CNS: Articles of Bobby Ramakant

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The chasm between TB and HIV continues

“The two worst global health problems have combined forces well. But the institutions addressing them have miserably failed to put their act together,” wrote Dr Tim France, a noted global health thought leader, in an op-ed article titled “The chasm between TB and HIV” which was widely published in several newspapers of high TB burden countries in Asia Pacific and Africa in 2006.

It is not natural disasters (like hurricanes or storms) which block access to TB care services most times, but manmade barriers that fuel injustices, inequities, greed, and risk factors that put people at risk of TB disease and death.

"The greater danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it.”

These golden words of Michelangelo perhaps sum up the fundamental gap in the fight to end TB worldwide.

5000 vertical HIV transmissions in India in 2021

States need tailored interventions to eliminate vertical transmission

Written by: Shobha Shukla, Bobby Ramakant

Edited by: Dr Trupti Gilada (CNS Medical Editor HIV & TB science)

published in aidsmap on 19 February 2024

published in aidsmap on 19 February 2024

149 experts call to find all TB to stop TB

One hundred and forty nine delegates of 78th National Conference of Tuberculosis and Chest Diseases ( NATCON) have endorsed a global call to find all TB to stop TB, which has 1 key ask: Stop missing TB cases, by taking 2 actions:

Replace smear microscopy 100% with WHO recommended molecular tests as soon as possible, along with a paradigm shift from a lab-centric to a fundamentally people-centric model to find TB, leaving no one behind
Find the missing millions! Screen everyone (and not just those with TB symptoms) in high burden settings with WHO recommended screening tools, and confirm those with presumptive TB using molecular tests.

Would you not be surprised to learn that an industry whose products kill over 8 million people every year (even when used as the manufacturer intended), and cause an array of health and environment disasters of epidemic proportion, has not been held to account fully? Yes we are referring to the Big Tobacco. Well, perhaps a very long wait could be over as governments of over 180 countries are meeting in Panama for advancing progress on global tobacco treaty - and it is likely that such a decision to make Big Tobacco Pay - may come forth, finally.

[हिन्दी] As the year 2023 comes to an end, it is indeed a quantum of solace moment in terms of finding all TB worldwide. Globally we could find a record number of new TB cases in a single year - historically. Over 7.5 million new TB cases were diagnosed in 2022 worldwide – highest ever in the age-old fight against TB (as per the latest Global TB Report of the UN health agency, the World Health Organization (WHO) which was released in November 2023).

Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and become resistant to (or no longer respond to) medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result of drug resistance, medicines become ineffective, and infections become increasingly difficult or impossible to treat. That is why AMR ranks among the top ten global health threats worldwide.

Not just a Portuguese connect, Goa also has a Paris link now. The “Global Call to find all TB to stop TB” which was launched earlier this month in Goa, India was in prime spotlight at the World Conference on Lung Health 2023 in Paris.

This podcast features Tariro Kutadza who is a noted Zimbabwean HIV and TB advocate, and has helped shape HIV and TB advocacy agendas at national, regional and global level. She is an elected member of the Zimbabwe Country Coordinating Mechanism and Southern Africa Regional Coordinating Mechanism, representing TB-affected communities in the Global Fund to fight AIDS, Tuberculosis, and Malaria (The Global Fund) and Advisory Panel of International Union Against TB and Lung Disease (The Union).

Listen to this podcast on Apple Podcasts, Amazon Music, Google Podcasts, Spotify, TuneIn, Podtail, BluBrry, Himalaya, ListenNotes, American Podcasts, CastBox FM, Ivy FM, Player FM, and other podcast streaming platforms.

[podcast] Making a difference in Nigeria with innovative new tools to find TB

This Podcast features Dr Sheshi Michael, who is a seasoned infectious Diseases expert, supporting the National TB programme in Nigeria at both National and sub-national levels. Currently is the KNCV Nigeria's Director, Private Sector TB Initiative. He is a member of the National drug-resistant TB Concilium of experts in Nigeria.

Listen to this podcast on Apple Podcasts, Amazon Music, Google Podcasts, Spotify, TuneIn, Podtail, BluBrry, Himalaya, ListenNotes, American Podcasts, CastBox FM, Ivy FM, Player FM, and other podcast streaming platforms.

Breaking access barriers and bringing quality healthcare closer to the people in Meghalaya

Unless the full cascade of quality healthcare services reaches closer to the underserved communities, how will we deliver on the promise of #HealthForAll? One positive ray of light comes from an underserved block of Meghalaya, a north-eastern state of India.

[video, podcast] "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has,” had said the famous anthropologist Margaret Mead. Bearing testimony to this, a small group of people in Bantayan Municipality of Cebu, Philippines, has changed the lives of many people affected by tuberculosis (TB). TB, despite being preventable and curable, continues to be the deadliest of the infectious diseases in high TB burden countries.

Are we putting money where the mouth is to reach the missing millions?

Unless we find people with TB and put them on treatment, how will we be able to reduce avoidable human suffering, untimely deaths, and break the chain of infection transmission? Finding TB remains the critical entry point to TB care pathway.

Leaders of all the UN member countries are expected to convene on 22nd September 2023 at the upcoming second United Nations General Assembly High Level Meeting (UNHLM) on TB (the first one was held in September 2018). The theme of this year's UNHLM is: “Advancing science, finance and innovation, and their benefits, to urgently end the global TB epidemic, in particular by ensuring equitable access to prevention, testing, treatment and care."

[podcast] Georgia's journey of reducing TB and drug-resistant TB rates

This podcast features Dr Nino Lomtadze, Head of Surveillance and Strategic Planning Department at Georgia's National TB Programme. Georgia was among the high MDR-TB burden countries till 2016 after which TB rates (including those of drug-resistant forms) have been dropping. TB decline has been 6-7% in recent years. TB surveillance and use of latest TB diagnostics and treatments have resulted in reduction in TB rates in Georgia.