In the news: Healthy babies born to HIV positive mothers, transparency in c-sections and more

A wrap of the health news over the past week.

Pushing HIV back

The Chhattisgarh government has announced that at least 213 HIV-infected women gave birth to healthy babies in 2016-’17 due to multi-medicine treatment initiated by the state. About 219 HIV positive pregnant women were provided with this treatment and the babies of 213 women were born without HIV infection, state health officials told news agencies.

However, six children were found to have been born with HIV infections and have been started on anti- retroviral therapy – a combination of medicines used to slow the rate at which HIV makes multiplies.
Chhattisgarh health officials said the state has 26,000 HIV positive people and was providing anti-retroviral therapy to 10,289 and is dealing with the current shortage of HIV drugs by breaking tablets for adults into standard doses for children

In related news, the Mumbai AIDS Control Society has begin the process of switching to the “test and treat” protocol of treatment for people with HIV and AIDS as per an order issued by the union health ministry earlier this month. All people with HIV infections will now be given antiretroviral therapy irrespective of their CD4 count – a measure of white blood cells that indicates the extent of infection. The National AIDS Control Organisation earlier recommended antiretroviral therapy only for patients with CD4 counts less than 350 cells per millimeter cube on two occasions three months apart.

The Mumbai AIDS Control Society is now starting the process of locating all the 8,000 people who got themselves tested at various government-run testing centres over the last few years, but have not been but on antiretroviral therapy yet. A spokesperson for the society told the Times of India that it has asked integrated counseling and testing centres for HIV to help them with identifying these patients. There is also a worry that asymptomatic HIV patients will object to being put on the strong antiretroviral medicines and this might be a roadblock in adherence to treatment.

Private hospitals to display C-section data?

The Central Government Health Scheme may soon make it mandatory for private hospitals to display the number of cesarean deliveries conducted by them for these hospitals to get and remain empanelled under the scheme.

A senior CGHS official told PTI that hospitals had been asked to voluntarily display this information, as per the existing memorandum between the two parties. However, as CGHS implements ew rules for empanelment, it is considering making display of c-section information mandatory.

The move comes after repeated entreaties to the government to raise awareness about unnecessary cesarean deliveries and surgical procedures performed on women during childbirth. Women and Child Development Minister Maneka Gandhi has raised the issue with the Health and Family Welfare Ministry and asked it to make it a providing information about c-section numbers mandatory for hospitals under CGHS.

Illegal sale of cancer drugs

A special court has taken note of highly potent anti-cancer drugs being sold by without licences for distribution or invoices recording the sale. A pharmaceutical dealer, who did not have a licence and from whom such drugs worth over Rs 50 lakh were allegedly recovered, approached the court seeking anticipatory bail, news agencies reported.

The court has rejected the anticipatory bail petition and expressed concern that such unregulated sale of cancer drugs put the lives of citizens at risk and also causes loss to the exchequer.

Under the Drugs and Cosmetics Act, a person selling medicines without a licence can get up to which five years imprisonment and a fine of Rs one lakh or three times the value of the confiscated drugs, whichever is more. The drug inspector had carried out the inspection at the pharmaceuticl dealer’s office informed the court that the value of the seized drugs was more than Rs 50 lakh.

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Relying on the power of habits to solve India’s mammoth sanitation problem

Adopting three simple habits can help maximise the benefits of existing sanitation infrastructure.

India’s sanitation problem is well documented – the country was recently declared as having the highest number of people living without basic sanitation facilities. Sanitation encompasses all conditions relating to public health - especially sewage disposal and access to clean drinking water. Due to associated losses in productivity caused by sickness, increased healthcare costs and increased mortality, India recorded a loss of 5.2% of its GDP to poor sanitation in 2015. As tremendous as the economic losses are, the on-ground, human consequences of poor sanitation are grim - about one in 10 deaths, according to the World Bank.

Poor sanitation contributes to about 10% of the world’s disease burden and is linked to even those diseases that may not present any correlation at first. For example, while lack of nutrition is a direct cause of anaemia, poor sanitation can contribute to the problem by causing intestinal diseases which prevent people from absorbing nutrition from their food. In fact, a study found a correlation between improved sanitation and reduced prevalence of anaemia in 14 Indian states. Diarrhoeal diseases, the most well-known consequence of poor sanitation, are the third largest cause of child mortality in India. They are also linked to undernutrition and stunting in children - 38% of Indian children exhibit stunted growth. Improved sanitation can also help reduce prevalence of neglected tropical diseases (NTDs). Though not a cause of high mortality rate, NTDs impair physical and cognitive development, contribute to mother and child illness and death and affect overall productivity. NTDs caused by parasitic worms - such as hookworms, whipworms etc. - infect millions every year and spread through open defecation. Improving toilet access and access to clean drinking water can significantly boost disease control programmes for diarrhoea, NTDs and other correlated conditions.

Unfortunately, with about 732 million people who have no access to toilets, India currently accounts for more than half of the world population that defecates in the open. India also accounts for the largest rural population living without access to clean water. Only 16% of India’s rural population is currently served by piped water.

However, there is cause for optimism. In the three years of Swachh Bharat Abhiyan, the country’s sanitation coverage has risen from 39% to 65% and eight states and Union Territories have been declared open defecation free. But lasting change cannot be ensured by the proliferation of sanitation infrastructure alone. Ensuring the usage of toilets is as important as building them, more so due to the cultural preference for open defecation in rural India.

According to the World Bank, hygiene promotion is essential to realise the potential of infrastructure investments in sanitation. Behavioural intervention is most successful when it targets few behaviours with the most potential for impact. An area of public health where behavioural training has made an impact is WASH - water, sanitation and hygiene - a key issue of UN Sustainable Development Goal 6. Compliance to WASH practices has the potential to reduce illness and death, poverty and improve overall socio-economic development. The UN has even marked observance days for each - World Water Day for water (22 March), World Toilet Day for sanitation (19 November) and Global Handwashing Day for hygiene (15 October).

At its simplest, the benefits of WASH can be availed through three simple habits that safeguard against disease - washing hands before eating, drinking clean water and using a clean toilet. Handwashing and use of toilets are some of the most important behavioural interventions that keep diarrhoeal diseases from spreading, while clean drinking water is essential to prevent water-borne diseases and adverse health effects of toxic contaminants. In India, Hindustan Unilever Limited launched the Swachh Aadat Swachh Bharat initiative, a WASH behaviour change programme, to complement the Swachh Bharat Abhiyan. Through its on-ground behaviour change model, SASB seeks to promote the three basic WASH habits to create long-lasting personal hygiene compliance among the populations it serves.

This touching film made as a part of SASB’s awareness campaign shows how lack of knowledge of basic hygiene practices means children miss out on developmental milestones due to preventable diseases.


SASB created the Swachhata curriculum, a textbook to encourage adoption of personal hygiene among school going children. It makes use of conceptual learning to teach primary school students about cleanliness, germs and clean habits in an engaging manner. Swachh Basti is an extensive urban outreach programme for sensitising urban slum residents about WASH habits through demos, skits and etc. in partnership with key local stakeholders such as doctors, anganwadi workers and support groups. In Ghatkopar, Mumbai, HUL built the first-of-its-kind Suvidha Centre - an urban water, hygiene and sanitation community centre. It provides toilets, handwashing and shower facilities, safe drinking water and state-of-the-art laundry operations at an affordable cost to about 1,500 residents of the area.

HUL’s factory workers also act as Swachhata Doots, or messengers of change who teach the three habits of WASH in their own villages. This mobile-led rural behaviour change communication model also provides a volunteering opportunity to those who are busy but wish to make a difference. A toolkit especially designed for this purpose helps volunteers approach, explain and teach people in their immediate vicinity - their drivers, cooks, domestic helps etc. - about the three simple habits for better hygiene. This helps cast the net of awareness wider as regular interaction is conducive to habit formation. To learn more about their volunteering programme, click here. To learn more about the Swachh Aadat Swachh Bharat initiative, click here.

This article was produced by the Scroll marketing team on behalf of Hindustan Unilever and not by the Scroll editorial team.