Professional Documents
Culture Documents
MDG 6
Combat HIV/AIDS, malaria and other
diseases
Submitted By:
Trivenika Avasthi
Pallav Parkhe
Nikhil S
Geetansh Choudhary
Ramit Mohan Chaudhuri
Jayanthi L V B Uday Kumar
Vineeth Jayendranath
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CONTENTS
INTRODUCTION...2
GOAL......2
HIV/AIDS....2
TRENDS OF HIV/AIDS
GOVERNMENT PROGRAMS
ANALYSIS OF EFFORTS
MALARIA4
TRENDS OF MALARIA
GOVERNMENT PROGRAMS
ANALYSIS OF EFFORTS
TUBERCULOSIS6
TARGETS BY 2015
GOVERNMENT PROGRAMS
RESPONSE OF CORPORATE...7
CORPORATES IN INDIA WORKING TOWARDS HIV/AIDS..8
ANALYSIS OF EFFORTS
ROADMAP FOR THE FUTURE
RECOMMENDATIONS
CORPORATES IN INDIA WORKING TOWARDS MALARIA...12
ANALYSIS OF EFFORTS
ROADMAP FOR THE FUTURE
CORPORATES IN INDIA WORKING TOWARDS TUBERCULOSIS14
ANALYSIS OF EFFORTS
ROADMAP FOR THE FUTURE
FINAL RECOMMENDATIONS..17
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Introduction
The Millennium Development Goals (MDGs) are eight international development goals that
were officially established following the Millennium Summit of the United Nations in 2000,
following the adoption of the United Nations Millennium Declaration. All 189 United
Nations member states and at least 23 international organizations have agreed to achieve these
goals by the year 2015. This report shall focus on MDG 6.
GOAL
MDG 6: Combat HIV/AIDS, malaria and other diseases
HIV/AIDS
Relevance of the MDG
Deeply concerned with the global HIV/AIDS epidemic, its devastating scale and impact,
constitutes a global emergency and one of the most formidable challenges to human life and
dignity, as well as to the effective enjoyment of human rights. This undermines social and
economic development throughout the world and affects all levels of society national,
community, family and individual. By the end of the year 2000, 36.1 million people worldwide
were living with HIV/AIDS, 90 per cent in developing countries and 75 per cent in sub-Saharan
Africa. AIDS afflicted all people, rich and poor, without distinction of age, gender or race,
further people in developing countries are the most affected and that women, young adults and
children, in particular girls, are the most vulnerable, which undermined Millennium
Development goal concerned with empowering women and promoting gender equality. The
continued epidemic of HIV/AIDS would also constitute a serious obstacle to the realization of
the global development goals
HIV/AIDS: The trends across the globe
The part of the world most impacted by HIV, sub-Saharan Africa, has cut the number of new
infections by 50% between 2001 and 2011. In the Middle East and North Africa however, the
number of people newly infected with HIV increased by 35% between 2001 and 2011, and the
rate of new HIV infections continues to rise in Eastern Europe and Central Asia. In the subcontinent region countries like Indonesia, Pakistan and Bangladesh have seen a rise in the no. of
new cases reported.
HIV/AIDS: The trends in India
The National AIDS Control Organization estimated that 2.39 million people live with HIV/AIDS
in India in 2008-09. HIV epidemic in India is to a large extent confined among the High Risk
Groups, i.e., Female Sex Workers, Injecting Drug Users, Men who have Sex with Men and
Transgender. The prevalence of HIV/AIDS is about 20 times higher in these groups as compared
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to that among the general population. Based on HIV Sentinel Surveillance 2008-09, it is
estimated that India has an adult prevalence of 0.31 percent with 23.9 lakh people infected with
HIV, of which, 39 percent are female and 3.5 percent are children..
However, epidemiological analysis revealed that the number of new annual HIV infection cases
has declined by more than 50 percent during the last decade. It is estimated that India had
approximately 1.2 lakh new HIV infected persons in 2009, as against 2.7 lakh in 2000. At all
India level, the estimated new HIV infections in 15+ years population also has shown a declining
trend and registering a decline by 20% during 2006-2009 (from 1,50,672 in 2006 to1,20,668 in
2009).
Indicator 1: HIV prevalence among pregnant women aged 15-24 years
Among pregnant women of 15-24 years, the prevalence of HIV has declined from 0.86% in 2004
to 0.48% in 2008.
Indicator 2: Condom use rate of the contraceptive prevalence rate (Condom use to overall
contraceptive use among currently married women, 15-49 years, percent)
According to NFHS III (national family health survey) Condom use rate of the contraceptive
prevalence rate (Condom use to overall contraceptive use among currently married women, 1549 years percent) was only5.2 % at all India level.
Indicator 3A: Condom use at last high risk sex (Condom use rate among non-regular sex
partners 15-24 yrs.)
The Behavioral Surveillance Survey (BSS) conducted to monitor the changes in knowledge and
behavior indicators indifferent risk groups with respect to HIV/AIDS indicates that Condom use
among non-regular sex partners is quite prevalent. According to BSS conducted in 2001 &
2006, the national estimates for Condom use at last high-risk sex (%) -Proportion of population
aged 15-24 years who used condom during last sex with non-regular partner registered a
19%increase from 51.9% in 2001 to 61.7% in 2006.
Indicator 3B: Percentage of population aged 15-24 years with comprehensive correct
knowledge of HIV/AIDS
According to BSS, the national estimate for proportion of population aged 15-24 years with
comprehensive correct Knowledge of HIV/AIDS in 2006 was 32.9 % reporting betterment from
2001 (22.2%).
Government Programmes:
When HIV infection was discovered in India in1986, the health authorities set up the NACO
which prepared an outline for National AIDS Control Programme (NACP) that was primarily
funded by the World Bank and technically supported by WHO.
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of malaria, most of whom live in India. However, Southeast Asia contributed to only 2.5 million
cases to the global burden of malaria. Of this, India alone contributed 76% of the total cases.
Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other
major diseases
Indicators
6.6 Incidence and death rates associated with malaria
6.7 Proportion of children under 5 sleeping under insecticide-treated bed nets
6.8 Proportion of children under 5 with fever who are treated with appropriate anti-malarial
drugs
WORLD PROGRES
The global estimated incidence of malaria has decreased by 17 per cent since 2000, and
malaria-specific mortality rates by 25 per cent.
In the decade since 2000, 1.1 million deaths from malaria were averted.
Countries with improved access to malaria control interventions saw child mortality rates
fall by about 20 per cent.
Thanks to increased funding, more children are sleeping under insecticide-treated bed
nets in sub-Saharan Africa.
INDIAs PROGRES
While in some isolated local areas it is possible to meet the MDG but for the country as a whole
we will definitely miss the deadline. This is true for the rural and urban malaria and other
ecotypes as well. In 2010, malaria caused 46,800 deaths in India, according to the Institute for
Health Metrics and Evaluation study. A whopping 80.5 per cent of the 1.2 billion people in India
currently live in malaria prone areas. Not surprisingly, it is considered highly unlikely that the
country will meet the Millennium Development Goals (MDG) to combat malaria by 2015.
The National Malaria Eradication Programme was launched in 1958. However, the malaria
related strategy has undergone various changes since then. Since 2005-06, the malaria prevention
and control activities are being implemented as a part of National Vector Borne Disease Control
Programme (NVBDCP) under overarching umbrella of the National Rural Health Mission
(NRHM).
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GOVERNMENT PROGRAMMES
National Vector Borne Disease Control Program (NVBDCP)
Urban malaria scheme (UMS)
Modified Plan of Operation (MOP)
Also certain NGOs like LEPRA society and Janakalyan Pratisthan have worked extensively
towards the control of malaria.
Analysis OG efforts:
Although the government has been and still is actively trying to eliminate the disease, there isnt
active participation from the NGOs or corporates till now.
Problems being faced:
Inefficient and gaps in reporting the Maria incidences due to deficiencies in coverage,
collection, and examination of blood smears and reporting systems.
The data from the private clinics do get reflected in the Government data in many cases.
Inaccesible areas cause deficiency in routine surveillance programmes
Shortage of dedicated staff
Widespread resistance of themalarial parasite to chloroquine
Delaysin release of programme funds to endemic districts by states.
TUBERCULOSIS
Relevance of the MDG:
Tuberculosis has been chosen as an MDG target because detecting tuberculosis and curing it are
key interventions for addressing poverty and inequality. Prevalence and deaths are more sensitive
markers of the changing burden of tuberculosis than incidence (new cases), although data on
trends in incidence are far more comprehensive and give the best overview of the impact of
global tuberculosis control. Since tuberculosis is an airborne contagious disease, primary control
is effected through finding and treating infectious cases and thus limiting the risk of acquiring
infection. However, with rising rates of HIV infection, the number of TB cases is likely to rise, as
people with HIV are more susceptible to TB.
Target to achieve by 2015:
The aim is to maintain at least a 70% case detection rate of new smear positive cases as
well as maintain a cure rate of at least 85%.
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This needs to be done in order to achieve the TB-related targets set by the Millennium
Development Goals for 2015 and to achieve TB control in the longer term.
India presently is on target set by the MDG goals of 70 % case detection rate and 85%
cure rate. In 2010 the Case detection rate was 72% and treatment success rate 87%. In
2nd quarter 2011 the Case detection rate was 78.6% and the success rate was 87.7%.
But it is facing fresh issues due to the emergence of :
a) Multidrug-resistant (MDR-TB) tuberculosis
b) Extensively drug-resistant (XDR-TB) tuberculosis
which has emerged as a fresh threat to the initiatives against TB eradication, not only in
India, but all over the world.
Government Programmes
RNTCP- Revised National Tuberculosis Control Program
DOTS- Directly Observed Treatment-Short course
DOTS-plus
RESPONSE OF CORPORATE
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Modicare Foundation
It was set up by Mr. Samir Modi in 1996 with the commitment to prevent the spread of
HIV/AIDS, enhance awareness and erase the myths and misconceptions surrounding it.
Key projects
Workplace HIV/AIDS Intervention Program (2000 onwards)
Under this program, the foundation has worked with industries like Jindal Iron & Steel Ltd
(Tarapur & Vasind), Jindal Stainless Ltd (Hissar & Jajpur), Godrej, Blue star, Indofil
Chemicals, Nike Shoes, Polar Group, Moja Shoes, JCB, Sandhar, ITC, Technova Graphics,
Colgate, Fortis Healthcare Ltd etc, MphasiS, Tata Consultancy Services etc. The Foundation
has been associated with various wings of the Armed Forces (Indian Army, Airforce and Navy)
and has developed tools and conducted awareness and peer education sessions with them.
Ambassadors of Change Program (Life Skills Program for Adolescents) -1997 onwards
The aim of the program is to encourage adolescents to make informed choices related to growing
up and HIV/AIDS, enabling them as well as their environments. The Foundation has trained
more than 50,000 adolescents through this programme. Regular sessions are conducted with
adolescents in government and public schools, colleges using methodologies that are interactive,
creative, fun and inspiring
The Sponsorship Program (1997 onwards)
It provides medical and nutritional support to people infected with the virus and their families.
Modicare Foundation has also established Support Groups of People living with HIV&AIDS
(PLWHAs) in order to provide psychosocial support to people infected with HIV as well as their
families.
Voluntary Counseling and Testing Center (2002 onwards)
Voluntary Counseling and Testing Center established by the Modicare Foundation in
collaboration with MAMC (Maulana Azad Medical College) and D-SACS ( Delhi State AIDS
Control Society) at the Lok Nayak Hospital, a government facility located in New Delhi,
provides a safe space where people can obtain information on HIV. Since its inception, the center
has worked with approximately 8000+ cases and is rated to be one of the best VCTC with trained
professionals managing it. The center is also linked with the ARV clinic at the hospital from
where clients can obtain referrals and access medical treatment.
Care and treatment of children (2007 onwards)
With the support of Clinton Foundation, Modicare Foundation worked as
Coordinating Agency for 5 Delhi based NGOs on the National Pediatric
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Their aim is to develop the skill and capability to run this center at Wadi as a world-class facility
for the benefit of the public, with the assistance of NACO, CII and prestigious medical institutes
such as CMC Vellore.
INDIAN OIL CORPORATION
Indian Oil in its Mission states To enrich the quality of life of community and has a policy of
non-discrimination in relation to HIV/AIDS infection for employment at recruitment level, as
well as training, transfer or promotion.
Indian Oil has associated itself with Bill & Melinda Gates Foundation to address the issue of
spread of HIV infection. Their state offices have been advised to extend all necessary assistance
to Project Directors of State AIDS control Society of National AIDS Control Organization,
Ministry of Health & Family Welfare, Government of India.
These retail outlets are also good rallying point for dissemination of HIV/AIDS related messages
including dispensing of condoms.
TATA STEEL
Tata Steel Ltd. started AIDS Awareness Programmes both in the workplace and in the
community. Tata Steel Ltd reaffirms its commitment to UNAIDS Theme for 2011 2015
Getting to Zero. The Company developed effective responses to the epidemic by building
special infrastructure and the establishment of the AIDS Cell, Tata Steel. This was subsequently
upgraded to Nodal Centre for AIDS with the task of bringing focused efforts across Tata Steel as
well as networking with other Medical Institutions, Governmental & International agencies.
PPTCT programme is a service component offered to pregnant Women Living with HIV/AIDS at
Tata Main Hospital in partnership with Sneh Kendra. Since past 5 years 23 HIV+ women have
delivered at TMH and none of the babies have tested HIV+.
Tata steel has received TERI Corporate Award for HIV/AIDS May 2008 for Sneh Kendra.
TCIF Golden Certificate was given in 2007. Award for Corporate Social Responsibility in
Public Health conferred by the US-India Business Council (USIBC), Population Services
International (PSI) and The Center for Strategic and International Studies (CSIS) for outstanding
contribution to combat HIV/AIDS in March 2007. Global Business Coalition on HIV/AIDS
Award 2003 for its initiatives on HIV/AIDS in the community.
Apollo Tyres
The companys HIV-AIDS Awareness and Prevention Programme is targeted at 4 key
stakeholders employees, customers, business partners and community. Under this, Apollo
undertakes awareness and prevention sessions and provides voluntary, confidential testing and
support.
In India, the company runs 21 Health Care Centers in prominent transshipment hubs for the
commercial vehicle community. Each of these centers is equipped with qualified doctors,
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paramedic staff and counselors, and also has its own network of peer educators who work with
the community to effect behavior change.
ANALYSIS OF EFFORTS:
Success:
Outreach: Though, the outreach of these corporate is limited to only their stakeholders. The sheer
number of stakeholders for corporations such as Reliance constitutes a significant change
Partnering:
Corporates have not only partnered with NGOs but also expanded links with existing health
services is important it enables the target group to gain access to services not provided by the
program and also avoids duplicating services.
Innovation:
The corporate bring about innovation in terms of tackling problems such as disease control.
With leaders in the field of expertise entering to alleviate causes of HIV, malaria and other
diseases.
Challenges:
Lack of infrastructural support by the government: Many corporates have focused onto providing
antiretroviral treatments to patients but lack of clinics to dispense these treatments and paltry
penetration have led to the success of these efforts being undermined
Retention of outreach workers:
While the corporate have encountered success in terms of partnering the retention of workers is a
huge challenge, moreover once a worker leaves a huge cost is incurred in terms of training and
hiring a new recruit.
Sensitizing industry stakeholders: Many companies have not yet realized the enormity of the
HIV and AIDS problem, its repercussions, and the high cost of inaction.
Message fatigue: Messages became ineffective with too much repetition. Moreover, repeated
interventions targeted groups saddled them with negative branding because of the stigma
associated with HIV and AIDS.
Roadmap for the future:
Corporate efforts are at this point limited only to their direct stakeholders and no efforts for
targeting high risk groups.
Specific efforts towards pregnant women not addressed. The indicator has not been addressed
Recommendations:
Take early decisive action. Companies that carry out HIV and AIDS interventions do so to
safeguard the health of their employees and because these efforts accord with their values and
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mission. Such efforts can meet resistanceat the corporate level, at the workplace, and in the
local communityespecially where action is taken early to stem an epidemic before it has
become generalized, when the perceived risk may be low. But taking early decisive action on
burden of death and disability and averts the high cost of treating and caring for large numbers of
people living with AIDS.
Document cost and effectiveness. There is much to learn from actions taken by businesses to
prevent HIV and treat and care for AIDS patients. It is important to learn by doing. But beyond
this, formal, independent evaluation is needed to assess the effectiveness of these interventions.
Better monitoring and evaluation will help in planning and implementing programs, in
identifying gaps, and, importantly, in sustaining, scaling up, and expanding initiatives.
Ranbaxy: Ranbaxy Laboratories Limited (Ranbaxy) launched Indias first new drug, Synriam,
for the treatment of uncomplicated Plasmodium falciparum malaria, in adults, dedicating the
New Age Cure for Malaria to the Nation, on World Malaria Day.
Launched on World Malaria Day as part of Ranbaxys corporate social responsibility (CSR),
Synriam is expected to become a part of Indias national malaria eradication programme. The
drug has been developed by Ranbaxy Laboratories, owned by Japans Daiichi Sankyo Co., in
collaboration with the department of science and technology (DST), Government of India, and
support from the Indian Council for Medical Research.
Godrej Consumer Products: Godrejs HIT insecticide spray has played a significant role in
increasing awareness about the disease and its prevention, with its HIT Kill Malaria campaign.
The campaign initiated in 2010, engages with a range of activities in schools and housing
societies, along with the municipal corporation in various cities.
Apart from an interactive website that encourages one to join the cause against malaria and never
miss an opportunity, the brand has included fun ways to contribute to the cause. Visitors can
share their stories of lost opportunities and get featured on the site, as well as be a part of the Do
Good initiative. For every person who joined the Do Good campaign, HIT donated Rs. 2
towards its Corporate Social Responsibility tasks that include creating awareness, cleaning up
and fumigation operations in slums.
Pfizer: Pfizer has dedicated itself to a platform of innovative, socially responsible, and
commercially viable activities to help close the malaria treatment gap
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Pfizer collaborates with the WHO and its Special Programme for Research in Tropical Diseases
(WHO/TDR) to target malaria and other neglected tropical diseases. In April 2009, Pfizer and
Medicines for Malaria Venture (MMV) signed an agreement which gives MMV access to Pfizer's
vast chemical compound library in order to test approximately 200,000 compounds for activity
against P. falciparum. Such public-private research partnerships are vital to overcoming the
health challenges of developing countries.
Pfizer partners with leading NGOs to find promising interventions that improve the utilization
and effectiveness of malaria treatment. At the 2006 Clinton Global Initiative, Pfizer announced a
five-year program (2007-2012), Mobilize Against Malaria, focused on improving access to
prompt and effective treatment, on preventing infection and the spread of malaria by improving
symptom recognition, treatment, and referral through local grassroots training, education and
awareness.
ANALYSIS OF THE EFFORTS
As per the data and progress report, it is evident that India will miss its MDG target relevant to
Malaria.
Analysis of efforts
Almost none of the corporate in India except for the pharmaceutical companies are targeting
malaria dedicatedly. The rest of the companies address the issue with the help of integrated
health camps, seminars, awareness campaigns. Although these initiatives are appreciable, they
are not solely focussed on the issue of Malaria. Therefore these initiatives cannot be termed as
long term approach towards achieving eradicating Malaria.
Roadmap to the future
1. Increase the inter-sectorial coordination between the government, NGOs and corporate.
2. Improving the data collection reporting systems.
3. Reduce the delay in implementing programmes, releasing and monitoring funds.
4. Develop efficient and affordable medicines preferably vaccines that will help reduce the
malaria incidences like in the case of polio.
5. Increase the coordination between Indian and foreign NGOs working towards the MDGs
6. Improve the efforts by corporate and NGOs in such a manner that they are sustainable
and have a long term approach.
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Microsoft Research developed biometric devices to track the treatment of patients. These
devices are used in many countries including India in implementing DOTS.
Microsoft has adopted a philanthropist approach.
NTPC
Novartis
Sandoz, together with its parent company Novartis, is taking a stand against TB and is the main
provider of TB drugs to the World Health Organization. For example, over the five-year period
from 2004, Novartis donated gold-standard TB medicines to the World Health Organization for
the treatment of half a million patients. Also, Novartis India is working with the Global TB
Alliance for TB Drug Development on the development of a new drug for the treatment of TB.
RIL
The company has established a well-equipped DOTS therapy centre at Mora village.The purpose
of this well equipped and adequately staffed centre is:
urban primary health care systems tend to be weaker and private health care predominates.
Further reducing treatment default of patients put on treatment under Programme is another
challenge in order to prevent drug Resistant TB. Linking HIV-infected TB patients to HIV care
and support and implementing measures to prevent TB in HIV care settings need further
strengthening. The Country needs to put in place more intensified measures on these areas to
reach and maintain a desirable progress in reducing TB infections.
Road map for the future:
Take steps to reduce malnutrition which is a major factor for low immune system in
children which subsequently makes them more vulnerable to diseases like TB.
HIV/AIDS incidence is also a factor for low immune system. Thus HIV?AIDS TB coinfection can be reduced with decrease in HIV/AIDS.
Setup laboratories, which have equipment to detect drug resistant forms of TB which
would allow health bodies to better calculate the scale of the disease and resources can be
focused on high risk areas.
Pharmaceutical companies should try to make TB drugs which are low in cost.
Final Recommendation:
In all the interest areas, it must be ensured that there is sustained commitment and financing. A
challenge for both the private and the public sector is to sustain the financing for prevention,
treatment, and care. Continued financing is especially essential for treatment programs, which,
once initiated, must not be interrupted. Developing strategies for sustaining programswhether
run by businesses or by governmentwill become increasingly important, providing a strong
impetus for greater private-public partnership and sharing of knowledge.
REFERENCES
Web-sites
http://www.triplepundit.com/2013/02/microsoft-research-india/
http://www.ril.com/downloads/pdf/RIL_CSR_2006.pdf
http://www.tbdots.com/novartissandozcsr/csr.shtml
http://www.globalconferenceoncsrindia.org/Speakers_data/NTPC%20CSR.pdf
http://pepsicoindia.co.in/purpose/other-community-initiatives.htmlhttp://www.modicarefoundation.com/content.aspx?gbin=c337d27a-a1f04291-91e2-a8b2298aef19
http://www.acclimited.com/newsite/corp_soc_resp.asp
siteresources.worldbank.org/.../IndianOilsInitiativesAgainstHIVAIDS.doc
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http://www.indiacsr.in/en/?p=8776
http://www.apollotyres.com/india/responsibility-health.aspx
http://www.mybangalore.com/article/1210/top-3-companies-for-excellence-in-csr.html
http://www.pfizer.com/responsibility/global_health/pfizer_malaria_partnership
http://www.ranbaxy.com/ranbaxy-launches-synriam-indias-first-new-drug/. http://www.godrej.com/godrej/G
odrej/Pdf/HillKillMalaria_250811.pdf
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