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

Feeling the Pressure of Prescriptions? Read this Now!

Published

on

Prescription medicines

Healthcare costs have been rising at runaway rates for the past few decades. In 2018, Americans spent nearly $3.7 trillion on health care, reports Fortune Magazine. That’s more than the GDP of the United Kingdom, Mexico, Spain!

This is increasingly a big problem for a nation that now spends significantly more as a country, and per person, than any other developed economy. While lawmakers and society will have to figure out a way to control these skyrocketing sums, on the individual level, it’s important for everyone to do as much as they can to keep their own costs in check — without sacrificing the care they need.

It isn’t always easy. One area where we continue to see higher expense is on pharmaceuticals. More and more people are now taking prescription drugs. This is good in many ways. They allow people to live with less pain, fewer symptoms, better mobility, and so much more.

But it also means that so many people have to find a way to pay for their sometimes expensive prescriptions. This makes getting the right coverage and getting the best advice from doctors more important than ever.

Nobody wants to put their wallet ahead of their health. And with the right strategy, you can hopefully avoid ever facing such a difficult situation. Try this advice and you can likely find savings for years to come.

1. Go With Generic Medication

Pharma companies invest billions in research and development. This pays off greatly when they come up with a great new drug that is used by many people. But the patent on that pill only lasts so long. Once it expires, anyone can make the same medicine and this naturally cuts the price.

This means that you don’t need to pay more for the label. Many people prefer to pay more for the name they know. But in many cases, the generic is literally the exact same thing — just with a lower price tag. Talk to your doctor and see if you can find some savings by going generic.

2. Fill Your Script in Bulk

There can be extra costs for pharmaceuticals each time you fill a prescription. Specifically, you might be on the hook for a co-pay whenever you get a new bottle. So if you only get 30 pills at a time for the month, that means 12 extra charges per year. In some cases, you may be able to instead get 90 pills. Not only do you now pay just 4 times per year, but it saves you a lot hassle.

“Buying in bulk” can also pay off if you get larger doses in some cases. Certain pills can just be cut in half, so getting 30 pills of 20 mgs then splitting them at home is the equivalent of 60 pills of 10 mgs. Doing this effectively accomplishes the same result if your doctor is on board.

3. Understand Your Plan

The more you know about your healthcare coverage, the more you can benefit. A lot of plans allow people wider access to doctors and clinics than they realize — and at very low costs. All it takes is understanding your policy a bit better to take advantage.

Medicare is a great example. It has been around for so long, and most people have relatives or friends who use it. So they think they know what it does and does not cover. But the popularity and availability of supplemental coverage has grown significantly over the decades, with Medicare Part D becoming a particularly great option. Because it makes many prescription drugs free — for such a small extra premium — it is one of the best ways to protect your health and your bank account.

Great Health Anyone Can Afford

The right prescriptions can be a life saver. We have so many options and ways to treat our issues nowadays, and it really is amazing for anyone who is suffering or wants to prevent a disease from progressing.

But it sure does cost a lot. That’s why you need to be smart and employ strategies like going generic, filling your prescription in bulk, and really understanding all the benefits available in your plan. 

When it comes to medication, you want to get exactly what you need at the lowest possible cost. You can’t afford to make sacrifices to your health. And with a few simple tips, you really will be able to afford whatever you need.

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

Continue Reading

Health

Putting your health on the best hands

Published

on

healthcare doctor

Our background can affect our priorities in life. For example, some people want to travel while others prefer to stay at home with their love ones. But if there is something that everybody should always be a priority no matter what, it is our health. Our health should always be the most important aspect in our lives, therefore, we always need to prioritize having access to the best health services to look after it. 

Having access to the best health services

Health is one of the most important things in life. Becoming sick can have a detrimental effect on our lives, and, in severe cases, receiving the proper treatment as soon as possible can mark the difference between life and death. Therefore, when we sign for a health service, we need to make sure that we will have access to the best professionals in the sector and the best facilities. 

This also extends to health services when we travel abroad. Over the last decades, Marbella has become a popular holiday destination and a trendy place for expats to start a new life. This southern Spanish town seems to have everything you could wish for, including which is probably the best private clinic in the country. 

Spanish public health system may seem flawless sometimes, especially if we expect a quick response to our health problems. Therefore, checking out for a Marbella private clinic during your stay is, by far, the smarter option.

A private clinic that has become renown, not only in Marbella  but on the entire country, for the excellent quality of the services they provide is Excelan. 

Excelan was especially designed keeping the needs of foreign patients in mind. Their team will provide you with multilingual assistance 24 hours a day, 365 days a year. 

But the services Excelan provides to their patients go way beyond the language. Excelan has its own fleet of private ambulances. Excelan has the latest models of ambulances to ensure safe, fast and comfortable transfers, all fully equipped with the latest technology to take care of the patient. A good example of Excelan being the smarter choice is that their ambulances are equipped with a hydro-pneumatic bench system (a system that absorbs the vibrations or sudden movements that could affect the vehicle while transferring the patient)  which can not be found in the public health service ambulances in the area. 

Excelan also incorporates the latest medical innovations. Their team of professional always keep up with the latest findings on the medical field. For example, Excelan’s doctors were pioneers in Spain on the Dr Hangover treatment.

And best of all, Excelan comes at a very affordable price. Excelan experts believe everybody should have access to the best medical services, so they provide the best treatments at a low price, all while keeping the higher quality standards.

Seeing a doctor at your own home

Visiting a doctor can be unpleasant sometimes. We need to travel to the doctor’s offices while being sick, and we often end up exposing ourselves to the illnesses of other patients. But Excelan Clinic offer their patients the services of the best GP doctor in Marbella.

Excelan offers the services of a GP doctor that will offer you whichever health services you need, wherever you need them. With a simple phone call, e-mail or whatsapp message, your doctor will visit you at your hotel, home, restaurant… The doctors are available 24/7, because your comfort and health should always comes first.

This option is especially recommended for tourists, since the staff is multilingual and this will help solving the possible language barriers. 

The professional team at Excelan has a lot of  experience and will make sure to give you a health service tailored to your needs. Because each patient is different and has different needs, opting out for a personalized service like the one provided by Excelan will always be the most intelligent option. 

Use your ← → (arrow) keys to browse

Continue Reading

Health

Key Methods for Identifying Hospital Staff

Published

on

healthcare workers

In hospitals and other healthcare organisations, it’s vital that patients are able to identify members of staff. It’s also necessary for staff members to be able to identify each other and their roles. Different methods can be used to identify staff so that the people who need to know who they are can easily recognize them. Employees can use lots of visual cues that tell people about their role, their name, and which hospital they work for. These are some of the ways you can make sure your staff members are easily recognizable to anyone who needs to know who they are.

Uniforms

Uniforms are a great way to identify the staff in a hospital and to distinguish between people working in different roles. They are essential in hospitals for hygiene purposes, but they also serve an important purpose when it comes to making employees recognizable and trustworthy. Different uniforms help your staff to see who works in what role, and this can also be useful for patients, especially those who are staying long-term. Using different colors, patterns, and designs for different roles is helpful. You might also have logos or extra information printed or embroidered onto uniforms to provide further help.

Name Badges

It’s not just roles that are important for patients and staff members to know. People should also be able to identify employees at a hospital by name. Name badges are an easy way to do this, putting names and roles in a visible place. Name badges should be easy to clean so that they can be wiped clean regularly. They might not always be appropriate to wear, but it depends on the environment and the duties of the person. Although name badges can be a quick way to identify someone, they shouldn’t replace employees introducing themselves.

Official ID for Security

Security is another reason staff members may need to identify themselves. They will need to show identification when they enter the hospital and will likely need to use it to access certain areas of the hospital. When you provide ID for hospital staff, you also need to offer solutions for carrying and displaying it. A lanyard can make it easy for a member of staff to have their ID visible at all times. Some people might prefer to pin or clip their IDs to their clothing instead, especially if they don’t want to have something hanging around their neck.

Identifying Information

It can also be useful to provide information that helps patients to identify staff members. This could include providing materials that tell them how to identify people in different roles. You can provide them with a guide to what doctors, nurses, and other members of staff wear. It’s also helpful to explain what different roles mean. It’s not very useful for a patient to know which uniform a phlebotomist wears if they don’t know what a phlebotomist does.

Help your patients to identify hospital staff and your employees to identify each other by providing visual cues and useful information.

Use your ← → (arrow) keys to browse

Continue Reading

Trending