Two-thirds of AIDS treatment drugs supplied globally by India

Agencies
June 4, 2019

United Nations, Jun 4: Taking a lead in the global fight against AIDS, India is supplying the world with two-thirds of the drugs to treat those infected with HIV, according to Indian diplomat Paulomi Tripathi.

"These affordable generic medicines have helped scale up access to treatment across developing countries," Tripathi, a First Secretary in India's UN mission, told the General Assembly on Monday.

"India is contributing in the international fight against AIDS: almost two-thirds of the antiretroviral drugs used globally are supplied by the Indian pharmaceutical industry," she said during a discussion on the Implementation of the Declaration of Commitment on HIV/AIDS and the political declarations on HIV/AIDS adopted by the General Assembly in 2001.

Tripathi emphasised the importance of continued political commitment to ensure that competing financing demands and changing priorities did not affect efforts to provide adequate resources to fighting HIV/ AIDS.

"Ensuring uninterrupted access of affordable antiretroviral drugs and quality care, as well as adherence to treatment through support services, is necessary to combat drug resistance," she said.

Domestically, "the focus is on reduction in new infection, elimination of mother to child transmission and elimination of stigma and discrimination by 2020," she added.

New infections have declined in India by more than 80 per cent from peak of epidemic in 1995 and deaths from the disease have come down by 71 per cent since its peak in 2005, she said.

Tripathi ascribed the progress to the involvement of communities, civil society and people living with HIV in policy and delivery of services and through intensified information, education and communication drives.

India, which is described as the pharmacy to the world has a special licence the UN-backed Medicines Patent Pool to manufacture anti-AIDS medicine TenofovirAlafenamide (TAF) for 112 developing countries.

According to a 2017 study by Harvard Business School, low-cost generic antiretroviral drugs from India "have been integral to the rapid scale-up of HIV treatment in Sub-Saharan Africa and other developing countries".

"A common first-line regimen of treatment decreased from $414 per person per year to $74 per person per year for Indian generics," it said.

Secretary-General Antonio Guterres said in his report that when the General Assembly held its first session on the AIDS epidemic in 2001 a "world without AIDS was almost unimaginable".

However, "the global determination to defeat one of history's greatest health crises has produced remarkable progress", he said.

The number of HIV-infected people around the world, the number receiving treatment has increased 5.5 times over the last decade, and behaviour change communications and condom distribution programmes have successfully reduced the spread of AIDS and many countries have eliminated mother-to-child transmission of HIV, Guterres said.

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News Network
April 28,2020

Kochi, Apr 28: The Central government on Tuesday told Kerala High Court that the Kerala government will have to take up with other states the matter pertaining to bringing back COVID-19 affected Malayali nurses.

A Division Bench of Justice PV Asha and Justice V Shircy asked the Kerala government to examine if there is any solution that may be considered and orally noted the suggestion that perhaps a video-conference may be conducted between the states on the matter.

The matter was posted for further hearing on April 30.

Counsel for the Central government said that the "Centre has issued guidelines for the protection of health workers. But in this specific case, state governments have assured that nurses are being given proper treatment."
"The plea is on apprehensions that they are not being treated well in the other states.

Centre could help if there is any necessary requirement thereafter," the Centre's counsel said.

Advocate Abraham Vakkanal, appearing for the state government, said that state chief secretary has written to Union cabinet secretary to relax travel restrictions amid COVID-19 lockdown to bring back the nurses.

Vakkanal said that the state has sought permission and is waiting for approval and will take further actions if permission is received on the matter.

Advocate Anupama Subramaniam, appearing for the petitioner, said that 68 Malayali nurses in other states have reached out to inform that they are not being given treatment and that facilities for food and shelter are also not readily available for them.

Kerala High Court had earlier asked the Centre and the state government to file their reply on the plea.

The court was hearing a petition seeking to bring COVID-19 affected Malayali nurses back to Kerala from other States considering their "poor health and working conditions".

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News Network
July 18,2020

Ayodhya, Jul 18: The Shri Ram Janmabhoomi Teertha Kshetra Trust has invited Prime Minister Narendra Modi to lay the foundation stone of a grand Ram Temple in Ayodhya either on August 3 or 5, both auspicious dates, said a spokesperson.

PM Modi had announced the formation of the Shri Ram Janmabhoomi Teertha Kshetra Trust on February 5.

Mahant Kamal Nayan Das, the spokesperson of Ram Mandir Trust president Nritya Gopal Das said, "We have suggested two auspicious dates -- August 3 and 5 -- for the prime minister's visit based on calculations of movements of stars and planets."

After a protracted legal tussle, the Supreme Court had on November 9 last year paved the way for the construction of a Ram Temple by a Trust at the disputed site in Ayodhya and directed the Centre to allot an alternative 5-acre plot to the Sunni Waqf Board for building a new mosque at a "prominent" place in the holy town in Uttar Pradesh.

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Agencies
May 23,2020

New Delhi, May 23: The nationwide lockdown will no longer help India in its fight against COVID-19, and in its place community-driven containment, isolation and quarantine strategies have to be brought into play, leading virologist Shahid Jameel said.

The recipient of Shanti Swarup Bhatnagar Prize for Science and Technology also stressed that testing should be carried out vigorously to identify coronavirus hotspots and isolate those areas.

"Our current testing rate at 1,744 tests per million population is one of the lowest in the world. We should deploy both antibody tests and confirmatory PCR tests. This will tell us about pockets of ongoing infection and past (recovered) infection. This will provide data to open up gradually and let economic activity resume," Jameel told PTI in an interview.

He stressed that testing has to be dynamic to continuously monitor red, orange and green zones and change these based on that data.

About community transmission of COVID-19 in India, Jameel said the country reached that stage long ago.

"We reached community transmission a long time ago. It's just that the health authorities are not admitting it. Even ICMR's own study of SARI (severe acute respiratory illness) showed that about 40 per cent of those who tested positive for SARS-CoV-2 did not have any history of overseas travel or contact to a known case. If this is not community transmission, then what is?" he posed.

Lockdown bought India time in its fight against coronavirus, but continuing it is unlikely to yield any further dividend, Jameel said.

"Instead, community-driven local lockdowns, isolations and quarantines have to come into play. Building trust is most important so that people follow rules. A public health problem cannot be dealt with as a law-and-order problem."

The nationwide lockdown, initially imposed from March 25 to April 14, has been extended thrice and will continue at least till May 31. The virus has claimed 3,720 lives and infected over 1.25 lakh people in the country so far.

Jameel has expertise in the fields of molecular biology, infectious diseases, and biotechnology. He is the CEO of Wellcome Trust/Department of Biotechnology's India Alliance and is best known for extensive research in Hepatitis E virus and HIV.

He said COVID-19 will eventually be controlled through herd immunity, which is acquired in two ways – when a sufficient fraction of the population gets infected and recovers, and with vaccination.

"It is estimated that for SARS-CoV-2 at least 60 per cent of the population would have to be infected and recovered, or vaccinated. This will happen over the course of the next few years," Jameel said.

Herd immunity is reached when the majority of a population becomes immune to an infectious disease, either because they have become infected and recovered, or through vaccination. When that happens, the disease is less likely to spread to people who aren't immune, because there just aren't enough infectious carriers.

"India has 1.38 billion people, a population density of about 400/sq km and a healthcare system ranked at 143 in the world. If we allow 60 per cent people to get infected quickly in the hopes of herd immunity, that would mean 830 million infections," Jameel said.

"If 15 per cent need hospitalization that means about 125 million isolation beds (we have 0.3 million). If five per cent need oxygen and ventilatory support, this amounts to about 42 million oxygen support and ICU beds; we have 0.1 million oxygen support beds and 34,000 ICU beds. This would overwhelm the healthcare system causing mayhem," he said.

Jameel said if the population level mortality is 0.5 per cent that would mean 40 lakh deaths. "Are we prepared to pay this price for herd immunity in the short term? Clearly not," he said.

He said it is unlikely that a vaccine would be available by the end of the year.

"Even then, we don't know yet how long it would give protection – weeks, months, one year, a few years? I don't think we will return to pre-coronavirus days for at least the next 3-5 years. This is also a chance to evaluate if we want to return to those unsustainable, environment-damaging ways. COVID-19 is a timely warning to reform our way of living," he said.

Jameel said it is hard to predict but plausible that COVID-19 would return in second or third wave.

"Later waves come when we don't understand the disease and become lax. A comparison to Spanish Flu is not entirely valid because in 1918 no one knew what caused it. No one had seen a virus till the mid-1930s as the electron microscope needed to view those was invented in 1931," he said.

"Today we know a lot more about the pathogen, its genetic makeup, how it transmits and how to prevent it. We need to be sensible and follow expert advice," he said.

If there is any scientific evidence linking deforestation, rapid urbanisation, climate change with pandemics like COVID-19, he said zoonotic viruses -- those that jump from animals to humans -- happen so when wild animal–human contacts increase.

"Deforestation destroys animal habitats bringing them closer to humans. When you cut forests, bats come to roost on trees closer to human habitations. Their viruses in secretions/stool get transmitted to domestic animals and on to humans. This happened clearly with Nipah virus outbreak in Malaysia in 1997-98 from fruit bats to pigs to humans," he said.

"COVID-19 possibly arose in wet animal markets due to dietary habits that bring all kinds of live and dead wild animals in close contact with humans," Jameel added.

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