Search the Internet          Tips

Recent Specials

A village sans lawyers Godhra and the      Kashmir Connection Where East Meets West A DNA rabies vaccine? Divide and Convert Out of Africa, Into India Miniatures from Mewa When Bhutto did      Musharraf in A terrorist haven? Garden for the blind The conference that      left everyone cold Emergency Excerpts The Inventor Distorting History 2 Distorting History 1 Kashmr: the road ahead The curse of diabetes Lives less lonely SOG: good or bad? MORE SPECIALS...

The Rediff Special/Shobha Warrier

The first case of AIDS, or Acquired Immuno-Deficiency Syndrome, in India was detected in 1986 in Tamil Nadu. Sixteen years later, as the world prepares to observe World AIDS Day on December 1, Tamil Nadu has 1.83 million cases, topping all the states. India is estimated to have four million cases of persons infected with HIV (Human Immunodeficiency Virus) or affected by AIDS cases while the total number of adults and children worldwide with HIV/AIDS is 40 million.

The Government Hospital for Thoracic Medicine at Tambaram Sanatorium, Chennai, was in the news recently when it was chosen for the initial activities of the Centers for Disease Control and Prevention, Atlanta, United States. The hospital was chosen because of the huge number of patients who visit it everyday, anywhere between 700 to 1000, and the different treatments required for them.

In 2000, the US government launched the Leadership and Investment in Fighting an Epidemic to strengthen HIV prevention-and-care efforts in Africa and India. The Centers for Disease Control and Prevention (CDC), in association with US Department of Health and Human Services agencies, implements the initiative. The CDC Global AIDS Program is already established in 25 countries in the world.

The CDC/GAP India formally began in October 2001 after identifying 'the gaps in existing programs' and the areas where the CDC could provide 'added value to the ongoing programs'. The initial activities will focus on HIV/AIDS care and support, and create a link between prevention and care. The CDC/GAP India has already established offices at the US embassy in New Delhi and at the US consulate in Chennai.

Moreover, the Tamil Nadu government and the CDC signed a memorandum of agreement on September 11, 2002, to control the deadly disease in India. "It is the willingness of Tamil Nadu to look at the problem and take measures to improve the conditions that made us start our initial activities here. The state has had a tradition of taking interest in dealing with the epidemic," says Nancy H Nay, associate director for operations CDC.

As per the agreement, the assistance of Rs 47.6 million is over a period of five years but, according Nancy Nay, the assistance is not related to cash alone. "It is much more. For example, to modernise the lab, we will select a contractor and pay him cash to do the work. We will purchase the equipment and provide training. This agreement is not like writing a cheque and handing it over to the other person. We have been working this way in some countries for decades."

In all probability, the relationship would continue beyond five years.

Established in 1928, the Government Hospital for Thoracic Medicine was a 'TB sanatorium'. In the early 1980s, it became the Government Hospital of TB and Chest Diseases, and in the late eighties, it was renamed the Hospital of Thoracic Medicine. However, with the admission of two HIV patients who had tuberculosis 1993, the hospital had to change its focus.

From two HIV patients in 1993, the hospital treated 6,876 the first eight months of 2002. Outpatients with HIV/AIDS went up from 427 in March 2001 to 1042 in August 2002 while the number of old patients increased from 2,876 to 6,632 during the same period. The number of HIV/AIDS patients visiting the hospital increased from 3,303 to 7,674, Till August 2002, the hospital has treated 95,118 HIV/AIDS patients, making it one of the largest AIDS care centre in India.

An alarming statistic is that in October 2002, 70.4 per cent of the outpatients who were tested at the hospital through voluntary counselling were found to be HIV positive, while 54.1 per cent of all patients tested from May 2001-August 2002 were found HIV positive.

The government hospital's deputy superintendent, Dr S Rajasekaran warned about the galloping rise of HIV infection. "Fifty per cent of those who tested positive belong to the 30-44 age group. Out of the 12,138 that tested positive, 66.4 percent are male, 33.1 per cent female and 0.5 per cent were eunuchs. The group that is unknowingly getting infected is the female. If we don't tackle this problem, it is going to rise alarmingly," he warned.

"We are under the impression that HIV/AIDS is prevalent mostly in the urban and semi-urban areas but our data shoes otherwise. From among our patients, 72.8 per cent are from rural areas and 27.2 per cent from the cities. Our focus to tackle AIDS should be in the rural areas," he added.

The HIV patients at the government hospital are given counselling and treatment for opportunistic infections and tuberculosis.

The initial programs of CDC/GAP include strengthening the hospital's information system, laboratory and laboratory information system; providing training in HIV/AIDS diagnosis and management to hospital staff at GTHM; and establishing a training centre for HIV/AIDS prevention and care.

Nancy Nay said that CDC/GAP would replicate its activities in other healthcare centres in the state and country, and develop model programs for "HIV/AIDS community based care". Another scheme is to strengthen the local and national response to HIV/AIDS in India by increasing the capacity of state AIDS control societies and NACO to plan, implement, monitor, and evaluate programs.

Dr Rajasekaran concludes, "We signed the agreement on September 11, 2002, exactly a year after terrorists struck the World Trade Center in New York. In a sense, HIV/AIDS is a disease that is terrorising people all over the world and with this agreement, we are trying to erase this terrorising disease from the face of the earth."

Also see:
Bill Gates announces $100 million to fight AIDS
More reports from Tamil Nadu

Image: Rahil Shaikh

The Rediff Specials