HIV AIDS: Where government has gone wrong, What government can do
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.
10 Tips for Starting Your Own Architectural Firm
Are you an architect with a dream of starting your own firm? If so, you’re in luck! Starting your own architectural firm can be a very rewarding experience. However, it’s not without its challenges. This blog post will discuss tips for starting your own architectural firm. With these tips, you’ll be well on your way to launching a successful business!
1) Identify Your Niche:
You’ll need to identify the type of architecture you want to specialize in before getting started. This could be anything from residential homes, commercial buildings, public spaces, or any other niche within the architectural field.
2) Build a Network:
As an architect, your network can make or break your business. Make sure to establish relationships with clients and potential partners as soon as you can. Joining local networking groups and attending events can help you build valuable connections.
3) Secure Funding:
If you don’t have enough capital to get started, consider applying for grants or loans from government agencies or investors. Having some capital behind you will give you more freedom to pursue projects that align with your goals and vision for your firm.
4) Develop a Business Plan
A successful business requires a plan. Your plan should include your vision for the firm, as well as strategies for marketing and managing finances. Having a clear roadmap to follow will make it easier to stay on track and reach your goals.
5) Protect Yourself Legally
It’s important to protect yourself legally when starting an architectural firm. Make sure you understand all of the relevant laws in your area, including licensing requirements and zoning regulations. You’ll also need liability insurance in case something goes wrong with one of your projects.
6) Invest in Technology
In order to keep up with the competition, you’ll need to invest in modern technology and tools. This could include anything from computer-aided design (CAD) software to a paper folding machine. Investing in the right technology can help you streamline processes, save time, and create a better final product.
Marketing is key to the success of any business. Make sure you have a good plan in place for reaching out to potential clients and increasing your visibility. Social media, content marketing, and search engine optimization (SEO) can all be helpful in this regard.
8) Hire Talented Employees
If you want your firm to stand out from the competition, you’ll need to hire talented employees. Look for individuals with experience in the architectural field who share your vision and passion for design.
9) Develop a Brand
Creating a unique brand identity is essential if you want your firm to stand out from the crowd. This could involve creating a logo, website, or slogan that captures the essence of what your firm stands for.
10) Stay Flexible
The architecture industry is constantly changing and evolving, so it’s important to stay flexible and adapt to new trends. Don’t be afraid to try something different or take risks when necessary. Doing so can lead to greater success in the long run.
Starting your own architectural firm can be a rewarding experience, but it requires planning and dedication. Make sure to follow these tips when getting started to ensure that you set yourself up for success!
6 Affordable Ways to Take Care of Your Dental Health
While many patients are looking towards dental tourism to get their dental health back in check, the good news is that you don’t need to. While yes, sometimes dental health care can, at times, be fairly pricey, there are things you can do to make sure that it’s affordable. So, here are some tips for keeping your dentist visits easy and affordable.
Brushing twice a day
Getting rid of bacteria in your mouth can be as easy as brushing twice a day. But it’s important to follow the proper technique for doing so. If you need more clarification, you can ask your dentist for advice. Bacteria in the mouth cause cavities, gum disease, and other dental problems. Getting rid of the plaque in your teeth is important to keep them healthy.
Flossing before brushing is one of the best things you can do for your oral health. Performing this dental hygiene routine can prevent gum disease and tooth decay. While you’re flossing before brushing, you’ll also remove food particles that are stuck in between your teeth. It’s also easier than brushing. In fact, flossing first can even increase the concentration of fluoride in your mouth. Fluoride strengthens your teeth’s enamel, which can help prevent cavities.
Having cash set aside for dental emergencies
While no one likes to think about dental emergencies, it’s so important that you do. Having cash set aside for dental emergencies is a smart way to ensure that your teeth stay healthy. A dollar spent on cleanings and X-rays can save you a lot of money on more expensive procedures down the road. Getting treated for an emergency is never convenient, and trying to figure out how to pay for it can be stressful. So, make sure you have some type of emergency fund for something like this.
While it’s fine to eat sweets in moderation, it’s best to try to avoid this unless it’s a special occasion. You’ve probably heard it enough times, but sugar can cause cavities. Ideally, you stick to drinking water and limit your sugar and salt intake.
Create an at-home oral care routine
Whether you’re wearing a teeth retainer or not, you’re going to need to have some type of oral care routine each night at home. Taking care of your dental health at home is a great way to avoid expensive trips to the dentist. You can save money in the long run, and you can prevent major issues that can cost hundreds of dollars to repair. The two most important things you’ll need to do is brush and floss. This keeps your gums and teeth healthy and free from cavities and gum disease.
Regular dentist visits
It’s also important to visit your dentist twice a year. Your dental hygienist will check your mouth for signs of oral cancer, gum disease, tooth decay, and other problems. They will examine your teeth and take x-rays of your mouth. This will help them determine if you need more in-depth treatment. Your dentist can also recommend a home oral care regimen tailored to your unique needs.
This includes the use of mouthwash, which can help remove plaque and freshen your breath. By all means, you should always take advantage of this. How can this be affordable? Well, by going to the dentist twice a year, they’ll be able to fix and prevent any potential issues before they even begin.
How to Look After Your Health Despite Your Disability
It’s important to stay healthy despite your disability. There are many risks associated with not looking after your general health, but there are also many benefits to putting more effort into these issues. Here are some tips for staying healthy despite your disability.
The Importance of Staying Healthy Despite Your Disability
There are a number of risks associated with not staying healthy despite your disability. These include an increased risk of infection, an increased risk of falls and other accidents, and an increased risk of chronic diseases such as heart disease, stroke, and diabetes.
Tips for Staying Healthy Despite Your Disability
Eat a Healthy Diet
Eating a healthy diet is important for everyone, but it’s especially important if you have a disability. A healthy diet can help you manage your weight, get the nutrients you need, and maintain your energy levels. There are lots of things you can do when you’re planning your meals:
Choose foods that have less fat and sugar. Fatty and sugary foods can contribute to weight gain, which can put a strain on your joints and muscles.
Include lots of fruits and vegetables in your daily diet. Fruits and vegetables are packed with essential vitamins and minerals, and they can help you stay hydrated.
Make sure you’re getting enough protein. Protein is necessary for tissue repair and growth, so it’s important to include it in your diet if you have a disability.
Getting Regular Exercise
Exercise is important for everyone, but it’s especially important if you have a disability. Regular exercise can help improve your flexibility, muscle strength, and overall mobility. It can also help reduce pain levels, improve mental health, and boost your energy levels. If you’re not sure where to start with exercise, talk to your doctor or physical therapist about an appropriate workout plan for you. There are also many adaptive fitness programs available that cater to people with disabilities.
Seeing Your Doctor and Dentist Regularly
It’s important to see your doctor and dentist regularly regardless of whether or not you have a disability, but it’s especially important if you have a disability. This is because people with disabilities often have additional health concerns that need to be monitored closely. Make sure to keep up with all of your appointments and follow any treatment plans that your doctors recommend. Looking after your teeth is key so you can keep issues like tooth decay and infections at bay.
Stress can take a toll on your physical and mental health, so it’s important to find ways to manage it. If you have a disability, you may find that you’re more susceptible to stress due to your limited mobility or chronic pain. There are lots of things you can do to help manage your stress levels:
Identify your triggers. What are the things that tend to trigger your stress? Once you know what they are, you can start to avoid or remove them from your life.
Practice relaxation techniques. There are many different relaxation techniques you can try, such as deep breathing exercises, meditation, or yoga.
Talk to someone. Sometimes talking to a friend, family member, therapist, or other support systems can help relieve stress.
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