HIV in India

HIV:
Since being first clinically identified in San Francisco in 1981, HIV [Human Immunodeficiency Virus] infection has spread its tentacles all across the globe with 40 millions HIV patients presently. HIV is a retrovirus which upon entering the human body mainly infects immune cells. The HIV virus can infect people primarily through 3 routes – sexual transmission, maternal to child transmission, and transfer of blood or blood products. Upon long term infection, the immunity of a person declines and eventually the person acquires AIDS [Acquired Immunodeficiency Syndrome] – The end stage of HIV infection. In this phase, the patient is vulnerable to a range of opportunistic infections and could die because of these infections.

HIV in India:
As many developing countries, India is facing a challenge in the HIV disease. In fact India has the highest number of HIV cases in the world. Presently India has more than 4 million HIV infected patients. The HIV disease is now mainly restricted to high risk groups like Commercial Sex Workers, truck drivers, and Intravenous Drug Users. However it has been cautioned by health experts that complacency on part of health authorities could mean that the infection spread from these high risk groups to the general population. Hence the importance of well planned and implemented HIV prevention campaigns and programs not only to raise awareness of HIV transmission routes but also to promote safe sex methods. For persons already infected with HIV, treatment can be expensive and indefinite. This Anti Retroviral Treatment [ART] also requires good compliance on the part of the patients, and regular monitoring by the clinical provider for medication adverse effects and viral resistance (to medications). Though this may seem that ART programs can be impractical to implement in poor countries, it has been seen that with proper planning and strong backing by governments – provision of ART is possible. Therefore, it is important for HIV prevention and ART programs to be implemented side by side.

In India, the Government run National AIDS Control Organization [NACO], set up in 1992, has been the main body responsible for coordinating the response to the HIV infection in the country. Along with NACO, there are State AIDS Control Organisations [SACO] which are responsible for coordination at the state level. Along with these there are many Non Governmental Organisations [NGO] and private bodies which are involved in HIV prevention programs and provision of ART. Inspite of these efforts by the government and NGO’s, HIV infection and the possibility of its further spread is a clear and present danger.

What does this mean to overseas Indians?
As responsible global citizens, we all should be concerned with the spread of HIV disease. In this manner also as overseas Indians we certainly should be concerned with the HIV situation in India. HIV has not only clinical implications but also social and economic implications. Unneeded and Unwarranted stigma associated with HIV infection leads to social isolation of HIV patients and also death of HIV infected breadwinners leads to economic hardship for the rest of the family members.

Not all of us may be HIV clinical/ public health experts or be able to be in the field working in HIV programs, but we can always support NGO’s or other agencies doing this work. Many of these NGO’s or agencies are dependent on external funding for proper functioning and implementation of their programs. This is where overseas Indians come into the picture. After identifying a NGO that we can be involved with, we could either contribute to their efforts by providing financial support or health advice if we are qualified to. We further could raise awareness of the HIV situation in India with other overseas Indians and also have fund raising drives to support the work of NGO’s. Thus, overseas Indians can in their own way contribute to the fight against HIV in India.

Globalisation and the fuss-Part I

Globalisation and the reactions to it have been well documented and published across internet portals and various books.
I don't want to take sides, but with all the criticism that has been heaped on Globalisation and its fallouts, I see merits in it. Well, maybe not in the present WTO/World bank conceived forms, but in a socially responsible form.
Depending on how you percieve Globalisation, it could mean no economic borders, free trade, free flow of information and so on. A teddy bear made in some dingy factory in Wuhan, China is later purchased by a parent in Munich, Germany. Callers from Sacremento , California enquiring about technical problems of their wireless router will get answers from call centers in Bangalore, India. This kind of cross global exchange of products and information would not be have concievable without globalisation. So why do critics have problems with this kind of exchanges? The argument is that the process is benefitting the big multinational corporations while the poor have been left behind. Some countries have benefited -Read India and China-, while many developing or poor countries have seen their local economies collapse leading to more misery of their downtrodden.
I think the solution here is not to place hurdles in the globalisation process, rather modify or alter the process to benefit the humble of the society. It has to made a sacred principle or an industry dictum of having corporate social responsibility. Every company or organisation profiting in the globalisation process should take developmental approaches that benefit the poor of their region, or be involved with governments in public-private partnerships to improve infrastructure. In this manner , the rewards of globalisation will not just remain in few hands but trickle down to the marginalised.
It has never foreborne good for a society if the divide between the rich and the poor gets wider and wider. It leads to increased rates of crime and social strife. But if this gap can be filled with dollops /heaps of corporate/governmental largesse, why place a spoke in the globalisation wheel. I will talk about the impact of information flow in todays age in the next globalisation blog.

GENOCIDES-Will we ever learn?

As much as humankind can shine in their discoveries, inventions, intellectual and technological prowess; they are blighted by their record of genocides .
The word Genocide is derived from greek [GENOS=Race]. It means " The systematic and planned extermination of an entire national, racial, political, or ethnic group".
Mankind has regularly involved in these barbaric acts too many a time for any complacency. We should have learnt our lessons from the Holocaust perpetuated by the vile Nazi regime. Despite many Holocaust museums and rememberance days, present day genocides continue. It belies our belief that we can allow such acts to happen. For long we have ignored them.
It always begins with hate and vindictiveness against a particular race or ethnicity ; and then it leads to planning of genocide. We saw this happen in Rwanda and we see this happen in Darfur. WE SHOULD NOT IGNORE HATE and SHOULD NOT TOLERATE HATE!
As one noted jewish holocaust survivor said " If not violence , what can hate against a race lead to?". Genocide is a pestilence and it should without much ado, eliminated.

HIV

HIV-Facts

1]HIV-I and HIV-II virus are retro-viruses belonging to the Lentivirus family. Other viruses in this family include the Simian Inmmunodefieciency virus, Equine anaemia virus, Feline immunodeficiency virus....
- 2]The first cases to be studied were in Los Angeles, 1981 , when doctors started to notice rare diseases among young homosexuals. These diseases like Pneumocystis Carinii- A fungal pneumonia- were usually noticed among only immunosuppressed individuals like Cancer patients, congenitally immunosuppressed individuals. So it was alarming when the cases surfaced in LA , New York Gay communities. Later on, Robert Gallo of USA and Pasteur Institute in Paris seperately identified the virus in 1983.
-3]The origin of the virus has been controversial from theories that range from the virus is a mutated form of chimpanzee virus to that it is a left over of the experimental studies done on Cancer causing viruses .
- 4]The modes of transmission through which one can acquire HIV infection:
- Exchange of body fluids where the virus is in high concentration - e.g :Sexual transmission
- Unsafe Blood transfusion/ Organ donation
- Mother to Child transmission
- Needle stick transmission, unsterile IV needles
- 5]HIV virus has 4 different clinical stages - the initial asymptomatic stage
-Generalised lymphadenopathy stage[enlarged lymph nodes]
- Symptomatic stage
- the last stage called -AIDS [acquired Immunodeficiency syndrome]
6] Currently , there are 40 million HIV cases in the world and every year 5 million new cases are reported.
7] HIV infection acts by suppressing the bodies immunity by infecting immune cells [CD4 cells] and leading to their destruction. Therefore the person becomes vulnerable to other infections which a normal person would not get.
8] HIV reproductive rate is low, that means it is not highly contagious, but persists in individuals for a long time, enabling the person to transmit to other.
9] HIV infection , as of now, does not have a cure. though there has been introduction of effective HIV suppressant[control] drugs like Zidovudine, Lamivudine, Nevaripine,.....These drugs basically act on different parts[enzymes] of the virus and suppress the numbers of virus-viral load. It has been seen in studies that treating an HIV pregnant women with nevirapine actually prevents the transmission of the virus to the child, if additional precautions like ceaserian section is performed and breast feeding is avoided.
10] HIV vaccine has been difficult to make, because of several reasons, one important reason being the mutation capacity of the Virus. so even if you prepare a vaccine, the virus could mutate and make the vaccine useless. Yet, there are some vaccine in Phase II trials in the USA.
11] The situation is we know that HIV virus as of now can exist only in Human beings. So, cant we see to that we prevent any further transmission and see that it is eliminated in the community. Well, that is the issue!
Many are to be educated on modes of transmission and be aware that HIV virus is not contagious [that is you dont get HIV virus like a common cold]
People, even educated ones , are not fully aware of facts of HIV virus , are misguided and misguide others. There is this panic mail saying that needles contaminated with HIV virus are left in theatres/Cinemas and upon being pricked , you get HIV. This mail is even being signed by a supposed doctor from Chennai!
First of all, one must be aware that the HIV virus- a RNA virus- is a very weak virus, outside its natural environment [ The Human host] it is very vulnerable . It would be very unlikely for a virus to survive for a long time in the air. Even if it does survive, you need a high viral load for it to cause infection in a pricked individual. This would be near impossible in a left over needle in a theatre. There is a higher chance that you could get Hepatitis -B , another disease that spreads through body fluid and which has a vaccine, than HIV. The rate of transmission for HIV through needle stick injury is less than 0.001. So, one should not panic with such supposed injury. Though , i feel obliged to state the current best practice for needle injuries in Hospitals is to have the wound washed with Sodium Hypochlorite solution and get anti-retroviral drugs.

Corruptio Optimi Pessima -INDIA and CORRUPTION

Corruption :

Whenever I think of corruption in India. I am reminded of 2 sayings in Latin:
"corruptio optimi pessima "-The corruption of the best is the worst .

"corruptisima re publica plurimae leges"- In the most corrupt state are the most laws .

Corruption has become so institutionalised in India , it is that even politicians would not make it an election plank. Anyway, why would politician even raise an issue which they are deeply immersed in!
The founding fathers of modern India in the 1940s envisioned a democratic country with opportunities and economic development for all. I doubt they would have foreseen the way corruption has become rooted in our system. The institutionalisation of corruption began in the 1970's with the governments turning a blind eye. The rot had begun.
Corruption is ubiquitous. Extending from the top echelons to the bottom most officials. It especially angers me when educated officials exploit the meekest in the hour of need. Go to a local taluk office to register a sale deed , you pay a bribe. Want to be admitted and treated in a government hospital , pay a bribe. even Member of Parliaments take money to raise questions in Parliament. I am surprised that India does not lead the world rankings in corruption [ http://ww1.transparency.org/surveys/index.html#barometer We can observe that corruption is mainly within the government services, while we rarely hear of corruption in the Private sphere. Yes, there is commercial exploitation in the Private fields, but that is another issue.
In many cases , bribery is inevitable . Or else, you would not have your work completed. Yes, a service which you are completely entitled to as a citizen of India to be performed in all fairness and efficiency, would not be done without the official resorting to the lowest form of human behaviour. It is easy to see here what is lacking here. It is "Anger"
Yes, I repeat Anger again! Why should we consider corruption as normal and a right of these mongrels. Why should we wait for the Government to change its behaviour. It will never, even well meaning individuals will get swamped by this nefarious system. Once again, I continue with the theme I used in the Africa post. We need people power to change this. The society's attitude towards bribery should change. A individual would find it difficult to change the system, but People power can and certainly should. It is time to say enough!If we say this is not possible. Remember the lawyer who returned from South Africa to India and brought the mighty British empire to its knees , All this with People power. If this was possible in the 1930s and 1940s , when there was little communication [read no mobile phones, TVs, internet], fast means of travel [Airflights] and global awareness/ education among the populace. Why can't it happen, now?
There are many individuals who would want to wipe away the blight of corruption from this Great country -India, but need direction. The direction is establishing organisations or groups of like minded individuals, and this could be made possible.
Can we envision a future where we do not have to bribe some one to get our marks sheet released or corrupt politicians being punished? Yes, We can!

Meanwhile, Iam providing some contact numbers of CBI, where incidents of Corruption can be reported: Delhi: 1st Floor, Block No. 4, C.G.O. Complex, Lodhi Road, New Delhi . Phone: 011-2436-1812

Mumbai: 3rd floor,TannaHouse,11-A,NathalalParaekhMarg,Colab. Phone: 022-22842816

Kolkotta: MSO Bldg, 2ndFloor, A Wing, DF Block,SaltLake, Kol-64.Phone: 033-22894412/ 10/ 09/ 08

Chennai: Shastri Bhavan, 26, Haddows Road. Phone: 044- 28273186

Bangalore: 36, Bellary Road, Ganganagar, Bangalore, Phone: 080-23332726/1026

Lokayuktha :124, I Floor MS Building ,Bangalore - 560 001 Phone: +91-80-2264334 Fax: +91-80-2252052Email: kla-reg@kar.nic.in

AFRICA Part-Deux

A NEW BEGINNING

Following the previous discussion in which we explored the historical reasons contributing to the present state of Africa, we will now examine current events and the pathways to progress.

Pestilences, Political Strife and Mobile phones!
Many ills affect Africa. With thousands dying of AIDS, Malaria, genocides and starvation. What leads to these preventable deaths?
It will be politically incorrect to say this, but in many instances it is the national governments of different countries which are responsible.
Many so-called leaders have a main objective of retaining power at all costs and looting the national coffers. These leaders are surrounded by sycophants and self-serving bureaucrats. The big losers are the ordinary people. Democratic set ups are few in Africa, with many autocratic and military governments. Unless this structure changes , the continent will suffer, no matter how much money is poured into development or health . Even western educated Africans fail in many ways in tackling these issues. It will be surprising to hear that in many cases , money from donors and international agencies goes unutilised because of lack of absorption capacity.
How can all this be changed? I feel in many ways , the outside world fails to recognises that Africa is home to numerous cultures and groups and refers to them as a homogenous unit. It is important to recognise the differences, inorder to make a beginning. That doesn't mean to neglect the common ties and strands which exist among the African nations. Grass root organisations and indigenous democratic movements are to recieve the maximum support and funding. Education , Health , and infrastructure should be made priorities of all governments, where current priorities lie in developing the military or filling the pockets of the bureaucracy. One positive thing , I note is the way the mobile phone network has picked up in the continent. Communication is a vital step in the progress of these nations. Free flow of information encourages democratic ideas and values. even with high rates of AIDS, countries like Botswana are showing economic growth. Uganda has been able to show that the growth of AIDS can be stemmed. Pressure from overseas and locally can force dictators to allow for free speech and demoratic` elections.
To sum it all up, things can change only if the people recieve power. This is achieved mainly through Education and tackling Health problems that sap the vitality of this great continent.
VIVA AFRICA!

Africa

AFRICA- Part I
Africa, a grand continent that was home to our Hominid ancestors ,evokes images of deserts, rainforests, long rivers, Gold, Diamonds, and very sadly also of Famines, HIV/AIDS, Malaria, Political Strife, Genocides.....
So, whats the story?
The past:
I will bravely try to mention some factors which I see are Important :

Africa , a continent with rich resources, home to multiple ethnicities and languages -has a history of ancient civilisations from the Pharoahs of Upper Nile Kingdoms to the Ashanti Kingdoms of West Africa . It has also been a recipient of western colonial expansions. Colonial powers from Dutch to the Britishers discovered the riches in both the land [ resources -Gold, Diamonds, Metals] and the people [Slavery]. European powers carved up the continent into their spheres of influence [ As they would do elsewhere in other parts of the world]. Even the Arabs got into the act with Slave trade. Few colonial governments ever devoted time or resources for developing the people they colonised. Development which if happened was for settling europeans [South Africa] or for transporting precious minerals. This process continued for hundreds of years.

Certainly there were enlightened Europeans who indeed had genuine concern for the continent like Albert Shweitzer, David Livingston, .... But the exploitative powers and climate prevailed.

Changes in political structures in Asia in the 20th century and the growing anti-colonial sentiments brought independence to many countries in Africa. Though , in many countries it was the elite or the armed forces which gained power. Also countries with many different tribes , languages, religions and cultures were formed as a single unit, just because they were so under the colonial governments. This led to and still leads to political problems [ Rwanda, Nigeria, Sudan]. In the next part , I will examine the present day situation and problems. Also, I examine options that could be the way forward.