Health Watch

World AIDS Day:

Sri Lanka ahead in combating

HIV/AIDS

Nadira Gunatilleke

Tomorrow is World AIDS Day. The whole world marks this day with various ceremonies and programs. Sri Lankans have many things to be proud of when it comes to combating HIV/AIDS. The main factor is Sri Lanka’s significantly low HIV/AIDS prevalence rate (less than 0.1) which is one of the lowest in the whole world since a long time. There are certain factors we have to take care of in order to maintain our proud status and there are certain internal and external forces that hate our extremely low HIV/AIDS prevalence rate. Therefore we have to be vigilant and active when it comes to maintaining this low prevalence rate.

According to Healthcare and Nutrition Minister Nimal Siripala de Silva, Social Services and Social Welfare Deputy Minister Lionel Premasiri, doctors, teachers and the general public, it is Sri Lanka’s rich cultural heritage and religions that protect the Sri Lankan society from HIV/AIDS.

They say that Sri Lankan culture never encourage people to engage in risky sexual practices and always encourage them to protect themselves and their loved ones.

It is same with all the religions in Sri Lanka. The culture and all religions encourage Sri Lankans to be faithful to themselves and to their spouses. But this is not so when it comes to many other non Asian countries.

What we should be concerned in order to maintain our low HIV/AIDS prevalence rate? This is the main factor Sri Lanka should be focused on at the moment. Although we are ready to accept or not, there are certain groups of persons such as migrant workers, drug addicts (who use needles to inject drugs), commercial sex workers, MSM (Men having sex with Men), LGBT ( Lesbians, Gays, Bisexuals and Trans Gender persons) in our society.

The percentage of such persons is very low. Majority of them live invisibly while some powerful LGBT persons live openly. But all of them face the same risk when it comes to health and HIV/AIDS.

When they visit health institutions, the authorities should make sure that they receive the best health care service plus education without discrimination. This is the only way of minimizing the spread of HIV.

These specific groups of persons face an additional risk because of their risky sexual behaviour.

It is well known fact that commercial sex workers are at a greater risk and they need to wear condoms. But sometimes their clients do not allow them to wear condoms.

Another well known fact is that the majority of MSM do not wear condoms for various reasons. LGBT persons face the same problem often.

Special attention should be paid to encourage above groups of persons to use condoms all the time and come forward and get themselves tested for HIV. So far the majority of HIV/AIDS awareness raising programs were not focused on them. It is some extra work for the NGOs to find out strategies and approach them, but it should be done no matter how hard and expensive it is. No point of educating the same target groups all the time.

What are the internal and external forces that have desire and power to increase our low HIV/AIDS prevalence rate? You may not believe what some (not all) Non Governmental Organisations (NGOs) do in connection with HIV/AIDS. Some of them are only interested in the flow of funds. What matters most is the hilarious attitudes of some persons who hold positions of such NGOs. But the bitter truth is low HIV/AIDS prevalence rate means less funds and donations for the NGOs and high HIV/AIDS prevalence rate means a lot of funds and donations for them. Here anyone can suspect the real intentions of some NGOs.

Some NGOS work hard utilising their funds very effectively on controlling HIV/AIDS while some NGOs do just the opposite. Sometimes one can suspect weather some NGOs working on preventing HIV/AIDS or promoting it because of their suspicious behaviours and strange approaches towards the issue.

Even mentioning about culture and religions is poisonous for them. They laugh at our rich cultural heritage and religions. They faint when a news item appears on a national newspaper stating that culture and religions make a significant contribution towards preventing HIV/AIDS and even call the journalist to express their protest against such a news item! The behaviour of external forces is not surprising at all.

Everything comes in the ‘goodwill’ wrapper. No one suspect about anything and no sign of a plan B or a hidden agenda. But we can hear certain words such as low condom use, suppression of women, low literacy rate, resistance etc all the time.

As watch dogs of the society it is our duty to tell the public the true situation that exist in the country. It is your duty to take care of yourself and your loved ones. It is our duty to protect our culture and religions which take care of Mother Lanka. It is very easy because we are still in the very early stage of the disaster. We have a stronger weapon than any other country in the world to fight against HIV/AIDS. It is our culture and religions. Our literacy rate is over 90 percent. We do not have a heavy work load. The only thing we have to do is living our lives as real Sri Lankans.

New HIV infections down by 17 percent

Most progress seen in sub-Saharan Africa:

According to new data in the 2009 AIDS epidemic update, new HIV infections have been reduced by 17 percent over the past eight years. Since 2001, when the United Nations Declaration of Commitment on HIV/AIDS was signed, the number of new infections in sub-Saharan Africa is approximately 15 percent lower, which is about 400,000 fewer infections in 2008. In East Asia HIV incidence has declined by nearly 25 percent and in South and South East Asia by 10 percent in the same time period.

In Eastern Europe, after a dramatic increase in new infections among injecting drug users, the epidemic has levelled off considerably. However, in some countries there are signs that HIV incidence is rising again.

The report, released by the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), highlights that beyond the peak and natural course of the epidemic - HIV prevention programs are making a difference.

“The good news is that we have evidence that the declines we are seeing are due, at least in part, to HIV prevention,” said Michel Sidib‚, Executive Director of UNAIDS. “However, the findings also show that prevention programming is often off the mark and that if we do a better job of getting resources and programs to where they will make most impact, quicker progress can be made and more lives saved.”

Changing approach

In this first double issue, the UNAIDS Outlook report further explores how ‘modes of transmission’ studies are changing the approach of HIV prevention efforts. The new magazine-style report looks at new ideas and ways to use the data collected in the companion epidemiological report.

Data from the AIDS Epidemic Update also show that at 33.4 million, (31.1 million - 35.8 million) there are more people living with HIV than ever before as people are living longer due to the beneficial effects of antiretroviral therapy and population growth. However the number of AIDS-related deaths has declined by over 10 percent over the past five years as more people gained to access to the life saving treatment. UNAIDS and WHO estimate that since the availability of effective treatment in 1996, some 2.9 million lives have been saved.

Concrete results

Dr. Margaret Chan, Director-General of WHO said, “International and national investment in HIV treatment scale-up has yielded concrete and measurable results. We cannot let this momentum wane. Now is the time to redouble our efforts, and save many more lives.” Antiretroviral therapy has also made a significant impact in preventing new infections in children as more HIV- positive mothers gain access to treatment preventing them from transmitting the virus to their children. Around 200,000 new infections among children have been prevented since 2001.

In Botswana, where treatment coverage is 80 percent, AIDS-related deaths have fallen by over 50 percent over the past five years and the number of children newly orphaned is also coming down as parents are living longer.

Courtesy:WHO

Re-cultivating the rice culture - a response:

Factors that lead to diabetes

Dr. Nishan Sudheera Kalupahana

I read the article entitled ‘Re-cultivating the rice culture’ in Health Watch on November 16, 2009 and wanted to add the following with regards to causes of diabetes. While it is possible that the increase in prevalence of diabetes in Sri Lanka is partly due to the shift of food culture from rice to flour as Dr. Siribaddana pointed out, the following factors also likely play a major role in this.

Abdominal obesity

Individuals with a higher amount of abdominal fat are at a higher risk of developing diabetes. It is now established that fat cells produce chemical messengers called adipokines which are affected when too much fat is stored in these cells as occurring in obesity.

Asian populations are especially prone to the development of abdominal obesity.

Weight loss leading to a reduced waist line will lower the risk of getting diabetes drastically. Cutting down the amount you eat, exercising more and monitoring your weight would help in losing weight.

Lack of physical activity

Due to lifestyle changes in the last few decades, people have become less physically active.

This is another risk factor for diabetes. Engaging in moderate-intensity exercise (e.g. brisk walking) for at least 30 minutes every day would reduce the risk of getting diabetes.

Increased intake of saturated and trans-fats

Research has shown that the intake of saturated and trans-fats are associated with an increased risk of developing diabetes. Foods that contain trans-fats are hydrogenated oils such as solid margarines.

Examples for saturated fats containing foods are full-cream milk, coconut oil and milk and animal fat. A shift from the above foods to whole-grains, low-fat dairy and poultry and vegetables and grains cooked without adding coconut milk (mirisata instead of kirata) will therefore reduce the risk of diabetes.

The writer is attached to the Faculty of Medicine, Peradeniya and the University of Tennessee Obesity Research Center, USA

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Many pregnant women take drugs harmful to baby

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REUTERS