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HIV AIDS: Where government has gone wrong, What government can do



HIV Aids in India where government has gone wrong

Photo: The Hindu

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:

  1. Demographic and epidemiological understanding
  2. Awareness
  3. Screening and counselling
  4. Treatment facilities and medicines
  5. 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.

Is this lack of information spread, a result of lack of resources or is it due to lack of political will? A significant chunk of taxpayer’s money on AIDS, like any other resource in India has been squandered with significant chunks making it to the chauffeurs of the corrupt. Lack of adequate money is definitely a problem, but a relatively minor one, compared to the mismanagement of the available resources. An approach for awareness, with low cost and huge promise, is the proper training of health care professionals. Mandatory improvements in the syllabus of medical schools and compulsory training of health care professionals to be better deal with immunocompromized AIDS patients, providing all medical services to HIV positive patients and to counsel patients on screening and precautions can be a game changer. While some namesake changes have been made in some medical curricula of advanced training but none to the internationally acceptable standards and barely any that impact primary care providers dealing with majority of patients. Formulation and implementation of laws against discrimination of HIV positive patients is also needed urgently. Another dimension of information dissemination and care is to focus on special groups. Recent international attention and support from charitable organizations along with government of India’s initiatives on free distribution of condoms to sex workers has been very productive. Successful select programs are currently targeting high-risk populations like truck drivers and sex workers but the biggest group with this affliction is currently ignored. This group is of the displaced urban poor migrant workers who are forced to work in non-native cities and seek sexual favours in questionable places. In a nation, that is busy unsuccessfully dealing with the symptoms of poverty and displacement, by the means of handouts that reach only select few and harassment to silence dissent, one needs to cure the actual disease of poverty that accentuates problems such as AIDS by means of holistic socio-economic development.

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.

Dr. Sukant Khurana is a New York based scientist, artist and writer of Indian origin. His basic research involves neurophysiology, computational neuroscience, sensory perception, addiction, learning and memory, while his applied research extends into many areas of drug discovery and problems of the developing world. Both his visual art and writing explore the issues of modernization, displacement and identity.

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Do sport and eat healthy to maintain an active and happy life



Testosterone is a vital men hormone that helps to maintain an active sexual life. Eating healthy and practising sport are the best way to have normal blood testosterone levels.

Living a healthy life has lots of benefits and two basic steps: healthy diet, going to the gym or practising sports regularly will certainly help to succeed. If you follow this tips you will see how it raises your spirits, you have a much better positive view and a greater self conscience. Your body will reach an ideal weight and full shape muscles.

Some of the benefits of practising sport

In first place practising sport helps to improve cardiovascular health, since the heart is the most important muscle in the human body. It also improves life expectancy and releases tensions and stress, two factors that can trigger psychic problems such as depression.

Regular sport helps to increase the lung capacity, it promotes digestion and when you do stretching activities as Pilates or yoga, it even prevents constipation and improves resistance, agility and balance.

There are many reasons to choose sport and today’s society is more aware than ever about the need of leading a healthy life under all circumstances.

You are what you eat: key points to make it happen

You must be more aware of what you are eating, putting aside manufactured products or those containing chemicals. Healthy eating is not diet to lose weight. A healthy lifestyle is based on investing a little more in healthier foods so you don’t have to spend time in doctors.

Good nutrition helps reducing weight itself and guarantees a better productivity in general terms: brain is in better condition because it is given the fuel required.

By eating five servings of vegetable or fruit a day it decreases the risk of suffering future health problems. If this measures are accompanied by going to the gym or practising regularly sport the benefits will be higher.

Those who go to the gym and want to have strong muscles, not only to have a good image, but to have better health, usually take dietary supplements. But only personal trainer or doctors can advise them.

100% natural testosterone supplement to maintain an active and happy sex life

Nowadays, more and more athletes recognize the importance of nutritional strategies to perform, and supplements have developed specific products for each situation and season. However, nutritional supplements are increasingly introduced in the health field, developing new supplements for weight loss, balancing strict diets or covering risky situations. In this matter, Testo Ultra stands out and seems to work on many men, a safe way to increase man’s strength, pleasure and virility without any health risk.

Testosterone is men’s fuel and begins to decrease when they are on their 30’s. Low testosterone levels can cause problems such premature ejaculation or erectile dysfunction, but European and U.S.physicians have already warned about the risk of taking testosterone without control.

Supplements as Testo Ultra are indicated for everyday sportsman that must maintain high levels of the male hormone, but not for men suffering erection problems and looking for an immediate response.

It may happen that lack of testosterone is not the origin of dysfunctional problems but fears or pathological problems that can be determined by a doctor or psychologist.

Testosterone has always been associated with male sexuality, as it occurs in men’s testicles, -also in women’s ovaries-, but to a lesser extent. Testosterone is the one in charge of starting male engine. But it is also associated with bone density, muscle mass, good levels of red blood cells, and a balanced state of mind, full of vitality. Instead, having low testosterone causes weight gain, increases breast fat, creates urination issues and lowers stamina and sexual performance.

Therefore, natural testosterone is very important to maintain an active and happy sex life in man.

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Culture and Lifestyle

Is A Car Harming Your Lifestyle?



Owning a car

The automobile has to be one of the greatest inventions of the 20th century. Thanks to the modern car, commuting times have been cut to the bone. Now, it doesn’t take days or weeks to travel hundreds of miles. And, there is the ease element. Walking, catching the train or jumping on a bus is a difficult, drawn-out procedure for travelers. Starting up the engine of the car is effortless.

It’s easy to see the helpful side-effects of a motor, especially when it’s integral to your life. Almost every person on the planet who can afford one has a car. Still, there are side-effects which may be harming your lifestyle. Read on to find out more about the dangers of owning a car.

Health And Well-Being

The obesity stats for last year are in, and they don’t make for good reading. According to the experts, nearly 1.9 billion adults over the age of 18 are obese. As a percentage, it’s close to 20% or one-fifth of the entire population. Factors include a poor diet and a lack of exercise, the latter of which has a link to cars. Driving is quick, easy, and doesn’t cause you to lose your breath. So, it’s no wonder people would rather get behind the wheel than walk to their destination. Cutting down on driving could help you burn an extra 200-300 calories a week, which would break down body fat. As it is, the body has to find alternative ways to exercise. Considering most people don’t get the 150 minutes of exercise a week they need, this isn’t likely to happen.

Road Accidents

Every time you board a plane, adrenaline pumps around the body. Plane crashes are rare, yet you can’t shake the nagging feeling in the back of your head. What if the engines fail? Flying seems dangerous, yet it isn’t as deadly as getting behind the wheel of a car. On average, almost 1.3 million people die as a result of an accident, and 50 million suffer an injury. Personal injury lawyers work around the clock to help their clients because car crashes never stop and never will. Even though it doesn’t seem likely, you have to prepare for the inevitable when driving. A major incident or a fender bender could cause physical and emotional harm that takes years to overcome. After all, all the predictions point to road traffic accidents becoming the fifth leading cause of death by 2030.


High cortisol levels are a health issue, but they deserve a special mention. Unlike obesity or whiplash, they are a leading cause of mental illness rather than physical. And, the brain is the most important organ in the body. As such, it’s vital that you keep it as healthy as possible yet driving might send you over the edge. Boffins reckon that 80% of drivers suffer from an attack of rage that they can’t explain. Whether it’s banging on the horn or getting into a fight, four-fifths of car owners are susceptible. You might think the latter is unlikely, but 7.6 million drivers admit to getting out of their vehicle to confront another motorist. There are legitimate reasons to get angry, particularly when you factor in the road traffic accident numbers. Still, stress is one of the leading causes of health deterioration in the western world. And, a car could add fuel to the fire.

Air Pollution

Global warming is real and it isn’t going to stop. Indeed, it won’t until the world does something about carbon pollution. What’s one of the leading causes of CO2? Yep, it’s cars, trucks, and motorcycles. The combustion engine releases thousands of harmful toxins into the atmosphere which chip away at the ozone layer. They also contribute to a warmer planet and melting ice caps. Seen as there are 1 billion vehicles on the road worldwide, the earth’s health is going to get worse. In fact, it could be irreparable by 2040 when the number of cars is set to double. A warmer planet might not impact you, but it will harm your children and grandchildren. By the time their kids are born, there might not be a world left for them to inherit.

Personal Finances

There are over a billion cars on the road, but that doesn’t mean they are affordable. Thanks to finance schemes, you can buy now and pay later. However, like a credit card, this can haunt you further down the line. Miss one payment and the car will be taken away, along with fines and penalties you can’t pay. Automobile debt is real and impacts millions of people around the world.

What do you think? Do the pros of cars outweigh the cons or is it the other way around?

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Culture and Lifestyle

Medicine: From The Study Of Gods To Healing Robots



V0018149 An invocation to I-em-hetep, the Egyptian deity of medicine.
Credit: Wellcome Library, London. Wellcome Images
[email protected]
An invocation to I-em-hetep, the Egyptian deity of medicine. Oil painting by Ernest Board.
By: Ernest BoardPublished: –
Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0

Throughout history, civilizations all over the world have sought to fight disease, postpone death and relieve suffering. After all, as being healthy is by far the best and only way to enjoy a longer life, it appears evident that doctors would have developed fascinating medical approaches and knowledge throughout time. The history of medicine, however, is a tale of mankind evolution, knowledge and, more often than not, a tale of beliefs. It is because today modern doctors believe that science has most answers — and will one day have all answers — that the role of the healer has changed from a holy figure to an experienced scientist. While there have been many eureka moments, the story of healing the body is not only a story of unsung medical heroes, but also a portrait of how human beings perceive their world.

The Gods made me sick

The earliest documented doctors that archaeology has revealed were Egyptian physicians 5,000 years ago. While there might have been doctors before that time in other countries, Egyptian papyri are for now the earliest evidence of medical knowledge. However, these writings attribute the responsibility of the health of the people to the pharaoh. In those times, healing methods were groups in sacred centres and consisted mainly of religious rites and ceremonies designed to ask the Gods for health. Another belief of the time was that diseases were the result of an angry deity. Consequently, the ceremonies needed to appeal to the Gods and offer a sacred apology for the offence. The belief that the divine could influence human health lasted for centuries, as even in the Middle Age, healing sacrifices were still encouraged in Pagan communities.

Studying the cure

Nowadays the approach to finding a cure has changed greatly. Scientists, and especially lab scientists, rely primarily on the observational study of patients in the retrospective of existing data as well as the investigation outside of clinical trials to find evidence of a cure’s success. This scientific process is relatively new in the world of medicine and dates back from the Industrial Revolution. In fact, people invented the steam engine before they understood how to diagnose and make more effective medications! But with the evolution of the observational field, more and more medical professions dive into the complex relations between the body and the mind, from a standard GP to a specialist neurologist.

Can robots heal us?

Finally, the evolution of medicine isn’t over yet. There is still a lot that doctors don’t understand, and a lot that they can’t treat. Consequently, new healing methods are discussed all over the world. Doctors have stopped waiting for a divine answer. Instead, they have been building nanobots, which will be able to navigate the body to repair internal damage locally. What sounds still like a sci-fi story is expected to happen by 2030. Will the human health be in the hands of robots? As surgeons already rely on robotic technology in the operating room, internal bots could be the next big heal!

In the end, the story of medicine is still to be continued. But it remains, for now, a story that highlights the resourcefulness of mankind and its desire to understand and manage the cause of all diseases and maybe, one day, defeat death too.

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