One day in India's news...
"Docs look the other way, HIV+ve patient's husband delivers baby"; "Potential cure for HIV discovered"; "Bhugaon School turns away two HIV Students"
All three of these headlines appeared in the June 29th Indian Express...
The articles about the Bhugaon School and the Potential cure for HIV both appeared on the front page, while the one about the pathetic doctors appeared on the second.
I'll discuss the positive article first. A potential cure for HIV has often been talked about as some mythical objective relegated to the world of science fiction. The nature of the H.I. Virus means that it inserts itself into the body's cells and once implanted firmly, has the capacity to force the infected cells to produce new, equally infected, cells. It also has the capacity to exist in the body in a resting state, meaning that it is inactive and indetectable for a number of years before lashing out and spreading quickly. Such a viral condition means that it is difficult to have a drug that constantly targets the active virus, because some components of the virus can be active while others are passive, thus making it difficult to combative enzymes that could knock out the virus to recognize the foreign virus.
The new research shows that a new enzyme has been found which can recognize HIV and recombine the very DNA structure of the H.I. Virus to neutralize it and cut it out effectively from infected cells.
The article, while being eminently optimistic about the future potential of this little enzyme, is also very cautious about being too forward in suggesting that this cure will be on the drug shelves any time soon. It hasn't been proved in anything outside of suceeding in a laboratory setting in three months in cutting out HIV from laboratory controlled human cells. The main benefit of this research is that it has potential to go further with testing.
To put this in the Indian context however, we must realistically admit that while it may be years away from being able to effectively battle HIV in the west, it is further away than that even for our clients from resource limited settings, unless they find themselves chosen for a drug trial.
It is reasonable to get excited about potential cures, yet while we remain optimistic on this front, we must also confront the grim realities of our previous reasons for celebration, including ART.
Anti-Retroviral Therapy was celebrated for reducing HIV in Magic Johnson's body to undetectable, it has worked similar miracles for many people around the world, but largely those in the west and those financially able to fund their treatment. To our clients here in Pune, and similar clients around the world, even ART is not accessible.
ART is on the horizon however, with India's governmnet promising 100,000 people access to it, we must do more to get the government to meet these goals as they have only delivered it to 18,000 of their countrymen and women.
We can celebrate global advances in the fight against HIV, yet we must remember where we work, we do not work in a lab, we work on the ground, and on the ground we must stay grounded in reality, and the reality is that economics still drives science and health. Until something happens to ease the economic burden of ART, many will weaken and die unnecessarily before the glimmer of hope for a cure even reaches the horizon of their thoughts.
Regarding the recent news that several schools in India have been denying admission to positive children, Wake Up Pune released a strongly worded rebuke to the school system and called on the state government to intercede in the matter. There is precedent for this, Kerala's high court recently ordered that five positive children denied their basic human rights of schooling recently be admitted to the school. Locally, a school in Sangli just reversed the error of their ways in bowing to local pressure to admit 28 positive children. The difference in these two stories however comes from the reaction after the children were admitted. We can only do so much to help the students get admitted, perhaps the greater challenge is reducing the society wide stigma that leads to them being denied admission, and then not fully welcomed once admitted. In Kerala, many parents withdrew their children from the school in protest to the admittance of the HIV positive children. Why did they do this? Ignorance. Children will not get HIV from interacting with other children. If you possess even basic knowledge about the virus this is understood, yet it is clear that without adequate education Indian society will continue to be retrograde in addressing this pressing issue and many more children will be unnecessarily denied their rights and stigmatized. There is hope, in Sangli the children were welcomed with flowers and community support. We can only hope that community action and increased awareness will drive a similar result in this Bhugaon case.
The third article provoked my most visceral reaction. Doctors are supposed to be the most educated and the most willing to help those in need. Yet in Meerut, at a Medical College, doctors shouted instruction across a room to a father on how to deliver his child while his HIV positive wife was in labor. Thankfully, and somehow luckily, the child was delivered healthy and HIV negative. The father had to cut the umbilical cord himself and then clean the bed and burn the soiled clothes outside. DOCTORS in India are SILENT, DOCTORS in India are IGNORANT, DOCTORS in India have FEAR, DOCTORS in India have STIGMA, and DOCTORS in India DISCRIMINATE against those who have HIV. If our most esteemed medical professionals don't know how to handle a situation affecting 5.7 million people in their country then where are we at the grassroots? Who are the role models? This needs to change.
All three of these headlines appeared in the June 29th Indian Express...
The articles about the Bhugaon School and the Potential cure for HIV both appeared on the front page, while the one about the pathetic doctors appeared on the second.
I'll discuss the positive article first. A potential cure for HIV has often been talked about as some mythical objective relegated to the world of science fiction. The nature of the H.I. Virus means that it inserts itself into the body's cells and once implanted firmly, has the capacity to force the infected cells to produce new, equally infected, cells. It also has the capacity to exist in the body in a resting state, meaning that it is inactive and indetectable for a number of years before lashing out and spreading quickly. Such a viral condition means that it is difficult to have a drug that constantly targets the active virus, because some components of the virus can be active while others are passive, thus making it difficult to combative enzymes that could knock out the virus to recognize the foreign virus.
The new research shows that a new enzyme has been found which can recognize HIV and recombine the very DNA structure of the H.I. Virus to neutralize it and cut it out effectively from infected cells.
The article, while being eminently optimistic about the future potential of this little enzyme, is also very cautious about being too forward in suggesting that this cure will be on the drug shelves any time soon. It hasn't been proved in anything outside of suceeding in a laboratory setting in three months in cutting out HIV from laboratory controlled human cells. The main benefit of this research is that it has potential to go further with testing.
To put this in the Indian context however, we must realistically admit that while it may be years away from being able to effectively battle HIV in the west, it is further away than that even for our clients from resource limited settings, unless they find themselves chosen for a drug trial.
It is reasonable to get excited about potential cures, yet while we remain optimistic on this front, we must also confront the grim realities of our previous reasons for celebration, including ART.
Anti-Retroviral Therapy was celebrated for reducing HIV in Magic Johnson's body to undetectable, it has worked similar miracles for many people around the world, but largely those in the west and those financially able to fund their treatment. To our clients here in Pune, and similar clients around the world, even ART is not accessible.
ART is on the horizon however, with India's governmnet promising 100,000 people access to it, we must do more to get the government to meet these goals as they have only delivered it to 18,000 of their countrymen and women.
We can celebrate global advances in the fight against HIV, yet we must remember where we work, we do not work in a lab, we work on the ground, and on the ground we must stay grounded in reality, and the reality is that economics still drives science and health. Until something happens to ease the economic burden of ART, many will weaken and die unnecessarily before the glimmer of hope for a cure even reaches the horizon of their thoughts.
Regarding the recent news that several schools in India have been denying admission to positive children, Wake Up Pune released a strongly worded rebuke to the school system and called on the state government to intercede in the matter. There is precedent for this, Kerala's high court recently ordered that five positive children denied their basic human rights of schooling recently be admitted to the school. Locally, a school in Sangli just reversed the error of their ways in bowing to local pressure to admit 28 positive children. The difference in these two stories however comes from the reaction after the children were admitted. We can only do so much to help the students get admitted, perhaps the greater challenge is reducing the society wide stigma that leads to them being denied admission, and then not fully welcomed once admitted. In Kerala, many parents withdrew their children from the school in protest to the admittance of the HIV positive children. Why did they do this? Ignorance. Children will not get HIV from interacting with other children. If you possess even basic knowledge about the virus this is understood, yet it is clear that without adequate education Indian society will continue to be retrograde in addressing this pressing issue and many more children will be unnecessarily denied their rights and stigmatized. There is hope, in Sangli the children were welcomed with flowers and community support. We can only hope that community action and increased awareness will drive a similar result in this Bhugaon case.
The third article provoked my most visceral reaction. Doctors are supposed to be the most educated and the most willing to help those in need. Yet in Meerut, at a Medical College, doctors shouted instruction across a room to a father on how to deliver his child while his HIV positive wife was in labor. Thankfully, and somehow luckily, the child was delivered healthy and HIV negative. The father had to cut the umbilical cord himself and then clean the bed and burn the soiled clothes outside. DOCTORS in India are SILENT, DOCTORS in India are IGNORANT, DOCTORS in India have FEAR, DOCTORS in India have STIGMA, and DOCTORS in India DISCRIMINATE against those who have HIV. If our most esteemed medical professionals don't know how to handle a situation affecting 5.7 million people in their country then where are we at the grassroots? Who are the role models? This needs to change.
posted by Deep Griha at 11:36 pm
0 Comments:
Post a Comment
<< Home