Connect with us

Health

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

Published

on

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.

Continue Reading
Comments

Health

How cloud based software is revolutionizing the medical profession

Published

on

EU flag

Modern clinics and surgeries are changing how they manage their administration through the use of new technology based entirely online in the cloud.  Now is the time to move away from paper based records and take advantage of the new technology that is available .

Not only will it give patients and clients a better service, but it will also increase the efficiency of the clinic and save both time and money, allowing more resource to go towards the health and well being of clients.

A better service for clients and patients, a better system for clinics

The benefits to a clinic that manages all the office and medical information through software clinic cloud are sizeable. Designed to facilitate the day to day workload of the medical professional it can manage all aspects of a clinic or medical surgery.

It allows complete electronic control over appointments and agendas, and can also provide a booking service that allows patients and clients to request their appointment online for the comfort of their own home, and can even allow them to choose the professional they would like to see. It can then be configured to send alerts to the booked professional, help avoid double booking and also helps avoid missed reservations by sending reminder emails or SMS.

Each professional at the clinic will be able to have their own user access to the program and their bookings calendar, with access permissions set to suit each users, so that they only have access to the information they need.

Not only is this software improving the booking process, it provides excellent assistance during the appointment. Full medical history of the patient is available at the click of a button, all stored in electronic format, with the ability to add information at each appointment. Some programs even have anatomical model modules that allow the recording of information in a visual way.

Streamlines accounting: Make invoices, budget, review defaults and carries a comprehensive cash control.

Improve the promotion of your business: Clinic Cloud also facilitates customer loyalty, for example through the creation of marketing campaigns by SMS.

Each professional will have their own agenda, so that the management of appointments and their payments will never have been so simple. In the same way, with the medical software you will be able to make the cash and the accounting easily.

The complete history system makes it really fast and simple: take the cards, comply with the Data Protection Law, make reports per session, and have absolute control of the patient’s account, their bonuses, and bills.

And because the software is stored in the cloud online, it is accessible from any device with an internet connection, for example on computer, tablet or smartphone. This means clinic management is simple and accessible 24/7, even when not in the office.

Not only does it hold medical records and appointment history, it can also manage billing and invoicing in a simple and easy to use way, making accounting much simpler.

Easy to use and easy to access

The great thing about cloud based software, is that it is very easy to access even for those with very little experience in software. No installation is needed, because it is stored online, and this means there are no upfront high licencing costs, cost is based on usage instead meaning clinics only have to pay for how much they use and store.

It also means not having to worry about updating the software, updates are carried out by the host without any impact on users.

Ease of access however, does not mean however that patient data is open to the world. The security of personal information is paramount, stored on servers that have the highest levels of security and comply with any data protection and privacy regulations. It is only accessible by those who have been given permission to do so, and should there ever be a problem with the host servers, the information is backed up regularly and can simply be accessed by another device.

Suitable for all types of clinics

The software available now is capable of being adapted to many different specialities.

Whether it is needed for general medicine, an aesthetic clinic, dermatology , podiatry, or dentistry all of it can be managed electronically online.

Good software will even have specialist modules, for example for dentistry to help manage that specialism.

Not only that it can also be used for targeted marketing to attract new and repeat customers through, and help drive additional revenue and footfall to the clinic with promotional campaigns.

The future of medical professionals is going to be embracing new technology, and the best way to start this is to begin managing your clinic online.

Prev postNext post
Use your ← → (arrow) keys to browse

Continue Reading

Health

The revolutionary way to reduce pain and risk in spine surgical procedures: Dr. Clavel’s non-invasive surgery

Published

on

surgery hospital

Medicine is a science that evolves constantly thanks to elite professionals who dedicate their lives to develop new techniques aimed to improve people’s health in the easiest –and less painful way possible. One of these top doctors is Dr. Clavel, a surgeon who believes that surgery is an art capable of transforming lives… And his work proves him right. This valuable health professional stands out in the neurosurgery field, a specialty that has been developing greatly in recent decades. However, most of its success stems from its advances in spinal surgery in patients with serious low back pain.

What is non-invasive lumbar surgery?

Invasive spinal surgeries have always been considered high-risk interventions because there are various anatomical structures that must be avoided prior reaching the affected area of the spine. Most spine surgical procedures —such as arthrodesis, fixation and fusion, require long back incisions, large muscle dissection and manipulation of nerve structures. All of these techniques can lead to significant blood loss, nerve injuries, muscle atrophy and ulterior chronic pain.

Since this was the only known technique to deal with these issues, Dr. Clavel decided to focus his research on improving traditional surgery methods to treat herniated discs or other physical difficulties lodged in the lumbar area, such as degeneration. His years of dedication led him to further deepen in the field of non-invasive anterior lumbar surgery: Non-invasive lumbar surgery. This revolutionary technique uses an anterior approach to perform the surgery. Thus, there is no need to manipulate or mobilize muscles nor nerves, so there is less risk of injuries. Plus, this kind of surgery does not require to perform osteotomies to introduce implants — which eliminates vertebral destabilization and blood loss, nor opening the back muscles. This translates in a safer intervention and less postoperative pain long term

The non-invasive lumbar surgery Performed by Dr. Clavel, represents a fundamental advance in the field of spinal surgery. It has been demonstrated that this surgical procedure would avoid the classic difficulty of common surgical-lumbar processes, in which bone structures must be destroyed –which means a high probability of damaging an important nerve. By accessing www.barcelonaspinecenter.com you will be able to find more detailed information related to this type of intervention, and the possibility of opting for a medical and surgical assessment.

Doctor Clavel, a leading expert

Pablo Clavel began working as a neurosurgeon in the city of Barcelona in 1995 after being trained in different American universities such as Emory University in Atlanta, Oklahoma University and San Diego University. After years of  experience in various private and public hospitals and teaching Neurosurgery courses at Cornell Hospital in New York,  ​​Dr. Clavel founded Instituto Clavel (Barcelona Spine Center) and he has been head of the Neurosurgery and Column Department since 2011.

Doctor Clavel is also an example of professionalism and vocation: despite his 20 years of professional experience, he keeps educating himself in order to achieve and develop the best surgery techniques. He combines the performance of spine surgery with research and teaching activities: he has published several relevant articles in scientific journals, and he is currently teaching courses and giving conferences about spine surgery worldwide.  He is also a medical advisor to Neosurgery SL, a company dedicated to researching and developing implantable medical devices in neurosurgery.

In addition to his work as a neurosurgeon Dr. Clavel also performs as a volunteer neurosurgeon in African countries such as Ethiopia, where the charity that he founded (Fundación Doctor Clavel) is currently training local doctors and nursing staff in neurosurgery procedures.

Use your ← → (arrow) keys to browse

Continue Reading

Health

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

Published

on

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.

Use your ← → (arrow) keys to browse

Continue Reading

Trending