Introduces Hib Vaccine Bangladesh

January 21st, 2009 healthwiki Child Health,HIV-Aids 0

Bangladesh has recently introduced a new combination vaccine that will protect its children against five killer diseases in one injection, including, for the first time, the deadly bacterium Haemophilus influenzae type b (Hib) that causes some severe forms of pneumonia and meningitis.

In a ceremony in Khulna District, southwest of the capital Dhaka, the Minister of Health and Family Welfare, Professor A. F. M. Ruhul Haque, along with other health officials and representatives of UN agencies and development partners administered the first shots of the combination vaccine to Bangladeshi children on January 15, 2009.

Hib is one of the causes of severe pneumonia and meningitis among children. The majority of them are children under five years of age. Even with treatment, thousands of children die of Hib disease every year. Survivors are often permanently disabled—paralysed, deafened or brain damaged.

The vaccine can prevent about one third of life-threatening cases of bacterial pneumonia, the leading infectious cause of death in children worldwide. In Bangladesh, it is estimated that 24% of under-five child deaths is due to pneumonia.

The vaccine will be provided under the routine immunisation programme (EPI) to nearly four million children born in Bangladesh every year. As Bangladesh records high routine immunisation coverage, it is estimated that Hib vaccine can save about 20,000 children’s lives annually year.

“This life-saving vaccine represents an important step forward in preventing childhood diseases in Bangladesh”, said A. M. M. Nasir Uddin, Secretary of the Ministry of Health and Family Welfare at the launch. “It will greatly help our country to achieve the Millennium Development Goal 4 which aims at reducing under-five mortality.”

In South-Asia, Sri Lanka and Pakistan introduced the Hib vaccine in 2008.

The new combination or 5-in-1 vaccine will protect children against Hib and four other deadly diseases: diphtheria, tetanus, pertussis, and hepatitis B. Instead of three different injections (for DPT, Hepatitis B and Hib), children will only need one injection at three different times during their first year of life: at the age of 6 weeks, 10 weeks and 14 weeks.

This will make it easier for health workers who will need less time and less logistics to immunise all children. It will also increase the uptake of vaccine as each child will get all five vaccines at once. At the same time, it will drastically reduce the system loss of the vaccines.

“We are proud to be part of this new initiative by helping with the procurement of the vaccines and supporting the training of about 60,000 health workers together with WHO,” said Unicef Deputy Representative in Bangladesh, Dr. Iyorlumun J Uhaa.

The introduction of the 5-in-1 vaccine in Bangladesh is carried out with financial and technical support from the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation) and its key partners including Unicef, WHO and the Hib Initiative.

GAVI will spend more than US$95 million for procuring more than 27 million doses for 2009—2010. The Government of Bangladesh will co-finance the purchase by investing US$5.6 million during the same period.

“Vaccines and improvement in health and immunisation systems are much needed in this part of the world,” said Dr. Julian Lob-Levyt, Executive Secretary of the GAVI Alliance. “We applaud Bangladesh for taking this important step to help prevent more childhood diseases.”

With high poverty, low literacy levels, and limited access to healthcare, many sick children in this densely populated country of 155 million never reach a hospital and often die at home. Vaccines that protect children against preventable high-mortality infections, such as Hib, were urgently needed. Now more children will be saved from early grave.

Dr Tareq Salahuddin…

Second SAARC Conference On HIV/AIDS

January 8th, 2009 healthwiki HIV-Aids 0

Second SAARC conference on HIV/AIDS, Tuberculosis and Respiratory Diseases was organized by SAARC Tuberculosis and HIV/AIDS Centre (STAC) on 15-18th December, 2008 in Kathmandu.

STAC started functioning in Kathmandu, Nepal since 1992 as one of the regional centres for SAARC with the objective to work for prevention and control of tuberculosis and HIV related tuberculosis in the region by coordinating the efforts of the National Tuberculosis Control Programmes of the member countries. Later on STAC has been mandated to work for prevention and control of HIV/AIDS in the region (during birth it was named SAARC Tuberculosis Centre. HIV/AIDS was added in the name in 2006).

While carrying out activities, STAC realised that it is also necessary to exchange knowledge based on research activities to have clear picture of the region and insight of newer ways. Keeping these in mind, STAC organised maiden conference in 2004 followed by the second one in 2008.

The theme of this conference was HIV/AIDS, tuberculosis and respiratory diseases. As HIV destroys one’s immune system, infected person becomes prone to opportunistic infections like tuberculosis and other respiratory tract infections. In such situation patients have to fight against multiple pathology. That is why, efforts needed to be made to disseminate knowledge not only on HIV but also infections like tuberculosis that takes the chance of immune suppression caused by HIV. That is exactly what STAC attempted in second SAARC conference on HIV/AIDS, Tuberculosis and respiratory diseases.

Delegates from SAARC countries presented paper elaborating HIV situation of their countries. In India, an estimated number of PLHA is 2.47 million. An estimated 85,000 and 70,256 people are living with HIV/AIDS in Pakistan and Nepal respectively. Though it is a matter of great relief that the prevalence of HIV/AIDS among adults is less than 1% in Bangladesh with an estimated number of infected 7500 we must not be complacent about the current data. HIV infection in Bangladesh is still believed to be confined among the vulnerable groups such as sex workers, injecting drug users because of their risk behavior.

One presentation informed that 77.2% of male IDUs in Dhaka have reported borrowing or lending used syringes. Once the virus is leaked and spread in general population, we will have to face the HIV epidemic.

We, as a nation have to be aware to prevent HIV infection. But what about those people who already are living with the virus? Do we have positive attitude towards them? Now time has come to stop scaring people in the name of HIV/AIDS. We have to understand that people can live with HIV infection.

All we need to have a positive approach towards PLHA. Acquiring HIV is unfortunate, not crime. If Mr. Co-chairperson of that specific session, living with the virus can roam around the world (he has to attend a lot of conferences) raising his voice for the rights of PLHA, why not others can live.

People with AIDS have to be within comprehensive coverage of ART. It is revealed from the conference that there is about ten times more DOTs center than ART centers in Nepal. ART needs to be made available at low cost to HIV positive people. They need to be given total support against all health hazards they could possibly suffer. If cushioned properly, people living with HIV/AIDS can also live a productive life.

Dr Enamul Hasib……

Reducing HIV Cases

November 29th, 2008 healthwiki HIV-Aids 0

Universal and annual voluntary testing followed by immediate antiretroviral therapy treatment (irrespective of clinical stage or CD4 count) can reduce new HIV cases by 95 percent within 10 years, according to new findings based on a mathematical model developed by a group of HIV specialists in WHO. The findings were published in The Lancet to stimulate discussion, debate and further research.

Authors of the study also report that the universal voluntary testing followed by immediate ART could have additional public health benefits, including reducing the incidence of tuberculosis and the transmission of HIV from mother to child. Additionally, the model suggests that there could be a significant reduction of HIV-related morbidity and mortality in resource-limited countries with generalised HIV epidemics.

The current WHO policy on treatment involves voluntary testing and clinical and/or immunological evaluation (e.g. Cd4 count) to determine eligibility for treatment with antiretrovirals.

The authors emphasise the theoretical nature of the exercise based on data and raise a number of concerns regarding feasibility, including the protection of individual rights, drug resistance, toxicity and financing challenges.

WHO-recommended preventive interventions need to be maintained and expanded. This includes male circumcision, partner reduction, correct and consistent use of condoms, and interventions targeting most-at-risk populations, also known as “combination prevention.”

WHO will convene a meeting early next year bringing together ethicists, funders, human rights advocates, clinicians, prevention experts and AIDS programme managers to discuss this and other issues related to the wider use of antiretroviral therapy for HIV prevention.

Thought of World AIDS Day

November 29th, 2008 healthwiki HIV-Aids 0

Around 40 million people worldwide are HIV positive, 95% of them live in developing countries.

In 2004, approximately five million people were newly infected with the virus. HIV/AIDS has killed more than 20 million people worldwide. 3.1 million people died of AIDS-related causes in 2004.

The Global Fund To Fight AIDS, Tuberculosis and Malaria (GFATM) was created in 2001 to provide major financial resources in the fight against three diseases. These diseases kill over 6 million people each year and the numbers are growing.

As of mid-2007, the Global Fund Board approved more than US$ 7.7 billion for programmes in 136 countries. Together with the efforts of many implementing partners, Global Fund-supported programmes have already saved 1.8 million lives. Till mid 2008, the Global Fund committed US$ 11.3 billion in 136 countries to support aggressive interventions against all three diseases.

The Global Fund announced its approval of nearly $3 billion in Round 8 funding to improve access to HIV treatment and prevention and help reduce deaths from TB and malaria by 50% by 2015. The Global Fund’s board approved 94 grants worth $2.75 billion over two years, representing the group’s largest funding round to date (Global Fund release, 11/10).

The decision was made in New Delhi, during the Global Fund Board Meeting. The Board decision was rendered particularly difficult because the unusually large average size of the proposals meant that there was not enough money to pay the full cost of the proposals recommended for approval by the Technical Review Panel (TRP).

As of mid 2008, Global Fund supported programmes are estimated to have averted more than 2.5 million deaths by providing AIDS treatment (ARV) for 1.75 million people, anti-tuberculosis treatment (DOTS) for 3.9 million people, and by distributing 59 million insecticide-treated bed nets for the prevention of malaria worldwide.

Round 8 funding support now brings the Global Fund’s overall portfolio to US$ 14.4 billion in 140 countries. “This is the highest amount of new financing approved by the Global Fund ever. These new resources will significantly help the world in achieving global targets such as universal access to AIDS treatment and prevention, and cutting the number of deaths from tuberculosis and malaria by half by 2015,” said Rajat Gupta, Chair of the Global Fund Board.

He added that 38% of the resources will be used for HIV/AIDS programmes, 11% for TB programmes and 51% for malaria programmes. Around 90% of the approved grants will be distributed to low-income countries, 77% of which are in Africa and the Middle East. The remaining funds will be dispersed to countries in Asia, Central Asia, Eastern Europe, Western Pacific, the Caribbean and Latin America.

Michel Kazatchkine, Executive Director of the Global Fund, said the “increased demand” for funding “requires a renewed resource mobilisation effort.” He added that the Global Fund has a “fantastic message to bring back to the rich nations of the world: programmes to fight these three diseases save lives, reduce disease burdens and strengthen health systems” (Global Fund release, 11/10).

There is abundant evidence that science-based HIV prevention is effective, especially when backed by high-level political leadership, a national AIDS programme, strong community involvement together with adequate funding. Components of successful prevention efforts include clear and accurate communication about HIV/AIDS and methods to prevent infection, HIV counselling and testing, and treatment.

Gap analysis reveals that vast majority of people living with HIV/AIDS in the developing world do not have access to the treatment, as a result of limited health care infrastructures and the high cost of many medications. It has been estimated that a total of US$7-10 billion a year is needed from all sources to address the HIV/AIDS epidemic in low and middle-income countries. Allocation of around US$5.4 billion stands as great commitment of Global Fund to fight AIDS.

Fight For The People with HIV/AIDS

November 29th, 2008 healthwiki HIV-Aids 0

For many of us, December 1 will be just like any other day. But millions of people living with HIV/AIDS around the world will be looking towards us to stand up beside them, call for action and help stop their sufferings. Each year on December 1 the world celebrates World AIDS Day.

Yet, thousands of people in the country infected with the virus face social discrimination and stigma from different fonts. According to Human Rights Watch, “People living with HIV/AIDS and those thought to be infected have been imprisoned, assaulted and even murdered.”

The stigma of AIDS has taken many lives before the disease itself killed them. But the reasons behind the suicides and extent of this have rarely come to our knowledge. Society’s limited understanding of this disease is causing innocent people to pay a terrible price.

Increasingly across the world, there are voices questioning in one angle. They question the narrow approach to a single disease, especially the huge financing for AIDS over all else in basic health care. Our approach to this disease needs to change for the sake of our people, our brothers and our sisters who are fighting against odds.

Social factors like discrimination, stigmatisation and rejection have pushed people living with HIV to become desperate and feel hopeless, to the extent of giving up their life. They face discrimination and lack of support not only from the society but also from his/her own family. “I have actually seen how lack of support and stigma really makes to lose hope. How can we live if nobody is willing to listen to our problems?” said one of the victims in a rehabilitation centre in the city.

They are also being confined from friends, scared for losing their jobs. This made them to live in phobia and their condition become worse as they need proper and adequate treatment that could provide them with better life.

Most of these people are not getting proper medical and nursing care as stigma is attached so strongly to this illness that even some well educated people refuse to serve them. Many are afraid of consulting the doctors as they did not wish other people to know about their predicament.

According to the experts, with the existing treatment, people with HIV can lead a normal life like the others particularly if they receive good support from their family members, especially their parents.

The situation is aggravated by the fact that major percentage of the HIV positive individuals are injectable drug users (IDUs), who are marginalised by society and criminalised by the law. HIV/AIDS has already been concentrated epidemic among the IDUs. They must be taken under rehabilitation to stop the spread of this threat.

Conditions of women living with HIV/AIDS are dismal. Women are blamed for carrying the infection, even though they may have got the virus from their partners (in most cases husbands). Instances have been reported, where husbands abandon their ailing wives and children to find another wife. Due to the fear of social and family desertion, women are hesitant to disclose their HIV/AIDS status. Also, disclosure may lead to loss of job and reputations. This fear and dithering will make women an easy target of violence and abuse.

Dr Md Rajib Hossain…