Nagpur: Dr. Ram Gopalkrishna is in Nagpur to attend the CIDSCON 2017 that is the 7th annual conference of the Clinical Infectious Disease Society of India.
He has super specializations in Internal Medicine and Infectious and Tropical ailments and is also a WHO consultant for South East Asia. On the sidelines of the CIDSCON conference, he spoke exclusively to Nagpur Today on a number of topics like AIDS & HIV, Dengue, Encephalitis, and AMR or Anti Microbial Resistance that may well be the hidden but most dangerous killer of India.
Though he admitted that 0.3% of Indians, which in absolute numbers is almost 40 lakhs, is HIV positive, the incidence of the dreadful disease is coming down, he avers.
India has the third largest HIV epidemic in the world. In 2015, HIV prevalence in India was an estimated 0.26%. In the same year, an estimated 68,000 people died from AIDS-related illnesses.
Among key affected populations, Sex workers and homosexuals have experienced a recent decline in HIV prevalence.
Prevalence among people who are addicted to injectible drugs was previously stable but has been rising in recent years.
Transgender people are also emerging as a group at high risk of HIV transmission. This is despite all four of these groups being prioritised in the Indian national AIDS response since its inception in 1992.
“But people’s contribution to fighting it is commendable. For instance, employers of truckers are now scheduling their drivers’ trips so they get to go home regularly. There are NGOs working actively with sex workers.” Said Gopalkrishnan.
( Although sex work is not strictly illegal in India, associated activities such as running a brothel are. This means authorities can justify police hostility and brothel raids, as happen all the time in Nagpur Ganga Jamuna red light area. )
“Stigma and discrimination against sex workers restrict their access to healthcare. A 2011 study indicated a significant association between police abuse and increased risk of HIV transmission and inconsistent condom use.
Sex workers are one of the high-risk groups targeted by India’s National AIDS Control Organization (NACO) with peer-to-peer HIV interventions (when individuals from key affected populations provide services to their peers or link them to services within healthcare settings). In 2015, NACO reported reaching 77.4% of sex workers with HIV prevention activities of this kind.
Other reasons why HIV is coming down is because of free medicines being given from govt. hospitals and medicine available in private hospitals also costing only Rs. 1000/ per month.
“With regular medication an HIV+ person can extend his life by 50 years; but he still loses about 10 years of his life span” says the Doctor.
Where are we vis a vis finding a cure for AIDS?
“The world is still at least 10 years away from finding a cure. Right now we are at the ‘animal testing’ stage but results are not very positive.
It may take even longer for any cure to come to India.”
Therefore what we need to do is follow the ABC for control of AIDS said Dr.Ram.
A – Abstinence
B – Be faithful
C – Condoms, every time
Why has Dengue killed maximum people in Maharashtra?
This widely reported ‘news’ could be misleading, said the Doctor.
“Simply because, Maharashtra has a comparatively good health care system and there is better Reporting of such killer diseases, so the incidence seems to be more. This disease is definitely killing a large number in Northern states like Bihar, UP, Haryana, Punjab but it is not being reported.”
The disease also has a propensity to spread in areas of high urbanization. The AEDES mosquitoes that spread diseases like Dengue, Chikungunya, Zika fever etc. live in cities rather than forested areas like others. They can breed in very little water like flowerpots, discarded tyres, bottles, water tanks even wet shower floors.
These mosquitoes bite during day break and evenings, so it is advisable to keep legs and hands covered at least during winters. In hot weather, usage of mosquito repellent creams like Odomos is advised. But remember, this is effective for 4 hours only, so remember to re apply, specially for kids.
The Doctor said that electric gadgets and ‘aggarbattis’ which are supposed to ‘kill’ or drive away mosquitoes have stopped working years ago and only give a false sense of security. Better to use nets, either mosquito nets or put net on your windows.
Anti Microbial Resistance could be very hazardous
Also known as AMR, that leads to drug resistance to almost all antibiotics among some bugs, could unknown to us, be a mega killer already warns Dr. Gopalkrishnan.
“These bugs or bacteria thrive in our hospitals AND homes. They lead to what we call ‘hospital acquired infections’ which have almost no cure and are fatal.
What has caused AMR?
“Simple! The Indians propensity to keep popping antibiotics, often without even a Doctor’s prescription. Most such drugs, despite being scheduled H drugs are available on the counter in most pharmacies. This HAS to change” says the Doctor.
In city ‘bastis’ and rural areas, we have quacks or ‘alternate therapy Docs’ also prescribing antibiotics.
A UK lady Doctor who was also in Nagpur for the conference piped in :
“If we continue abuse and over use of such drugs, which were once considered miracle drugs, we will leave no usable antibiotics for our grandkids. Then even infections from simple occurrences like a fall leading to bruises, a minor operation, a C section could lead to fatal infections that will not be controlled by any drugs.” She warns.
It is high time the Indian government and medical fraternity everywhere begin fighting this on a war footing following WHO laid down norms.
If we start doing it and follow through, we COULD, may be, bring the situation under control in 10 years…