(CNS): An appeal has been sent to the heads of the World Health Organization (WHO) and the Stop TB Partnership by noted health advocates to come forward in support of Dr Binayak Sen - a medical doctor who is allegedly wrongly serving a life sentence in India. Dr Binayak Sen, a medical practitioner and a civil liberties' activist, was sentenced to life imprisonment in Chhattisgarh. Probably his stand for human rights exposing gross injustices meted out to tribal population by the state, and a report had irked the government which slapped upon him violation of two draconian laws: Chhattisgarh Special Public Security Act and Unlawful Activities Prevention Act (UAPA).

His wife Ilina Sen, who is a Professor at the Mahatma Gandhi Antarrashtriya Hindi Vishwavidyalaya in Wardha, said to CNS: "It is a sad reflection on our system that once a false case is registered in the name of security, it is almost impossible to turn the clock back, even if facts stare us in the face indicating that the case had no basis. To this, if we add dimensions of face saving, prestige, and drubbing the nose into the ground of uncomfortable critics, we have Chhattisgarh and Binayak Sen" said Ilina Sen.

So what is the 'evidence' against Dr Binayak Sen? According to Ilina Sen, the 'evidence' against Binayak Sen in court is as follows:

- Hearsay evidence from police officers about Binayak's presence in naxal meetings, his supposed association with 'hard core naxals' who are not even named in any case anywhere in the country

- Supposed seditious literature pertaining to resistance of US imperialism and atrocities committed during the salwa judum seized from their house during police search

- Correspondence addressed to the ISI (not Pakistan's ISI but to Walter Fernandez, Director of Indian Social institute (ISI) in New Delhi)

- Correspondence with people bearing Muslim names constitutes the rest of the evidence

Authorities claimed Dr Binayak Sen is a 'fake doctor' because no stethoscope was found in his house. Should every doctor hang a stethoscope in his house as well? Does a gold medal from second-ranked medical institute in the country - Christian Medical College (CMC) Vellore, the 2004 Paul Harrison Award, Global Health Council's Jonathan Mann Award 2008, founding Shaheed Hospital in Chhattisgarh and serving tribal communities for close to thirty years are not evidence enough to give him due recognition as a medical practitioner?

That is why civil society from a range of stakeholders has appealed to the WHO and also to the Stop TB Partnership to come out in support of this medical doctor who has been victimised unduly in Chhattisgarh.

"He has also fought actively for the state to examine and redress the social determinants of poor health and huge burden of malnutrition that contributes to and co exists with the significant burden of TB amongst the marginalised tribal communities" said the letter submitted to the heads of WHO and the Stop TB Partnership.

"Dr Binayak Sen is a paediatrician and public health specialist who has dedicated himself to the welfare of the poorest and most disadvantaged members of society, and since 1978, well before DOTS was introduced in India, has been working in the field of tuberculosis (TB). In 1978, leaving his academic career at the Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, Dr Sen joined a Quaker-supported rural tuberculosis center in Central India. It was here Dr Sen practised innovative and needs-based approaches to control TB by convincing the authorities to be flexible in providing anti-tubercular drugs to communities who would otherwise discontinue their treatment for specific and understandable reasons, for example, difficulties to access health facilities during monsoon. We believe his approach was similar to community DOTS that has been adopted at a much later stage" further reads the letter submitted to the WHO and the Stop TB Partnership.

"Subsequently, during 1982-87, Dr Binayak Sen established a DOTS centre at a hospital run by mine-workers in Chhattisgarh state which he helped set up and initiated TB promotion involving the mining communities themselves in awareness activities. Later, in 1994, founding a non-governmental organisation, Dr Sen focused on poverty and malnutrition in TB control and spoke about it in various forums, governmental and non-governmental. In a recent writing he expressed his concern about the growing trend of drug resistant forms of the disease in India and emphasised the need for systematic WHO studies to explore the relationship between TB and body mass index (BMI) in the country" said the above mentioned letter to the WHO.

"Dr Chan and Dr Ditiu, it is in this context we would like to bring to your attention that Dr Binayak Sen's incarceration is a huge tragedy and loss to the field of public health. At the local level we fear that the loss of this champion and also the services he provided and have not been replaced will contribute to an increased risk of further spreading of tuberculosis. Dr Sen has and would have continued to contribute tremendously through public health policy formulation and advocacy at the state level and the education and training of health activists and through his own practice to the effective control of tuberculosis in India. But Dr Sen is now in prison on false charges, sentenced for life. India urgently needs him to be free" said the letter submitted to Dr Margaret Chan, Director-General of the WHO and Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership.

Let's hope that the apex institutions in the world on health and TB will come out strongly in support of public health champions like Dr Binayak Sen. (CNS)

Bobby Ramakant – CNS

(The author is a World Health Organization (WHO) Director-General’s WNTD Awardee 2008 and writes extensively on health and development through Citizen News Service (CNS). Email: This email address is being protected from spambots. You need JavaScript enabled to view it., website: www.citizen-news.org )

(CNS): Since times immemorial, the human race has sought health, happiness and wealth —not necessarily in that order. Wars have been fought and lives have been lost due to the overwhelming desire of possessing them. These three basic ingredients are thought to be essential for a meaningful life. Ironically, in our crazy race for securing 'happiness and health', we at times are actually moving away from it. Life has become so hectic and busy that it is taking its toll on our health and wellbeing. More and more people seem to be suffering from a host of health related problems, courtesy different types of stresses of everyday life, which are more often self created. 

The WHO slogan for World Health Day,2011 (which is on 7th April) is Combat drug resistance - no action today, no cure tomorrow. This is so very true, not only for our physical health, but also for our emotional well being. If we become resistant to love and compassion today, there will be no cure from negative thoughts tomorrow. It seems ridiculous, but alas! It is true that people lose their health to make money and lose their money to restore their health. By thinking seriously about the future, they forget about the present, such that they live neither for the present nor for the future. They live as if they will never die and they die as if they had never lived.

Even doctors and scientists agree that a positive and happy attitude towards life goes a long way in curing and healing physical/mental ailments. 

In Bhutan gross national happiness has been the yardstick to measure the country’s prosperity since 1970. But recently, even the British Prime Minister David Cameron has joined the bandwagon, saying that, "It's time we admitted that there's more to life than money and it's time we focused not just on GDP but on GWB – general well-being. Well-being can't be measured by money or traded in markets."

"GDP is crumbling as a target – it is already out of date," says Andrew Oswald, professor of economics and behavioural science at the University of Warwick. Oswald was one of the first economists in the country to research what he labels "emotional prosperity."

There is a growing body of research which feels that happiness is mandatory to preserve good health. Normally public health research focuses on the study of disease to combat ill health. But way back in 1938, Dr Dr Arlie Bock, the director of the then Department of Hygiene at Harvard University, decided to focus this research on young healthy men. "All admit that the sick need care, but very few apparently have thought it necessary to make a systematic inquiry as to how people keep well and do well," he said. The Grant Study of Adult Development, initiated by Dr Bock, is the world's longest-running study of adult life, and provides some interesting insights into mental and physical well-being. Under this study researchers have been studying men in the USA, following them from adolescence to retirement, with the aim to discover what it takes to live well. 

George Vaillant, (pronounced valiant) the director of this Harvard study, points to the strength of evidence provided by it. "The power of the Grant study was that it had 73 years of real behaviour – not just self-reporting – with which to judge its notions of a rewarding life."

By the time the Grant Study men had entered retirement, researchers had identified seven major factors that predict healthy aging, both physically and psychologically: Employing mature coping skills (like stoicism and altruism), was one of them. The others were education, a good marriage, not smoking, not abusing alcohol, some exercise, and maintaining a healthy weight.

Vaillant's interest lies in the power of relationships, and in finding a correlation between healthy aging and human happiness. According to him, "Warm, intimate relationships are the most important prologue to a good life. It is social aptitude, not intellectual brilliance or parental social class, that leads to successful aging."

"Life ain't easy," he points out. "Terrible things happen to everyone. You have to keep your sense of humor, give something of yourself to others, make friends who are younger than you, learn new things, and have fun."

"Understanding the links between well-being and health is an important aspect of the work of WHO," says Somnath Chatterji,, a scientist in the Health Statistics and Informatics department of the World Health Organization. "This will help develop policies for promoting health in ageing populations, which are facing increasing chronic illnesses."

Ed Diener, a professor of psychology at the University of Illinois, in the USA, who has studied the effect of happiness (or subjective well-being) for 30 years, says, "There are many types of data all pointing to the fact that happiness leads to health and a longer life, of course, among many other factors."

Scientific research apart, we are all aware that happiness of the mind has a direct impact on our mental and physical well being. We see this all around us. Jealousy, anger, intolerance, and other negative feelings are some of the poisons which can undo the curative actions of the best of medicines and make us perpetually unhealthy. How often do we crib about a colleague/acquaintance who is always complaining about others and about life in general? On the other hand we also recall proudly about those who face life’s challenges with a smile. They may be medically under a cloud, but spread sunshine around them, and in the process mitigate their own physical woes. There are many empowering stories of ordinary men and women who got a control over debilitating sickness through sheer will power and a happy disposition. My mother is one of them. Despite being crippled by arthritis, she leads a full life at the age of 82 years, spreading joy and happiness in the life of all those who come in contact with her, unmindful of her constant intense pain.

So begin this World Health Day with a morning prayer of thanksgiving to God; eat healthy food during the day, topping it up with contentment and cheerfulness; go for an evening walk; find some time to stand and wait till her mouth can, enrich that smile her eyes began (a la W H Davies); and, above all, make at least one person smile.

Repeat this every day, and you have the perfect recipe for a happy-well rather than sad-sick existence.

Respect life with all its ups and downs, and live it to the fullest. 

Shobha Shukla - CNS

(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Diabetes Media Initiative (CNS-DMI).She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP. Email: This email address is being protected from spambots. You need JavaScript enabled to view it., website: www.citizen-news.org)

According to The Lancet, non-communicable diseases (NCDs), mainly heart disease, stroke, diabetes, cancers, and chronic respiratory disease, are responsible for two out of every three deaths worldwide and the toll is rising. A landmark global alliance between leading scientists and four of the world's largest NGOs brings together evidence from a 5-year collaboration with almost 100 of the world's best NCD experts and proposes a short-list of five priority interventions to tackle the increasing global crisis. Reducing tobacco and salt use, improving diets and physical activity, reducing hazardous alcohol intake, and achieving universal access to essential drugs and technologies have been chosen for their health effects, cost-effectiveness, low costs of implementation, and political and financial feasibility. 

 

Just 5 months ahead of the UN High-Level Meeting (HLM) on NCDs, only the second of its kind to focus on a global disease issue and with the potential to stimulate action globally as well as nationally, The Lancet NCD Action Group and the NCD Alliance launch a clear set of commitments in The Lancet that they would like to see from the meeting.

 

"The most important outcome of the UN HLM on NCDs will be sustained and strong high-level political support for a framework of specific commitments to tackle the NCD crisis as part of a costed national health plan", explain the authors. The aim is to reduce NCD death rates by 2% per year which will avert an estimated 36 million deaths over 10 years.
Despite numerous national and international policies, strategies, and plans to tackle NCDs progress has been slow—partly, say the authors, because of the "pressing nature" of other global health issues.

 

In the lead up to the UN meeting, the authors call on heads of state and governments to commit to a coordinated set of feasible actions and interventions for which specific and timed targets and indicators can be developed, and against which progress can be measured.

 

The top priority must be to reduce tobacco use followed by lowering salt intake, say the authors. Key to the success of this intervention will be the accelerated implementation of the Framework Convention on Tobacco Control (FCTC) to achieve the proposed goal, "a world essentially free from tobacco by 2040", where less than 5% of the population uses tobacco; achieving this goal would prevent at least 5.5 million premature deaths over 10 years.

 

By 2025, they would like to see salt intake reduced to less than 5 g per person. They point out that reducing global salt consumption by just 15% through mass-media campaigns and reformulation of processed foods and salt substitution could prevent an estimated 8.5 million deaths in just 10 years.

 

Importantly, the costs of these interventions will be small, say the authors. The yearly cost to implement tobacco control and salt reduction will be less than US 50 cents per person per year in countries like India and China. The total package of priority interventions will require a new global commitment of about $9 billion per year.

 

Key to the immediate delivery of these interventions is a set of priority actions—securing broad political leadership at the highest levels nationally and internationally, support for strengthening health systems (with a strong focus on primary care), building international cooperation and consensus for priority interventions (particularly primary prevention), and establishing independent monitoring systems and accountability mechanisms for assessing progress. (CNS)

 

 

 (The author is a World Health Organization (WHO) Director-General’s WNTD Awardee 2008 and writes extensively on health and development through Citizen News Service (CNS). Email: This email address is being protected from spambots. You need JavaScript enabled to view it., website: www.citizen-news.org)

 

Some 440,000 cases of multidrug-resistant tuberculosis (MDR-TB) are identified each year, causing at least 150,000 deaths from a disease that should be curable. Extensively drug-resistant TB (XDR-TB), which has an even higher fatality rate, has now been reported in 69 countries. “Drug-resistant TB is the end result of a number of different failures, each of which, on its own, is solvable with existing tools. To address all of the issues and stop the spread of this disease requires a comprehensive, multi-pronged strategy, such as The Union has developed”, says Dr Nils E Billo, Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union).

 

The rising incidence of antimicrobial resistance will be the focus of this year’s World Health Day, marked on Thursday, 7 April. The World Health Organization selected this theme to highlight the fact that many essential medicines are at risk of losing their effectiveness, due to inappropriate use, poor monitoring and other practices that jeopardise global advances against infectious disease. Tuberculosis is among the most dangerous diseases affected by this trend, according to The Union, which supports the WHO’s emphasis on the problem.

 

When TB is misdiagnosed or the treatment is poorly managed, the doors open to drug resistance. Consequently training for people at every level of the health care system is central to The Union’s approach. Each year courses are offered in high TB burden areas of Africa, Asia, Europe, Latin America and the Middle East designed to train clinicians and other health care workers about MDR-TB. The goal is for them not only to understand how to diagnose and treat the disease, but also how to put into place the practices that can prevent it from developing, such as improved infection control procedures and effective management of drug supplies.

 

Patients who do not correctly take the medicines required to complete their TB treatment are at high risk for developing drug-resistant tuberculosis and passing on these new strains of the disease to others. Strong programmes for case detection, diagnosis and patient monitoring are all critical to avoid this scenario. At the request of national tuberculosis programmes (NTPs), The Union’s MDR-TB experts are helping them review plans, procedures, policies and systems and making suggestions for improvement. In recognition of the pivotal role of laboratories in diagnosing and monitoring drug-resistant strains of the disease, The Union has also helped develop an international network of TB reference laboratories.
Use of poor quality medicines and drug shortages are also leading causes of drug-resistant TB. If the quality of first-line TB drugs is not assured - or the supply is not adequate to meet the needs of those in treatment - patients will not be cured and may develop MDR-TB. They will then require treatment with the more expensive second-line drugs (SLD). The Union is regularly part of all discussions concerning TB medicines at the international level, and published a joint report with Médecins sans Frontières (MSF) on DR-TB medicines last month. The Union also works closely with NTPs to support them in the implementation of best practices for ordering, storing and distributing medicines, as well as to assure the quality of the medicines selected for national procurement and to monitor their quality.

 

Treating drug-resistant TB is much more expensive and can take up to two years - creating a strain on both patients and health systems. Through its operational research and clinical trials programmes, The Union continually seeks new solutions to issues of prevention, treatment and control. The STREAM study, part of the USAID-funded TREAT TB Initiative, will soon begin enrolling patients in an international clinical trial of a nine-month treatment regimen for MDR-TB that has been very successful in a smaller study. This new regimen holds the potential to revolutionise treatment for the disease.
“New miracle tools from faster diagnostic tests to TB vaccines are being sought”, says Dr Billo, “and they may eventually address the issue of MDR-TB. But, in the meantime, it is absolutely essential to provide adequate funding for the well-trained staff, fully equipped health-care facilities and laboratories and quality-assured medicines that will allow us to take care of the patients who are sick today. These people can’t wait for tomorrow’s cures - and there is no reason they should have to.” (CNS)