As another world AIDS day passes by and the epidemic shows no sign of end, we need to evaluate the status of AIDS in India. Our country is one of the hotspot of acquired immunodeficiency syndrome (AIDS), an incurable syndrome that eventually befalls on large fraction of human immunodeficiency virus (HIV) positive individuals. While globally the number of AIDS patients has started to stabilize but epidemic is nowhere close to being over. This global epidemic has already turned out to be a major killer of humankind on an epic scale comparable to black death and smallpox. As per the latest estimates by UNAIDS, it is the fourth leading cause of death. In India, the state of affairs is so unsatisfactory that we still have frequent cases of mass infection of poor patients due to the negligence of hospitals, horrible mistreatment of HIV positive individuals and lack of even basic care for millions of AIDS patients. While the problems of AIDS in India are manifold and would require efforts from all the sectors of Indian society, in this article we want to bring forward key failures of the Indian government. We focus on five core issues that require immediate attention, if we wish to see the tail of this AIDS epidemic:
Demographic and epidemiological understanding
Screening and counselling
Treatment facilities and medicines
Need to develop indigenous cures
Demographic and epidemiological understanding: In India, it is difficult to trust the total number of AIDS patients, as grossly contradicting government figures makes one wonder if the actual magnitude of the epidemic is even larger than what is currently reported. The latest estimates released by the National AIDS Control Organization (NACO), an organization run under the auspices of the ministry of health, indicates that national adult HIV prevalence in India is approximately 0.29%, which corresponds to an estimated 3.4 million plus people living with HIV in our country (Annual report NACO 2009-2010). In contrast in 2005, NACO reported 5.21 millions HIV positive individuals. One can only wonder if such a change in the figures is an effort to put lipstick on the pig or there was a fundamental error in one of the two estimates. There has been some beating around the bush, blame laying and unsatisfactory explanations in response to this contradiction but if there was a genuine error then what is conclusively being done to avoid future errors, is currently not clearly known. Apart from getting the right overall numbers, what is also needed, is detailed demographic and epidemiological data. Different strains of HIV are prevalent in the different parts of the world and progression of AIDS is also different in people of different genetic background, for example there is a very small fraction of people that innately do not contract AIDS. Such trends of immunity to AIDS are either absent or currently not known in the Indian population. It is rather appalling that in India, the land that holds genetic diversity next to the continent of Africa, we for some silly reasons have been using data solely from the White Caucasian populations. This over dependency on western data is wrong for three reasons: 1) The strains of HIV prevalent in different regions are different, 2) The genetic diversity of India makes comparison to one ethnic group meaningless and 3) Apart from the Anglo-Indians with significant European heritage, no ethnic group in India, whatever be their surname and notions of self identity, share that close of genetic identity with the European populations to justify the current usage. What is needed is to understand the spread of different strains of HIV in India and the progression of diseases in individuals with a different genetic background.
Awareness: The first case of AIDS in India was diagnosed way back in 1986. Subsequently some apparent movement of bureaucratic and political machinery took place that in the following year resulted in the formation of National AIDS control program (NACP). In reality, the understanding of Indian government and media on the danger of this disease was largely missing until recently and is still rather poor. Even till late nineties, it was not entirely uncommon to hear voices in the Indian media claiming that AIDS is likely a trouble of promiscuous foreign lands and not of a conservative India. The media and the government forgot that this land of billion plus is first the land of Kamasutra and then of Gandhian moral curtains. Such ethnic biases that come wrapped in moral judgments cost lives everywhere. Even in the United States, initially AIDS was largely thought to be a disease of homosexuals and Afro-Americans, a curse of God for the decadent. In India, the lackadaisical approach in dealing with AIDS was also due to undermining the spread of HIV through blood transfusion and not realizing the severity of needle sharing by drug addicts and poor hospital administrative/clinical measures. As an addition to the existing policy, firstly the government needs to be aware of the full cost of AIDS and then it needs to take action to better inform the health care professionals and public at large. Media also adds to the trouble by rarely looking beyond less glamorous issues than some odd cricketing century of Tendulkar or birth of Bachchan granddaughter, occasionally mentioning somewhat sensational denial of basic services to HIV positive individuals or some innocent people being infected at a mass scale, instead of serious discussion of issues. Serious discussions, even when managing to creep in from the nooks and crannies of the sensational mainstream news, fails to gather attention beyond one media cycle.
Screening and counselling: Roughly 85% of new infections are via the heterosexual route and efforts towards premarital counselling for HIV can reduce half to three fourth of this spread. In Goa and Andhra, the high prevalence states, the state governments proposed bills in 2006 to make HIV testing compulsory before marriage, but ethical concerns and political issues have thus far stopped the actual implementation. This issue of mandatory testing poses a real ethical concern as on one hand we do not have any patient confidentiality where people are denied their due rights due to their HIV status and on the other hand, who can justify the infection to innocent spouses, mostly females via their less than faithful counterparts? One needs to evolve a system where an employer and an insurer, cannot know the HIV status of the patient but a spouse can. It is not going to an easy nut to crack for any government, leave alone Indian, but the administration has not even started inching in the right direction of evolving such a mechanism.
Treatment facilities and medicines: National AIDS control program (NACP-III, 2007-2012) of India has a total budget of about 2.6 billion dollars but only a minor fraction of it is for the treatment. This is unacceptably low amount of money being spent on treatment, especially the amount that finally trickles down the bureaucratic apparatus. One may wonder what do we mean by treatment of an incurable syndrome? The progression of HIV positive individuals to AIDS is very different. Once patient contracts full blown AIDS his/her survival can vary from months to decades. This survival, apart from patient to patient variability, depends on the availability of antiviral drugs and treatment facilities. It is possible that India may have lost much of its potential to produce generic and cheap anti-retroviral relief due to twists in the international politics and India’s easy compliance with pressures. It is possible that recent aid to African countries to counter AIDS, has likely come with strings attached as they have almost stopped use of cheaper generic anti-retroviral drugs. Indian anti-retroviral drugs that were much cheaper than Western products have not just lost a market in Africa but their share in India is also tapering. We would recommend evolution of an informed policy that considers efficacy and costs of all compounds with the goal to save as many lives as possible.
Need to develop indigenous cures: Let us focus on vaccines, a preventative approach that actually holds a long-term cure of AIDS. While there have been some sporadic islands of successes in the ocean of failure in finding vaccine for AIDS, the international efforts are finding new promises and ruling out failed ideas with every passing day. We wonder why not a single significant effort worthy of mention is being pioneered in India? Given that we as Indians have become comfortably numb to the thought of India as a second or third grade country that is a recipient of high-end technology and fruits of scientific research, an average Indian, even if bluntly reminded of the state of affairs, howsoever offended, will not break sweat for long about the lack of innovation. The concern is far graver than the lack of innovation and the lack of national pride. If we need vaccine for AIDS, as soon as it is available in the West, unlike the case with polio or smallpox, we cannot take our begging bowl to world as we did in early years after independence or grossly overpay our way out, as we frequently do to procure any technology, ranging from our medicines to our warplanes. The problem with HIV vaccine stems from to the issues of demographics and epidemiology. Different strains of HIV are prevalent in different parts of the globe. HIV is very diverse, in fact some strains only show 40% homology between each other, not that different of genetic homology between you and a banana and in fact less than you and an earthworm. Thus to combat a hyper-mutable virus one needs to work on local strain and keep local population genetic profile and overall epidemiology in mind to solve the AIDS epidemic in India.
Will India rise to the challenge novel anti-retrovirals and indigenous vaccine? Likely not. Even in the well developed sectors like information technology, India only delivers small software packages for foreign products and does not manufacture a single major internationally recognizable product. This is not due to dearth of scientists or of money. In fact, India has very high numbers of biomedical scientists and research institutions spread across the country for the size of its economy. The problem is of incompetence, lack of management, corruption and nepotism. The political infestation of research is palpable in Delhi where corruption and lack of accountability permeates all levels of research epithet. One need not go into the obvious appointment of unqualified vice chancellors and administrators of universities and directors of research institutes based on proximity to political parties in power. A look at say, the University of Delhi University, a supposed prime University of India, can give you an idea of the political stooges running the show of research in India. Apart from corrupt management, there exist a large number of the so-called scientists who do not have a single major internationally known finding to their name but are busy sliding papers in “friendly” obscure journals and frequently get awarded national and regional honours. This abysmal state of affairs keeps very successful and patriotic scientists out of this Indian swamp that is sure to kill any good science.
In summary, current government efforts are either missing or misplaced and are largely wrought with corruption and inefficiency. A significant blow can be landed to AIDS epidemic with effective government policies. We hope that this article along with many other efforts raises awareness of public and its representatives for better combating the scourge of AIDS.
The Major Players In The Vaping Game
Vaping is big business, with health officials all over the world encouraging smokers to put down their cigarettes in favour of e-cigs. Vaping is commonly marketed as a healthier alternative to smoking, so you may think that major tobacco companies are threatened by the ever-growing popularity of e-cigarettes. This would make sense unless you did a little digging online and discovered that many of the vaping game’s major players are actually leading tobacco companies. Research suggests that some of the best-selling vaping brands, including Blu and 10 Motives are owned by tobacco companies, many of which belong to the market monopolists, Big Tobacco. This infographic provides information about the parent companies that are profiting from vaping, and as you can see, some of the tobacco giants are heavily involved. Although 80 percent of brands were found to belong to independent firms, nine of the best-selling vaping brands belong to companies or subsidiaries of Big Tobacco (British American Tobacco, Japan Tobacco International, Imperial Brands plc and Philip Morris International), Huabao International Holdings and Stada Arzneimittel. Five brands belonged to parent companies that were not associated with tobacco. It’s often assumed that buying e-cigarettes takes money out of the pockets of tobacco giants, but this infographic raises an interesting point. With the market buoyant, it looks as though many of the major players in the tobacco game are also set to profit from e-cig sales. With this useful infographic, you can learn more about who is playing and winning and vaping game.
Infographic design by Go Smoke Free
The future of medicine: nanobots
The advances in technology have managed to change the world and the way we live today, and the studies and research in the field of medicine and technology with the use of nanobots represents a new field that opens the future to treatments that can extend, by far, the life expectancy of humans. The use of nanotechnology in the medicinal field has been put to practice for a few years now, with many pharmaceutical and medicinal labs using nanofibers and electrospinning equipment to introduce new techniques in the development of medicinal advances.
Scientists and researchers at the University of Cambridge are working to bring medicine to a new stage, that is, to bring the benefits of technological advancement to the patient with the use of Nanobots, which “navigate” our body and can even repair internal damage, prevent organ malfunction and serve as patches to stabilize our cellular function.
Nanotechnology brings together sciences such as physics, biology, chemistry, engineering and social sciences to understand, manipulate and exploit the physical characteristics of matter at the nanoscale.
The use of nanotechnology with which Cambridge scientists currently work represents a 50-year breakthrough in the field of medicine, which will enable us to live longer and have more effective treatments in the near future, for example, to destroy cancerous immune cells through nanotechnology or nanobots.
According to the progress made by the Cambridge Academy of Therapeutic Sciences, nanobots patrol our body to detect serious damage and repair small heart attacks, and leave no evidence of the event, or develop and use biological scissors, which are capable of cutting or deleting defective genes.
Following the new opening of the new academy of the Cambridge Academy of Therapeutic Sciences, it is being achieved that these advances of science and technology applied to medicine, and supported by the research of teachers and doctors, are being directed to a new form of treatments “Of the future”, in the present, and in a way to achieve to change the quality of life of human beings.
Dealing With The More Sensitive Side To Health Issues
It’s an unfortunate fact of life, but we can all find ourselves under the weather from time to time. Sometimes these illnesses can’t be helped, and there nothing too serious at all. But sometimes, you can also find yourself dealing with some more serious illness, some that even come with sensitivities. And then, you can find yourself faced with an entirely different kettle of fish. So what are you supposed to do? If you’ve never dealt with a lot of illness in life, then you may need a bit of advice. Read on for information on how to deal with sensitive illness issues.
Being sick is one thing, being able to avoid it is another. It’s tough to be able to fall ill and know that you may not have had to suffer in the first place. This can often be the case when your job causes your health issues. But, it’s important that you speak up. Even if you may not feel like you can, it’s important that you raise the issue with your employer. Speaking up can often seem scary, especially if you feel like you don’t want to make a fuss. But, you need to make it known that you’ve been made ill, take action, and find a solution if you can.
Then, you may want to think about protecting your health too. When you’re self-employed, own your own business, or aren’t covered for sickness at work, you may suffer should you fall ill and not be able to work. This is where critical illness cover comes in. It’s easy to think that this is something that the financial services industry wants to sell you. But, should you be ill for a long time and be unable to work, the payments would be a blessed release.
Treatment is something that we all need for healthcare issues. But sometimes, your treatment options aren’t as traditional as others. And that can make you a little self-conscious about seeking help. This is particularly the case when you’re suffering from a mental illness. The stigma around mental health can make talking to someone feel shameful. But that’s not the case. You should do some research into different doctors to find a professional that you’ll be comfortable speaking to. Because seeking help and getting treatment is the most important thing.
At the same time, you may also want to get support with health and illness related issues when you’re struggling to cope alone. Many professionals can help here. From a wrongful death lawyer to a home healthcare nurse, depending on your circumstances. Sometimes, the issue might be sensitive, but if getting support makes things better, do it.
Dealing With Grief
And finally, if you find yourself at the end of a healthcare journey, particularly with a loved one, you may be suffering deeply with grief. It can be an awful experience to have to go through. But the important thing is that you do something about coping with grief so that you can continue on with the rest of your life in the best way possible.
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