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Science

Curious Bends – WhatsApp doc, nuclear nonsense, AIDS in Mizoram and more

1. As they amass a bigger nuclear arsenal, both India and Pakistan also attend a non-proliferation conference every year

“While most of the momentum behind the humanitarian initiative comes from non-nuclear weapons states, its success ultimately depends on how it influences states with nuclear weapons. Because India and Pakistan are the only two such states that have consistently attended the conferences, it’s important to assess their respective incentives for participation.” (5 min read, thebulleting.org)

2. An AIDS epidemic in Mizoram is about to start

“This infrastructure worked well until a year ago. Till 2010, said an official in the state AIDS control society, the number of new HIV cases was rising every month in the state. And then, in 2010-’11, it slowed to about 100-150 new cases a month. Even this slower rate has meant that from 4,000 cases across the state in 2010, Mizoram now has double the number of cases – according to the official, about 9,000-10,000 cases. With this funding delay, this number of new cases might rise faster once more.” (12 min read, scroll.in)

3. Scientists need a ritual to reflect on all the evils that have enabled our world

“If it was we who discovered the expansion of the universe through the redshifts of galaxies, then it was we who stole Ahnighoto. If it was we who understood the nature of the atom, then it was we who bombed Hiroshima and Nagasaki. If it was we who cured smallpox, then it was we who ran the experiment at Tuskegee. We can’t choose our heritage, but we can choose how we live with it. In that respect, I think that we cannot in good faith take pride in the light if we do not also take responsibility for the dark.” (10 min read, slate.com)

+ The author of this piece, Ben Lillie, is a scientist-turned-writer.

4. Bill Gates: you can help the world save 34 million lives

“If we can prevent 10 million tuberculosis deaths, 21 million deaths from AIDS, and 3.3 million maternal fatalities, that comes to 34.3 million lives saved–a number roughly equivalent to the entire population of Canada.” This can be achieved mainly by doing things we already know how to do. (3 min read, qz.com)

5. WhatsApp doctors! You are here!

“When she joined NH four months ago, Bhende was only doing e-consults as part of the hospital’s experiments with digital OPDs. “We started with a variety of social media platforms, like Skype, Whatsapp, emails, SMS, but over time we have realised that Whatsapp works best,” says Bhende, who specialises in gestational diabetes and does consultations with over 350 patients on the app.” (3 min read, timesofindia.com)

Chart of the Week

“On April 25, Nepal was hit with the biggest earthquake in 80 years—but just how big was it? Amidst the destruction, there was a spat on the issue between the US and China. The US Geological Survey (USGS), which monitors earthquakes worldwide, reported that the Nepal earthquake measured at a magnitude of 7.8. However, the China Earthquakes Network Center (CENC), which hopes to provide a similar service, measured the same earthquake at a magnitude of 8.1. A difference of 0.3 in the magnitude of the seismic activity may not seem like much, but the apparently small differences in magnitudes of earthquakes reported by different agencies around the world are, in real-life, huge. Because if we are to believe the Chinese data, the Nepal earthquake may have been 2.8 times bigger than if we believe the US data.” (2 min read, qz.com)

How earthquakes are measured. Credit: qz.com
How earthquakes are measured. Credit: qz.com

 

Categories
Science

Tuberculosis's invisible millions – in cases and money

Tuberculosis (TB) has killed more than a billion people in the last 200 years. That’s more than any other infectious disease in that period. And, what’s worse is that, according to the World Health Organisation (WHO), less than half the cases worldwide are ever diagnosed.

India suffers the most. It has the highest burden of TB in the world: More than 2 million suffer from the disease, and this is despite years of work to control the disease.

TB was declared a global health emergency by the WHO in 1993. Then, in 2001, the first global “Stop TB Plan” came into effect, with an international network of donors and private and public sector organisations tackling TB-related issues around the world together.

The disease is prevalent among both rich and poor countries, but has more disastrous consequences in the latter because of limited access to healthcare, poor sanitation and undernutrition. The matter is worsened because of co-morbidity, where those with weakened immune systems—having suffered from diabetes or AIDS—fall prey to TB and die.

tb1

And even between developing economies, there is significant variation in treatment levels because of difficulties in identifying new infections. In 2012, while China and India together accounted for 40% of the world’s burden of TB, the prevalence among 100,000 people was at least 167 in India and less than half that in China (about 68).

Technology can help

In an article in the journal PLOS Medicine, Puneet Dewan from the Bill & Melinda Gates Foundation and Madhukar Pai of McGill University have called for global efforts to identify, treat and cure the 3 million “missed” TB infections every year.

“Reaching all these individuals and ensuring accountable, effective TB treatment will require TB control programs to adopt innovative tools and modernize program service delivery,” they write.

In January 2015, the WHO representative to India, Nata Menabde, said the decline of TB incidence in the country was occurring at 2% per year, instead of the desired 19-20%. She added that it could be pulled up to 10% per year by 2025 if the country was ready to leverage better the available technology. The WHO’s goal is to eradicate TB by 2050. But for India that may prove to be too soon. 

This is also what Dewan and Pai are calling for. The tech interventions could be in the form of e-health services, the use of mobile phones by doctors to notify centers of new cases, and disbursing e-vouchers for subsidized treatment.

And their demands are not unreasonable, given India’s progress so far. First, India has met one of the United Nations’ ambitious Millennium Development Goals by cutting TB prevalence to half in 2015 compared to prevalence in 1990. Second, according to Menabde, India is also on track to halve TB mortality by the end of this year compared to that in 1990. The accomplishment testifies to commitment from public and private sector initiatives and places the country in a good position from which to springboard toward stiffer targets. Continued support can sustain the momentum.

tb2

In 2012, the previous government made TB a notifiable disease—mandating medical practitioners to report every TB case detected—going some way in reducing the number of “missing” cases. It also banned blood tests to diagnose TB for the lack of a clinical basis. While the delay in implementing these measures contributed to the rise of multidrug-resistant strains of the disease, they also revitalised efforts to meet targets set by the WHO at an important time. Then bad news struck.

Causing self-harm

India’s health budget for 2015-16 has not even managed to keep up with inflation. It is a mere 2% more than the previous year. For TB, this budgetary belt-tightening has meant taking a few steps back in the pace of developing cures against multi-drug resistant strains and in efforts to improve the quality of treatment at frontline private-sector agencies, which already provide more than 60% of patient care.

Dewan and Pai think TV programs, such as Aamir Khan’s Satyamev Jayate, and Amitabh Bachchan’s admission that he is a TB survivor will promote enough awareness to force changes in healthcare spending—but this seems far too beamish an outlook when the funding cuts and regulatory failures are factored in.

A new draft of the National Health Policy (NHP) was published in December. Besides providing a lopsided insight into the government’s thoughts on public healthcare, it made evident that ministers’ apathetic attitude, and not a paucity of public support, was to blame for poor policies.

Nidhi Khurana, a health systems researcher at the Johns Hopkins Bloomberg School of Public Health, summed up the NHP deftly in The Hindu:

The NHP refutes itself while describing the main reason for the National Rural Health Mission’s failure to achieve stronger health systems: “Strengthening health systems for providing comprehensive care required higher levels of investment and human resources than were made available. The budget received and the expenditure thereunder was only about 40 per cent of what was envisaged for a full revitalisation in the NRHM framework.” If this is not the case against diminished public funding for health, what is?

Categories
Science

Tuberculosis’s invisible millions – in cases and money

Tuberculosis (TB) has killed more than a billion people in the last 200 years. That’s more than any other infectious disease in that period. And, what’s worse is that, according to the World Health Organisation (WHO), less than half the cases worldwide are ever diagnosed.

India suffers the most. It has the highest burden of TB in the world: More than 2 million suffer from the disease, and this is despite years of work to control the disease.

TB was declared a global health emergency by the WHO in 1993. Then, in 2001, the first global “Stop TB Plan” came into effect, with an international network of donors and private and public sector organisations tackling TB-related issues around the world together.

The disease is prevalent among both rich and poor countries, but has more disastrous consequences in the latter because of limited access to healthcare, poor sanitation and undernutrition. The matter is worsened because of co-morbidity, where those with weakened immune systems—having suffered from diabetes or AIDS—fall prey to TB and die.

tb1

And even between developing economies, there is significant variation in treatment levels because of difficulties in identifying new infections. In 2012, while China and India together accounted for 40% of the world’s burden of TB, the prevalence among 100,000 people was at least 167 in India and less than half that in China (about 68).

Technology can help

In an article in the journal PLOS Medicine, Puneet Dewan from the Bill & Melinda Gates Foundation and Madhukar Pai of McGill University have called for global efforts to identify, treat and cure the 3 million “missed” TB infections every year.

“Reaching all these individuals and ensuring accountable, effective TB treatment will require TB control programs to adopt innovative tools and modernize program service delivery,” they write.

In January 2015, the WHO representative to India, Nata Menabde, said the decline of TB incidence in the country was occurring at 2% per year, instead of the desired 19-20%. She added that it could be pulled up to 10% per year by 2025 if the country was ready to leverage better the available technology. The WHO’s goal is to eradicate TB by 2050. But for India that may prove to be too soon. 

This is also what Dewan and Pai are calling for. The tech interventions could be in the form of e-health services, the use of mobile phones by doctors to notify centers of new cases, and disbursing e-vouchers for subsidized treatment.

And their demands are not unreasonable, given India’s progress so far. First, India has met one of the United Nations’ ambitious Millennium Development Goals by cutting TB prevalence to half in 2015 compared to prevalence in 1990. Second, according to Menabde, India is also on track to halve TB mortality by the end of this year compared to that in 1990. The accomplishment testifies to commitment from public and private sector initiatives and places the country in a good position from which to springboard toward stiffer targets. Continued support can sustain the momentum.

tb2

In 2012, the previous government made TB a notifiable disease—mandating medical practitioners to report every TB case detected—going some way in reducing the number of “missing” cases. It also banned blood tests to diagnose TB for the lack of a clinical basis. While the delay in implementing these measures contributed to the rise of multidrug-resistant strains of the disease, they also revitalised efforts to meet targets set by the WHO at an important time. Then bad news struck.

Causing self-harm

India’s health budget for 2015-16 has not even managed to keep up with inflation. It is a mere 2% more than the previous year. For TB, this budgetary belt-tightening has meant taking a few steps back in the pace of developing cures against multi-drug resistant strains and in efforts to improve the quality of treatment at frontline private-sector agencies, which already provide more than 60% of patient care.

Dewan and Pai think TV programs, such as Aamir Khan’s Satyamev Jayate, and Amitabh Bachchan’s admission that he is a TB survivor will promote enough awareness to force changes in healthcare spending—but this seems far too beamish an outlook when the funding cuts and regulatory failures are factored in.

A new draft of the National Health Policy (NHP) was published in December. Besides providing a lopsided insight into the government’s thoughts on public healthcare, it made evident that ministers’ apathetic attitude, and not a paucity of public support, was to blame for poor policies.

Nidhi Khurana, a health systems researcher at the Johns Hopkins Bloomberg School of Public Health, summed up the NHP deftly in The Hindu:

The NHP refutes itself while describing the main reason for the National Rural Health Mission’s failure to achieve stronger health systems: “Strengthening health systems for providing comprehensive care required higher levels of investment and human resources than were made available. The budget received and the expenditure thereunder was only about 40 per cent of what was envisaged for a full revitalisation in the NRHM framework.” If this is not the case against diminished public funding for health, what is?

Categories
Science

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