhra Pradesh, Organisation Director JVR
The review comes a month ntry, so we will focus on pre
Karnataka and Nagaland. Th Prasada Rao.
before India sends a nine- venting mother to child trans
ese states, along with Tamil
The Prime Minister was member strong delegation to mission by giving free nevir
Nadu, Maharashtra and Mani keen to discuss innovative str New York to participate in the apine to infected mothers and
pur, account for almost 75 per ategies and steps taken to con- United Nations Assembly’s new-borns,” said Thakur.
Meanwhile, trials for anti
Contd...
retroviral therapy to contain
the Pacific Rim, unless the industry is and dependence on imports as a result of
mother to child transmission
guaranteed fair and reasonable profit. implementation of US-style patent laws
have been completed. "The
Pakistan has also been forced to imple has been repeated in other countries.
Pune-based National AIDS Re
ment the provision of EMRs post the
Patent rights are clearly working
TRIPs agreement.
search Institute (NARI) is pro
against patient rights. The case of AIDS
Earlier, the US had taken India to the drugs also exposes the myth that product
cessing the data from 11
WTO dispute panel to enforce patent patent regimes help in fighting diseases.
centres across the country
monopolies in pharmaceuticals. Besides By preventing the making of low cost
and the results so far have
India and Brazil, the Dominican Repub generic drugs, 24 patents on drugs can
been
promising^’
said
lic, Argentina, Vietnam and Thailand become a cause for the spread of diseases
NACO’s Prasada Rao.' The
have all been threatened by the US under rather than the cure of diseases in the
data should be ready in a mon
its Special 301 laws. Challenging the third world. And patent monopolies pre
th, he said.
might of the WTO, the US government vent low cost medicines from reaching
Welcoming UN Secretary
and pharmaceutical giants, CIPLA, an those who need them the most—the poor.
Indian drug company, announced that it
Since patent monopolies lead to higher
General Kofi Annan's setting
would sell AIDS therapy for $ 350 a year prices, measures for safeguarding the
up of a global fund for AIDS,
or less to Medicines Sans Frontiers, public interest are very necessary. Such
India will now ask for a larger
which will distribute it for free in Africa. measures include compulsory licences;
share of foreign aid for Asia.
In 2000, Glaxo Wellcome threatened to licences of right; automatic lapse; revo
According to UNAIDS, while
sue CIPLA when it tried to sell a generic cations; use and expropriation by the
India has 10 per cent of the
version of a Glaxo anti-AIDS drug combi State; provisions against failure to work
world’s population of with
nation in Ghana. The African Regional or insufficient working; and limitations
HIV/AIDS, it Just gets 1 per
Patent Authority ruled against Glaxo, but on the importation of the patented arti
CIPLA stopped selling the generic drugs. cles and on failure to satisfy national
cent of the global funds to con
Even industrialised nations have been market demand. These measures are nec
tain the disease. "We plan to
severely impacted by changes in patent essary because in their absence private
Change all that,” said Thakur.
laws. In 1994, after the North American gain is at public cost.
The Indian Express
Free Trade Agreement (NAFTA) came
into force, pharmaceutical plants started
This is an edited extractfrom
24 May 2001
to close down in Canada.
Patents: Myths & Reality by Vandana Shiva,
This pattern of closure of domestic
published by Penguin India
industry and manufacturing, capacity
The Hindustan Times
By Sanchita Sharma
23 May 2001
NYCU - HIV/AIDS
39
10per cent of
NACO cooked up AIDS
data, alleges NGO
PH Newsservice
NEW DELHI. May
*
26
Days before departure of Health
Minister Dr C P Thakur for
Geneva where he would chair a
UNAIDS Programme on AIDS to
lobby for a bigger chunk of inter
national aids for AIDS victims, an
NGO has alleged that the govern
ment is trying to create an unnec
essary panic about AIDS and the
situation is not at all alarming.
Alleging that National AIDS
Control Organisation (NACO)
under Health Ministry and
UNAIDS have cooked up all AIDS
related data to create a panic wave
about AIDS in the country which
can facilitate bringing foreign
funds, the NGO - Joint Action
Council Kannur (JACK) - said that
the apex AIDS control organi
sation was misleading the country
After the Geneva tour. Dr
Thakur is scheduled to visit New
York to attend UN's special session
on AIDS and is expected to ask for
xa bigger pie from the $9 billion
global fund mooted by UN
Secretary General Kofi Annan for
fighting AIDS throughout the
world.
Accusing NACO, the convenor
of JACK Purushottaman Mulloli
today told reporters that a careful
scrutiny of NACO figures over a
period of last 15 years has revealed
that the real situation is different
from what NACO was projecting.
The Prime Minister’s meeting
with state representatives of six
high-risk states - Andhra Pradesh,
Karnataka, Maharashtra, Tamil
Nadu. Manipur and Nagaland had evoked a strong response from
Mr Mulloli. Attacking the Prime
Minister's statement in which he
asked the states to wage a war
against AIDS, he said, “somebody
must have misguided Prime
Minister to become a party to the
continued false hype over AIDS
epidemic in India.’’
NACO methodology of data col
lection - both previous sero-surveillance and existing sentinel sur
veillance - has attracted wrath
world’s HIV
cases in India
from the NGO which claimed that
the shift from previous method to
the existing sentinel surveillance
was associated with a reduction in
HIV infection rate from earlier 2.2
per cent to 0.7 per cent. Quoting a
question, which was answered in
the Parliament, Mr Mulloli said
that the number of people died due
to AIDS in 1997, 1998 and 1999 was
287, 217 and 114 respectively. “Can
you call the situation alarming?,”
he asked.
However, refuting the charges
levelled by the NGO. the NACO
chief J V R Prasada Rao said that
the figures given to the Parliament
were only reported case and the
actual might be many times more
than what is being reported. “The
charges made by the JACK is ab
solutely baseless as all doubts have
been explained many times earlier.
Despite clearing the doubts, the
NGO is making the charges time
and again and I don’t know
whether there is any taker for its
arguments. The charges are too
ridiculousjo reply,” he added.
Deccan Herald
27 May 2001
AIDS awareness
drive next month
STATESMAN NEWS SERVICE
Bangalore, May 19: India
accounts for 10 per cent of (he
world’s HIV/Aids cases, with 87
per cent of them falling in the 1544 age group, a lop official has
said on Saturday.
.
The country has four million
Aids/HIV cases as against 40 mil
lion cases reported world-wide,
joint secretary, ministry of youth
affairs and sports R.K. Mishra told
reporters here.
While the percentage of afflic
tion in the under-14 age group was
3.6 per cent, it was 9.4 per cent
among people over 45 years of
age.
Of the total 20,304 Aids cases
reported, males accounted for 77
per cent. Tamil Nadu (9714 cases,
48 per cent) reported the highest
number of cases, followed by
Maharashtra and Karnataka.
Of the 4,41,264 people tested in
Karnataka for HIV, 8595 were
found sero-positive and the num
ber of Aids cases reported up to
March this year was 979, he
added. (UNI)
__________
The Asian Age
20 May 2001
Plan for AIDS meet
NEGOTIATORS, WORKING on a
draft plan of action to be pre
sented in a UN conference on
HIV/AIDS next month, had not
agreed upon several of its key
provisions, leading to difficulties
in preparations for the event.
However, two chief negotiators,
ambassador Penny Wensley of
Australia and ambassador Ibra
Deguene Ka of Senegal, on Fri
day said that they would be able
device a deal on the issue of
financing the plan.
PTI, United Nations,
KOLKATA, May 26. — Family Health Awareness Drive will
be held from 1 to 15 June to promote awareness about sexu
ally transmitted diseases. It’ll be organised by West Bengal
State AIDS Prevention and Control Society.
Health workers will visit homes in rural areas and slums to
check for STD symptoms, provide information about the dis
eases and offer treatment to the affected. The health workers
will also meet high risk groups,.such as prostitutes, in urban
areas.
AIDS Society officials said this was part of a larger cam
paign required to fight AIDS which is spreading alarmingly.
The Society has conducted four rounds of “HIV sentinel sur
The Hindustan Times
veys” between February 1998 and October 2000.
27
May 2001
According to the last report, 1.725 per cent of 1,101 high risk
groups, selected froq^ Kolkata, Cooch Behar, Bankura, Burdwan and South 24-Parganas, tested HIV positive. About 0.39
per cent of1,530 ante-natal care mothers, from Kolkata, Burdwan, North 24-Parganas and North Bengal, tested positive. The Statesman
Officials said the epidemic had to betaekled on war footing. 27 May 2001
40
NYCU - HIV/AIDS 0
Understanding AIDS
David Miller is head of UNAIDS in
India. He says that when 20 years ago
on June 5,1981, thefirst case of
HIV/AIDS was detected by the US
Centerfor Disease Control and Pre
vention, it was described as a ‘strange'
syndrome affecting five patients. To
day, A IDS is the Number One killer in
Africa and till now, nearly 22 million
people have died worldwide ofthis
disease. India's HIV-positive popula
tion numbers 3.86 million. India will
be actively participating in theforth
coming UN General Assembly
Special Session (UNGASS) on
HIV/AIDS in New York. Miller spoke
to Narayani Ganesh about how to
deal humanely with the epidemic:
What has struck you the most about
how we in India deal with
HIV/AIDS?
The extraordinary commitment of
the people working in this field, both
within the government and NACO,
our key partners, and in groups of
people living with HIV, NGOs pro
viding care, support and information,
along with the broader community of
international agencies. I think AIDS
has really seized the attention and
earned the commitment of so many.
• In a country as large and as diverse
as India, it is easy to lose sight of the
magnitude of the problem. In
real terms,.there are just un
der four million people living
with HIV here. That’s a huge
number. The size of the popu
lation infected, the size of the
population affected and the
size of the challenge in reach
ing them all — all of these
things are impressive and are
great cause for concern.
Other countries have a
great deal to learn from suc
cessful Indian models of inter
vention. The intervention happening
with truck drivers and sex workers
here is extraordinary. UNAIDS
wants to make this knowledge avail
able to other areas and countries.
How do you plan to carry successful
Indian models to other countries?
UNAIDS is commissioning a series
of “best practice” case studies that de
scribes models and the processes they
employ. Models don’t have to be per
fect, but it is important that, even at
this stage, key lessons learnt can. be
shared. At a recent meeting with the
CMs of high prevalence states, the
prime minister talked about the need
to intensify prevention participation
in young people and the need to in
volve religious establishments which
exercise immense influence and so
can have a huge impact.
The forthcoming UNGASS is de
signed to engage political leaders to
ensure commitment of sustained ef
forts to respond to HIV. It will bring
regional responses together and act
as a vehicle of advocacy for increas
ing global commitment. Work has to
be directed at the public, community,
How reliable are the tests?
If the first.test is positive, then a
second test is done. If there is any
doubt, a third — a “tie-breaking” test
is done. The tests are how very reli
able. AIDS has taught us in the last 20
years that in order for our interven
tion to work, both on a clinical and
public health level, we must encour
age people with HIV to be our col
leagues in our fight against
HIV/AIDS.
Communication must always be
maintained despite leaps in technolo
gy because HIV is not only a.medical
phenomenon; it is a profoundly social
phenomenon. That’s why working
with those directly affected and the
focus on human rights is important:
The corrosion caused by stigma,
along with a necessary focus on
women and gender, and education
both in schools and among
health professionals, should all be
attended to.
Do you think the output of an HIV
positive employee is likely to be
lower than that ofa non-HIV-positive
employee?
Given the psychological trauma,
fear of non-acceptance, fear of under
performance and knowledge of a
shortened lifespan — I should think
an HIV-positive employee would
only work even harder to
show that they deserve
<<The problem is in
acceptance and support
ensuring that people with
from their employers and
HIV know that they have
colleagues.
Is it right for employers or in
it so that their health can
companies to make
be monitored. For that we surance
an HIV/AIDS detection test
need much larger availmandatory?
| ability ofquality services
Certainly not. There is no
added value in doing so. Test
a for voluntary counselling
ing should be voluntary, not
f and testing (VCT) »
mandatory. In the context of
care and support, we’re cur
other conditions that reduce immune rently developing packages for the
functioning. But this is of course ex workplace that we hope to recom
tremely rare. The evidence is over mend to businesses in India. The
whelming that HTV does, indeed, lead package will have information, rec
ommendations about VCT, coun
to AIDS.
Can one be HIV-positive and yet not selling for employees, attitudes and
experience A IDS?
stigma. We're already using this pack
There have been some cases where age within the UN organisations,
for more than a decade, AIDS has not globally. So are several oil companies.
manifested itself in a HIV-positive banks and others.
person. Evidence suggests that fac
Has UNAIDS helped resolve cases
tors like general health state, nutri
where an individual's dignity has been
tion, psychological state, exercise, etc.
undermined because of being
also play an important role in main
HIV-positive?
taining good health in people with
Yes, indeed. There was a move in
HIV. We have difficulty in determin some countries to publicise the
ing the precise linkages between psy names of HIV-positive people to en- —
chological and immunological health. courage the community not to have—
national and regional levels to have
an impact. Migration, especially eco
nomic migration between countries
and even between states, in a
large country like India necessitates
spreading the message across
borders.
Globally, what is the most common
trauma associated with HIV-positive
persons?
When people are diagnosed with
HIV, it is expected that they will re
spond with great distress and shock.
Where there is no pre- or post-test
counselling, no sufficient support
from family and community, and
where the infected feel marginalised
because of their lifestyle or the com
munity’s fear of HIV/AIDS, the ini
tial shock may turn into depression,
chronic stress and even psychiatric
states and in some rare cases, suicidal
responses. These reactions appear to
occur irrespective of the circum
stances across cultures, across the di
vide of the resource-rich and the re
source-poor, all because HIV is asso
ciated with death and decline.
But isn 't opinion divided on whether
HIV is the only cause ofAIDS?
AIDS stands for acquired immuno-deficiency virus. Some of the
hallmark diseases associated with
HIV could be brought about with
What is the most effective treatment
for HIV?
Some treatments can enhance the
quality of life while others act as pro
phylactics. The problem is in ensuring
that people with HIV know that
they have it so that their health can
be monitored. For that we need
much larger availability of quality
services for voluntary counselling and
testing (VCT).
Talks on funding
battle against
AIDS
united nations, may 22. Diplomats
and officials from more than 100
countries have embarked on
week-long negotiations to finalise
an action programme to combat
AIDS worldwide which includes
norms for spending up to $10 bil
lions a year by 2005 in developing
countries.
The action plan, called ‘Decla
ration of commitment’, will be
adopted by the General Assembly
at a special three-day session
scheduled to begin on June 25.
The draft being finetuned en
dorses the call by the millennium
summit of the Assembly held in
September to reverse and halt the
HIV/AIDS epidemic by 2015 and
sets interim targets which the
member-states are expected to
meet
Diplomats participating in the
discussions said they were grap
pling with a number of complex
issues, including the all important
question of how to fund the battle
against AIDS.
The U.N. Secretary-General,
Mr. Kofi Annan, has called for the
establishment of a global AIDS
and health fund to fight HIV and
other infectious diseases and has
estimated $7 to 10 billions of ad
ditional funding per year would
be needed to tackle the problem.
So far it is not clear whether
that much funds would be avail
able. The U.S. President, Mr. Ge
orge Bush, had promised $200
millions but that is considered ve
ry' inadequate.
The head of the joint U.N. pro
gramme on HIV/AIDS (UNAIDS),
Dr. Peter Piot, told reporters that
the problem of funding was at the
centre of the fight against AIDS.
“The simple truth is that with the
current resources, it is not going
to be possible to contain this.”
Echoing this view, the Ambas
sador of Senegal and co- facilita
tor of the talks, Ibradegu’Ne Ka,
called on the international com
munity to help countries in their
national efforts to mobilise
enough resources to combat the
disease.
The other co-facilitator, Ms.
Penny Wensley of Australia;
stressed the need for both politi
sex with them. We played a proactive
cal engagement and financial re
role in dissuading the authorities con-—
sources.
cemed from doing so. It goes against
“Without these, we will have lit
basic human rights and runs the risk w
tle hope of holding back an epi
of driving epidemics 'underground'
demic that continues to spread,
by creating disincentives for people p CM and to place not just individuals,
to come forward for VCT, care and.E
‘ but communities and entire
treatment. UNAIDS encouragesH" CO countries, at grave risk,” she said.
beneficial disclosure, ethical partner O 2
pti
The Hindu
counselling and appropriate use of«C co
CM
HIV case-reporting.
23 May 2001
41
Try the Cipla therapy
ipla has registered excel
lent growth for 2001 with
38 percent improvement in
top line and 34 per cent increase in
bottomline. The company’s entry
into generic business in a big way
has paid rich dividends. Cipla’s
recent offer for anti-AIDS drugs to
South African countries will
enhance exports. Strong presence
in asthmatic,-antibiotic and cardio
vascular segments will help to
retain leadership position in the
domestic market. Cipla is likely to
emerge as a leading global player
in both anti-AIDS and inhaler seg
ments.
C
DOMESTIC FORMULATION
Cipla occupies third position in
the domestic formulations market
and commands a market share of
4.74 per cent. The company is
growing rapidly at 22.1 per cent
compared to the market growth of
10.1 percent. Ciplacurrently mar
kets 346 products and is the mar
ket leader in the generic segment
with more than 100 products. The
company has strong presence in
anti-asthmatic, antibiotics, cardio
vascular, anti-AIDS and anti-can
cer. It is expected that the compa
ny will maintain leading position
in these segments due to several
fast moving brands and rapid
introduction of new products.
GENERICS BUSINESS
Cipla was the first one to enter the
competitive generics business and
has occupied leadership position
in this segment The company
offers more than 100 different
generic products in all major ther
apeutic categories. This is a 'very
specialised business driven by
retailers, who get better margins
and hence push the generic prod
ucts. Cipla has been able to
achieve 38 per cent growth in top
line in 2001 mainly due to its
thrust on generics.
INHALER SEGMENT
Cipla is the market leader in anti
asthmatic inhaler segment with
over 70 per cent market share.
This segment is growing at more
than 20 per cent per annum, main
ly due to increase in pollution
leading to a spurt in the number of
INTELLIGENT INVESTMENT FOR THE WEEK
BY
K RC
R E S E A ,RCffl
^therapeihic'
g4^T-3CAtEGP,RY;
Silagra
Venlor
Dinox
Duovir
Nevimune
Seroflo
Obestat
Rofixx
Sidenafil
Venlafaxine
Didanosine
Li mi vudi ne+Zjdovudine
Nevirapine
Sal melrol+Fluticasone
Sibutramine
Rofecoxib
asthma cases in patients. One of its
major products, Asthalin inhaler
has annual sales of more than Rs
30 crores and has growth rate of
more than 30per cent. The compa
ny offers full range of inhalers,
rotahalers and spacers that have
gained
excellent
acceptance
among- the asthma patients. The
company has introduced CFCfree,
environment-friendly
Budecort inhalers for the first time
in India. The CFC-free products
have a huge export potential .The
inhaler therapy is preferred to
tablets since the. dose required is
about 1/10 of the oral dose. More
over, the drug directly goes to the
lung and gives instantaneous relief
to the patient. Cipla is putting up a
dedicated facility in Kurkumbh at
a capital outlay of Rs 60 crores for
the manufacture of inhalers.. We
feel that the company will be able
to maintain a leadership position
due to the entire range of inhalers
and with the advantage of
economies of scale.
NICHE MARKET
Cipla has presence in niche seg
ments such as cardiovascular, antiAIDS, anti asthmatic and anti-can
cer. The company has several
products in each of these segments
will help it to offer the entire range
of products. Amlopres-AT and
Trivedon have around 30 per cent
growth rates in the cardiovascular
segment. Asthalin inhaler and
Aerocort are growing at. 30 per
cent and 18 per cent respectively
in the anti-asthmatic segment. The
company is offering a cocktail
therapy for the treatment of AIDS.
ANTI-AIDS
Cipla has a strong presence in the
anti-AIDS segment and is offering
the entire range of products. The
company has reduced the prices of
42
Erectile dysfunction
Anti-depressant
Anti-AIDS
Anti-AIDS
Anti-AIDS
Anti-asmatic
Obesity
NSAIDS
countries. This is very costly and
timc-coftsuming. The company
has chalked out ambitious plans to
increase exports from 25 per cent
to 40 per cent in four years. We
expect the exports to jump further
due to the major supply of anti
*
AIDS drugs to the South African
countries and rapid export of other
products.
EXPORT OF BULK DRUGS
Cipla has plans to export bulk drug
Omeprazole to Andrx corporation,
US. Andrx is one of the largest
manufacturers of generic drugs in
the US and the only company to
have six months exclusive market
ing rights after the expiry of the
Omeprazole patent. We expect
good export.eamings, as the quan
tities involved will be very large.
anti-AIDS drug five limes in the
domestic market through the tech
nological advancements. The
company’s recent offer to supply
the cocktail of drugs consisting of EMERGING AS A LEADING PLAYER
Lamivudine,
Nevirapine
and Cipla is likely to emerge as a lead
Stavudine at $350 per patient per ing global player in the anti-AIDS
year to Medicins Sans Frontieres and inhaler segments. The compa
has given it an international recog ny’s recent offer to MSF to supply
nition. Cipla has ambitious plans the cocktail of anti-AIDS drugs at
to supply anti-AIDS drugs at con $350 per patient per year has been
cessional prices to African coun most appreciated .The company
tries at a fraction of international has extended the same offer to the
price ranging from $5,000 to African countries. This is likely to
$8,000 charged by MNCs. The get a good response. Cipla is also
company manufactures the entire setting up a Rs 60 crores dedicated
range of anti-AIDS drugs namely: facility at Kurkumbh for inhalers.
Lamivudine, Zidovudine, Navi- The company has * commenced
rapine, Didanosine and Stavudine. advertisement for inhalers and
This has given a big boost to the AIDS in the media. We expect that
capabilities of the Indian scientists the company to emerge as a lead
that they can economically manu ing global player in anti-AIDS and
facture these drugs meeting inter inhalers segment.
national specifications. We expect
the company to become a leading GLOBAL ALLIANCES
global supplier of anti-AIDS Cipla has entered into alliances
drugs. This in turn will enhance .with reputed international compa
the export of other products of the nies for marketing its products.
company due to better visibility.
The company as a strategy has not
NEW PRODUCTS
established overseas offices but
Cipla has introduced more than has entered into marketing
100 new products in the generic alliances for cost effectiveness.
segment. The company has also These alliances will help the com
introduced branded products in pany to become a leading global
anti-epilepsy, anti-AIDS, psychia player and will also help to
try, Obesity and NS A IDS seg enhance the exports. The yearly
ments. These products are likely to results of the year 2001 arc in line
contribute significantly in the cur with the expectations. Sales dur
rent year and will help the compa ing 2001 were up-by 38 per cent
ny to improve the market share.
from Rs 759.75 crores to Rs
THRUST ON EXPORTS
1,047.65 crores in the year 2000.
Cipla has given maximum thrust •The operating margin went up
on exports and currently exports to from 19.9 per cent to 20.6 per cent
more than 130 countries. Exports due to lower other expenses.
have jumped by 84 per cent from
The Asian Age
Rs 140 crores in the year 2000 to
Rs 258 crores in the year 2001.
28 May 2001
The company has registered more
than 1,000 products in various
NYCU - HIV/AIDS
0
Reveal the truth
Allegations made by a non government organisation that the
National Aids Control Organisation (NACO) has exaggerated
information regarding the seriousness of the spread of AIDS in
the country calls for an immediate enquiry into the matter. The
NGO, Joint Action Council Kannur (JACK), has alleged that
NACO has painted an alarming picture of the AIDS scenario in
the country, when in fact the situation is really not that serious.
It has pointed out that a close examination of figures provided by
NACO itself indicates that the AIDS situation is far from alarm
ing. There is a fall in the HIV infection rate from 2.2 per cent to
0.7 per cent, the NGO has said, and statistics provided in
Parliament indicate that the number of deaths due to AIDS has
been declining steadily from 287 in 1997 to 217 in 1998 and 114 in
1999. In addition to accusing NACO of misrepresenting facts, the
NGO has also alleged that NACO, which is administered by the
Ministry of Health, has done this in order to secure more funds
from international aid agencies that are working to control the
spread of AIDS. The allegations have made a few days ahead of a
United Nations AIDS conference at Geneva that will be chaired
by Minister of Health, Dr C P Thakur. The minister is expected to
request more funds from global agencies to tackle AIDS in the
country. There is a possibility that the NGO has its facts wrong
and is itself guilty of misrepresenting the real picture. After all
the figures that are being used to prove the argument are not nec
essarily reliable. It is a fact that most cases of HIV and AIDS go
unreported because of the social stigma attached to the illness.
There is therefore a need to act with caution while interpreting
statistics. For some time now, there have been claims and coun
terclaims regarding the seriousness of the AIDS problem in
India. Little has been done to set the record straight and the com
mon man remains in the dark on the matter. An immediate
enquiry into the matter is called for. If the NGO’s allegations are
true then we need to know why NACO chose to distort the truth.
Was this part of a strategy to make people treat the spread of
AIDS very seriously? Or was it, as alleged, a means to secure
more money from, international donors? Either reason is unten
able and points to a deeply flawed strategy that needs to be cor
rected. Getting to the bottom of the real picture is a starting point
and the government must investigate the allegations without
delay. It is unfortunate that the president of NACO has respond
ed to the allegations by simply dismissing them as “too ridicu
lous to reply”. This will not do. The people have the right to know
about a matter that affects them deeply and it is up to the gov
ernment now to throw light on the matter.-
Deccan Herald
29 May 2001
R 51 rtha YV tn
IVCULUCLAJ IV
sition in the Rs 1.2 billion market.
-We have already launched
launch
4- mncp
LdUllVll *
1
HAULS
four
drugsand
- Virolam,
Vlro-Com
Nevipan -Vlro-Z,
in the
anti-AIDS drugs
anti-drugs segment. We will
O
launch another four in the next
Plants may someday
deliver HIV vaccine
ByE.J. MUNDELL
ORLANDO: A spinach packed with HIV suppressing
proteins may be the first step in the use of plants as a
cheap, safe method of delivering AIDS vaccines to
those who need them. “The ideal situation would be a
prescription for a bowl of spinach” that would either
help prevent or treat HIV infection, said lead study au
thor Dr. Alexander Karasev of Thomas Jefferson Uni
versity in Philadelphia, Pennsylvania. He presented his
team’s findings here Tuesday at the annual meeting of
the American Society for Microbiology.
Researchers elsewhere have investigated the idea of
using plants as “factories” to produce and deliver vac
cines, but Karasev’s team is among the first to focus on
HIV. This approach could be of particular benefit in
underdeveloped countries where logistics make vac
cine production and delivery impractical.The Pennsyl
vania researchers focused on “tat”—a protein that
helps HIV reproduce within cells and, at the same,
works to suppress the activity of the human immune
system. For this reason, tat is an ideal target for the de
velopment of both a preventive vaccine and as a treat
ment for those already infected with HIV.
But why use plants to produce and deliver such a
vaccine? “The essential point is that vaccines are a
very expensive business, so anything that can drive the
cost down will be beneficial,” Karasev told Reuters
Health. Vaccines that grow naturally in plants would
be much cheaper to harvest than those produced in
the lab, he said./Reuters;
—-
The Times of India
29 May 2001
1998. According to Ministry of
Health Figures, 30,249 HIV cases
have been reported in Vietnam as
Hanoi: Unicef has decided to pro of March of this year, the organi
sation said. The actual figure may
vide an additional $450,000 to
fight AIDS in Vietnam because of be 10 times higher, health experts
say. Unicef said the $450,000 will
the disease's increasingly rapid
be used in part to fund pro
spread among ordinary people,
the organisation said. While intra grammes aimed at prevention of
venous drug users continue to be aids among adolescents and at
prevention of HIV transmission
the most frequent victims,
from mothers to children. A por
HIV/AIDS is now spreading fast
tion will also be used to encour
from high risk groups into the
general population," Unicef said. age more open discussions about
the disease, the organisation said
It said infection rates for HIV
in a statement.
_ .
among pregnant women in
creased tenfold between 1994 and The Economic Times
Unicef gives $450,000
more to Vietnam
29 May 2001
INDIAN PHARMACEUTICAL major couple of months," said Sajiv
Ranbaxy Laboratories Ltd is set to Kaul, regional director (India and
add by July, four more anti-AIDS Middle East) of Ranbaxy
formulations in its existing portfolio Laboratories. New Delhi/!ANS
of four drugs to strengthen its poThe Pioneer
28 May 2001
NYCU - HIV/AIDS
43
rhe Hindustan Time*
17 February 2001
MAGAZINE
____ ———
44
NYCU - HIV/AIDS
9
like Ken}.around KO per cent of the deleucd a* I ns negative.
Another effort is underseas
*
in
beds cater to only aids patients. “Al the
present rate of disease incidence, India Guiarat for the pa>t fesv years now. 1'wo
THE first case of AIDS in India was report will surpass Africa in another decade," medical colleges in Surat and Jamnagar
ed in 19X6. Today, there are more that warns G Bodeker. chairperson of gifts. have promoted the u>e of traditional
3.7 million patients — equalling that of Maharashtra, Tamil Nadu and the medicine for treating lliv positive peo
South Africa. Yet, the country has not Northeastern states have reported (he ple. This is part of a project being spon
formulated an integrated policy on aids highest number of aids cases. "A rapid sored by the Gujarat government and
treatment. "There have been few rigor research response is the need of (he has involved the traditional practition
ous clinical trials in the country and hour,
**
adds Bodeker. "One has to look ers of the area. Another effort is being
fewer still have been in the field of aids," at traditional medicine for a parallel made at the Tambaram Sanatorium in
says Q B Saxena of the Indian Council approach to aids cure, but the awareness Chennai,
*
where (he ancient Siddha sys
for Medical Research, New Delhi. is still missing." added Shailaja tem oPmedicinc is being used to treat
Keeping this in mind, a conference svas ‘Chandra, secretary, department of aids patients. "But there is a long way
held in New Delhi recently to highlight Indian systems of medicine and health, before traditional medicines get due
the traditional cures from different parts
Traditional medicine is showing recognition,"
says
Ranjit
Roy
of India to combat the deadly HIV virus, some results. A success story has been Chaudhury, president of dsprud. While
Organised by the Delhi Society for registered by S Rohaigi in Kanpur, a lhc number of patients increase by the
the Promotion ol Rational Use of Drugs practitioner who has been trying tn treat day, some questions need to be
(dsprud) and the UK-based Global patients suffering from Alt's, luberculo- answered. Rigorous clinical (rials have
Initiative for Traditional Systems of si$ Jnd polio through traditional medi- to be carried out, a dosage decided and
1 lealth (gifts). the conference sought to cjnc, Qne of his patients, a se\cn-month quality control ensured, feel experts. ■
“serve as a forum to share experiences pregnant woman was put on
DOWfl to Earth
and efforts being made to combat the immunopotentiators — drugs that
15 J3nU3fV 2001
disease through alternate medicines."
enhance immunity — as soon as she was
J
Though Africa Millers the maximum detected as illy positive. The infant was
burden ot the disease, it was felt that the
mv positive anti was pul on the
disease could soon assume alarming immunopotentiators immediately after
pnportions in India, too. In countries, |<irth. After three months, the child was
Growing killer
to manufacture generic HIX' aid agencies tiiat die trade rules die World Trade Organisation’s
drugs at low cost. The United administered by the Worid Trade trade rules to make it easier for
States lias complained to the Otganisation
arc
hindering poor countries to manufacture
Worid Trade Organisation tiiat access to essential medicines in low cost drugs. Justin Forsyth.
tins requirement for local produc die developing world. Although Oxfam’s director of policy, said.
tion discriminates against tiie US the rules allow poor countries to “The World Trade Organisation
pharmaceutical industry.
produce their own generic drugs, must change the rules tiiat the
Bernard Pdcoul, director of these countries’ attempts to do so drug industry is now using to
tiie Mddecins Sans Frontiferes’ liave often been met by US cripple cheap, local competition,
Gavin Yainey HMJ
Access to Essential Medicines threats of_ trade
__________
,__
sanctions (BMJ
which in turn is inflating tiie cost
campaign, said: “"Ilie lives of 2000320:207) or legal challenges of new and patented medicines."
In a move tiiat could start an
International health agencies hundreds ol thousands ol by phannaceutical companies.
jn a case that goes to court international price war on HIV
have condemned the US gov patients depend on this system
ernment for threatening the [in Brazil). Ihe US action will on 5 March, a coalition of 40 dings, an Indian genetic drugs
Brazilian policy of providing also intimidate countries which drug companies is suing the manufacturer,
Cipla,
lias
free dings to patients infected would like to take up Brazil s South African government—with announced tiiat it will sell triple
offer to help them produce Kelson Mandela named as a combination HI\’ therapy to
with HIV.
defendant-for manufacturing Medecins sans Frontifcres for $350
'Hie US government has initi AIDS medicines."
Brazils hc.ilili ministry esli- generic HIV drugs.
ated lcg.il proceedings against
a year per patient The cost to
Brazil, through tiie Worid Trade mates that the number of deaths
“Limiting generic manufac governments will be $600 a year
Organisation’s dispute settlement from AIDS has halved since it turing capacity is in the interests per patient. Five major drug com
body, claiming tiiat Biazil's pro started distributing free HIV of tiie pharmaceutical industry," panies promised last year to cut
duction of generic HIV drugs drugs. A ministry spokesperson said Ellen *t Hoen of Mddecins tiie costs of its HIV drugs in die
breaks international laws on said, “'lliis policy has resulted in Sans Frontifcres. “A” ' die US,by developing
world
(BMJ
a significant improvement in the its trade threats. .
iding out 2000320:1357), but their prices
patent protection.
Brazilian laws provide patent quality of life of people living tiie message, 'don't mess with our are still three times those offered
protection to foreign drug com with HIV and AIDS, as well sav phannaceutical companies.' ”
by Cipla.
Oxfam launched its own
panies if they manufacture their ings to the Brazilian government
product in Brazil. These laws have amounting to S422m (£281 m)." campaign (Cut the Cost) this Oxfam's Cut die Cost campaign ~ is
Concern is growing among week, which calls for a change in at www.oxfom.org.uk/cuithccos't
allowed local Brazilian companies
US trade action
threatens
Brazilian AIDS
programme
British Medical Journal
17 February 2001
NYCU - HIV/AIDS
45
HIV infections
hit a record
high in United
Kingdom
San Francisco’s
HIV infection
rate doubles
Gavin Yamey BMJ
Giles Kent London
’Ihe annual rate of new HIV
infections in men who have sex
with men in San Francisco has
doubled over the past four years.
from 1.04% in 1997 to 2.2% in
21X11.
Illis rise lias alarmed *epi
dcmiologists because die inci
*
dence of HIV infection in the
city’s gay community had been
stable from 1992 io 1996. Willi
McFarland, diief of die San
Francisco
seroepidemiology
unit, told die BMJ: "The weight
of evidence now suggests that
this is a rebound epidemic.”
The doubling in incidence
reflects a significant increase in
the proportion of men having
unprotected anal intercourse.
Tliis proportion has gone up in all
groups of men who have sex widi
men, regardless of age, ethnic
group, or intravenous drug use.
The proportion of men who
never have sex without a con
dom has fallen, and the propor
tion having multiple partners
has risen.
Tlie city’s public health offi
cials had hoped that the new
antiretroviral therapies, which
were launched in die mid-1990s,
might suppress HIV transmis
sion and even extinguish the
Paul Torello, 36, sells sex on die streets of San Francisco for money
for drugs. He tells his clients that he is HIX' positive but many are
still happy to have unprotected sex
epidemic. Instead, believes Dr
McFarland, die advent of these
dnigs may have led to die rising
incidence.
"The pool of|x>tcntially infec
tious people rose,” he said,
“because they were living
longer from combination thera
py. Because they were living
longer and healthier lives, they
became more likely to have
unprotected sex.
Also, some
men were optimistic that [Highly
active antiretroviral therapy] was
a cure or dial it could be used
for post-exposure prophylaxis,
so diey were less likely to protect
themselves.”
Dr McFarland believes dial
activist groups in San Francisco
who have challenged whether
HIV causes AIDS may also have
encouraged some men to aban
don safe sex (BMJ 2000
*321:
772). “Anything that feeds denial
of the disease,” he said, “can
have a negative impact on
behaviour."
The San Francisco Depart
ment of Public Health and the
AIDS Research Institute at die
University of California in San
Francisco have responded to the
new incidence figures with an
“11 point action plan,” which re
emphasises prevention.
British Medical Journal
03 February 2001
'Hie number of people who
acquired HIV in die United
Kingdom last year is die highest
for any year since 1985. and it
will probably exceed die num
ber for dial year too. a report
from die Public Health Lilxira
*
lory Service has said. Tlie num
ber of cases reported so
far—2868 (compared with 3222
in 1985)—is set to increase as
more reports of HIV diagnoses
continue to come in.
For the second year run
ning, more new infections were
acquired through heterosexual
sex than through homosexual
sex—1315 compared with 1096.
“We cannot afford to be com
placent about safer sex," said
Barry Evans, head of the HIV
division of die laboratory service.
People were coming forward for
testing who had been infected
several years ago, but diere had
been increases in odier sexually
transmitted diseases, such as
gonorrhoea, which showed dial
people were putting diem selves
at risk of contracting HIV
Tlie number of new cases in
2000 was 7% higher than in
1999.
Scientists isolate
HIV blocker in
placenta
blastocyst implantation, but its die infection. Tlie level of
potential for inhibiting HIV' has leukaemia inhibitor)' factor was
not been discovered before now, significantly higher in die
said Dr Bruce Patterson from placentas of women who did not
the Children’s Memorial Hospi transmit die vims to tiieir babies
Scientists have isolated a power tal in Chicago, Illinois. ;uid asso than in women whose infants
(Journal
of (finical contracted die infection, the
ful blocker of HIV that is pro ciates
*87-94).
study found.
duced in die placenta and may Invesfigation 2001; 107:2
Tlie researchers looked at Scott Gottlieb New York
one day be used to prevent
mother to child transmission of levels of leukaemia inhibitory British Medical Journal
factor in the placentas of HIV
the virus.
17 March 2001
Scientists have known that positive women who had trans
mitted
die
virus
to
tiieir
infants
the molecule, called leukaemia
inhibitory factor, has a key role and of other HIV jxisitive
in maintainingpregnancy and in women who did not pass on
46
.
British Medical Journal
03 February 2001
NYCU - HIV/AIDS
blood samples in the year 2000.
1 in 4 pregnant
The equivalent figures for 1998
and 1999 were 22.8% and 22.4%
women in South
respectively.
Africa has HIV__ The government’s claim that
The South African government
has released its annual figures
on HIV and AIDS, which show
a continued increase in the
numbers of people contracting
the vims. About 4.7 million
South Africans currently have
the virus, compared with 4.2
million in 1999.
the rate of increase in the dis
ease was slowing prompted
questioning from several experts
in the field. The controversy has
arisen from the 1998 figure.
which experts believe was as an
overestimate.
Several provinces showed a
substantial rise in prevalence.
~uch as Kwa-Zulu Natal, which
howed a rate among pregnant
/omen of 36.2%, compared
nth 32.5% in the previous year.
The most worrying increase
/as among young women in
heir late 20s, who showed a
irevalence rate of 30.6%. The
iirvey's authors noted that this
jroup of women has consistenty shown the highest rates of
ncrease over the years.
Women aged under 20
howed a much lower prevaence rate (16.1%).
*at SidleyJohannesburg
A baby with HIV looks out of
her cot in Johannesburg
British Medical Journal
31 March 2001
Some 24.5% of pregnant
women were infected with HIV,
according to a survey of 16 548
In brief
1980s. The study, from die US
Centers for Disease Control and
Prevention (CDC).in Atlanta.
Georgia, found tliat half of all
Americans with AIDS can
adults and adolescents whose
expect to live longer: A new
study finds dun Americans whose AIDS was diagnosed in 1995
could expect to survive for 46
AIDS is diagnosed now can
*ct
cx|K
to live nr.nly three years months or more, compared with
11 months for those in 1984
longer than |xuicnis whose
illness was diagnosed in the mid2001:285:1308-15).
International
eflfort to find AIDS
vaccine for India
India’s health ministry and the
International AIDS Vaccine Ini
tiative have signed an agreement
to accelerate efforts to develop
and test an AIDS vaccine against
HIV subtype C, the predomi
nant strain in India.
Under the agreement, the
inidative—which was set up in
1996 with money from UNAIDS
(the joint United Nations pro
gramme on HIV and AIDS),
individual governments, and
private foundations—will invest
several million dollars in the
development of an AIDS vac
cine in India. It will be similar to
the modified vaccinia Ankara
vaccine against HTV designed by
researchers at the Medic.il
Research
Council’s
human
immunology unit in Oxford, but
appropriate for use in India.
"Essentially, the International
AIDS Vaccine Initiative will facil
itate the transfer of technology
so India can acquire a vaccine
based on the modified vaccinia
Ankara vector," Dr J V Prasada
Rao, director of the National
AIDS Control Organisation hi
India told the BMJ.
The initiative will fund the
US company Therion Biologies
in Cambridge, Massachusetts, to
design a recombinant vaccine
based on the modified vaccinia
Ankara vector and containing
gene sequences cloned by
Indian scientists from HIV sub
type C in India.
Canapali Mudur New Delhi
British Medical Journal
31 March 2001
British Medical Journal
24 March 2001
NYCU - HIV/AIDS
0 47
Drug company to sell AIDS drugs
at less than cost price
Scott Gottlieb Arm
* York
Bristol-Myers Squibb has raised
the stakes in an dibit to cut (he
prices of drugs to treat AIDS in
Africa by announcing that it will
sell two antiretroviral drugs in
combination for S1 (66p) a day.
just below the cost price. It is the
first lime that any ding manufac
turer has made such a proposal.
Hie move came a week after
rival pharmaceutical company
Merck unveiled its own round of
new price cuts, and it is further
evidence that die drug industry is
bowing to international pressure
to increase supplies of cheap
medicines (17 March, p 635).
Bristol-Myers
said
that
didanosine (ddl), which is sold
as Videx. and stavudine (d4T),
which is sold as Zerit, would be
made available at 85 cents and
15 cents a day respectively under
a programme backed by the
United Nations. So far the com
pany has struck supply agree
ments with Senegal. Uganda.
Rwanda. and the C.6tc d’Ivoire.
In the United States, by contrast.
one day’s dose of the two dings
costs SIS, according to BristolMyers.
Ollicials at Bristol-Myers also
said that the company will not
use its patent on stavudine in
South Africa to bltxk that coun
try’s efforts to buy less expensive
versions of die drug from gener
ic manufacturers in India. Bris
tol-Myers acknowledged dial it
has almost no patent protection
for its AIDS dnigs in sub-Saha
ran Africa. It claims a patent for
stavudine only in South Africa,
and it now has no patent for
didanosine in any sub-Saharan
country.
Tliis means that any nation
or medical centre in die region
could legally buy generic copies
of diose drugs if it chose to do
so. The company is hoping diat,
at the lower prices, manufactur
ers of the generic drugs will not
have an incentive tc» Ixxnlcg the
comjxmy’s medications.
"Our goal here is to energise
a grouiKlswell of action that
needs to be undertaken if we arc
going to do any g<x»d in lighting
di’is terrible problem in Africa.”
said John McGoldrick. executive
vice president of Bristol-Myers.
‘This is groundbreaking.”
said Kate Kraus, a member of
Act-Up, a group that has led
protests around the world
against die big drug manufactur
ers. "’Ihis is die fnst time that a
US ding company has acknowl
edged that generic dings are the
key to saving lives.”
Britain’s GlaxoSmithKline,
die world’s largest supplier of
drugs for HIV and AIDS,
pledged last month to widen its
own access initiative by supply
ing drugs to a range of non
profitmaking organisations at
discounts of more dian
But even at die newly
reduced prices, doctors say that
the dnig therapy might remain
far beyond the economic reach
of most in Africa. Stavudine and
didanosine must still be com
bined with a third drug to com
plete die AIDS regimen.
C
British Medical Journal
24 March 2001
AIDS: S-G Welcomes Withdrawal of Case Against South Africa
Welcoming the withdrawal of a
case by pharmaceutical companies
against the Government of South
Africa. United Nations SecretaryGeneral Kofi Annan on 19 April
expressed hope that this development
would help increase access to AIDS
medicines for those in need.
The South African case, which
was withdrawn by 39 pharmaceutical
companies
and
associations,
challenged
provisions
of the
Medicines and Related Substances
Control Amendment Act of 1997.
The Act aimed to operationalize key
elements of the National Drug Policy,
including generic substitution.
grcllcr competition in public drug
potential bcnc.iis beyond South
procurement, improved drug quality.
and more ration'll use of medicines.
according
to
the
Joint
UN
Programme on HIV/AIDS. which
welcomed the resolution.
African borders, saying he hoped the
In a statement released by his
spokesman, Mr. ?\nnan voiced
expectation that the amicable
settlement could “result in medicines
to treat HIV/AIDS and other diseases
becoming much
more
widely
available in South Africa, al prices
that those who need them can
afford."
care
Mr. Annan also looked to the
amicable scllh men! of the case
“presages a new era of cooperation
between governments and the private
sector in the struggle for belter health
.
*
ihroughoc
(he
developing
world."
The Secret.:ry-General paid
tribute to those who helped facilitate
the resolution of the matter, saying,
“the credit for this positive outcome
goes lo the wisdom and perseverance
of the parlies concerned. and lo the
constructive intervention of President
Thabo Mbeki." ■
UN News Letter
01 April 2001
48
NYCU - HIV/AIDS
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