A to Z News

Updated Guidelines on PEP

2016-09-20T22:58:00.001-07:00

The Centers for Disease Control and Prevention (CDC) has issued new evidence-based guidelines, "Updated Guidelines for Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV — United States, 2016" that provide updated recommendations for providers regarding non-occupational post-exposure prophylaxis (nPEP) for exposure to HIV outside the healthcare setting.

The new guidelines expand on the 2005 U.S. Department of Health and Human Services recommendations and are intended to help reduce the development of new HIV infections via effective nPEP administration to patients following a single exposure to blood, genital secretions, or other potentially infectious bodily fluids that may carry HIV. The 2016 updated guidelines include new scientific data from human and animal studies as well as information on pediatric dosing. In addition, it includes consideration of new antiretroviral drugs that were approved since the 2005 guidelines.

66097 Tourists Arrived in August 2016 on e Tourist Visa

2016-09-15T23:59:00.000-07:00

196.6% Growth in Tourists Arrival on e-Tourist Visa in August 2016 over the Same Period in 2015

UK Continues to Occupy Top Slot followed by USA and China Amongst Countries Availing e-Tourist Visa Facility During August 2016

A total of 66,097 tourists arrived in August 2016 on e-Tourist Visa as compared to 22, 286 during the month of August 2015 registering a growth of 196.6%

Commencing from 27th November 2014 e-Tourist Visa facility was available until 25th February 2016 for citizens of 113 countries arriving at 16 Airports in India. The Government of India has extended this scheme for citizens of 37 more countries w.e.f 26th February 2016 taking the tally to 150 countries. Status of achievements in respect of e-Tourist Visa availed by International tourists visiting India last year in 2015 has been surpassed in the first 06 months of the current calendar year 2016.

The following are the important highlights of e-Tourist Visa during August, 2016:-

(i) During the month of August, 2016 a total of 66,097 tourist arrived on e-Tourist Visa as compared to 22,286 during the month of August, 2015 registering a growth of 196.6%.

(ii) During January- August 2016, a total of 6,06,493 tourist arrived on e-Tourist Visa as compared to 1,69,976 during January-August 2015, registering a growth of 256.8% .

(iii) This high growth may be attributed to introduction of e-Tourist Visa for 150 countries as against the earlier coverage of 113 countries.

(iv) The percentage shares of top 10 source countries availing e-Tourist Visa facilities during August, 2016 were as follows:

UK (19.4%), USA (13.2%), China (6.7%), France (6.4%), Spain (6.1%), UAE (5.5%), Germany (4.6%), Australia (3.7%), Canada (3.5%) and Korea Republic of (2.4%).

(v) The percentage shares of top 10 ports in tourist arrivals on e-Tourist Visa during August, 2016 were as follows:

New Delhi Airport (45.30%), Mumbai Airport (21.53%), Chennai Airport (8.82%), Bengaluru Airport (7.58%), Kochi Airport (4.60%), Hyderabad Airport (3.52%), Kolkata Airport (2.07%), Amritsar Airport (2.01%), Ahmadabad Airport (1.44%) and Trivandrum Airport (1.36%).

Over 66,000 travellers arrived in India on e-tourist visa in August this year, recording a growth of about 197 percent over the same period last year. Among the countries availing e-tourist visa facility, the UK occupied the top slot, followed by the US and China, the Union Tourism Ministry said in a statement. "During the month of August, 2016 a total of 66,097 tourist arrived on e-Tourist Visa as compared to 22,286 during the month of August, 2015 registering a growth of 196.6 percent," it said. During January-August this year, a total of 6,06,493 tourist arrived on e-tourist visa as compared to 1,69,976 during the corresponding period last year, witnessing a a growth of 256.8 percent. "This high growth may be attributed to introduction of e-tourist visa for 150 countries as against the earlier coverage of 113 countries," the statement said. Launched on November 27, 2014, the facility was initially available for citizens of 113 countries arriving at 16 airports in India.It was later extended for citizens of 37 more countries. Among the top 10 source countries availing the facility in August, the UK share was maximum with 19.4 percent, followed by the US (13.2 percent), China (6.7 percent), France (6.4 percent), Spain (6.1 percent), UAE (5.5 percent). The share of Germany was 4.6 percent, while that of Australia 3.7 percent, Canada 3.5 percent and Korea 2.4 percent.

PEP treatment if given within 8 hours, can help rape victims prevent HIV contraction

2016-09-09T22:38:00.001-07:00

The initiative to administer this treatment should be taken by the relatives of the victim and also the law enforcement agencies which usually focus mainly on the crime angle, he suggested.

Rape victims can be prevented from contracting an HIV infection if a ‘post-exposure prophylaxis’ (PEP) treatment is given to them within eight hours of the sexual assault, a medical expert has claimed.

However, the treatment, which can prove to be life-saving for victims of sexual assault, is neither mandated nor is provided in India due to lack of awareness, AIDS Society of India (ASI) President Dr Ishwar Gilada told PTI.

“In cases of rape, along with legal aid a treatment of post-exposure prophylaxis should be immediately given to sexual assault victims. This will cut down the chances of infection to 100 per cent,” Gilada said.

A proactive three-day movement for creating public awareness for the use of PEP to prevent the spread of HIV infection in victims of sexual assault started in Mumbai from Saturday, where HIV clinicians from several medical faculties deliberated on how to put the evidences into a policy and take swift action.

“In a country like India, we have to work hard to put an end to sexual assault incidents. But warding off the fear of HIV infection is very easy, if all are made aware of the treatment,” he said.

The last few years have witnessed an alarming rise in rape cases in India. According to the National Crime Records Bureau (NCRB) statistics, 36,735 rape cases were reported in the country in 2014.

“In cases of rape, along with providing immediate trauma care, precaution should also be taken to ensure that the victim does not contract sexually transmitted diseases (STD), including HIV,” he said.

“In order to alleviate the danger of HIV infection, PEP should be administered to the victims. This is a short term, inexpensive and an anti-retroviral treatment (ART) which can prove effective if started within eight hours of the rape incident,” Gilada said.

The initiative to administer this treatment should be taken by the relatives of the victim and also the law enforcement agencies which usually focus mainly on the crime angle, he suggested.

ASI is a professional non-profit organisation of medical doctors and researchers in HIV/AIDS aiming to promote and disseminate clinically-oriented medical teaching and coordinated medical management of HIV disease.

National AIDS Research Institute’s (NARI) Director In-charge and ASI’s annual national conference ASICON 2015 Co-Chairman, Dr Raman Gangakhedkar said the latest WHO guidelines on HIV make available two key recommendations that were developed during the revision process this year, one of them being administration of PEP.

“Daily use of oral post-exposure prophylaxis is recommended as a prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches,” Gangakhedkar said.

“In any case of sexual assault or an accidental exposure to HIV infection, like condom rupture between two partners, this treatment would help reduce the risk by 100 per cent. More and more awareness would help to control this infection in India,” he said.

In 2013, the World Health Organisation (WHO) had issued consolidated guidelines on the ‘Use of anti-retroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach’.

Incredible India Tourism Investor’s Summit 2016 IITIS

2016-09-09T05:03:00.002-07:00

While the ambit of the travel and tourism industry in India is looking prospective, the government is looking at attracting national and international investments to explore new opportunities and improve core infrastructure.

The Ministry of Tourism announced a three-day event called the Incredible India Tourism Investor’s Summit 2016 (IITIS) as a significant platform for the investors across the globe to explore investment opportunities available in the tourism sphere of one of the fastest growing economies. The event is scheduled to take place at Vigyan Bhawan, New Delhi, starting on 21 September. The landscape of India’s tourism sector has arguably brought a new paradigm of growth and development in creating employment, generating income and fostering entrepreneurship. However, foreign investment in the sector and branding the country as a hub of new business development keeping tourism as the key focus is yet to see remarkable development. Dr. Mahesh Sharma, the Minister of State for Culture and Tourism, Government of India, said in a statement that the domestic tourism sector is expected to attract investments to the tune of INR 500,000 million from around 600 projects during this three-day investors’ summit.

Investment system revolutionised

To change the investment policies across industries in India, which have not always had investor-friendly business models, this summit looks at showcasing the investment ecosystem in the tourism industry and help global investors understand the investment-ready projects in the country. A recent press note from the ministry outlines that this three-day event will strive to catalyze partnership in form of B2B linkages and identify opportunities for local players to move up the value chain through technical collaboration and global partnerships.

While the ministry is also trying to project the Indian tourism industry as a lucrative investment destination for the leading investors in the global travel and tourism sector, the investors can also expect tangible projects in various states and union territories of India.

Vinod Zutshi, the Secretary at the Ministry of Tourism, explained how the tourism landscape in India is undergoing significant transformation. “The travel and tourism sector in the country presents a plethora of investment opportunities in areas of infrastructure development, both from India and overseas. With the streamlining of infrastructure in the core and tourism-related sectors through investments and partnerships between the public and private sectors, Incredible India can be catapulted amongst the most sought after destinations in the world,” Vinod said.
What to expect at the IITIS?

The tourism investment summit will have presentations from all states which have investible properties or projects, and sessions describing why India is the right market to invest at this critical juncture of global economic upswing.

There will be participations from major stakeholders, including states/UTs, with interesting projects related to the banks & financial institutions, business developers, cruise liners, domestic investors, entertainment companies, global investors, helicopter services, hoteliers, infrastructure-developers, international associations, restaurateurs, spa and yoga centres, tour and travel operators, urban developers, venture capitalist and civic amenity providers among others.

However, the highlight of the summit would be the 600 projects from across the country and from varied tourism sectors on the table of 140 investors from 70 different companies for final discussions. Complementing business discussions, there will be around 21 seminars across two days with some of the tourism industry leaders covering interesting thematic sessions on states and their tourism potential. International tourism boards from USA, UAE, Thailand, Hong Kong & Shanghai and Singapore will have their road shows alongside their Indian counterparts from Gujarat, Maharashtra and Madhya Pradesh.

Suman Billa, Joint Secretary, Ministry of Tourism, made a presentation on IITIS during a press meet in New Delhi, where he promised the summit to hold innovative panel discussions on core infrastructure for tourism, sessions on start-ups, digital India, investing in ‘Swadesh Darshan’, MICE and niche tourism products keeping a special focus on the Northeast and its development.

Health Ministry bans 344 drugs

2016-03-16T00:17:00.002-07:00

The Health Ministry has banned 344 fixed drug combinations through a gazette notification issued over the weekend. These include several common cough syrup solutions,analgesics and antibiotic combinations, many of which are sold over the counter.

The ban, which comes into effect immediately, follows recommendations of an expert committee formed to examine the efficacy of these drug combinations. The industry though may question the basis of the ban and seek judicial intervention.

The list of banned drugs includes Nimesulide, which had been a cause of concern for long for health experts for its continued use in India despite being banned in most of the developed nations. Fixed drug combinations have mushroomed in the market as companies in their quest for newer products — and often to beat price control — mix and match ingredients into a single molecule to market them as newer remedies.

Fixed drug combinations have mushroomed in the market as companies in their quest for newer products — and often to beat price control — mix and match ingredients into a single molecule to market them as newer remedies.

Here is the complete list of all drug combinations banned by the ministry:

* fixed dose combination of Aceclofenac + Paracetamol + Rabeprazole

* fixed dose combination of Nimesulide + Diclofenac

* fixed dose combination of Nimesulide + Cetirizine + Caffeine

* fixed dose combination of Nimesulide + Tizanidine

* fixed dose combination of Paracetamol + Cetirizine + Caffeine

* fixed dose combination of Diclofenac + Tramadol + Chlorzoxazone

* fixed dose combination of Dicyclomine + Paracetamol + Domperidone

* fixed dose combination of Nimesulide + Paracetamol dispersible tablets

* fixed dose combination of Paracetamol + Phenylephrine + Caffeine

* fixed dose combination of Diclofenac + Tramadol + Paracetamol

* fixed dose combination of Diclofenac + Paracetamol + Chlorzoxazone + Famotidine

* fixed dose combination of Naproxen + Paracetamol

* fixed dose combination of Nimesulide + Serratiopeptidase

* fixed dose combination of Paracetamol + Diclofenac + Famotidine

* fixed dose combination of Nimesulide + Pitofenone + Fenpiverinium + Benzyl Alcohol

* fixed dose combination of Omeprazole + Paracetamol + Diclofenac

* fixed dose combination of Nimesulide + Paracetamol injection

* fixed dose combination of Tamsulosin + Diclofenac

* fixed dose combination of Paracetamol + Phenylephrine + Chlorpheniramine + Dextromethorphan + Caffeine

* fixed dose combination of Diclofenac + Zinc Carnosine

* fixed dose combination of Diclofenac + Paracetamol + Chlorpheniramine Maleate + Magnesium Trisillicate

* fixed dose combination of Paracetamol + Pseudoephedrine + Cetrizine

* fixed dose combination of Phenylbutazone + Sodium Salicylate

* fixed dose combination of Lornoxicam + Paracetamol + Trypsin

* fixed dose combination of Paracetamol + Mefenamic Acid + Ranitidine + Dicyclomine

* fixed dose combination of Nimesulide + Dicyclomine

* fixed dose combination of Heparin + Diclofenac

* fixed dose combination of Glucosamine + Methyl Sulfonyl Methane + Vitamin D3 + Manganese + Boron + Copper + Zinc

* fixed dose combination of Paracetamol + Tapentadol

* fixed dose combination of Tranexamic Acid + Proanthocyanidin

* fixed dose combination of Benzoxonium Chloride + Lidocaine

* fixed dose combination of Lornoxicam + Paracetamol + Tramadol

* fixed dose combination of Lornoxicam + Paracetamol + Serratiopeptidase

* fixed dose combination of Diclofenac + Paracetamol + Magnesium Trisilicate

* fixed dose combination of Paracetamol + Domperidone + Caffeine

* fixed dose combination of Ammonium Chloride + Sodium Citrate + Chlorpheniramine Maleate + Menthol

* fixed dose combination of Paracetamol + Prochlorperazine Maleate

* Combikit of 3 tablets of Serratiopeptidase (enteric coated 20000 units) + Diclofenac Potassium & 2 tablets of Doxycycline

* fixed dose combination of Nimesulide + Paracetamol Suspension

* fixed dose combination of Aceclofenac + Paracetamol + Famotidine

* fixed dose combination of Aceclofenac + Zinc Carnosine

* fixed dose combination of Paracetamol + Disodium Hydrogen Citrate + Caffeine

* fixed dose combination of Paracetamol + DL Methionine

* fixed dose combination of Disodium Hydrogen Citrate + Paracetamol

* fixed dose combination of Paracetamol + Caffeine + Codeine

* fixed dose combination of Aceclofenac (SR) + Paracetamol

* fixed dose combination of Diclofenac + Paracetamol injection

* fixed dose combination of Azithromycin + Cefixime

* fixed dose combination of Amoxicillin + Dicloxacillin

* fixed dose combination of Amoxicillin 250 mg + Potassium Clavulanate Diluted 62.5 mg

* fixed dose combination of Azithromycin + Levofloxacin

* fixed dose combination of Cefixime + Linezolid

* fixed dose combination of Amoxicillin + Cefixime + Potassium Clavulanic Acid

* fixed dose combination of Ofloxacin + Nitazoxanide

* fixed dose combination of Cefpodoxime Proxetil + Levofloxacin * Combikit of Azithromycin, Secnidazole and Fluconazole

* fixed dose combination of Levofloxacin + Ornidazole + Alpha Tocopherol Acetate

* fixed dose combination of Nimorazole + Ofloxacin

* fixed dose combination of Azithromycin + Ofloxacin

* fixed dose combination of Amoxycillin + Tinidazole

* fixed dose combination of Doxycycline + Serratiopeptidase

* fixed dose combination of Cefixime + Levofloxacin

* fixed dose combination of Ofloxacin + Metronidazole + Zinc Acetate

* fixed dose combination of Diphenoxylate + Atropine + Furazolidone * Combikit of Fluconazole Tablet, Azithromycin Tablet and Ornidazole Tablets

* fixed dose combination of Ciprofloxacin + Phenazopyridine

* fixed dose combination of Amoxycillin + Dicloxacillin + Serratiopeptidase * Combikit of Fluconazole Tablet, Azithromycin Tablet and Ornidazole Tablets

* fixed dose combination of Ciprofloxacin + Phenazopyridine

* fixed dose combination of Amoxycillin + Dicloxacillin + Serratiopeptidase

* fixed dose combination of Azithromycin + Cefpodoxime

* fixed dose combination of Lignocaine + Clotrimazole + Ofloxacin + Beclomethasone

* fixed dose combination of Cefuroxime + Linezolid

* fixed dose combination of Ofloxacin + Ornidazole + Zinc Bisglycinate

* fixed dose combination of Metronidazole + Norfloxacin

* fixed dose combination of Amoxicillin + Bromhexine

* fixed dose combination of Ciprofloxacin + Fluticasone + Clotrimazole + Neomycin

* fixed dose combination of Metronidazole + Tetracycline

* fixed dose combination of Cephalexin + Neomycin + Prednisolone

* fixed dose combination of Azithromycin + Ambroxol

* fixed dose combination of Cilnidipine + Metoprolol Succinate + Metoprolol Tartrate

* fixed dose combination of L-Arginine + Sildenafil

* fixed dose combination of Atorvastatin + Vitamin D3 + Folic Acid + Vitamin B12 + Pyridoxine

* fixed dose combination of Metformin + Atorvastatin

* fixed dose combination of Clindamycin + Telmisartan

* fixed dose combination of Olmesartan + Hydrochlorothiazide + Chlorthalidone

* fixed dose combination of L-5-Methyltetrahydrofolate Calcium + Escitalopram i

* fixed dose combination of Pholcodine + Promethazine

* fixed dose combination of Paracetamol + Promethazine

* fixed dose combination of Betahistine + Ginkgo Biloba Extract + Vinpocetine + Piracetam

* fixed dose combination of Cetirizine + Diethyl Carbamazine

* fixed dose combination of Doxylamine + Pyridoxine + Mefenamic Acid + Paracetamol

* fixed dose combination of Drotaverine + Clidinium + Chlordiazepoxide

* fixed dose combination of Imipramine + Diazepam

* fixed dose combination of Flupentixol + Escitalopram

* fixed dose combination of Paracetamol + Prochloperazine

* fixed dose combination of Gabapentin + Mecobalamin + Pyridoxine + Thiamine

* fixed dose combination of Imipramine + Chlordiazepoxide + Trifluoperazine + Trihexyphenidyl

* fixed dose combination of Chlorpromazine + Trihexyphenidyl

* fixed dose combination of Ursodeoxycholic Acid + Silymarin

* fixed dose combination of Metformin 1000/1000/500/500mg + Pioglitazone 7.5/7.5/7.5/7.5mg + Glimepiride 1/2/1/2mg

* fixed dose combination of Gliclazide 80 mg + Metformin 325 mg

* fixed dose combination of Voglibose+ Metformin + Chromium Picolinate

* fixed dose combination of Pioglitazone 7.5/7.5mg + Metformin 500/1000mg

* fixed dose combination of Glimepiride 1mg/2mg/3mg + Pioglitazone 15mg/15mg/15mg + Metformin 1000mg/ 1000mg/1000mg

* fixed dose combination of Glimepiride 1mg/2mg+ Pioglitazone 15mg/15mg + Metformin 850mg/850mg

* fixed dose combination of Metformin 850mg + Pioglitazone 7.5 mg + Glimepiride 2mg

* fixed dose combination of Metformin 850mg + Pioglitazone 7.5 mg + Glimepiride 1mg

* fixed dose combination of Metformin 500mg/500mg+Gliclazide SR 30mg/60mg + Pioglitazone 7.5mg/7.5mg

* fixed dose combination of Voglibose + Pioglitazone + Metformin

* fixed dose combination of Metformin + Bromocriptine

* fixed dose combination of Metformin + Glimepiride + Methylcobalamin

* fixed dose combination of Pioglitazone 30 mg + Metformin 500 mg

* fixed dose combination of Glimepiride + Pioglitazone + Metformin

* fixed dose combination of Glipizide 2.5mg + Metformin 400 mg

* fixed dose combination of Pioglitazone 15mg + Metformin 850 mg

* fixed dose combination of Metformin ER + Gliclazide MR + Voglibose

* fixed dose combination of Chromium Polynicotinate + Metformin

* fixed dose combination of Metformin + Gliclazide + Piogllitazone + Chromium Polynicotinate

* fixed dose combination of Metformin + Gliclazide + Chromium Polynicotinate

* fixed dose combination of Glibenclamide + Metformin (SR)+ Pioglitazone

* fixed dose combination of Metformin (Sustainded Release) 500mg + Pioglitazone 15 mg + Glimepiride 3mg

* fixed dose combination of Metformin (SR) 500mg + Pioglitazone 5mg

* fixed dose combination of Chloramphenicol + Beclomethasone + Clomitrimazole + Lignocaine

* fixed dose combination of Clotrimazole + Ofloxaxin + Lignocaine + Glycerine and Propylene Glycol

* fixed dose combination of Chloramphennicol + Lignocaine + Betamethasone + Clotrimazole + Ofloxacin + Antipyrine

* fixed dose combination of Ofloxacin + Clotrimazole + Betamethasone + Lignocaine

* fixed dose combination of Gentamicin Sulphate + Clotrimazole + Betamethasone + Lignocaine

* fixed dose combination of Clotrimazole + Beclomethasone + Ofloxacin + Lignocaine

* fixed dose combination of Becloemthasone + Clotrimazole + Chloramphenicol + Gentamycin + Lignocaine Ear drops

* fixed dose combination of Flunarizine + Paracetamole + Domperidone

* fixed dose combination of Rabeprazole + Zinc Carnosine

* fixed dose combination of Magaldrate + Famotidine + Simethicone

* fixed dose combination of Cyproheptadine + Thiamine

* fixed dose combination of Magaldrate + Ranitidine + Pancreatin + Domperidone

* fixed dose combination of Ranitidine + Magaldrate + Simethicone

* fixed dose combination of Magaldrate + Papain + Fungul Diastase + Simethicone

* fixed dose combination of Rabeprazole + Zinc + Domperidone

* fixed dose combination of Famotidine + Oxytacaine + Magaldrate

* fixed dose combination of Ranitidine + Domperidone + Simethicone

* fixed dose combination of Alginic Acid + Sodium Bicarbonate + Dried Aluminium Hydroxide + Magnesium Hydroxide

* fixed dose combination of Clidinium + Paracetamol + Dicyclomine + Activated Dimethicone

* fixed dose combination of Furazolidone + Metronidazole + Loperamide

* fixed dose combination of Rabeprazole + Diclofenac + Paracetamol

* fixed dose combination of Ranitidine + Magaldrate

* fixed dose combination of Norfloxacin + Metronidazole + Zinc Acetate

* fixed dose combination of Zinc Carnosine + Oxetacaine

* fixed dose combination of Oxetacaine + Magaldrate + Famotidine

* fixed dose combination of Pantoprazole (as Enteric Coated Tablet) + Zinc Carnosine (as Film Coated Tablets)

* fixed dose combination of Zinc Carnosine + Magnesium Hydroxide + Dried Aluminium Hydroxide + Simethicone

* fixed dose combination of Zinc Carnosine + Sucralfate

* fixed dose combination of Mebeverine & Inner HPMC capsule (Streptococcus Faecalis + Clostridium butyricum + Bacillus mesentricus + Lactic Acid Bacillus)

* fixed dose combination of Clindamycin + Clotrimazole + Lactic Acid Bacillus

* fixed dose combination of Sildenafil + Estradiol Valerate

* fixed dose combination of Clomifene Citrate + Ubidecarenone + Zinc + Folic Acid + Methylcobalamin + Pyridoxine + Lycopene + Selenium + Levocarnitine Tartrate + L-

Arginine

* fixed dose combination of Thyroxine + Pyridoxine + Folic Acid

* fixed dose combination of Gentamycin + Dexamethasone + Chloramphenicol + Tobramycin + Ofloxacin

* fixed dose combination of Dextromethorphan + Levocetirizine + Phenylephrine + Zinc

* fixed dose combination of Nimesulide + Loratadine + Phenylephrine + Ambroxol

* fixed dose combination of Bromhexine + Phenylephrine + Chlorepheniramine Maleate

* fixed dose combination of Dextromethorphan + Bromhexine + Guaiphenesin

* fixed dose combination of Paracetamol + Loratadine + Phenylephrine + Dextromethorphan + Caffeine

* fixed dose combination of Nimesulide + Phenylephrine + Caffeine + Levocetirizine

* fixed dose combination of Azithromycin + Acebrophylline

* fixed dose combination of Diphenhydramine + Terpine + Ammonium Chloride + Sodium Chloride + Menthol

* fixed dose combination of Nimesulide + Paracetamol + Cetirizine + Phenylephrine

* fixed dose combination of Paracetamol + Loratadine + Dextromethophan + Pseudoepheridine + Caffeine

* fixed dose combination of Chlorpheniramine Maleate + Dextromethorphan + Dextromethophan + Guaiphenesin + Ammonium Chloride + Menthol

* fixed dose combination of Chlorpheniramine Maleate + Ammonium Chloride + Sodium Citrate

* fixed dose combination of Cetirizine + Phenylephrine + Paracetamol + Zinc Gluconate

* fixed dose combination of Ambroxol + Guaiphenesin + Ammonium Chloride + Phenylephrine + Chlorpheniramine Maleate + Menthol

* fixed dose combination of Dextromethorphen + Bromhexine + Chlorpheniramine Maleate + Guaiphenesin

* fixed dose combination of Levocetirizine + Ambroxol + Phenylephrine + Guaiphenesin

* fixed dose combination of Dextromethorphan + Chlorpheniramine + Chlorpheniramine Maleate

* fixed dose combination of Cetirizine + Ambroxol + Guaiphenesin + Ammonium Chloride + Phenylephrine + Menthol

* fixed dose combination of Chlorpheniramine + Phenylephrine + Caffeine

* fixed dose combination of Dextromethorphan + Triprolidine + Phenylephrine

* fixed dose combination of Terpinhydrate + Dextromethorphan + Menthol

* fixed dose combination of Dextromethorphan + Phenylephrine + Zinc Gluconate + Menthol

* fixed dose combination of Chlorpheniramine + Codeine + Sodium Citrate + Menthol Syrup

* fixed dose combination of Enrofloxacin + Bromhexin

* fixed dose combination of Bromhexine + Dextromethorphan + Phenylephrine + Menthol

* fixed dose combination of Levofloxacin + Bromhexine

* fixed dose combination of Levocetirizine + Ranitidine

* fixed dose combination of Levocetirizine + Phenylephrine + Ambroxol + Guaiphenesin + Paracetamol

* fixed dose combination of Cetirizine + Dextromethorphan + Phenylephrine + Zinc Gluconate + Paracetamol + Menthol

* fixed dose combination of Paracetamol + Pseudoephedrine + Dextromethorphan + Cetirizine

* fixed dose combination of Diphenhydramine + Guaiphenesin + Ammonium Chloride + Bromhexine

* fixed dose combination of Chlorpheniramine + Dextromethorphan + Phenylephrine + Paracetamol

* fixed dose combination of Dextromethorphen + Promethazine

* fixed dose combination of Diethylcabamazine Citrate + Cetirizine + Guaiphenesin

* fixed dose combination of Pseudoephedrine + Dextromethorphan + Cetirizine

* fixed dose combination of Chlorpheniramine + Phenylephrine + Dextromethophan + Menthol

* fixed dose combination of Ambroxol + Terbutaline + Dextromethorphan

* fixed dose combination of Dextromethorphan + Chlorpheniramine + Guaiphenesin

* fixed dose combination of Terbutaline + Bromhexine + Guaiphenesin + Dextromethorphan

* fixed dose combination of Dextromethorphan + Tripolidine + Phenylephirine

* fixed dose combination of Paracetamol + Dextromethorphan + Chlorpheniramine

* fixed dose combination of Pholcodine + Phenylephrine + Promethazine

* fixed dose combination of Codeine + Levocetirizine + Menthol

* fixed dose combination of Dextromethorphan + Ambroxol + Guaifenesin + Phenylephrine + Chlorpheniramine

* fixed dose combination of Cetirizine + Phenylephrine + Dextromethorphan + Menthol

* fixed dose combination of Roxithromycin + Serratiopeptidase

* fixed dose combination of Paracetamol + Phenylephrine + Triprolidine

* fixed dose combination of Acetaminophen + Loratadine + Ambroxol + Phenylephrine

* fixed dose combination of Cetirizine + Acetaminophen + Dextromethorphan + Phenyephrine + Zinc Gluconate

* fixed dose combination of Diphenhydramine + Guaifenesin + Bromhexine + Ammonium Chloride + Menthol

* fixed dose combination of Chlopheniramine Maleate + Codeine Syrup

* fixed dose combination of Cetirizine + Dextromethorphan + Zinc Gluconate + Menthol

* fixed dose combination of Paracetamol + Phenylephrine + Desloratadine + Zinc Gluconate + Ambroxol

* fixed dose combination of Levocetirizine + Montelukast + Acebrophylline

* fixed dose combination of Dextromethorphan + Phenylephrine + Ammonium Chloride + Menthol

* fixed dose combination of Dextromethorphan + Bromhexine + Guaiphenesin + Menthol

* fixed dose combination of Acrivastine + Paracetamol + Caffeine + Phenylephrine

* fixed dose combination of Naphazoline + Carboxy Methyl Cellulose + Menthol + Camphor + Phenylephrine

* fixed dose combination of Dextromethorphan + Cetirizine

* fixed dose combination of Nimesulide + Paracetamol + Levocetirizine + Phenylephrine + Caffeine

* fixed dose combination of Terbutaline + Ambroxol + Guaiphenesin + Zinc + Menthol

* fixed dose combination of Codeine + Chlorpheniramine + Alcohol Syrup

* fixed dose combination of Dextromethorphan + Phenylephrine + Guaifenesin + Triprolidine

* fixed dose combination of Ammomium Chloride + Bromhexine + Dextromethorphan

* fixed dose combination of Diethylcarbamazine + Cetirizine + Ambroxol

* fixed dose combination of Ethylmorphine + Noscapine + Chlorpheniramine

* fixed dose combination of Cetirizine + Dextromethorphan + Ambroxol

* fixed dose combination of Bromhexine + Dextromethorphan + Ammonium Chloride + Menthol

* fixed dose combination of Ambroxol + Guaifenesin + Phenylephrine + Chlorpheniramine

* fixed dose combination of Paracetamol + Phenylephrine + Chlorpheniramine + Zinc Gluconate

* fixed dose combination of Dextromethorphan + Phenylephrine + Cetirizine + Paracetamol + Caffeine

* fixed dose combination of Dextromethophan + Chlorpheniramine + Guaifenesin + Ammonium Chloride

* fixed dose combination of Levocetirizine + Dextromethorphan + Zinc

* fixed dose combination of Paracetamol + Phenylephrine + Levocetirizine + Caffeine

* fixed dose combination of Chlorphaniramine + Ammonium Chloride + Sodium Chloride

* fixed dose combination of Paracetamol + Dextromethorphan + Bromhexine + Phenylephrine + Diphenhydramine

* fixed dose combination of Salbutamol + Bromhexine + Guaiphenesin + Menthol

* fixed dose combination of Chlorpheniramine + Ammonium Chloride + Noscapine + Sodium Citrate

* fixed dose combination of Cetirizine + Dextromethorphan + Bromhexine + Guaifenesin

* fixed dose combination of Diethyl Carbamazine + Chlorpheniramine + Guaifenesin

* fixed dose combination of Ketotifen + Cetirizine

* fixed dose combination of Terbutaline + Bromhexine + Etofylline

* fixed dose combination of Ketotifen + Theophylline

* fixed dose combination of Ambroxol + Salbutamol + Theophylline

* fixed dose combination of Cetririzine + Nimesulide + Phenylephrine

* fixed dose combination of Chlorpheniramine + Phenylephrine + Paracetamol + Zink Gluconate

* fixed dose combination of Acetaminophen + Guaifenesin + Dextromethorphan + Chlorpheniramine

* fixed dose combination of Cetirizine + Dextromethorphan + Phenylephrine + Tulsi

* fixed dose combination of Cetirizine + Phenylephrine + Paracetamol + Ambroxol + Caffeine

* fixed dose combination of Guaifenesin + Dextromethorphan

* fixed dose combination of Levocetirizine + Paracetamol + Phenylephirine + Caffeine

* fixed dose combination of Caffeine + Paracetamol + Phenylephrine + Chlorpheniramine

* fixed dose combination of Ketotifen + Levocetrizine

* fixed dose combination of Paracetamol + Levocetirizine + Phenylephirine + Zink Gluconate

* fixed dose combination of Paracetamol + Phenylephrine + Triprolidine + Caffeine

* fixed dose combination of Caffeine + Paracetamol + Phenylephrine + Cetirizine

* fixed dose combination of Caffeine + Paracetamol + Chlorpheniramine

* fixed dose combination of Ammonium Chloride + Dextromethorphan + Cetirizine + Menthol

* fixed dose combination of Dextromethorphan + Paracetamol + Cetirizine + Phenylephrine

* fixed dose combination of Chlorpheniramine + Terpin + Antimony Potassium Tartrate + Ammonium Chloride + Sodium Citrate + Menthol

* fixed dose combination of Terbutaline + Etofylline + Ambroxol

* fixed dose combination of Paracetamol + Codeine + Chlorpheniramine

* fixed dose combination of Paracetamol+Pseudoephedrine+Certirizine+Caffeine

* fixed dose combination of Chlorpheniramine+Ammonium Chloride + Menthol

* fixed dose combination of N-Acetyl Cysteine + Ambroxol + Phenylephrine + Levocertirizine

* fixed dose combination of Dextromethorphan + Phenylephrine + Tripolidine + Menthol

* fixed dose combination of Salbutamol + Certirizine + Ambroxol

* fixed dose combination of Dextromethorphan + Phenylephrine + Bromhexine + Guaifenesin + Chlorpheniramine

* fixed dose combination of Nimesulide + Certirizine + Phenylephrine

* fixed dose combination of Naphazoline + Chlorpheniramine + Zinc Sulphate + Boric Acid + Sodium Chloride + Chlorobutol

* fixed dose combination of Paracetamol + Bromhexine + Phenylephrine + Chlorpheniramine + Guaifenesin

* fixed dose combination of Salbutamol + Bromhexine

* fixed dose combination of Dextromethorphan + Phenylephrine + Guaifenesin + Certirizine + Acetaminophen

* fixed dose combination of Guaifenesin + Bromhexine + Chlorpheniramine + Paracetamol

* fixed dose combination of Chlorpheniramine + Ammonium Chloride + Chloroform + Menthol

* fixed dose combination of Salbutamol + Choline Theophylinate + Ambroxol

* fixed dose combination of Chlorpheniramine + Codeine Phosphate + Menthol Syrup

* fixed dose combination of Pseudoephedrine + Bromhexine

* fixed dose combination of Certirizine + Phenylephrine + Paracetamol + Caffeine + Nimesulide

* fixed dose combination of Dextromethorphan + Cetirizine + Guaifenesin + Ammonium Chloride

* fixed dose combination of Ambroxol + Salbutamol + Choline Theophyllinate + Menthol

* fixed dose combination of Paracetamol + Chlorpheniramine + Ambroxol + Guaifenesin + Phenylephrine

* fixed dose combination of Chlorpheniramine + Vasaka + Tolubalsm + Ammonium Chloride + Sodium Citrate + Menthol

* fixed dose combination of Bromhexine + Cetrizine + Phenylephrine IP+Guaifenesin + Menthol

* fixed dose combination of Dextromethorphan + Ambroxol + Ammonium Chloride + Chlorpheniramine + Menthol

* fixed dose combination of Dextromethorphan + Phenylephrine + Cetirizine + Zinc + Menthol

* fixed dose combination of Terbutaline + N-Acetyl L-Cysteine + Guaifenesin

* fixed dose combination of Calcium Gluconate + Levocetirizine

* fixed dose combination of Paracetamol + Levocetirizine + Pseudoephedrine

* fixed dose combination of Salbutamol + Choline Theophylinate + Carbocisteine

* fixed dose combination of Chlorpheniramine + Vitamin C

* fixed dose combination of Calcium Gluconate + Chlorpheniramine + Vitamin C

* fixed dose combination of Chlorpheniramine + Paracetamol + Pseudoephedrine + Caffeine

* fixed dose combination of Guaifenesin + Bromhexine + Chlorpheniramine + Phenylephrine + Paracetamol + Serratiopeptidase (as enteric coated granules) 10000 SP Units

* fixed dose combination of Paracetamol + Pheniramine

* fixed dose combination of Betamethasone + Fusidic Acid + Gentamycin + Tolnaftate + lodochlorhydroxyquinoline (ICHQ)

* fixed dose combination of Clobetasol + Ofloxacin + Miconazole + Zinc Sulphate

* fixed dose combination of Clobetasole + Gentamicin + Miconazole + Zinc Sulphate

* fixed dose combination of Levocetirizine + Ambroxol + Phenylephrine + Paracetamol

* fixed dose combination of Permethrin + Cetrimide + Menthol

* fixed dose combination of Beclomethasone + Clotimazole + Neomycin + lodochlorohydroxyquinone

* fixed dose combination of Neomycin + Doxycycline

* fixed dose combination of Ciprofloxacin + Fluocinolone + Clotrimazole + Neomycin + Chlorocresol

* fixed dose combination of Clobetasol + Ofloxacin + Ketoconazol + Zinc Sulphate

* fixed dose combination of Betamethasone + Gentamicin + Tolnaftate + lodochlorhydroxyquinoline

* fixed dose combination of Clobetasol + Gentamicin + Tolnaftate + lodochlorhydroxyquinone + Ketoconazole

* fixed dose combination of Allantoin + Dimethieone + Urea + Propylene + Glycerin + Liquid Paraffin

* fixed dose combination of Acriflavine + Thymol + Cetrimide

* fixed dose combination of Betamethasone + Neomycin + Tolnaftate + lodochlorohydroxyquinoline + Cholorocresol

* fixed dose combination of Clobetasol + Neomycin + Miconazole + Clotrimazole

* fixed dose combination of Ketoconazole + Tea Tree oil + Allantion + Zinc Oxide + Aloe Vera + Jojoba oil + Lavander oil + Soa noodels

* fixed dose combination of Clobetasol Propionate + Ofloxacin + Ornidazole + Terbinafine

* fixed dose combination of Clobetasol + Neomycin + Miconazole + Zinc Sulphate

* fixed dose combination of Beclomethasone Diproprionate + Neomycin + Tolnaftate + lodochlorhydroxyquinoline + Chlorocresol

* fixed dose combination of Betamethasone + Gentamycin + Zinc Sulphate + Clotrimoazole + Chlorocresol

* fixed dose combination of Borax + Boric Acid + Naphazoline + Menthol + Camphor + Methyl Hydroxy Benzoate

* fixed dose combination of Bromhexine + Dextromethorphan

* fixed dose combination of Dextromethophan + Chlopheniramine + Bromhexine

* fixed dose combination of Menthol + Anesthetic Ether

* fixed dose combination of Dextrometharphan + Chlopheniramine + Ammonium + Sodium Citrate + Menthol

* fixed dose combination of Ergotamine Tartrate + Belladona Dry Extract+Caffeine + Paracetamol

* fixed dose combination of Phenytoin + Phenobarbitone

* fixed dose combination of Gliclazide 40mg + Metformin 400mg

* fixed dose combination of Paracetamol + Ambroxol + Phenylephrine + Chlorpheniramine

* fixed dose combination of Oflaxacin + Ornidazole Suspension

* fixed dose combination of Albuterol + Etofylline + Bromhexine + Menthol

* fixed dose combination of Albuterol + Bromhexine + Theophylline

* fixed dose combination of Salbutamol+Hydroxyethyltheophylline (Etofylline) + Bromhexine

* fixed dose combination of Paracetamol+Phenylephrine+Levocetirizine+Sodium Citrate

* fixed dose combination of Paracetamol + Propyphenazone + Caffeine

* fixed dose combination of Guaifenesin + Diphenhydramine + Bromhexine + Phenylephrine

* fixed dose combination of Dried Alumnium Hydroxie Gel + Prophantheline + Diazepam

* fixed dose combination of Bromhenxine + Phenylephrine + Chlorpheniramine + Paracetamol

* fixed dose combination of Beclomethasone + Clotrimazole + Gentamicin + lodochlorhydroxyquinoline

* fixed dose combination of Telmisartan + Metformin

* fixed dose combination of Ammonium Citrate + Vitamin B 12 + Folic Acid + Zinc Sulphate

* fixed dose combination of Levothyroxine + Phyridoxine + Nicotinamide

* fixed dose combination of Benfotiamine + Metformin

* fixed dose combination of Thyroid + Thiamine + Riboflavin + Phyridoxine + Calcium Pantothenate + Tocopheryl Acetate + Nicotinamide

* fixed dose combination of Ascorbic Acid + Manadione Sodium Bisulphate + Rutin + Dibasic Calcium Phosphate + Adrenochrome mono Semicarbazone

* fixed dose combination of Phenylephrine + Chlorpheniramine + Paracetamol + Bromhexine + Caffeine

* fixed dose combination of Clotrimazole + Beclomethasone + Lignocaine + Ofloxacin + Acetic Aicd + Sodium Methyl Paraben + Propyl Paraben

PrEP could prevent 185,000 new HIV infections

2016-03-03T03:36:00.003-08:00

Increasing diagnosis, care and treatment of people living with HIV could lead to a large decrease in HIV incidence, preventing some 168,000 new infections by the year 2020, according to a new US Centers for Disease Control and Prevention (CDC) analysis presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2016) last week in Boston. The impact of pre-exposure prophylaxis (PrEP) would be comparatively modest, but its importance would be greater if more people with HIV are not on treatment with undetectable viral load.

Emine Yaylali of the CDC and colleagues developed a dynamic model of HIV transmission, looking at what would happen if 90% of people living with HIV are diagnosed, 85% are linked to care and 80% start antiretroviral therapy (ART) and achieve viral suppression – key goals in the continuum of care outlined in the US National HIV/AIDS Strategy.

Studies have shown that the risk of HIV transmission is reduced to almost zero when people with HIV are on ART that successfully suppresses viral load, and consistent use of tenofovir/emtricitabine (Truvada) as PrEP has been shown to decrease the likelihood of HIV-negative people acquiring HIV to a similar extent. But the relative contribution of these interventions in controlling local and national HIV epidemics is unknown.

The researchers started with the estimate that 87% of people with HIV were diagnosed, 80% were linked to care and 36% of those diagnosed had achieved viral suppression in 2015.

They then assessed the effect of raising these percentages to the National HIV/AIDS Strategy goals, based on the 96% reduction in the risk of new infections in the HPTN 052 study of serodiscordant heterosexual couples when the partner with HIV was on effective ART.

They also looked at the benefit of PrEP used by 40% of high-risk men who have sex with men (MSM), 10% of people who inject drugs and 10% of high-risk heterosexuals. For efficacy, they used the 73% risk reduction in the iPrEx trial for MSM with detectable tenofovir/emtricitabine drug levels, 75% in the Partners PrEP trial for heterosexual couples, and 49% in the Bangkok Tenofovir Study for people who inject drugs.

The model predicted that increasing the number of people on ART with undetectable viral load would, by itself, prevent more than 168,000 new infections by 2020.

Expanding PrEP would avert approximately 17,000 additional infections over the next five years. Together, expanded treatment and PrEP would prevent 185,000 new infections – a 70% reduction.

However, if diagnosis and treatment rates remained stable at 2015 levels, expanded use of PrEP alone could potentially prevent 48,000 new infections, showing that its impact is greater if more people with HIV remain off treatment with detectable viral load.

“If we expand the use of our current prevention strategies today, we can significantly reduce new HIV infections tomorrow,” Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, stated in a CDC press release. “This study confirms that we have the right tools to dramatically reduce new HIV infections, but we have a long way to go in order to make those reductions a reality.”

“We urgently need to close gaps in HIV care and treatment for people living with HIV,” added Eugene McCray, director of CDC’s Division of HIV/AIDS Prevention. “At the same time, in the short term, we need to rapidly expand access to PrEP and other life-saving prevention tools.”

HIV hides and grows inside the body even when undetectable in blood

2016-03-03T03:32:00.002-08:00

HIV can hide and grow in body ‘sanctuaries’ after disappearing from blood, study says

Researchers pinpoint how HIV hides and grows inside the body even when undetectable in blood

HIV continues to replicate in the body even if it’s undetectable in the blood after antiretroviral treatment, scientists have discovered.

It explains how the virus rapidly bounces back – and keeps growing – after a patient stops taking antiretroviral drugs.

Study author Dr Steven Wolinsky, chief of infectious diseases at Northwestern’s Feinberg School of Medicine, said: ‘We now have a path to a cure.

‘The challenge is to deliver drugs at clinically effective concentrations to where the virus continues to replicate within the patient.’

Potent antiretroviral drugs are able to seemingly get rid of HIV from the bloodstream in most patients.

After the treatment, their blood tests may not detect the virus.

However, HIV is still growing in a viral reservoir within the lymphoid tissue in the body at that time.

And, it ‘quickly rebounds’ in the blood after patients stop taking the drugs.

Scientists concluded that latently infected cells or ongoing low levels of HIV replication maintain those viral reservoirs during antiretroviral treatment.

Scientists long believed that the reservoir only contained long-infected cells in a resting place – instead of newly infected cells.

That’s because none of them had seen viruses with new genetic mutations that arise when HIV completes its growth cycles.

Furthermore, most patients don’t develop drug resistant mutations – which would seem likely if HIV was growing in the presence of drugs.

The study analyzed viral sequences in serial samples of lymph node cells.

They also examined blood from three HIV-infected patients.

Each of those patients had no detectable virus in their blood.

The scientists determined that the viral reservoir was constantly replenished by low-level virus replication in the lymphoid tissue.

Infected cells would then move from those ‘protected sanctuaries’ and into the blood, they found.

Therefore, infected cells in drug-sanctuaries within the lymphoid tissue can still produce new viruses.

HOW HIV INFECTS

HIV infects CD4+ T-cells, which play a vital role in the immune system and protect us from diseases. As HIV progresses, it reduces the number of active T-cells in the body until the immune system cannot function correctly, a state known as 'acquired immune deficiency syndrome' or AIDS.

Current World Health Organisation guidelines, which the UK government follows, recommend only beginning HIV treatment when the number of T-cells in the bloodstream falls below a certain level.

However, the new model predicts that treatment should start as soon as possible after infection to prevent AIDS from developing in the long term.

They can also infect new target cells and replenish the viral reservoir.

That’s why drugs have not been able to completely purge the body of latently infected cells – and kill the virus all together.

The scientists utilized a mathematical model to track the amount of the virus and number of infected cells as they grew in the sanctuaries – and as they then moved through the body.

The model showed that HIV grows in areas where antiretroviral drug concentrations are lower than in the blood.

The scientists concluded that it is important to deliver high concentrations of antiretroviral drugs to all locations in the body where HIV may grow and evolve.

As such, drugs that penetrate these ‘newly discovered sanctuaries’ will be required to eliminate the viral reservoir – and may bring the medical community closer to finding a cure.

Co-author Dr Angela McLean, a professor of mathematical biology at Oxford University, said: ‘The study is exciting because it really changes how we think about what is happening in treated patients.

‘It helps explains why some strategies that tried to clear the reservoir have failed.’

The study was published in the journal Nature.

A new study shows that HIV can still live and grow in the body even after disappearing from the blood following aggressive antiretroviral therapy.

The research, published in the journal Nature on Wednesday, involved looking at samples of cells from the lymph nodes of three patients who appeared to have cleared the virus. The researchers found that cells in the lymph node tissue can still produce new viruses and infect new target cells.

The groundbreaking idea of viral reservoirs of HIV made headlines in July 2014 when a Mississippi girl born with HIV, who was believed to be cured after early treatment, tested positive for the virus after stopping therapy. In her case, doctors think the infection reemerged from a viral reservoir that contained cells in a resting state that were not proliferating.

The latest study, funded by the US National Institutes of Health, appears to show a different type of “sanctuary,” as the researchers called it, that harbours cells with low levels of HIV replication that move into the blood. Researchers used a mathematical model to track the amount of virus and the amount of infected cells as they grew and moved through the body.

This suggests that virus growth could occur in a place where drug concentrations are very low.

“These findings are important as it is critical for the field of HIV cure research to know whether new infectious cycles are indeed continuing in patients on seemingly effective treatment,” said Deborah Persaud, a professor of infectious diseases at Johns Hopkins University School of Medicine.

But Persaud, who was not involved in the lymph node research but was part of a team caring for a baby who had received a treatment similar to the Mississippi child, said the study is limited by its small sample size and the fact that the analyses were done during the first six months of combination treatment “when the infected pools are still very dynamic.” She said a similar study on patients with longer-term treatment may offer more clues about what is going on.

Co-author Steven Wolinsky, chief of infectious diseases at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician, said in a statement that the research indicates that “the challenge is to deliver drugs at clinically effective concentrations to where the virus continues to replicate within the patient.”

Angela McLean, a professor of mathematical biology at Oxford University and who supervised the mathematical modeling, added that the study “really changes how we think about what is happening in treated patients.”

“It helps explain why some strategies that tried to clear the reservoir have failed,” she said.

Putting Household Water Treatment Products to the Test

2016-02-10T03:12:00.000-08:00

WHO’s new International Scheme to Evaluate Household Water Treatment (HWT) Technologies ensures that products used to treat water in homes are effective in protecting health.

Globally, an estimated 1.9 billion people rely on water supplies that are contaminated with faeces. This requires many to use household water treatment (HWT) technologies to help prevent disease and make water safe for drinking.

The global market for HWT products has now become flooded with products. From chlorination to filtration systems and solar disinfection, the options for purifying water are endless. Manufacturers claim their products make water safe for drinking, but in low-income countries, where many of these devices are essential, labs lack the capacity to verify these claims.

But, times are changing.

“The primary benefit from household water treatment is protecting health,” says WHO's Dr Batsi Majuru.

Now, the health benefits of HWT are increasingly recognized and the need for independent and rigorous evaluation is essential, adds Dr Majuru.

It is estimated that when used correctly and consistently, HWT and safe storage of water can reduce diarrhoeal diseases by as much as 45%, and save thousands of young children every year.

An international evaluation scheme

The International Scheme to Evaluate Household Water Treatment Technologies was established in 2014 to independently and consistently assess the performance of HWT products against WHO health-based criteria - an evaluation system similar to how pharmaceuticals and insecticide-treated bed nets are pre-qualified.

WHO International Scheme to Evaluate Household Water Treatment Technologies

Under the Scheme, a product can be evaluated if it is low-cost, appropriate for low-income settings, free standing and able to treat enough water to serve a limited number of individuals for a day. Products that meet these requirements are tested to see how well they remove microbiological contaminants, such as bacteria, viruses and protozoa, from drinking water. Product performance is classified based a 3 tiered system and those that achieve the highest removal of pathogens are given a 3-star rating.

Recently, WHO released the first round of results on 10 HWT technologies ranging from ultrafiltration to chemical disinfection and found 8 met performance targets. These products reach an estimated 60 countries and millions of users. Every year, WHO plans to test new technologies and release results to help countries like Ethiopia that are working to scale-up HWTselect the technologies that meet WHO performance criteria.

Improving regulation in Ethiopia

Ethiopia is often affected by droughts and floods, meaning that safe drinking water can be hard to come by and diarrhoeal diseases are common. To address the situation, the Government launched the ‘One WASH Programme’, which aims to achieve universal access to safe water, sanitation and hygiene, and improve safe storage and treatment practices in the household.

Prior to WHO’s scheme, many laboratories tried to evaluate HWT products, but there were no standard protocols or test processes. Now, the Ethiopian Food, Medicine and Health Care Administration Control Authority, which is mandated to test the safety of pharmaceuticals, food and beverages, is also mandated to regulate HWT products.

“Previously, we only conducted document reviews and chemical testing on chlorine-based HWT technologies being used in the country,” says Bikila Bayissa, Deputy Director General of Food & Medicines Quality Assessment, Ethiopian Food, Medicine and Health Care Administration & Control Authority. “Now, through WHO’s Scheme, we are also focusing on the microbiology, which is critical to ensuring drinking water is safe.”

WHO is working with the Government of Ethiopia to train staff from various government laboratories, ministries and regulatory bodies on how to do the microbiological testing to evaluate product performance, as well as implementing WHO Guidelines on Drinking-water Quality.

“Many HWT products are imported from other countries, but no one knows if they are good or bad,” says Dr Almaz Gonfa, coordinator, Food Microbiology and Food Safety Research Lab at Ethiopian Public Health Institute. “The WHO Scheme will help Ethiopians know the products they are using are actually cleaning their water and protecting their health.”

Scaling-up in more countries

Universal access to safe drinking water is called for in the Sustainable Development Goals. By strengthening protection and management of water supplies, including at the household level, WHO and governments are taking steps to achieve this goal.

This year, WHO is working with the Government of Ghana to develop HWT performance standards and a certification and product labeling system to aid users in making informed purchases. Once launched, the certification programme will support the Government’s National Strategy for Household Water Treatment and Safe Storage, aimed at reducing waterborne diseases by 2025.

“WHO’s scheme will help make sure the technologies in Ghana effectively clean water, are appropriate for local households and meet international standards,” says Kweku Quansah, programme officer, Ghanaian Ministry of Local Government & Rural Development.

“Once we pass technologies through the evaluation process, individuals will have the assurance that these technologies are internationally verified,” he adds.

Gliptin New Anti Diabetes Drug Cuts Treatment Cost by 80%

2016-02-03T04:53:00.001-08:00

There's a new diabetes drug in the market which apparently cuts cost by 80%. We kid you not. This comes as good news for millions of diabetics tackling the debilitating disease.

By lowering the cost of therapy for patients by 80%, the new drug in the 'gliptin' family has disrupted the anti-diabetes market. With 15 companies offering offering the drugs, cost for a day's treatment is down from Rs 45 to an average daily price of Rs 9. This miracle drug could make life easier for the people tackling with the disease which gradually attacks and weakens all body organs.

The cost of gliptin treatment amounted to Rs 16,200 per year (at Rs 1,350 per month). With the entry of the new molecule and subsequently aggressive pricing by domestic companies over the past six months, the cost of therapy has dropped to approximately Rs 3,285 a year (at Rs 270 a month), translating into national savings of roughly Rs 1,300 crore for patients. The new entrant teneligliptin is also the fastest selling in the Rs 1,430 crore gliptin family which occupies 20% of the total anti-diabetic market.

Diabetics in the country have something to cheer about. A new drug in the 'gliptin' family has disrupted the anti-diabetes market by lowering the cost of therapy for patients by 80%, making it easier for millions of diabetics to tackle the debilitating disease which gradually attacks and weakens all body organs.

With the launch of teneligliptin molecule, the popular gliptin category has witnessed a price erosion of over 80% in the last six months, bringing down the cost from 45 for a day's treatment to an average of 9, with over 15 companies now offering it.

Most gliptins are priced around 45 for a day's therapy, taking the cost of treatment for patients to nearly 16,500 a year ( 1,350 a month).

The entry of the new molecule and subsequent aggressive pricing has led to the cost of therapy coming down to approximately 3,285 a year (or 270 a month), translating into savings of roughly 1,300 crore for patients.

The new entrant teneligliptin is also the fastest selling in the 1,430 crore gliptin family, which occupies 20% of the anti-diabetic market.

Teneligliptin, a third-generation new oral anti-diabetic drug manufactured by Mumbai-based Glenmark, received regulatory approval and was priced aggressively at nearly 20 for a day's therapy when it was first launched in June last year.

The launch of Zita Plus and Ziten (teneligliptin brands) by Glenmark paved the way for the entry of a host of other players to launch the molecule in the oral diabetic market, which is valued around 6,000 crore.

As per AIOCD data (December 2015), there are 16 teneligliptin brands in the market, with total sale of 36 crore.

The economic burden of diabetes is high in India as most patients pay out-of-pocket, and due to lack of medical reimbursement.

Worse, the cost of treatment also includes consultation, investigations, drugs, monitoring, complications, while the complications related to the disease may increase it substantially.

Dr Anoop Misra, chairman Fortis-C-DOC Hospital for Diabetes says, "Low cost medications are surely needed in India, however, all of us look at safety data before prescribing any medication. For teneligliptin, safety data is not long term, and confined to patients from far eastern countries, hence confidence to prescribe this medication viz-a-viz other gliptins is lower."

With the entry of the new molecule, the cost of therapy has dropped to approximatelyRs 3,285 a year (at Rs 270 a month), translating into national savings of roughly Rs 1,300 crore for patients.

Price war breaks out among anti-diabetes drug Gliptin in Market

2016-02-03T04:50:00.000-08:00

Teneligliptin, a drug to control diabetes, is in the middle of an intense price war. While Mankind Pharma reduced its price by 50 per cent within 24 hours of a launch, Glenmark is evaluating the option of decreasing the price. A week ago, Zydus Cadila, another prominent player, already launched the lowest-priced Teneligliptin.

India's Gliptin market, estimated at Rs 2,000 crore yearly, is growing at around 60 per cent annually. Of the 68 million diabetics in India, about 1.85 million are on the Gliptin therapy to manage their type-2 diabetes.

According to October data from the All-India Organisation of Chemists and Druggists (AIOCD), the country's anti-diabetic drug market is seeing a growth of 25 per cent at Rs 7,638 crore.

"We are evaluating the option of lowering the price of our two Teneligliptin brands (Ziten and Zita Plus) to get more patients in the advanced Gliptin therapy fold," says Sujesh Vasudevan, president and head of India Business, Glenmark Pharmaceuticals.

Glenmark had launched these two drugs earlier this year at Rs 20 a tablet, half the price of the medicine sold by many multinational drug firms. Last year, anti-diabetes drugs accounted for only Rs 100 crore to Glenmark's overall revenue of Rs 6,600 crore. While it is a dominant player in dermatology, the company is now planning to expand its product portfolio in other therapeutic areas like diabetes.

Mankind Pharma, which launched its own Teneligliptin generic 'Dynaglipt' on November 23 at Rs 20 a tablet, decreased the drug's price a day later to Rs 8.60 a tablet.

"Diabetes is a growing epidemic; to cater to it, we are targeting the middle-class and rural diabetic patients, so that it becomes affordable and more economical. The change in prices will help reduce the cost of medicines by about half," said R C Juneja, chairman & founder, Mankind Pharma. The company is targeting at least Rs 200 crore in annual revenue from this drug.

Zydus Cadila, which launched its own generic drug 'Tenglyn' at Rs 7 a tablet a week ago, has no immediate plans to reduce the price further, according to a senior company executive.

"Considering the incidence of the disease, benefits of the drug, and price, Gliptin could become a large-volume drug and face further price erosion as volumes grow," says D G Shah, secretary-general, Indian Pharmaceutical Alliance (IPA).

The Organisation of Pharmaceutical Producers of India, representing multinational companies, refused to comment on the subject.

INTERPRETER OF REMEDIES

Glenmark to reduce teneligliptin prices (Rs 20 per tablet at present)

Mankind & Zydus Cadila have priced these below Rs 10 a tablet

Teneligliptin is a drug of gliptin category that has shown significant results in controlling blood sugar in type-2 diabetics

India Adds More HIV/AIDS, Cancer Drugs To Essential Medicines List

2016-01-12T22:56:00.001-08:00

The government has revised its list of essential medicines to add drugs for diseases ranging from cancer and HIV/AIDS to hepatitis C, in a move aimed at making them more affordable.

The update to the National List of Essential Medicines (NLEM) is just the third since it was compiled in 1996.

It increased the list to 376 medicines from 348 and includes drugs ranging from analgesics and antivirals to contraceptives, cardiovascular and anti-tuberculosis drugs.

Reuters reported in April that more HIV/AIDS and tuberculosis medicines were likely to be added to list, which is posted on the Central Drug Standard Control Organisation's (CDSCO) website.

"The NLEM 2015 has been prepared adhering to the basic principles of efficacy, safety, cost-effectiveness; consideration of diseases as public health problems in India," a notice on the website said.

India had been criticised because the former list left out some life-saving drugs.

The new list takes cues from the World Health Organisation's 2015 list of essential drugs, which the United Nations agency defines as those that satisfy the priority healthcare needs of people and ensure affordability.

The revision comes after months of deliberations by a committee of experts formed by the government last May. Views of the pharmaceutical industry and NGOs were also considered, the CDSCO said.

The committee recommended that the list, which is effective immediately, be revised every three years.

In initial thoughts, industry executives said they were yet to study the list's impact.

"We will be seeking clarification and a better understanding of its implications," said Ranjana Smetacek, director general of the Organisation of Pharmaceutical Producers of India (OPPI) which represents large foreign drugmakers.

The Indian Pharmaceuticals Alliance, which represents large local drugmakers, did not respond to requests for immediate comment.

It is likely that medicines in the new list will be brought under price control, as was done with the previous list, some in the industry said.

Drug pricing is a contentious issue in the country, as nearly 70 percent of the population lives on less than $2 a day and health insurance is inadequate.

India contributes roughly 1 percent of its total gross domestic product to healthcare, among the lowest levels of funding in the world.

Industry executives say drug prices in the country are also among the lowest in the world.

India's drug pricing regulator has struggled in the past year to implement price caps and expand them to cover more drugs.

When it fixed prices of about 100 medicines citing public interest last year, the industry fired back with lawsuits.

The government soon curbed the National Pharmaceutical Pricing Authority's (NPPA) powers, restricting it from fixing the price of medicines not on the essential medicines list.

Price caps cover roughly 30 percent of the drugs sold in the country.

India reports 32 percent declining in HIV/AIDS

2016-01-12T00:35:00.000-08:00

India is estimated to have registered a 66 per cent decline in new HIV infections from 2000 and 32 per cent decline from 2007, according to the latest round of HIV sentinel surveillance and estimations conducted by the National AIDS Control Organisation (NACO), released by the Union Health Ministry.

There were around 86,000 new HIV infections in 2015. The report noted that Andhra Pradesh and Telangana, Bihar, Gujarat and Uttar Pradesh currently account for 47 per cent of the number of total new infections among adults with each of these States contributing 7,500 or more new infections in 2015.

West Bengal and Rajasthan registered more than 5,000 new HIV infections, but less than 7,500 new infections, while Maharastra, Odisha and Tamil Nadu have new infections in the range of 3,000-4,000. Chhattisgarh, Delhi, Haryana, Jharkhand, Karnataka, Madhya Pradesh and Punjab have 1,000-2,400 new infections among adults and the rest of the States have less than 1,000 new adult HIV infections in 2015.

New infections among adults have declined by 50 percent or more in the State of Andhra Pradesh and Telangana, Karnataka, Maharashtra, Manipur and Odisha during 2007-2015. Bihar, Jharkhand, Kerala, Mizoram, Nagaland, Rajasthan and Uttarakhand are the states where annual new infections declined by 32-47 percent during the same period.

However a rising trend in new infections among adults during 2007-2015 has been detected in Assam, Chandigarh, Chhattisgarh, Gujarat, Sikkim, Tripura and Uttar Pradesh.

The report further noted that since 2007, the number of AIDS-related deaths declined by 54 percent in 2015 with an estimated 67,600 people dying of AIDS-related causes nationally.

The annual number of AIDS deaths has declined by 70-81 per cent during 2007-2015 in Karnataka, Maharashtra and Tamil Nadu. Annual AIDS related deaths declined by 60-70 percent from baseline values of 2007 in Andhra Pradesh and Telangana, Goa, Himachal Pradesh and Nagaland, while a decline of 40-47 percent was estimated in Chhattisgarh, Gujarat and Punjab.

Injectable HIV Treatment Would Change Lives

2016-01-12T00:32:00.000-08:00

This month ViiV Healthcare and Janssen Sciences announced that Phase III trials for a bimonthly HIV treatment injection would begin in mid-2016. This year the two

companies will be evaluating the commercialization of a long-acting formulation to be used as an injectable maintenance treatment for patients who have achieved viral suppression.

Injectable treatments have been the buzz in HIV treatment research for a while, but this announcement represents a tangible hope that a new form of treatment is within our grasp. In a few years, many people living with HIV might be able to throw away their pillboxes for good.

The current oral regimen continues to be a reason for poor adherence to HIV treatment. Also, the daily pill can sometimes be viewed as a symbol of second-class status.

No matter how healthy I am, people still see someone whose health is subpar.

In the U.S., the majority of people living with HIV are not able to stay on treatment and maintain viral suppression. The possibility of a bimonthly injection wouldn’t just improve adherence to medication and reduce transmission, it would revolutionize the lives of HIV-positive people.

If you are not living with HIV, just try to imagine it for a second. Imagine being a young person and being told that you can still live a long and healthy life, but only if you adhere to this daily regimen with few to no mistakes. Sounds simple enough, but factor in trying to carry the enormous weight of HIV stigma and concealing

your diagnosis to the outside world — as most initially try to do — and you have 365 reasons to fail. For so many, a bottle of pills isn’t just a bottle of pills, but an embarrassing reminder to yourself and others, that you contracted a virus that is avoidable.

That sounds harsh. HIV shouldn’t have to be something people are ashamed of. But what should be does not change the reality of the majority of people with HIV who are utterly mortified and almost paralyzed by the idea of people finding out their status.

Now, imagine being told that all it will take to keep you healthy and living the life you want is six doctor visits a year. Sure, it may not still ideal, but what disease is? It is a hell of a lot better than the alternative. An HIV injectable treatment represents an opportunity to resume life knowing that you are virally

suppressed even if you are not quite ready or able to take on managing your virus full time.

Today, managing HIV doesn’t just require a daily pill. It requires a person to develop an entirely new state of mind — one that requires strength, an awareness of what it means to be positive today, and the support of friends and loved ones. If that were so easy to come by, HIV wouldn’t still be the problem that it is.

An injectable treatment would remove the daily reminder of a disease that shouldn’t but often does hold people back. It would mean the freedom of waking up and going about your day without a siege of panic because you forgot to take your medication. It would mean the removal of shackles to a pill bottle so sleepovers can be spontaneous and packing for vacations is done sans stress. Frankly, an injectable treatment would simply mean a better life.

Indiana town adopts B.C.’s HIV-treatment model after outbreak

2016-01-12T00:29:00.001-08:00

A small Indiana community where two out of every five residents are considered at high risk of HIV infection is reaching out to B.C. experts for help.

Austin, Ind., is suffering through an unprecedented outbreak of the disease. With a population of 4,200, 10 per cent are currently injecting prescription opioid drugs on a daily basis, said Diane Janowicz, assistant professor at the Indiana University School of Medicine.

Since last year, 184 new HIV infections have been identified.

“Thirty-nine per cent of the population are identified as high risk. That’s an incredibly high prevalence compared to other parts in the U.S.,” Dr. Janowicz said.

The university, working with the National Institute on Drug Abuse, has asked for help from the BC Centre for Excellence in HIV/AIDS. The intention is for the centre to bring its so-called treatment-as-prevention model of health care to the beleaguered community. Treatment-as-prevention is a collection of antiretroviral treatments that reduce the HIV virus load in blood and vaginal and rectal fluids, to decrease the risk of HIV transmission.

B.C. has seen a steady decrease in the number of deaths resulting from HIV since the introduction of an intense antiretroviral therapy program that began in 1996. There has been a 90-per-cent decrease in the number of new cases since 30 years ago.

As of last year, only 250 cases of HIV were recorded in B.C.

In Austin, the outbreak began last year and is linked to intravenous injection of opiate pain medication that users crush. It has prompted a warning from the U.S. Centers for Disease Control and Prevention to alert health officials to be on guard against clusters of HIV and hepatitis C infections.

“Indiana University will bring their colleagues here to see how we implemented our strategies in British Columbia, to learn about our treatment programs and to see how we have made the improvement happen,” said Julio Montaner, director of the BC Centre for Excellence of AIDS/HIV.

“It’s easier said than done. This program is very complex and it is difficult to implement,” he said.

For example, he said it can be difficult for doctors to reach patients and ensure they have access to the kinds of drugs and programs needed for the therapy to be effective.

A state epidemiologist said in a news report in the Indy Star last year that fewer than half those diagnosed with HIV had been prescribed antiretroviral treatments.

Prior to the outbreak in Austin, there was only one clinic providing health care in the town.

The Indiana team, including the B.C. doctors, plans to use mapping technology to examine risk factors for HIV transmission. Other research will investigate the clustering of HIV transmissions. And scientists will evaluate how to counter the damage of injection-drug use through harm-reduction services.

“The situation in Indiana marks a critical need for implementing best practices in harm reduction and HIV prevention. Treatment-as-prevention is a model for opening up access to early HIV treatment and care, for reducing stigma and for targeted disease elimination,” Dr. Montaner said in a news release.

“Providing sustained, consistent treatment and care ensures that an individual’s viral load decreases, dramatically reducing the likelihood of disease progression and secondarily stopping HIV transmission.”

B.C.’s treatment model has also been widely adopted in other jurisdictions of the world including China, Latin America and Europe.

“The BC Centre for Excellence in HIV/AIDS is recognized internationally for [its] outstanding work in providing access to treatment and care for those affected by or at high risk of HIV in urban and rural areas in British Columbia,” Dr. Janowicz said.

ITC and HUL in health care

2015-12-27T22:16:00.002-08:00

ITC to expand its Savlon brand across markets, while HUL is aggressively pushing its Lifebuoy handwash programme

Hindustan Unilever (HUL) and ITC, two of the biggest consumer goods companies in India, are set to square off in health care, a category that is rapidly gaining traction. Kolkata-based ITC, which acquired antiseptic liquid brand Savlon from Johnson & Johnson last year, is now launching what is possibly its biggest offensive against its Mumbai-based rival HUL.

Savlon Double Strength soap, launched in select geographies recently, will slowly but steadily be extended across markets, say officials in the know. Additionally, ITC will use its cigarette distribution network to push both Savlon soap and antiseptic liquid into rural areas. It will also launch what company executives describe as a "modernised" handwash range - basically a refurbished set of handwashing products under the Savlon brand, targeting mainly the urban markets.

The idea, say executives, is to present a strong counter to Lifebuoy. Savlon will also compete with British consumer goods major RB's antiseptic Dettol, but ITC's focus will be on Lifebuoy, which has in the past few years strengthened its position in rural areas with its handwashing programme at schools and local communities.

ITC would specifically tap local doctors and chemists to push Savlon into rural households, adding heft to its distribution network which was earlier restricted to wholesalers and retailers, company executives said.

Sandeep Kaul, ITC's chief executive for its personal care product business, says, "Substantial investments are being made in development of insight into health care. We are excited with the prospects of Savlon and will continue to bring alive the brand in an engaging and relevant manner.

Industry sources say ITC's push into the doctor and chemist channels is linked with this group's familiarity with the Savlon antiseptic liquid. While rival Dettol has traditionally enjoyed the lion's share (80-85 per cent according to industry estimates) of the Rs 200-crore antiseptic liquid market, Savlon is not an altogether unfamiliar name to doctors and chemists. At 8-10 per cent market share, Savlon has held its own as number two, drawing ITC into buying it last year, say experts.

The Kolkata-based FMCG major is expected to leverage this latent equity of Savlon while tapping doctor and chemists in rural or even urban areas. In the soap segment, where HUL is the market leader, the game is expected to be tougher for ITC. At Rs 10,000 crore, the Indian branded soap market is one of the most saturated. It is growing at a rate of five-six per cent a year, according to market experts.

HUL controls an estimated 45 per of this market. It is followed by Godrej Consumer, at around 10-11 per cent, while RB (maker of Dettol) and Wipro (Santoor brand of soaps) trade positions at third and fourth positions, each with a share of eight-nine per cent. For ITC, its Vivel brand of soaps in the beauty segment has struggled to go beyond two-three per cent in terms of market share, say experts, thanks to intense competition.

But the prospect of its soap doing well is higher in health care, given the potential of the market, say company executives. At 30-35 per cent of the market, the health & hygiene segment of the branded soap market is growing at double-digit rates, ahead of the overall market.

The category has also got a boost with Prime Minister Narendra Modi's Swachh Bharat Mission, launched last year. Every soap maker in the country has gained from the initiative and made inroads into the category to capitalise on growth. ITC is now making that big leap, say experts.

Kaul hints at this when he says, "We will consider all categories that can expand the brand's consumer reach and build it further."

Competitors in the health and hygiene soap segment include Lifebuoy, Dettol and Santoor. While Lifebuoy's market share is estimated to be in around 15 per cent, Dettol and Santoor have an estimated share of eight-nine per cent each, according to market experts.

Analysts, however, warn of an impending trouble for ITC while taking on the established players, notably Lifebuoy. "It is hard to challenge a product like Lifebuoy in the rural markets, but ITC has the ability to do it with the right pricing strategy," says Amnish Aggarwal, senior vice-president (research) at Mumbai-based brokerage Prabhudas Lilladher.

H.I.V. Education That Aims to Empower

2015-12-27T22:06:00.001-08:00

Thanks to medical advances, a diagnosis of H.I.V., while still very serious, is no longer the death sentence it once was. For organizations trying to communicate information about testing and prevention, though, the devastation the virus has caused over the decades remains ever-present.

Traditional public service announcements tend to rely on shock and shame, with mixed success. But when Arizona public health officials began contemplating a new campaign, they wanted to change that.

“We needed a coordinated media strategy and it needed really to focus less on fear-based messaging and more on empowering people,” said John Sapero, office chief for H.I.V. prevention for the Arizona Department of Health Services.

About a year ago, the health department turned to one of its regular media partners, the marketing agency Moses Inc., to create a P.S.A. aimed at encouraging people to visit a website, HIVAZ.org, where they could get information about testing and other resources.

The ads, displayed on billboards, bus shelters and other outdoor areas in the Phoenix and Tucson areas, each depict a person going about an everyday activity — jogging, shopping, talking on the phone — and encountering an unnoticed hazard: a street signpost, a glass door, an open manhole cover.

“It’s only dangerous if you don’t know it’s there,” the ads say. The HIVAZ.org web address and the phrase “Awareness is the answer” are at the bottom. The campaign also has a digital component intended to direct people to the site.

“Slipping or bumping into a door — all of us do it, and it’s dangerous if you don’t know it’s there,” said Louie Moses, president and creative director of Moses Inc. The ultimate goal is to get people to visit the website, he said, where they can receive information about getting an H.I.V. test. The site also offers support resources for patients and information about how people can reduce their risk of contracting the virus.

The initiative had its challenges. The ads had to address a serious topic on a shoestring budget, not to mention the agency had to figure out how to make a pair of headphones look as if they were flying off a jogger’s ears.

To create the eye-catching images, Moses Inc. tapped the advertising photographer Blair Bunting, known for his work capturing athletes in motion, to stage the moments of “impact.”

“The images best represented what we felt like H.I.V. could be for someone who contracted it,” Mr. Bunting said.

He added, “You have to have this image that makes it look like control has been lost.”

The entire campaign had a budget of $300,000, money that the Centers for Disease Control and Prevention distributed to the Arizona Department of Health Services.

With those constraints, Mr. Bunting and his crew had to make the most of their studio time to create the trio of images, using equipment like wind machines and a riser to create the appearance of a person plunging headlong into an unpleasant situation.

Mr. Moses said if the project had been a conventional ad campaign, underwritten by a corporate advertising budget, the cost would have been $5 million to $10 million.

The agency donated “literally hundreds of hours,” he said, while Mr. Bunting said he worked with about 20 percent of his usual budget for the shoot. In addition, Aunt Rita’s Foundation, a nonprofit that works with Arizona’s health department on H.I.V. awareness and prevention, was able through its partners to secure donations of space to display some of the ads.

The efforts have paid off, Mr. Sapero said. Last fall, the HIVAZ.org site had about 9,000 new visitors over a period of about two months. This year, after the campaign began, that figure jumped to 39,000 over the same time period, while the number of repeat visitors to the site rose from 15 percent of overall visitors to more than 40 percent.

“Clearly, people are coming to the site, seeing what it’s about,” he said. “They’re bookmarking it and they’re coming back again.”

The campaign clicked with viewers because it eschewed shaming and judgment, said Nidhi Agrawal, professor of marketing at the University of Washington, who has studied the effect of P.S.A.s for drinking and driving. “You’re taking the stigma away, and when we create distance from the stigma, people can think about it more objectively.”

Mr. Moses said advertisers and nonprofits have learned a great deal about how to communicate messages about H.I.V. since the disease first came onto the national radar in the 1980s.

“We did some pretty shocking ads back then,” he said. “At the time we didn’t know any better, and we wanted to get awareness; we wanted people to know the name AIDS.” Current campaigns tend to focus on H.I.V., the virus that causes AIDS, because health officials and advocates want to connect with patients before the disease progresses to AIDS.

“We kind of learned from the past we didn’t want to shock and scare and judge the group of people we were talking to,” Mr. Moses said. “Since then, the research says that shocking and embarrassing and shaking your finger at the potential consumer does the exact opposite. It just makes them hide.”

Ms. Agrawal agreed that eliciting negative emotions backfires, because people then focus on their feelings instead of absorbing the message. “People are too busy managing the shame and the fear to respond to the P.S.A. or respond to the problem,” she said. (A recently unveiled campaign in cities like New York and San Francisco that is focused on H.I.V. prevention strikes a similar tone to Arizona’s.)

Mr. Bunting said they wanted the Arizona P.S.A. to circumvent those feelings.

“It wasn’t very heavy-handed,” he said. “It made it comfortable for people to talk about something that’s usually a very uncomfortable situation.”

HIV rates still high despite innovations in treatment

2015-12-27T22:01:00.001-08:00

Scientific advances for HIV/AIDS have exploded in recent years, and doctors have new ways both to treat people who already have the disease and to prevent others from acquiring it.

But despite new research that allows scientists to track, treat and prevent HIV better than ever before, the disease continues to spread, including in Louisiana.

Baton Rouge is ranked first in the nation for estimated HIV and AIDS case rates per 100,000 people, while New Orleans is ranked third for HIV and fourth for AIDS, according to newly released 2014 Centers for Disease Control and Prevention figures.

How to link people infected with the disease to health care and why they continue to go untreated are questions that physicians nationwide — and in Louisiana — are trying to answer.

A recent New England Journal of Medicine article titled “Applying Public Health Principles to the HIV Epidemic — How Are We Doing?” offered a somewhat pessimistic view of the status quo. In the essay, Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention, and his co-authors called for doctors, as well as local and state health agencies, to adopt a more aggressive approach to combating the spread of the disease, pointing to alarming trends.

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“Most people living with HIV infection in the United States are not receiving antiretroviral treatment; notification of partners of infected people remains the exception rather than the norm; and several high-risk behaviors have become more common,” they wrote.

DeAnn Gruber, the HIV program director for Louisiana’s Department of Health and Hospitals, said she read the article as highlighting that the nation is at a crossroads in terms of HIV care.

“We’re at a real turning point in the epidemic of HIV,” Gruber said. “What they’re raising too is that even though there have been some advances, there’s still a lot of work to be done.”

At-risk communities

The work is particularly needed within smaller, often stigmatized communities.

In line with national trends, gay men contract half of all of the new HIV infections in Baton Rouge, said Timothy Young, the head of the HIV/AIDS Alliance in the Baton Rouge area.

Last year, around 24 percent of the more than 5,000 people living with HIV/AIDS in Baton Rouge were not receiving care related to the disease, according to DHH and CDC estimates.

As for preventing the spread of HIV, Young said that just telling people to have safe sex is not enough.

“There is a disconnect between that knowledge and behavior. We know that trying to teach increased and effective condom use has not been effective,” Young said.

Gruber said smaller subsets of gay and bisexual men, particularly black gay men, have higher risks of being exposed to the disease. Young said the reason involves more than race and sexual orientation, and even geography can come into play.

“People tend to have sex within their own race and ethnic groups within a relatively small geographic area,” Young said.

HIV tends to spread in some communities because of risky behaviors, such as anal sex without condoms. But other risky behaviors are on the rise as well.

Increases in opiate use nationwide have led to more HIV infections from needle-sharing, according to the CDC essay.

Baton Rouge has certainly felt the strain of opiate-usage increases, as the city recorded a record number of heroin deaths this year.

Health experts know that needle sharing and unprotected sex are problems, and they know which communities they most affect. But transforming that knowledge into action is difficult, they say.

Young, DHH and many public health experts are strong advocates of “pre-exposure prophylaxis,” a daily pill called Truvada that people with risky lifestyles can take to prevent getting HIV.

A CDC report from November said the daily pill could reduce the risk of HIV acquired from sex by 90 percent and of HIV from drug injections by 70 percent. But the CDC also estimated that one in three primary care doctors and nurses do not know about the treatment, meaning it is not as widespread as it could be.

Possible solutions

Young said the key to combating HIV is identifying every member of the community who is infected with the disease, linking them to treatment and spreading messages about prevention.

The CDC essay heralded an effort in San Francisco, where a combination of increased testing, partner notification and treatment led to a 40 percent decrease in new HIV infections between 2006 and 2014.

Gruber said New Orleans recently received two grants, totaling $5 million over the next few years, that could help build a San Francisco-like model in that city. She said the money will be directed toward building networks that address behavioral health, housing, employment and transportation for people with HIV.

Gruber said it’s likely that DHH will pluck the most successful aspects of what they do in New Orleans and implement them in Baton Rouge.

One of the state’s most successful initiatives, called “LA Links,” focuses on identifying people who are HIV-positive and connecting them to medical care and support services. The program exists in Baton Rouge, New Orleans and Shreveport, and is set to expand.

Within its two-year existence, Gruber said, around 500 people have enrolled in “LA Links.” About 87 percent of them have started receiving medical treatment.

The New England Journal of Medicine article also emphasizes the importance of newly diagnosed people reporting their partners so that they can get tested. The doctors who authored the study argue that reporting partners is a critical way to trace and stop the spread of the disease.

“Despite the importance of these services, interviews to elicit names and contact information of partners were documented to have been conducted with only about half the people who received a diagnosis of HIV infection in 2014, and patients who named partners named relatively few,” they wrote.

Louisiana state law does not require people to report their sexual partners, but Gruber said the state’s partner services office works hard to have people disclose their partners and then to inform those people of their potential exposure to HIV.

Young said asking people to name partners does not always yield results, for some people will not be honest, some do not remember and others simply do not know. He said the rise of hookup apps, like Grindr — a social networking app that lets users share their location — has led to many fleeting relationships that could make it more difficult for people to report their sexual partners.

“That’s not necessarily a positive sign when we’re trying to control the high rate of STDS that we have here in Louisiana,” Young said.

Barriers to treatment

Stigma is still the biggest barrier to getting people into testing and treatment, Young said.

He said the fear of being associated with HIV is so pronounced that more than 25 percent of those who are newly diagnosed with the disease in Louisiana have already progressed to AIDS.

“We have people who don’t want to test, don’t want to be seen accessing care or going to known providers of HIV care, and are living with the situations that may have allowed them to become HIV-positive in the first place,” Young said.

The good news for people who worry about the stigma of having HIV is that treatment is better than ever, Young and Gruber said.

HIV is no longer a death sentence with a ticking clock; people with the disease who are in treatment can live normal life spans and healthy lives.

It’s unclear how much of a game changer Medicaid expansion might be for treating people with HIV/AIDS in Louisiana. While Gov. Bobby Jindal has declined to expand Medicaid, the federal health insurance program for the poor, Gov.-elect John Bel Edwards has said he wants that to be among his first moves once he takes office.

J.T. Lane, DHH’s assistant secretary for public health, said the state already covers HIV testing and that clinics that are federally qualified health centers can reimburse patients.

DHH spokeswoman Ashley Lewis said that if Medicaid is expanded, it would open up more avenues for recipients to receive overall medical coverage and it could increase specific types of federal funding for people in the state with HIV/AIDS.

Young said the state needs to do more, although he acknowledged that HIV treatments are largely covered for patients right now because of specific federal funding in that area.

“We also know that Louisiana doesn’t have any skin in the game in the sense that there are currently no state dollars dedicated to HIV prevention, which is very sad when we have some of the highest rates,” Young said.

Every year 35 lakh babies are born prematurely in India, Health Minister JP Nadda tells Parliament

2015-12-27T21:37:00.002-08:00

Over thirty five lakh babies are born annually in India, making it the country with the highest number of premature births of infants, according to a World Health Organisation report.

Union Minister for Health and Family Welfare JP Nadda told the Parliament on Tuesday while replying to a question in Rajya Sabha, "As per the World Health Organisation (WHO) Publication 'Born too Soon: The Global Action Report on Preterm Birth' out of an estimated annual 2.7 crore live births, in India 35 lakh babies are born preterm and out of these 3.03 lakh babies die due to complications of preterm birth."

He said that Under National Health Mission (NHM), key interventions are being implemented all over the country to bring down infant mortality rates.

"Under NHM, government promotes institutional delivery through Janani Suraksha Yojna cash incentive scheme for pregnant mothers and Janani Shishu Suraksha Karyakaram which entitles all pregnant women and sick infants to absolutely free and no expense treatment at public health facilities," the Minister said.

He said under NHM, strengthening of newborn care services by establishing facilities for the care of sick newborns such as Special New Born Care Units, New Born Stabilisation Units and New Born Care Corners and provision of home-based newborn care through Asha workers is provided.

Health Minister J P Nadda and Priyanka Chopra launch campaign to combat anemia among teenagers

2015-12-27T21:29:00.000-08:00

The Health Ministry officially launched a programme on Wednesday to cut down on anaemia levels among the large adolescent population in the country. Anaemia is a medical condition in which a person suffers from lack of red blood cells/haemoglobin in his/her blood levels, resulting in fatigue, impaired physical growth and weariness. The condition occurs due to deficiency of iron.

Government data show that at least 56 per cent of girls and 30 per cent of boys in the age group of 15-19 years in India are anaemic, with a large percentage suffering from moderate to severe anaemia.

Under the programme titled ‘Weekly Iron and Folic Acid Supplementation’ (WIFS), adolescent children, who go to government or aided school as well as those who have dropped out, will be administered a tablet once a week for 13 months. Counselling and a proper information campaign will also be conducted to ensure timely implementation of the programme.

“Through this programme, we can can turn a young India into a healthy India. It is a matter of great happiness for me,” said JP Nadda, the Minister of Health and Family Welfare, at the launch in New Delhi. He added that the programme aims to cover 11.2 crore adolescents across the country.

“It is our responsibility to ensure that the young energy is channelized in the right direction. This can only be achieved if the adolescents are physically and mentally well-prepared for the future of their country,” he said.

The launch was also attended by popular actress Priyanka Chopra, who is the UNICEF’s goodwill ambassador.

“The statistics for anaemia are so scary, particularly among the girl child. WIFS is a way of solving our problem to a great extent,” said Chopra, who has spent almost a decade endorsing the campaigns of the Health Ministry and UNICEF.

Chopra said that her health improved to a great extent after she started taking the iron tablets.

In India, even though malnutrition is widely prevalent among men, women and children, lack of leadership and political action has resulted in millions suffering stunted growth and high incidence of heart diseases. The mortality rate among children below the age of five is also high in India.

“Although examples of state-level leadership are emerging, we believe that national policy commitments and national target-setting are critical to clarifying and emphasising policy priorities,” wrote Lawrence Haddad and Purnima Menon, senior research fellows at the International Food Policy Research Institute.

Renewed focus also needs to be on India’s national health spending, which has gone down from 4.5 per cent of GDP in 2004 -05 to 4 per cent in 2013-14. World bank data showed that in US, the health expenditure is 17% of the GDP in 2013-14 and 9% in the UK.

Through this initiative, launched on Wednesday, at least 11.2 crore adolescents across the country would be given iron and folic acid supplements to reduce nutritional anaemia.

Nadda said that a nationwide campaign is the need of the hour as "accessibility is not the problem, awareness is".

"We have to make India aware about the issue, resources are not a problem. It is a step to make young India healthy India," he said.

The minister also said: "People start comparing countries and say that India is not up to the mark but that is wrong. We should compare India to equivalent countries. India is a country that cannot be compared as it has own strengths and weaknesses."

Priyanka Chopra also lent her voice to a video clip made for taking the message about the benefits of the tablet forward. The actress said that she feels fortunate to be a part of a campaign for the next generation.

The programme will reach adolescents through schools and anganwadi centers on a fixed day of the week. Biannual de-worming for control of worm infestation, information and counselling to improve their dietary intake and screening for moderate and severe anaemia will also undertaken in the programme.

Realising that pills tend to repel children, the health ministry is also mulling various options of providing food supplements in place of tablets.

As the campaign focusses on young India, the event saw a teenager Kajal, who is associated with an NGO working towards the same goal, list out her favourite dishes and she also narrated how she lost her younger sister due to the lack of care at the right time.

Talking about future plans, Nadda said: "We are taking help of digital India as well. Soon, message in regional languages will come on mobile phones asking about the medicines."

UNICEF representative to India Louis Georges Arsenault also attended the programme.

Mother's Health and Poverty Behind Child Malnutrition In India

2015-12-19T04:57:00.003-08:00

Short maternal stature, extreme poverty, poor dietary diversity and mother's lack of education are among the top five risk factors for malnutrition in children in India, according to a new Harvard study.

Nearly 40 per cent of all children in India are stunted - of extremely low height for their age - and nearly 30 per cent are underweight, researchers said.

The study from Harvard T H Chan School of Public Health has now pinpointed the five top risk factors responsible for more than two-thirds of the problem.

The study is the first to comprehensively analyses and estimate the relative importance of known risk factors for child under nutrition.

Examining an array of 15 well-known risk factors for chronic under nutrition among children in India, the study found that the five top risk factors were essentially markers of poor socioeconomic conditions as well as poor and insecure nutritional environments in children's households.

Using data on nearly 29,000 children aged 6-59 months from the 3rd India National Family Health Survey, conducted in 2005-06, the researchers found that the five most important predictors of childhood stunting and underweight were short maternal stature, a mother with no education, extreme poverty, poor dietary diversity and maternal underweight.

Meanwhile, factors such as Vitamin A, breastfeeding, use of iodised salt, improved water and sanitation, and even immunisation - all currently high priority interventions in the global discourse on addressing under nutrition - accounted for less than 15 per cent of the cases of under nutrition.

"There is an immediate need to not waste time and resources on short-term and 'doable' interventions," said study senior author S V Subramanian, professor of population health and geography.

"While asking people to change behaviours and offering piecemeal solutions might provide some short-term relief, such strategies cannot be substituted for the urgent need to improve food and livelihood security," Mr Subramanian said.

The study was published in the journal Social Science and Medicine.

Fertility Rates Boosted by Surgery

2015-12-15T22:44:00.002-08:00

A fertility specialist at Taipei Veterans General Hospital (TVGH) on Monday said that while about one in every 10 men might have infertility problems, the use of microsurgical testicular sperm extraction (mTESE) can helped increase fertility rates.

The hospital cited a recent case of a 33-year-old man, surnamed Yu , who was diagnosed with azoospermia — the absence of motile (and hence viable) sperm in semen — and was told by doctors at other hospitals that there no hope of impregnating his partner.

However, a team of doctors at TVGH were able to retrieve sperm from Yu’s right testicle via mTESE, and the couple recently gave birth through in vitro fertilization (IVF) treatment.

TVGH Division of Male Reproductive Medicine director William Huang, who performed the surgery, said that about 1 percent to 1.5 percent of males in Taiwan suffer from azoospermia.

Azoospermia can be categorized into obstructive and non-obstructive forms. Obstructive azoospermia means that the individual can produce sperm, but that none are present in the ejaculate, while non-obstructive azoospermia relates to abnormal sperm production within the testes, Huang said

“Non-obstructive azoospermia is one of the most challenging problems to deal with in male infertility and relies on mTESE for treatment,” he said.

Using the mTESE method, doctors can use magnification of up to 24 times to search for areas with increased sperm count to collect sperm for IVF treatment.

“The main feature of mTESE, compared with the traditional method of testicular biopsy, lies in its precision,” Huang said, adding that while a testicular biopsy can be seen as cutting down many trees in a forest and trying to find a few apples within them, mTESE is like precisely locating where the apples are growing, then picking the apples that are needed.

Division statistics showed that the fertility rate of couples with non-obstructive azoospermia after mTESE treatment was 77.52 percent last year, with rates of pregnancy that reached 24 weeks being 39.7 percent, while the 24-week pregnancy rate increased to 50 percent this year, Huang added.

Huang said that the reason for azoospermia is still unknown, but might be related to genetic mutation or environmental influences, such as exposure to high temperaturse, radioactive substances, smoking, drinking alcohol, or consuming unhealthy food.

“I urge men to undergo fertility testing before their partners, because the procedure is not as complicated as it is for women,” he said.

Drinking Green Tea too often may lower Fertility

2015-12-15T22:36:00.002-08:00

Are you a green tea lover? Read this carefully as the cup packed with antioxidants and other health benefits may adversely affect your fertility and development in case of frequent use, warn researchers.

In experiments over fruit flies, the team from University of California-Irvine discovered that excessive consumption adversely affected development and reproduction in fruit fly populations. According to them, one should avoid high dose of green tea or any natural product as nutraceuticals such as green tea, while growing in popularity, are largely unregulated.

“While green tea could have health benefits at low doses, our study and others have shown that at high doses, it may have adverse effects,” said Mahtab Jafari, associate professor of pharmaceutical sciences. “Further work is needed to make any definite recommendations but we suggest that green tea should be consumed in moderation,” she added.

Researchers from the University of California-Irvine tested this theory using fruit flies. They found that excessive consumption affected the development and reproduction of the fruit fly population. According to the team, anyone should at least avoid consuming a high dose of green tea or any products with nutraceuticals which are popular are usually unregulated. Mahtab Jafari, associate professor of pharmaceutical sciences said, "While green tea could have health benefits at low doses, our study and others have shown that at high doses, it may have adverse effects. Further work is needed to make any definite recommendations but we suggest that green tea should be consumed in moderation."

For the study, Jafari and colleagues investigated the effects of green tea toxicity on the development and reproduction in fruit fly Drosophila melanogaster. Embryos and larvae were subjected to various doses of green tea polyphenols.

Larvae exposed to 10mg of green tea were slower to develop, were born smaller and exhibited a dramatic decline in the number of emerged offspring. Ten milligrams of green tea made the flies more susceptible to starvation and heat stress but protected them against dehydration.

Female offspring showed decreased reproductive output and a 17 per cent reduction in lifespan while males were unaffected, the study found. Ten milligrams of green tea caused morphological abnormalities in reproductive organs such as testicular and ovarian atrophy. Jafari believes that high doses of green tea may cause “too much” apoptosis or cell death.

Derived from the plant Camellia sinensis, green tea is popular worldwide for its purported brain and heart health and anti-cancer properties. Jafari noted that in other tests with mice and dogs, green tea compounds in large amounts dramatically reduced body weight and, in mice, negatively affected embryo development.

“We are planning to measure total consumption and identify and quantify the metabolites of natural products in flies,” Jafari pointed out, adding that these experiments will enable us to have a better understanding of toxic doses in humans. The paper appeared in the Journal of Functional Foods.

Rise in Temperature Will Affect Male Fertility

2015-12-15T22:28:00.001-08:00

Doctors report 20-25 per cent fall in sperm count

The rising temperatures in the city caused by climate change will have a major impact on men as with the increase in temperature, their fertility decreases, claimed medical experts.

“The temperature of Mumbai is comparatively better than other western regional states. But the fluctuation in temperature is a concern. If there is a long span of days when the temperature is above 27 degree Celsius, then it affects the fertility in men as the sperm count drops,” said Dr Suchitra Pandit, gynecologist and obstetrician, Kokilaben Dhirubhai Ambani Hospital. Addressing the concern, Dr Hetal Parekh, consultant fertility physician, from Hiranandani Hospital said, “We have seen that in winter months, men are more fertile than in summer months due to the difference in temperature. So, if winters also become warmer, the fertility in men will be adversely affected thus resulting in low reproduction rate.”

In the past one decade, the western coast of India has been witnessing more incidents of heat waves. And on certain days, the mercury level goes up to 38 degree Celsius. “The rising occurrences of heat waves have become more manifested in the past one-decade,” said Subimal Ghosh, climate change expert from department of civil engineering, IIT-B.

As per the medical experts, excessive exposure to heat results in decrease in sperm count in men. “Rise in temperature, will also affect the sexual behavior of people. It will decrease the production of sperm and increase its mortality,” said Dr Parekh.

In the last 20 years, the doctors said that they have observed a decrease in sperm count by over 20-25 per cent.

Experts across the city have said that they witnessed a rise in the number of cases of infertility among men. And one of the reasons for it is the continuous exposure to heat. This could further aggravate in the long run with more rise in temperature.”

For the effective production of sperms, the scrotum needs to be two degrees cooler than the body’s ideal temperature 98 degree Fahrenheit. But it is a long run process. Shift in temperature for a day does not affect the sperm formation as it takes 10 weeks for a single sperm to reach maturity,” said Dr Sudeshna Ray, coordinator, department of gynaecology and obstetrics at Jaslok Hospital.

Also, according to an article published in the conversation.com, an independent, not-for-profit media outlet, in 2015, “Many developing countries, such as India, already experience hotter climates than the United States. As a result, these developing countries are more likely to feel the effects of climate change, which could include worse fertility outcomes.”

Doctors state Other causes

Doctors also highlighted other factors that are leading to infertility among men in the city. “Men should avoid wearing tight pants that increases the temperature of the scrotum. Also, people tend to keep their laptops on their lap for hours that also raises the temperature of the scrotum. Also, while driving for long distances, they should take breaks in between to adjust their body temperature,” said Dr Pandit.

United States HIV cases down 20 percent

2015-12-15T22:21:00.001-08:00

U.S. HIV cases down 20%, but up 87% for 2 groups

Southern states currently have greatest incidence of HIV infection, CDC says

While the overall number of HIV diagnoses continues to fall in the United States since the first cases were documented 30 years ago, at least two groups of the population are seeing a sharp increase in those numbers.

A report by the Centers for Disease Control and Prevention released this month shows a nearly 87% increase in the number of HIV diagnoses of African-American gay and bisexual males and Latino gay and bisexual males, aged 13-24.

Overall, the number of diagnoses for the entire population dropped by 19% from 2005-2014, the analysis showed.

A risky environment

There is a high prevalence of HIV in the African-American gay and bisexual community, according to Dr. Eugene McCray, director of the CDC's Division of HIV/AIDS Prevention.

"If you are a young black man, and are having sex with other black men, your chance of being exposed is really high," he said.

Part of the problem, he said, is the low rate of condom use in that community.

Adding to the risk is the fact that nearly a third of black gay and bisexual men between the ages of 13-24 who are HIV-positive don't know it, said Dr. Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention.

"A fair proportion haven't been diagnosed. It creates a risky environment," Mermin said.

In all ages of black gay and bisexual men, the number of diagnoses increased 22% over the past decade, but those rates have been leveling off since 2010, the CDC report showed. Latino gay and bisexual men of all ages have also seen their number of HIV diagnoses rise by 24% over the past 10 years.

In the same time period, the number of HIV cases has dropped 35% among heterosexual adults, 63% among intravenous drug users, and 22% among all African-Americans, according to the CDC. Women have also seen a significant decline in HIV infections, down 40%, from 12,499 diagnoses in 2005 to just 7,533 in 2014, with the biggest drop occurring among African-American women, who have seen the number of cases nearly drop in a half, from 8,020 HIV diagnoses in 2005 to 4,623 in 2014.

Southern states have highest incidences of HIV

Across the country, Southern states currently have the greatest incidence of HIV infection, illness and death. In fact, while the South represents about a third of the general population, it is home to 44% of those who are HIV-positive. Those individuals are also three times more likely to die than those with HIV living in other parts of the country.

Mermin said it's very important to target groups that have been disproportionately impacted by HIV with more intervention.

"We have to accelerate access to HIV testing, treatment and prevention, including PrEP (Pre-Exposure Prophylaxis), to those at greatest risk," he explained.

Today, more than 1.2 million people in the United States are HIV-positive. About one in eight of those infected are unaware of their status.

Zimbabwe children still at great risk of HIV/AIDS new data shows

2015-12-15T22:18:00.005-08:00

Janet Dube knows the pain of raising a child born with HIV.

Her four-year-old son is one of an estimated 170,000 children living with HIV/AIDS in Zimbabwe, and figures released by the country's statistics agency on Wednesday showed the virus is the leading cause of death among children under five.

A Census Analysis Mortality Report from 1992-2012 revealed that despite progress in fighting the virus, HIV and AIDS had claimed the lives of thousands of Zimbabwean children under five.

"I live in constant fear about my child's health as he sometimes skips medication when we fail to travel to the city (Bulawayo) to get (medication)," Dube, 27, from Filabusi, about 100km (60 miles) from Bulawayo, told the Thomson Reuters Foundation.

Dube, however, is one of the lucky HIV patients who gets free antiretroviral therapy (ART) from a government hospital, though she sometimes goes without medication for herself and her son when she does not have the bus fare to travel to Bulawayo.

When her son goes without medication, it increases her concern about whether he will live long enough to go to school.

About 17 percent of Zimbabwean adults, more than 1.4 million, live with HIV and AIDS, according to UNAIDS figures, making the southern African nation one of five African countries where around 20 percent of adults have HIV or AIDS.

According to the Zimbabwe Network of People Living with HIV's (ZNNP+) executive director, Muchanyara Mukamuri, only 40 percent of children in Zimbabwe who need it are receiving antiretroviral therapy.

Dube said a lack of adequate nutrition adds to her concern about her and her son's health as Zimbabwe's rural areas are facing acute food shortages.

"We just don't have enough to eat," said Dube, a single mother who receives monthly food assistance from a Bulawayo church.

The United Nations Population Fund (UNFPA) Zimbabwe residentrepresentative, Cheikh Tidiane Cisse, said that while the number of children dying before the age of five had fallen in the past three decades, more still needed to be done in the HIV/AIDS sector.

"Access to antiretroviral therapy and antenatal care must be increased," Cisse said.

Zimbabwe's long-running economic crisis has not spared the health sector, and there have been large cuts in public health spending.

Last month, Finance Minister Patrick Chinamasa allocated $301 million to the health and child welfare ministry, but public health campaigners and experts said domestic funding for HIV and AIDS remained inadequate.

In September, the United States approved funding of $95 million under the President's Emergency Plan for Aids Relief (PEPFAR), which is also expected to increase the supply of antiretroviral therapy for children.

As for Dube, she can only hope.

"Each day I blame myself (for her son's condition), I wish one day they get a cure (for HIV)," she said.