Fusing journalism and TB – telling the stories as they are

Archive for February 2011

The Stop TB Award for Excellence in Reporting on Tuberculosis – last date 30 April 2011

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This is a great opportunity for journalists who have been writing on TB during the year gone by, despite shrinking or absent spaces in newspapers and journals for the issue. I’d like to articulate a possibly uninformed thought here. In my understanding, Awards for journalism are the front end of a long backend process. The backend process should ideally consist of intensive efforts to build capacities of large numbers of journalists to write informed reports on TB. Then they should be encouraged to write stories with the help of small bursaries and travel grants. This backend process results in quality stories.

I know this works and I am fortunate to have been part of such efforts through The EU-India Media Initiative on HIV/AIDS and can say with confidence that the process we were taken through helped us to write stories that sold, and stories that media houses saw value in. The Award came at the end of the initiative as the frontend effort. This holistic package is badly needed for TB journalism and sooner the better. We don’t have time to wait if we want quality and quantity coverage on TB. It takes sustained resources and will to do this.

Bharathi Ghanashyam

About the Stop TB Award
The Stop TB Award for Excellence in Reporting on Tuberculosis fosters, recognizes and awards outstanding reporting in print that materially increases the public’s knowledge and understanding of tuberculosis (TB), including multidrug-resistant TB, in countries affected by the disease. The award is supported by the Lilly MDR-TB Partnership.

More details available here

Written by JournalistsAgainstTB

February 27, 2011 at 7:01 am

Posted in TB and Media

What if?

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What if we could really do all this? Let the film say it all! The Global Plan to STOP TB – 2006 – 2015.

A STOP TB Partnership film.

Watch on!

Bharathi Ghanashyam

Written by JournalistsAgainstTB

February 26, 2011 at 3:02 pm

Posted in TB and Media

Now we’re talking!

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In what could be seen as the fence eating the crop, the shutting down of public sector vaccine units is costing the government! Report by Kounteya Sinha in The Times of India.

NEW DELHI: Shutting down manufacturing of vaccines at the public sector vaccine units is costing the government dear. Take the example of the BCG vaccine against tuberculosis. It used to cost the health ministry Rs 13 per vial in 2007-08 when it was being supplied by the public sector BCG Lab in Chennai. Now with vaccine production in the lab shut, due to “supposed non-adherence” with WHO’s good manufacturing practices (GMP) standards, the ministry is purchasing the same vaccine at more than double the cost from the private sector.

Read more

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February 23, 2011 at 4:44 pm

Posted in TB and Media

Score the Goals – a graphic novel on MDGs

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With only four years until the 2015 deadline for achieving the Millennium Development Goals (MDGs), the challenge remains to make children fully aware of them and of the important role they can play in achieving them. Sport stars – and football players in particular – often act as role models and, as such, can be of great added value to the UN and their partners, when disseminating key messages and values.

Teaming up to achieve the Millennium Development Goals

‘SCORE THE GOALS: Teaming Up to Achieve the Millennium Development Goals’ is a 32-page educational comic book featuring 10 football UN Goodwill Ambassadors, who become shipwrecked on an island on their way to playing an ‘all-star’ charity football game. Whilst on the island, the team has to tackle the eight MDGs along their journey towards being rescued.

The 10 football players featuring in the comic book are Emmanuel Adebayor, Roberto Baggio, Michael Ballack, Iker Casillas, Didier Drogba, Luis Figo, Raúl, Ronaldo, Patrick Vieira, and Zinédine Zidane.

The comic book is primarily aimed at 8-14 year old children and provides a fun interactive way to help them understand, familiarise and reflect about the eight MDGs as well as inviting them to take action through several activities provided in the adjoining educational guide.

The book was launched on 24 January 2011 at the UN in Geneva by Spanish and Real Madrid goalkeeper Iker Casillas and the UN Secretary-General’s Special Adviser on Sport for Development and Peace, Mr. Wilfried Lemke (see press release here).

The project has been carried out in a ‘One-UN’ spirit and is the result of successful inter-agency collaboration between the following UN partners

Reproduced in Journalists against TB with permission from United Nations Sport for Development (UNOSDP)

Written by JournalistsAgainstTB

February 16, 2011 at 4:01 pm

Posted in TB and Media

New vaccines against TB seem to be in sight

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JATB is proud to feature Jonanneke Nieuwenhuis, Associate, Communications and Advocacy Relations, TBVI for a second time. She has contributed valuable information on the status of new vaccines against TB. It is important for us to debate on what this progress means for India. How are we going to leverage this progress to make it work for us? Can we move towards replicating Pulse Polio for TB in case we get vaccines that work? Where is India’s own research in this very vital area? It would be interesting to know.
Bharathi Ghanashyam

New vaccines against tuberculosis seem to be within eyesight but many practical and financial issues have to be overcome. Although it will still take years to develop, test and license new products, researchers are optimistic about the progress that is being made. Now, funding and collaboration are some of the key requirements to push through.

Scientists came together at the annual research meeting of the TuBerculosis Vaccine Initiative (TBVI) early February. Here they presented each other their results, challenges and lessons learned. TBVI’s research network exists of partners from around forty different universities, institutes and industries. The aim of the network is to get new vaccines on the market around 2020 and to do so it has a broad portfolio in which various approaches to vaccine and biomarker research are being used.

In the past year, several vaccines have advanced to different stages of clinical trials. Just recently, a candidate vaccine from the Statens Serum Institute in Denmark attracted global attention from mainstream media because of its encouraging research results and also candidates from the UK, Germany, France and Spain are showing promising outcomes.

In order to eliminate tuberculosis, some challenging goals have to be set. While describing the route to new vaccines, Christian Lienhardt of the WHO stressed that more funding is needed. This was confirmed by Willem Hanekom of the South African Tuberculosis Vaccine Initiative who said: “Ultimately it’s a resource issue”. Several researchers added the need for collaboration. Hanekom for example, calls for biomarker studies to be integrated in vaccine trials and for industries to become more involved. “We need critical players to unite.” It’s exactly for this reason that WHO’s Uli Fruth is happy about the TBVI network. Fruth: “I was delighted to see a plethora of collaborations that the consortium has stimulated amongst the partners, which in the absence of the TBVI structure would probably not have happened. I feel that it is these intensive and enthusiastic collaborations which have enabled the progress in research over the past year, which is nothing short of stunning.”

Recently, the European Parliament accepted a resolution for the European Commission, the Council and WHO to stress the importance of providing new tuberculosis vaccines. This kind of political support is essential. New, effective and safe vaccines can be delivered but for this to happen, combined efforts are needed of scientists as well as politicians, advocates, media, donors and industry. Incredible amounts of funding and energy have been invested already. Not finishing this project would be like building a house without putting a roof on.

Jojanneke Nieuwenhuis
Associate, Communications and Advocacy Relations, TBVI

The views expressed in the report are entirely of the author

Written by JournalistsAgainstTB

February 13, 2011 at 4:12 pm

Posted in TB and Media

TB spares no one – a priceless nugget of history

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My friend Mr Raja Chandra, who is married to Princess Indrakshi, the daughter of Late His Highness Maharaja Jayachamaraja Wadiyar of the erstwhile Royal State of Mysore in Southern India has sent in this priceless nugget of history. I urge readers to also pay some attention to the text I have italicised, which tells us that we have been grappling with the same issues for decades without making much headway. I have posted it unedited. Thank you Raja for giving us permission to use this in our blog. Journalists against TB is grateful for this.
Bharathi Ghanashyam

Speech by His Highness, the Maharaja Krishna Raja Wadiyar IV at the opening of the Princess Krishnajammanni Sanatorium on 18-11-1921.

Ladies and Gentlemen, It, is a matter of sincere gratification to my mother and myself, as it is, I am sure, to Colonel Desa…raj Urs and my nephew, that this Ins…titution, which we owe in a, large measure to their generosity, is to be opened to-day, Our cordial acknowledgments are due to them for so beneficent a gift.

Of all diseases with which the health authorities are called upon to deal, none is perhaps more difficult and unsatisfactory than tuberculosis. The exceptionally heavy toll taken by this insidious disease among the adult and working members of the community makes the problem before us one of gravity and urgency, requiring organized and sustained effort on the part of both the people and the authorities -health and civic- in preventing its spread and minimizing its ravages.

TB spares no one - Three daughters of Princess Krishnajammanni and Col. Des Raj Urs who were victims of Tuberculosis along with their mother. Rajakumari Tripurasundari Cheluvajammanni ( 14 years- died in 1910) Rajakumari Kempananjammanni (16 years - died in 1913) Rajakumari Devajammanni ( 15 Years - died in 1913)

The value of educational measures in combating phthisis cannot be exaggerated. No measures, however useful and beneficent in their scope, can be of any avail so long as those for whom they are mainly intended remain apathetic and indifferent; and if any headway is to be made against the disease, it is necessary that every endeavor should be used in the direction of the diffusion of knowledge regarding health matters generally tuberculosis in particular, not only in schools colleges, but amongst the ignorant, so that they realize how infectious the disease is, and how necessary it is to effect an improvement in domestic hygiene. The one great need is knowledge and the more people to appreciate the value of light and air, the greater will be the chance of success.

It is, I believe, generally recognized by the medical profession that properly equipped sanatoria go a long way towards staying the ravages of tuberculosis. Advanced cases may not be susceptible to treatment, it is possible to prevent the alarming spread of the disease by separation of the affected persons from those who are still un-attacked and it is here that the chief value of the Sanatorium lies. It is an institution which aims at serving the interests both of the individual and of the community. I trust that it may be possible to start before long one or two tuberculosis dispensaries in the city. They will ensure timely aid and treatment and will form valuable auxiliaries to the Sanatorium, and will also prove most useful from an educational standpoint.

Ladies and Gentlemen, many of you present here are aware of the bitter experience that we have ourselves gone through. Not only my beloved sister, in whose memory the institution has been founded, but her three daughters fell victims to the dire disease. You can therefore, understand with how full a heart my mother and I pray that this hospital may afford relief to the poor and afflicted, and that divine providence may help us to realize the hopes with which we are starting it to-day.

I have much pleasure now in declaring Princess Krishnajammanni Sanatorium open.

Written by JournalistsAgainstTB

February 6, 2011 at 5:37 am

Posted in TB and Media

A pictorial essay on 100+ years of TB – a problem that refuses to go away!

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By Jasvinder Sehgal

TB stamp - Portugal 1929

Anti TB stamp Yugoslavia 1940s

TB Seal - 1951

This is a pictorial essay on TB and these stamps date back to as far as 1940s indicating that we are grappling with a problem that refuses to go away. I have met philatelists who are of the opinion that stamps are good ambassadors for spreading awareness about TB. Recently at Villupuram in India, Tuberculosis awareness stamps worth INR 2,00,400 were released. The amount collected by the sale of the stamps would be utilized for the purpose of creating awareness among the people at large about tuberculosis, its preventive and curative aspects as well as distribution of medicines through the Self-Help Groups (SHHGs) and field workers. Such endeavors can inspire the masses also to contribute towards eradication of tuberculosis.

TB Seal - from when Sri Lanka was called Ceylon

Lahore TB Seal 1963

South African Tuberculosis seals 1976

We are a group of journalists to whom this medium is new, so we request readers to pardon the ‘techy’ glitches we have encountered while placing the stamps. Advice on how to do this better is welcome!

TB stamp - Bermuda

South Africa - TB stamps

TB stamp

TB stamps - assorted

Written by JournalistsAgainstTB

February 5, 2011 at 6:57 am

Posted in TB and Media

Tuberculosis diagnosis – its importance for eradicating the white plague

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Journalists against TB is honoured to feature guest writer, Jasmine Grenier, a medical student from Mc Gill University, Montreal, Canada.

As medical students, we have all heard about the white plague, consumption, phthisis, the wasting disease, Tuberculosis: the disease commonly known as TB. We have heard our peers in the medical field and elsewhere discuss the causes, the prognosis, the ravaging course of the disease and the hopeless statistics of infection and mortality. We have heard people say it is a disease of the poor, and we have strongly defended that it is a disease of the world. We know that tuberculosis has been successfully controlled in some areas but remains an imminent threat in others. Not so long ago students in Montreal were given a PPD test in schools as routine testing to screen for M. Tuberculosis infection and although there are still some areas and population groups which are more at risk (such as the Inuit and Cri populations in the north of Quebec as well as children who recently immigrated to Canada from high TB burden countries), there is no longer a significant threat in the city. However, there are countries where the infection and disease burden is enormous. Countries such as India see almost 2 million new TB cases per year, which all require proper diagnosis, treatment plan and completion of treatment to ensure cure.

It is often believed that the main hindrance in reducing the rate of infection and mortality in developing countries, which generally hold the highest burden of disease, is the lack of appropriate medication for the type of tuberculosis (latent, active, pulmonary, extra-pulmonary) and for the length required (6 months in most cases, and up to 2 years, in cases of significant multi-drug resistant TB). That is of course a problem which is continuously encountered and has been greatly tackled by the WHO and the Stop TB Partnership. Most of us have heard of DOTS – Directly Observed Treatment, Short-course; which has been endorsed by the WHO and implemented as widely as possible. This program strives to ensure availability of diagnosis and ‘directly observed’ drug therapy so as to optimize adherence, which is often difficult to maintain for complicated drug regiments that last months at a time and often imply significant side-effects. It is true then, that the administration of and adherence to TB treatment represents an ongoing challenge. However, there is another aspect of TB management that causes significant drawbacks: the diagnostic process.

Over the years, the causes and manifestations of TB have been eluded: starting off as mythical causes, we now not only know the infectious agent but also its complete infectious mechanism. The treatment has also evolved, from sanatorium care to a complex multi-drug regimen. The only thing that has not changed substantially is the diagnostic process, at least until recently. The most reliable diagnostic method for tuberculosis remains Robert Koch’s sputum smear microscopy and sputum culture, discovered in 1882. Although when used in conjunction both these tests are reliable, a culture takes weeks to grow which is much longer than one would hope to wait for the diagnosis of active TB disease. This is without mentioning the difficulty in diagnosing TB in HIV co-infected patients, whose sputum usually shows up as smear negative even when active TB disease is present. If TB is not diagnosed early, patients continue to spread the infection to those around them. In many developing countries, TB is diagnosed as many as 2 – 3 months after the patient becomes symptomatic. Thus, undiagnosed TB and delays in diagnosis continues to fuel the epidemic of TB.

In the search for new diagnostics, there have been many that have been attempted, such as the interferon-gamma release assay (IGRA), for one. This has proven to be a very specific diagnostic test, endorsed by the WHO, for the diagnosis of latent TB only. In fact, these tests cannot distinguish between latent and active TB infection and so remain mostly irrelevant for high burden areas where active TB is the biggest priority. However, some practitioners use IGRAs for the diagnosis of active TB as well, for which it is not specific at all. What the WHO encourages and what researchers are investigating is an ideal point-of-care test (one that can be conducted on the spot and which results can be obtained at that time) for the diagnosis of active TB disease. In the midst of this search a new type of test was developed and is now commonly found: serological rapid test kits. These tests measure the presence of antibodies against M. Tuberculosis. They are sold, imported and used in many high burden countries, especially in the private sector. Although most of these test kits claim 100% accuracy, serological tests for the detection of active TB have been proven to be inaccurate and inconsistent. For the first time in its history, the WHO has issued a negative policy advising against the use of TB serological tests. However, these inaccurate tests are widely sold and administered by practitioners and are often used to determine initiation of anti-TB therapy. The damage that a TB misdiagnosis can inflict is immense, as nicely illustrated by a recent story, entitled “A deadly misdiagnosis” in the New Yorker magazine by Michael Specter (published in November 2010). Whether a person receives antibiotics when none are needed or whether a person does not receive treatment for an active disease has tremendous consequences on the level of drug resistance, mortality and transmission of the infection in the community.

In our fight against Tuberculosis, it is important to remember that the challenges we face are manifold but that by recognizing the different problems, we can address them and move forward. The negative policy by the WHO is a grand step toward eradicating inaccurate diagnostic tests. In conjunction with this effort, the Stop TB Partnership’s New Diagnostics Working Group, co-chaired by Dr. Madhukar Pai a leading TB researcher affiliated with McGill University, is pioneering research and innovation in TB diagnostics. Moreover, the development of new and accurate point of care tests seems to be promising. Cepheid, a molecular diagnostics company, has recently manufactured the Xpert MTB/RIF (using the GeneXpert platform), a point of care test for the diagnosis of TB. The test is a completely automated PCR assay that is highly sensitive and specific and detects presence of M. Tb in the sputum as well as resistance to Rifampin in only two hours. This test can be done on table top, does not require a sophisticated lab or a highly trained personnel to operate it. The WHO recently endorsed this assay, and although its cost is still too great to allow for mass distribution throughout the developing world, price negotiations have been put in place and the test shows promise, especially if it can be used at the point of treatment in high TB burden settings to achieve early diagnosis.

Advancements like DOTS and the Xpert assay address core issues in the management of TB but there are many more factors that play a significant role in the development of the disease such as the overall health status of the patients and even more fundamentally, their nutritional status. As healthcare professionals-to-be these are issues that we must keep in mind and work to overcome. Although global control of tuberculosis remains difficult, the progress being made must encourage us to share our knowledge with our peers, to advocate and to work toward better solutions.

The views expressed in this post are entirely of the author.

Written by JournalistsAgainstTB

February 2, 2011 at 4:27 pm

Posted in TB and Media

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