Kerala AIDS e Forum

Sunday, January 30, 2011

Will Kerala make Pre-marital HIV test Mandatory ?

11 January 2011

http://www.thehindu.com/2011/01/11/stories/2011011157230400.htm

Make pre-marital HIV test must: women's panel

Staff Reporter

Commission forwards suggestion to government

Other States had to withdraw legislation after protests

Thiruvananthapuram: The Kerala Women's Commission has recommended to the State government to pass a resolution or to frame laws, if necessary, to make pre-marital HIV testing compulsory in the State. The Commission's recommendation, which has been listed prominently in its latest annual report, was forwarded to the government following a sample study conducted in the State in 2009-10, its chairperson D. Sreedevi said.

“We have seen many cases where the women became infected with HIV after marriage. I have interacted with organisations working with HIV-positive people, where several women said that they were infected by their partners. There is no harm in ensuring that one is not HIV-positive before getting married,” Ms. Sreedevi said.

The Commission has also recommended to the government to formulate special schemes to ensure the welfare of children who are HIV-positive. However, the recommendation of the Commission is sure to open a Pandora's Box as there are several ethics and human rights issues involved. Several NGOs as well as networks of HIV-positive people are bound to be up in arms against compulsory testing for HIV. It is the National AIDS Control Organisation's (NACO) stated policy that HIV testing should always be voluntary, with compulsory pre-testing and post-testing counselling. Compulsory or coercive testing for HIV is not the national policy as it is felt that the social stigma carried by the HIV-positive tag will make a lot of people who require medical care go ‘underground'.

In fact, all the other States which proposed compulsory pre-marital testing for HIV — Goa , Andhra Pradesh and Maharashtra — have had to abandon the legislations because of protests it sparked and also because of the innumerable questions brought up by these legislations regarding public health costs, infrastructure and social implications.

http://www.thehindu.com/2011/01/11/stories/2011011157230400.htm

From: KeralaAIDS@yahoogroups.com [mailto:KeralaAIDS@yahoogroups.com]
Sent: Monday, January 10, 2011 11:53 PM
To: KeralaAIDS@yahoogroups.com
Subject: [KeralaAIDS] Will Kerala make Pre-marital HIV test Mandatory ?

Kerala women's panel wants HIV test before marriage

Indo-Asian News Service, 10 January 2011

http://www.ndtv.com/article/cities/kerala-women-s-panel-wants-hiv-test-before-marriage-78339

Thiruvananthapuram: The Kerala Women's Commission (KWC) has asked the state government to pass resolutions and if necessary, a law to ensure that all those who get married undergo an HIV test.

"This is an issue that is affecting the entire humanity and hence adequate measures have to be taken to safeguard all," KWC chairperson Justice (retd) D. Sreedevi said.

The commission made the request in the wake of several cases where men got married in spite of knowing that they were HIV positive.

KWC submitted an annual report with the recommendations to the state government last week. The panel also asked the government to support the children of the HIV affected.

According to the Kerala State Aids Control Society (KSACS), a total of 55,167 people have been infected by HIV/AIDS in the state.

The HIV prevalence rate in the general population is 0.26 percent, which is less than the national average of 0.34 percent.

The KWC expects that with the budget session of the Kerala assembly scheduled for the first week of next month, their demand will be considered by the government.

http://www.ndtv.com/article/cities/kerala-women-s-panel-wants-hiv-test-before-marriage-78339

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Mandatory Pre-marital HIV Test Proposal Draws Flak

17 January 2011

C. Maya

http://www.thehindu.com/2011/01/17/stories/2011011757290900.htm

Pre-marital HIV test proposal draws flak

Thiruvananthapuram: The State Women's Commission's proposal to the State government to consider framing laws for making pre-marital HIV testing compulsory has drawn flak from various quarters for being ‘ill-conceived and flawed.'

‘‘None can impose pre-marital HIV testing as a general policy as it should always be voluntary. Pre-marital HIV testing should be the informed choice of the persons involved and not a coercive policy,'' an NGO representative said. The National AIDS Control Organisation (NACO) clearly stated that mandatory HIV testing should not be a pre-condition for employment or for providing health care and in the case of marriage, only if a partner insisted on it.

‘‘What is the rationale behind compulsory HIV testing before marriage? Will the Government also come up with a law banning all those who tested HIV-positive from getting married? What if one partner becomes HIV positive after marriage — will the government insist on divorce? As though the social stigma suffered by HIV-positive persons is not enough, this will create a separate class of citizens," an activist working for the rights of HIV-positive persons' networks said.

Past attempts

There have been attempts in the past too, to impose compulsory HIV pre-marital testing through legislations. In the U.S., in 1987, 33 States had considered bringing a legislation for compulsory pre-marital testing. The States of Illinois and Louisiana enacted the legislation in 1988 that marriage licence will not be issued unless HIV test certificates were produced by both parties involved.

The result was that in the first six months after the legislation was enacted, there was a 22.5 per cent reduction in the issue of marriage licence in Illinois. It also turned out that the pre-marital HIV testing was the most expensive public health programme ever. During the first six months, in Illinois, eight out of 70,846 marriage applicants tested positive and the cost for the screening was 2.5 million dollars, according to reports published in the Journal of American Medical Association (JAMA) in 1989. The State of Louisiana repealed the legislation after six months of enacting it, while Illinois followed suit in 1989.

No support

JAMA pointed out that the goal of any screening programme should be to identify infected individuals so that appropriate intervention measures could be taken to prevent further spread of the disease. In the case of compulsory pre-testing, not only was the programme ineffective in identifying more infected people, it was not cost-effective and the target population did not support the programme. In India, Goa, Andhra Pradesh and Maharashtra could not enact the legislation regarding compulsory HIV testing despite the declarations of the State governments. In 2004, a meeting of Catholic bishops in Thrissur had passed a resolution that pre-marital HIV testing be made mandatory because ‘unsuspecting families needed to be protected.'

Fear of discrimination

Human rights activists pointed out that the proposed legislation was well-meaning but that in the long term, such a generalised policy could be bad for the HIV control programme itself because fear of social discrimination would force people to flee rather than come forward to declare their HIV status. The partners to be involved in a marital relationship could reach an agreement on HIV testing and volunteered to test themselves. Rights activists pointed out that given the level of corruption and manipulation in the system, it would not be very difficult for people to come up with false certificates also. There were other important questions such as who would bear the costs involved, the number of test kits and other resources that would be required.

http://www.thehindu.com/2011/01/17/stories/2011011757290900.htm

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NRHM Common Review Mission in Kottayam and Kozhikode

16 December 2010
Staff Reporter
http://www.thehindu.com/2010/12/16/stories/2010121667940300.htm

NRHM Common Review Mission to arrive today

To evaluate implementation of scheme

Team to visit Kottayam and Kozhikode districts

It will moot strategies to correct constraints

Thiruvananthapuram: A high-level delegation from the Union Ministry of Health and Family Welfare which is part of the fourth Common Review Mission (CRM) of the National Rural Health Mission (NRHM) is arriving in the city on Thursday on a five-day visit to evaluate the State's progress in the implementation of the NRHM.

The last time the CRM had visited the State was at the end of 2008, when Thiruvananthapuram and Wayanad districts had been chosen for evaluation. This time, the team will evaluate Kottayam and Kozhikode.

The CRM was set up to review and evaluate the implementation and the progress of the NRHM, identifying the strengths and core areas of concern in each State and recommending strategies for correcting the constraints.

The last CRM report on Kerala had suggested that a stronger monitoring and evaluation mechanism be set up to ensure that the NRHM achieved its goals in Kerala. It had pointed out that the State needed to assess and understand better the unmet needs of its target population before planning and implementing health initiatives under the NRHM.

It had also been pointed out that there was wide variation in the performance and quality of services delivered by similar type of health care institutions. “Optimum use of resources is an area in which Kerala's health system has to formulate strategy in order to bring cost effectiveness in services delivered,” the CRM report had suggested.

The State had come in for appreciation for the marked improvement in hospital infrastructure and equipment, the setting up of Kerala Medical Services Corporation Ltd. for streamlined drug supply across State, use of ASHAs to reach out to the community, and the palliative care programme.

One of the suggestions put forth by the last CRM to Kerala, which the State seems to have implemented faithfully, is a programme for monitoring and preventing lifestyle diseases in the community.

The CRM team will hold briefings with the State Health officials and conduct field visits before presenting their findings.

http://www.thehindu.com/2010/12/16/stories/2010121667940300.htm
© Copyright The Hindu

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KSACS Invites EoI to Empanel Faith Based Organisations (FBOs)

[Attachment(s) from Info Desk / Media Monitor included below]

Note: Please find the Call from Kerala State AIDS Control Society (KSACS) for Expression of Interest (EoI) by clicking here

FBOs to be roped in to combat HIV/AIDS

Jisha SuryaExpress News Service, 28 Jan 2011
http://expressbuzz.com/states/kerala/fbos-to-be-roped-in-to-combat-hivaids/243007.html

THIRUVANATHAPURAM: 'Let love be our religion in our fight against HIV and AIDS'. It is not a statement made by any of the religious organisations, but, the catchphrase for the latest campaign against HIV/AIDS planned by the Kerala State AIDS Control Society (KSACS).

After successfully ensuring the participation of various sections of society in its campaign against AIDS, the KSACS now plans to rope in faith-based organisations (FBOs) in its HIV prevention activities.

As the first step, the KSACS has invited expression of interests (EoIs) from interested FBOs. It is the influence of religion in people and the vital role played by FBOs in the social context that influenced KSACS to go in for such a novel idea. The campaign, obviously, will be based on principles of morality.

According to S Ajai Kumar, jointdirector of KSACS, the KSACS expects support from organisations such as Kerala Catholic Bishop's Council (KCBC), Nair Service Society (NSS), Sree Narayana Dharma Paripalana Yogam (SNDP) etc.

"Religious institutions and FBOs have made tremendous impact on the State's health and educational sector. People belonging to various faith dimensions are deeply influenced by the teachings of their religion. "In fact, people are inclined to be more influenced by religious leadership than the civil governments," he said. KSACS had organised meetings with religious heads and FBOs a couple of years ago.

During the consultations, the need of the intervention from FBOs in controlling and preventing HIV/AIDS was stressed. Based on this suggestion, KSACS has decided to get FBOs involved in a systematic and regular basis. Kerala Catholic Youth Movement (KCYM), the youth wing of KCBC, is already active in their campaign against AIDS under the programme 'Sneha Douthyam'.

KSACS is planning to empanel interested FBOs to undertake programmes in all the districts in the state on a regular basis. These FBOs will organise programmes as per the guidelines of the KSACS. Interested FBOs can approach the KSACS headquarters till February 10 and submit their EoIs.

http://expressbuzz.com/states/kerala/fbos-to-be-roped-in-to-combat-hivaids/243007.html

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1 of 1 File(s)

KSACS-FBO-EoI.pdf

Attachment(s) from Info Desk / Media Monitor

Friday, December 17, 2010

Expansion of Second Line Treatment

Note: Please pass on this message to all concerned.

From: Dr. B. B. Rewari
Sent: Thursday, December 16, 2010 5:41 PM
To: AIDS Community
Subject: [aids-se] FOR INFO: Expansion of Second Line Treatment
Importance: High

Dear All,

The National AIDS Control Organisation (NACO) has decided to make second line Antiretroviral Therapy (ART) available to all those in need of it - whether they underwent first line treatment in the government sector or private sector. In the first phase, and with immediate effect, universal access to second line treatment would be started at four Centres of Excellence – J J Hospital in Mumbai, GHTM in Tambaram, MAMC in New Delhi and STM in Kolkata. This will be open to patients from any part of the country.

The person in need of second line treatment will have to register at the nearest ART centre. This could be a person with suspected treatment failure, or a person already on second line treatment. The local ART centre will then send the patient’s details to the State AIDS Clinical Expert Panel (SACEP) at these four Centres of Excellence, as per existing operational guidelines, and prior appointment shall be given. The person shall then report to SACEP where further evaluation like viral load tests will be conducted as required. A decision would be taken on whether there is genuine treatment failure necessitating second line treatment.

This pilot initiative would be studied over a period of three months, which would give an indication of the number of additional persons seeking second line treatment, thus enabling capacity addition to proceed in a planned and phased manner for expansion to other Centres of Excellence and ART plus centres.

Thank You.

Dr. B. B. Rewari,
National AIDS Control Organisation (NACO),
New Delhi.

This is a posting from the Solution Exchange AIDS Community facilitated by the UNAIDS Country Office in India
Update your contact details at http://www.solutionexchange-un.net.in/login.php
To join the AIDS Community click on http://www.solutionexchange.net.in/communities/aids
For more information on AIDS Community visit http://www.solutionexchange-un.net.in/aids.htm

Tuesday, December 14, 2010

RE: [KeralaAIDS] Musli Power X-Tra Said to Improve CD4 & Hb Counts [1 Attachment]

[Attachment(s) from Dr. Chandramohan included below]

Note: Please find postings from Dr. Pradeep and Dr. Chandramohan.

Dr. Pradeepkumar writes:

Dear All,

I am a qualified Ayurvedic physician and am the member secretary of the Ethics Committee of an institution conducting research and providing treatment.

It is a pity to see this situation. Everywhere it is taken for granted that any Herbal remedies can be prescribed by any one for any of the diseases. It is even more pathetic to know that studies of doubtful credibility conducted by laymen are reported and published in periodicals.

Herbal formulations without any basic references cannot be AYURVEDA. As per the 1945 Drugs and Cosmetics Act 1945, specific Ayurvedic text books are mentioned. Any drugs prepared and prescribed for the indications mentioned in these classics are only exempted from rigorous research because those medicines for the prescribed indications are is time tested.
However, MUSLI POWER as I understand is a New Chemical Entity (NCE). Thus, as per the said Act, it needs to go through all rigorous research including toxicity tests. This formulation cannot be called an AYURVEDIC medicine unless there is proper reference in any of the classics mentioned in the Drugs and Cosmetics Act.

Incidentally, there is something interesting now running successfully in Karnataka. It is known as "SWARNA BINDU PRASHANA" which might soon come to any of your household. This is an age old practice where they used to add honey, ghee, vacha and gold rubbed together given to infants given once in life time. Now few big institutions have converted it into a business. They are advertising to give this to children between 0-16 years once a month on a particular day that is PUSHYA NAKSHATHRA continuously to increase the child's brain power, immunity etc. This is administered in hospitals giving 2-4 drops per child. Further, now they have even approached clinics in various places and have developed centres to administer the same. The charge varies from Rs.50, Rs100, Rs.250 per dose. From that 25% is given to the clinic. There is a booming business of 1000 to 1500 children being brought for this in few centres. When they approached me I shot the following questions which they could not answer.

The questions raised by me were as follows:

Where is the proper reference for this? Is it as per the Drugs and Cosmetics Act ?
Which authentic source has mentioned about PUSHYA Nakshatra ?
Is there any study done in this line? Is there any publications ?
What are the actual ingredients ?
If swarna bhasma is used what are the precautions taken to assure there is no heavy metal poisoning?
What are the measures taken for standardization?
Even if you assume that there is some reference what is the need to administer this in a hospital or a clinic with medical supervision?

After asking these questions, I am facing threat from different institutions.

Ayurveda is facing a great threat from issues like this which has to be tackled. However, Who Will Bell the Cat ???

Dr. K. R. Chandramohan Nair writes:

Dear All,

Please find attached a news paper cutting from the Kerala Koumudi dated 8 December 2010. It talks about the said study.

The Original Posting and the responses received so far is available at http://health.groups.yahoo.com/group/KeralaAIDS/message/379

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1 of 1 Photo(s)

MusliPower_K_Koumudi_8Dec10.jpg

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Attachment(s) from Dr. Pradeep, Dr. Chandramohan

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Re: [KeralaAIDS] Musli Power X-Tra Said to Improve CD4 & Hb Counts

Note: Dr. Rakesh and Dr. Jayakrishnan are continuing the discussion regarding a 'study' on Musli Power X-Tra claiming to improve CD4 and Haemoglobin counts for people living with HIV.

Dr. Rakesh. T. P. writes:

Dear All,

I was purchasing some medicine from a medical shop couple of days ago, and I saw Musli power bottle on the shelf. I requested to hand over a bottle just to read the contents. People around were looking at me. The following are worthy to note about the 'drug' which is claimed to benefit people living with HIV:

· Cost of 30 capsule is just Rs.750/- !!

· Indication : Aphrodisiac

· Kerala Govt. Drug controller approved

· ISO 2000 certified

· Can be taken with all 'english' and ayurvedic drugs safely

· Cardiac patients may need extra doses for action !

· contents are nellica, kanmadam, etc. etc...

There are no contraindications it seems. You just need to be alive.

I think now we have something for a short note on Musli Power !!

Dr. Jayakrishnan T. writes:

Dear All,

Are people at the NGO Atmata Kendram eligible to conduct a clinical study especially when people living with HIV are involved? Why there is high rate of lost to follow up in the study? What about the participants excluded from analysis? Finally, the "world" would also want to know the amount of money received by the "Researchers".

The Original Posting and the responses received so far is available at http://health.groups.yahoo.com/group/KeralaAIDS/message/379

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