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Draft HIV/AIDS bill leaves out key provisions

Positive people's networks have protested the deletion of 38 key provisions in the latest version of the HIV-AIDS Bill which is being discussed by the law ministry and health ministry.

The bill was drafted by the health ministry and the Lawyers' Collective in 2006 after discussions with individuals and organisations representing various concerned sections of society, including people living with HIV, sex workers and injecting drug users. It was then sent to the ministry of law and justice for vetting.

In the versions sent back by the ministry, many important provisions were missing. One of the provisions not included is to guarantee emergency health services for people with HIV. HIV patients are often denied treatment in hospitals despite being an emergency, hence the need for this special provision which requires a health official to be appointed, who will give orders within 24 hours if such a situation arises.

Another missing provision in the latest version of the bill is protecting property rights of a child of parents with HIV. Often such rights are unfairly snatched away by relatives.

(Source: Azera Rahman, www.iGovernment.in, October 22, 2009, AIDS-INDIA eFORUM)

Mandatory testing of pregnant women for HIV

The announcement by the India’s Parliamentary Forum on HIV and AIDS that pregnant mothers will be required to undergo an HIV test, should be viewed with concern. UNAIDS executive director Michel Sidibe is reported to have agreed with the forum's stand.

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Undernourished women get food support

Approximately 80% of women living with HIV and AIDS in Nagaland come from families living below the poverty line. "Many of these women are too poor to even afford one square meal a day which is vital for them to gain energy to withstand the strong effects of their medications," according to the department of Women Development.

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Panchayat wants AIDS care centre to be moved out

A village administration in Nalgonda district of Andhra Pradesh, has passed a resolution asking a community care centre for people living with HIV or AIDS to be shifted out of the village, said a source quoting a local villager. 

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NACO commits to paying for HIV treatment

Patients suffering from AIDS need no longer worry about the heavy expenses of treatment. The National AIDS Control Organisation (NACO) recently stated before the Bombay High Court that it would provide “free of cost appropriate” treatment to HIV-positive patients in the state of Maharashtra.  

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Early ART is cost effective

As numerous studies conclude that early initiation of antiretroviral therapy reduces illness and prolongs lives, government programmes have responded with doubts of the financial sustainability of a programme that starts treatment early. The tide might soon start changing.

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Don't qualify for care

A brief account in the AIDS INDIA egroup conveys the tragedy of people seeking care for AIDS. Jay Prakash describes his encounter with a 35-year-old man in a Delhi ART centre. The man had returned from his job abroad because of health problems, and then found out that he was positive. He was registered at a government ART centre in Delhi, but did not qualify for ART because his CD4 count was high. However, he was very weak and his weight was barely 37 kilos, when he came to a hospital for help. The hospital discharged him after some medical treatment. He was also turned away from various care homes that he approached for help, apparently because he did not qualify for admission under their guidelines.

Awareness campaign uses photograph without consent

The Tamil Nadu State AIDS Control Society used a woman's photographs in an AIDS awareness campaign without her consent!   The newspaper report in The Times of India does not give more details on how exactly TANSACS obtained the photographs of the woman and her child but they apparently date back to when the child, now four years old, was an infant.

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Speciality hospital refuses treatment

The Kerala High Court has issued notices to the National Human Rights Commission (NHRC), the Kerala State Aids Control Society (KSACS) and the state government on a petition challenging an NHRC order.

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Peer counselling is the best

Those who are themselves HIV-positive are best suited to counselling and helping others in a similar situation. This is the verdict from many HIV-positive patients in Maharashtra. The National Aids Control Organisation wants to engage professional counsellors at the treatment and counselling centres attached to ART centres, but patients are against this change.

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Court fines officials for neglecting HIV-positive prisoners

The lack of medical attention for prisoners in Indian jails is a major concern when they suffer from serious diseases, whether chronic conditions like heart ailments and diabetes or infections like tuberculosis which also happens to be an opportunistic infection in AIDS.  

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Parents’ HIV phobia forces children out of school

The school is run by the local zilla parishad at Hasegaon village and is flooded with requests by parents for transfer certificates so that they can admit their children in other schools.

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AP concentrates on high risk groups

People identified as being in the high risk group for HIV/AIDS are getting a little more attention in Andhra Pradesh. The Andhra Pradesh State Aids Control Society (APSACS) has launched its ‘Shubham’ campaign to determine the HIV status of people at a higher risk of contracting the disease, reports the Express News Service on July 13, 2009. 

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The impact of Big Funding

Criticism about the Bill and Melinda Gates Foundation has been circulating for years but few people are willing to go on record with their statements. Two recent reports have created a stir.  

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Warning: HIV-positive

The many accounts of positive people being denied healthcare must be recorded to remind us that things haven't changed much over the years.

The Indian Express (May 22, 2009) reports on a patient who approached the Uttar Pradesh government's Swaroop Rani Nehru Hospital and was initially refused treatment for an infection. When he was finally admitted, a sign was placed above his bed saying ‘HIV’. The words ‘HIV’ were removed after a protest from the Allahabad Network for People Living with HIV Positive, but was replaced with the words ‘ART’ and a red ribbon. To add insult to injury, the patient's attendants were asked to buy gloves and other material from the market and also to dress the wound themselves. The superintendent of the hospital is quoted as saying that she provided five medical kits for the treatment of the patient. Presumably this is to indicate that care was given. (SAATHII)

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Needle stick injuries: who gets hurt and why

Healthcare professionals routinely refuse care to positive people, or charge them more for treatment. Part of this is certainly just plain prejudice. But some are also afraid of HIV infection. Are healthcare staff trained and equipped to prevent occupational exposure to blood borne infections?

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Unprotected sex is still a major hazard

Less than one in two sex workers in Goa knows how to reduce her risk of HIV infection through sex; only one in five has access to free condoms from NACO; almost one in three is forced to have sex without protection and the same proportion has no knowledge of HIV. These are some of the major findings of a survey of female sex workers, a group that is obviously very vulnerable to HIV infection because they may have difficulty convincing their clients to use condoms.

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Is the "auto disable" syringe the solution?

The Telegraph, Kolkata, reports on a visit by Marc Koska, the inventor of the non-reusable, "auto disable" syringe. AD syringes are designed for a single use. Once the plunger of the syringe is pressed, it locks to prevent reuse and, thus, unauthorised packaging or resale. The technology was developed specifically for use in developing countries where unsafe injection practices are widely reported. The AD cause is strengthened by a 2005 study that found 62% of injections in India unsafe because the syringes were reused.

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NGO challenge of patent for HIV drug would drastically cut price

The non-profit Initiative for Medicines, Access, & Knowledge (IMAK) is fighting to prevent the pharmaceutical company Abbott from patenting the anti-HIV drug lopinavir/ritonavir. Abbott has filed for a patent for the drug before the Indian Patent Office but HIV activists say the claim is mendacious because there is little that is new in the drug.

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Doctors do your duty…

The healthcare profession needs to pull its socks up. Here are some complaints reported in the AIDS-INDIA egroup:

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Torture in the name of de-addiction

De-addiction centres in India have been known to hold drug users against their will, beat them and deny them medicines including those that relieve withdrawal symptoms.

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Treatment that can kill

Standard practices have been stipulated in all healthcare facilities to prevent contamination from used needles. But they are not being followed. Union Health Minister Kiran Walia who did the rounds of five government hospitals in Delhi - Aruna Asaf Ali, Ambedkar, Lok Nayak, Susrut Trauma Centre and Babu Jagjeevan Ram - was shocked to find that the needle destroyer used to break used needles and prevent their re-use was “defunct”. Walia issued a show-cause notice to the doctor at Lok Nayak Hospital’s ART clinic where she saw used needles strewn around instead of being destroyed. 

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CD4 and starting ART: time to revise the guidelines?

When should anti-retroviral treatment (ART) start? According to World Health Organisation guidelines for ‘resource-limited settings’, treatment should start before the CD4 count falls below 200 cells/mm3. ‘Consideration’ should be given to treating patients with a CD4 count below 350.  

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Food is medicine

People with HIV need extra nutrition to improve their immunity and also to tolerate their medications.  So it's great to hear of any effort to increase people's access to food.

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Asian migrant women at risk

Women from Asia migrating to the Arab states for work are particularly vulnerable to HIV infection. 

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HIV hidden in rural India

The March 2009 issue of AIDS Care, carried details of a study titled ‘Profile of adults seeking voluntary HIV testing and counselling in rural central India: Results from a hospital-based study’ by Nikita Pant Pai and others. A significant finding of the study was the high risk factor for married women.

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Testing prisoners

A survey in four central jails in Maharashtra ordered by the Bombay High Court found that HIV prevalence in prisons is higher than it is in the general population. 

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Second-line treatment hurdles

Access to the government’s anti-retroviral therapy (ART) programme depends on where you live, and more so for second-line treatment. ART is the most effective medication for HIV discovered so far and is provided at two levels.

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Providing HIV care to children

The January 2009 issue of the Indian Journal of Medical Research (IJMR) contains a study and a commentary on the challenges of providing HIV care to children in India where 3.8% (approximately 100,000) of an estimated 2.5 million persons living with HIV/AIDS (PLHA) are children. Of the 1.78 lakh people on anti-retroviral therapy (ART) in 2008, 12,000 are children.

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