Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 150
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Code Context


        trigger_error($message, E_USER_DEPRECATED);

    }
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 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.'
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deprecationWarning - CORE/src/Core/functions.php, line 311
Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421
App\Controller\ArtileDetailController::index() - APP/Controller/ArtileDetailController.php, line 150
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Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120
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Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
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Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
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Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51
Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98

Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 151
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Code Context


        trigger_error($message, E_USER_DEPRECATED);

    }
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 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.'
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deprecationWarning - CORE/src/Core/functions.php, line 311
Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421
App\Controller\ArtileDetailController::index() - APP/Controller/ArtileDetailController.php, line 151
Cake\Controller\Controller::invokeAction() - CORE/src/Controller/Controller.php, line 610
Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120
Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94
Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 97
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51
Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98

Warning (512): Unable to emit headers. Headers sent in file=/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php line=853 [CORE/src/Http/ResponseEmitter.php, line 48]
Code Context
            if (Configure::read('debug')) {

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        LATEST NEWS UPDATES | AIDS agency orders cheap drug by Ankur Paliwal    </title>
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Stavudine disfigures, affects peripheral nervous system permanently





THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less..."/>
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Stavudine disfigures, affects peripheral nervous system permanently





THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less..." />
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                            <div style="text-align: justify"><br /></div><div style="text-align: justify"><em>Stavudine disfigures, affects peripheral nervous system permanently</em></div><div style="text-align: justify"><br /></div><div style="text-align: justify">THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less monitoring of patients, they say. NACO provides free treatment to HIV/AIDS patients in the country.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">In 2010, the WHO had revised its HIV/AIDS treatment protocol and recommended countries to phase out stavudine as the preferred first-line therapy due to its long-term, irreversible side-effects. The drug causes lipodystrophy, or irregular distribution of fat in the body, resulting in sunken cheeks and buffalo humps at the back and neck. It also damages peripheral nerves, causing numbness and burning pain in hands and feet. WHO had urged countries to move to less toxic alternatives such as zidovudine, tenofovir and abacavir. In line with its recommendations, Kenya, South Africa and a few other countries announced shifting from stavudine to tenofovir over the next five years. Developed countries, including EU nations and the US, have long been using stavudine as the last opted drug.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">India&rsquo;s HIV/AIDS treatment protocol remains unchanged. The technical resource group of the Union health ministry held a meeting soon after the release of WHO recommendations. It acknowledged the side-effects of stavudine but reached no consensus on phasing it out. Minutes of the meeting show that some members had argued that if all patients on stavudine are shifted to tenofovir, the expenses will nearly double.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">As per NACO&rsquo;s protocol, zidovudine should be given as the first preferred drug. If the patient developes complications like anaemia, stavudine is the option. Tenofovir is the last resort.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">But in practice stavudine is always the first choice of doctors, says Loon Gangte of non-profit Delhi Network of Positive People. &ldquo;In several instances, doctors change the treatment regime to zidovudine or tenofovir only after pressure from patient support groups,&rdquo; says Shivangi Rai, legal officer with Lawyers Collective. The lawyers group is fighting a public-interest litigation in the Supreme Court to make stavudine the last option in NACO&rsquo;s treatment protocol.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Doctors say they prefer stavudine and zidovudine because they are bound by the treatment protocol. A member of NACO&rsquo;s technical resource group, on requesting not to be named, says: &ldquo;We prefer stavudine as it is well tolerated and requires less monitoring. Besides, only five to seven per cent patients suffer from lipdystrophy and peripheral neuropathy.&rdquo; Despite repeated queries, NACO refused to divulge the number of patients on stavudine.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Side-effects caused by stavudine mostly goes unreported because NACO does not have a programme to keep vigil on the health complications, says Leena Menghaney, campaign coordinator (India), Medecins Sans Frontieres, an international non-profit that works on access to essential medicines.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Public health activists say it is not just about giving the right drug, but giving the quality of life. With stavudine-induced disfigurement, patients face a double stigma. Anuradha of NAZ Foundation that works with HIV-positive children, adds: &ldquo;Our children feel alienated in school due to their appearance. It lowers their self-esteem.&rdquo; Of 16 HIV-positive children at NAZ who get treatment, 14 are on stavudine; eight have developed lipodystrophy.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">When anti-HIV programme took off in India in 2004, stavudine was the only option. But now other safer and equally effective options are available, says Menghnany. But doctors often keep shuffling patients between stavudine and zidovudine, even though the patient develops side-effects to both. Patients with frequent regimen changes suffer from virological resistance and increased mortality. It is important to choose the safest treatment regime, she says, adding, tenofovir is the safest available option for adult patients. Studies show though tenofovir can cause renal complications, its risk of side-effects is six times less than that of stavudine.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">But tenofovir was not even listed in the tender NACO procured in November.</div><div style="text-align: justify"><img src="https://im4change.in/siteadmin/tinymce/uploaded/HIV AIDS.bmp" alt="HIV AIDS" width="389" height="132" /></div><div style="text-align: justify">Rai argues with both global and domestic aid, NACO has no dearth of funding. Bulk order brings down the cost. Studies show tenofovir is cost-effective; treatment cost to reduce further health complications is higher for other drugs (See table: How cost-effective). It has additional advantage, says Menghaney. One needs to take just a pill of tenofovir a day, which improves compliance with the treatment regime.&nbsp;</div><div style="text-align: justify"><br /></div>                                                           
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Stavudine disfigures, affects peripheral nervous system permanently





THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less..."/>
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Stavudine disfigures, affects peripheral nervous system permanently





THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less..." />
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    <h1 class="cat-box-title">AIDS agency orders cheap drug by Ankur Paliwal</h1>
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		 Published on</span><span class="text-date"> Jan 10, 2012</span>
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                            <div style="text-align: justify"><br /></div><div style="text-align: justify"><em>Stavudine disfigures, affects peripheral nervous system permanently</em></div><div style="text-align: justify"><br /></div><div style="text-align: justify">THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less monitoring of patients, they say. NACO provides free treatment to HIV/AIDS patients in the country.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">In 2010, the WHO had revised its HIV/AIDS treatment protocol and recommended countries to phase out stavudine as the preferred first-line therapy due to its long-term, irreversible side-effects. The drug causes lipodystrophy, or irregular distribution of fat in the body, resulting in sunken cheeks and buffalo humps at the back and neck. It also damages peripheral nerves, causing numbness and burning pain in hands and feet. WHO had urged countries to move to less toxic alternatives such as zidovudine, tenofovir and abacavir. In line with its recommendations, Kenya, South Africa and a few other countries announced shifting from stavudine to tenofovir over the next five years. Developed countries, including EU nations and the US, have long been using stavudine as the last opted drug.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">India&rsquo;s HIV/AIDS treatment protocol remains unchanged. The technical resource group of the Union health ministry held a meeting soon after the release of WHO recommendations. It acknowledged the side-effects of stavudine but reached no consensus on phasing it out. Minutes of the meeting show that some members had argued that if all patients on stavudine are shifted to tenofovir, the expenses will nearly double.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">As per NACO&rsquo;s protocol, zidovudine should be given as the first preferred drug. If the patient developes complications like anaemia, stavudine is the option. Tenofovir is the last resort.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">But in practice stavudine is always the first choice of doctors, says Loon Gangte of non-profit Delhi Network of Positive People. &ldquo;In several instances, doctors change the treatment regime to zidovudine or tenofovir only after pressure from patient support groups,&rdquo; says Shivangi Rai, legal officer with Lawyers Collective. The lawyers group is fighting a public-interest litigation in the Supreme Court to make stavudine the last option in NACO&rsquo;s treatment protocol.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Doctors say they prefer stavudine and zidovudine because they are bound by the treatment protocol. A member of NACO&rsquo;s technical resource group, on requesting not to be named, says: &ldquo;We prefer stavudine as it is well tolerated and requires less monitoring. Besides, only five to seven per cent patients suffer from lipdystrophy and peripheral neuropathy.&rdquo; Despite repeated queries, NACO refused to divulge the number of patients on stavudine.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Side-effects caused by stavudine mostly goes unreported because NACO does not have a programme to keep vigil on the health complications, says Leena Menghaney, campaign coordinator (India), Medecins Sans Frontieres, an international non-profit that works on access to essential medicines.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Public health activists say it is not just about giving the right drug, but giving the quality of life. With stavudine-induced disfigurement, patients face a double stigma. Anuradha of NAZ Foundation that works with HIV-positive children, adds: &ldquo;Our children feel alienated in school due to their appearance. It lowers their self-esteem.&rdquo; Of 16 HIV-positive children at NAZ who get treatment, 14 are on stavudine; eight have developed lipodystrophy.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">When anti-HIV programme took off in India in 2004, stavudine was the only option. But now other safer and equally effective options are available, says Menghnany. But doctors often keep shuffling patients between stavudine and zidovudine, even though the patient develops side-effects to both. Patients with frequent regimen changes suffer from virological resistance and increased mortality. It is important to choose the safest treatment regime, she says, adding, tenofovir is the safest available option for adult patients. Studies show though tenofovir can cause renal complications, its risk of side-effects is six times less than that of stavudine.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">But tenofovir was not even listed in the tender NACO procured in November.</div><div style="text-align: justify"><img src="https://im4change.in/siteadmin/tinymce/uploaded/HIV AIDS.bmp" alt="HIV AIDS" width="389" height="132" /></div><div style="text-align: justify">Rai argues with both global and domestic aid, NACO has no dearth of funding. Bulk order brings down the cost. Studies show tenofovir is cost-effective; treatment cost to reduce further health complications is higher for other drugs (See table: How cost-effective). It has additional advantage, says Menghaney. One needs to take just a pill of tenofovir a day, which improves compliance with the treatment regime.&nbsp;</div><div style="text-align: justify"><br /></div>                                                           
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Stavudine disfigures, affects peripheral nervous system permanently





THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less..." />
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                                                <div>
                            <div style="text-align: justify"><br /></div><div style="text-align: justify"><em>Stavudine disfigures, affects peripheral nervous system permanently</em></div><div style="text-align: justify"><br /></div><div style="text-align: justify">THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less monitoring of patients, they say. NACO provides free treatment to HIV/AIDS patients in the country.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">In 2010, the WHO had revised its HIV/AIDS treatment protocol and recommended countries to phase out stavudine as the preferred first-line therapy due to its long-term, irreversible side-effects. The drug causes lipodystrophy, or irregular distribution of fat in the body, resulting in sunken cheeks and buffalo humps at the back and neck. It also damages peripheral nerves, causing numbness and burning pain in hands and feet. WHO had urged countries to move to less toxic alternatives such as zidovudine, tenofovir and abacavir. In line with its recommendations, Kenya, South Africa and a few other countries announced shifting from stavudine to tenofovir over the next five years. Developed countries, including EU nations and the US, have long been using stavudine as the last opted drug.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">India&rsquo;s HIV/AIDS treatment protocol remains unchanged. The technical resource group of the Union health ministry held a meeting soon after the release of WHO recommendations. It acknowledged the side-effects of stavudine but reached no consensus on phasing it out. Minutes of the meeting show that some members had argued that if all patients on stavudine are shifted to tenofovir, the expenses will nearly double.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">As per NACO&rsquo;s protocol, zidovudine should be given as the first preferred drug. If the patient developes complications like anaemia, stavudine is the option. Tenofovir is the last resort.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">But in practice stavudine is always the first choice of doctors, says Loon Gangte of non-profit Delhi Network of Positive People. &ldquo;In several instances, doctors change the treatment regime to zidovudine or tenofovir only after pressure from patient support groups,&rdquo; says Shivangi Rai, legal officer with Lawyers Collective. The lawyers group is fighting a public-interest litigation in the Supreme Court to make stavudine the last option in NACO&rsquo;s treatment protocol.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Doctors say they prefer stavudine and zidovudine because they are bound by the treatment protocol. A member of NACO&rsquo;s technical resource group, on requesting not to be named, says: &ldquo;We prefer stavudine as it is well tolerated and requires less monitoring. Besides, only five to seven per cent patients suffer from lipdystrophy and peripheral neuropathy.&rdquo; Despite repeated queries, NACO refused to divulge the number of patients on stavudine.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Side-effects caused by stavudine mostly goes unreported because NACO does not have a programme to keep vigil on the health complications, says Leena Menghaney, campaign coordinator (India), Medecins Sans Frontieres, an international non-profit that works on access to essential medicines.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Public health activists say it is not just about giving the right drug, but giving the quality of life. With stavudine-induced disfigurement, patients face a double stigma. Anuradha of NAZ Foundation that works with HIV-positive children, adds: &ldquo;Our children feel alienated in school due to their appearance. It lowers their self-esteem.&rdquo; Of 16 HIV-positive children at NAZ who get treatment, 14 are on stavudine; eight have developed lipodystrophy.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">When anti-HIV programme took off in India in 2004, stavudine was the only option. But now other safer and equally effective options are available, says Menghnany. But doctors often keep shuffling patients between stavudine and zidovudine, even though the patient develops side-effects to both. Patients with frequent regimen changes suffer from virological resistance and increased mortality. It is important to choose the safest treatment regime, she says, adding, tenofovir is the safest available option for adult patients. Studies show though tenofovir can cause renal complications, its risk of side-effects is six times less than that of stavudine.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">But tenofovir was not even listed in the tender NACO procured in November.</div><div style="text-align: justify"><img src="https://im4change.in/siteadmin/tinymce/uploaded/HIV AIDS.bmp" alt="HIV AIDS" width="389" height="132" /></div><div style="text-align: justify">Rai argues with both global and domestic aid, NACO has no dearth of funding. Bulk order brings down the cost. Studies show tenofovir is cost-effective; treatment cost to reduce further health complications is higher for other drugs (See table: How cost-effective). It has additional advantage, says Menghaney. One needs to take just a pill of tenofovir a day, which improves compliance with the treatment regime.&nbsp;</div><div style="text-align: justify"><br /></div>                                                           
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Home हिन्दी

AIDS agency orders cheap drug by Ankur Paliwal

Published on Jan 10, 2012   Modified on Jan 10, 2012

Stavudine disfigures, affects peripheral nervous system permanently THE National AIDS Control Organisation in November procured in bulk anti-HIV drug stavudine, which is being phased out worldwide. NACO officials unofficially cite funds crunch for depending on the low-cost drug. Stavudine requires less monitoring of patients, they say. NACO provides free treatment to HIV/AIDS patients in the country. In 2010, the WHO had revised its HIV/AIDS treatment protocol and recommended countries to phase out stavudine as the preferred first-line therapy due to its long-term, irreversible side-effects. The drug causes lipodystrophy, or irregular distribution of fat in the body, resulting in sunken cheeks and buffalo humps at the back and neck. It also damages peripheral nerves, causing numbness and burning pain in hands and feet. WHO had urged countries to move to less toxic alternatives such as zidovudine, tenofovir and abacavir. In line with its recommendations, Kenya, South Africa and a few other countries announced shifting from stavudine to tenofovir over the next five years. Developed countries, including EU nations and the US, have long been using stavudine as the last opted drug. India’s HIV/AIDS treatment protocol remains unchanged. The technical resource group of the Union health ministry held a meeting soon after the release of WHO recommendations. It acknowledged the side-effects of stavudine but reached no consensus on phasing it out. Minutes of the meeting show that some members had argued that if all patients on stavudine are shifted to tenofovir, the expenses will nearly double. As per NACO’s protocol, zidovudine should be given as the first preferred drug. If the patient developes complications like anaemia, stavudine is the option. Tenofovir is the last resort. But in practice stavudine is always the first choice of doctors, says Loon Gangte of non-profit Delhi Network of Positive People. “In several instances, doctors change the treatment regime to zidovudine or tenofovir only after pressure from patient support groups,” says Shivangi Rai, legal officer with Lawyers Collective. The lawyers group is fighting a public-interest litigation in the Supreme Court to make stavudine the last option in NACO’s treatment protocol. Doctors say they prefer stavudine and zidovudine because they are bound by the treatment protocol. A member of NACO’s technical resource group, on requesting not to be named, says: “We prefer stavudine as it is well tolerated and requires less monitoring. Besides, only five to seven per cent patients suffer from lipdystrophy and peripheral neuropathy.” Despite repeated queries, NACO refused to divulge the number of patients on stavudine. Side-effects caused by stavudine mostly goes unreported because NACO does not have a programme to keep vigil on the health complications, says Leena Menghaney, campaign coordinator (India), Medecins Sans Frontieres, an international non-profit that works on access to essential medicines. Public health activists say it is not just about giving the right drug, but giving the quality of life. With stavudine-induced disfigurement, patients face a double stigma. Anuradha of NAZ Foundation that works with HIV-positive children, adds: “Our children feel alienated in school due to their appearance. It lowers their self-esteem.” Of 16 HIV-positive children at NAZ who get treatment, 14 are on stavudine; eight have developed lipodystrophy. When anti-HIV programme took off in India in 2004, stavudine was the only option. But now other safer and equally effective options are available, says Menghnany. But doctors often keep shuffling patients between stavudine and zidovudine, even though the patient develops side-effects to both. Patients with frequent regimen changes suffer from virological resistance and increased mortality. It is important to choose the safest treatment regime, she says, adding, tenofovir is the safest available option for adult patients. Studies show though tenofovir can cause renal complications, its risk of side-effects is six times less than that of stavudine. But tenofovir was not even listed in the tender NACO procured in November. Rai argues with both global and domestic aid, NACO has no dearth of funding. Bulk order brings down the cost. Studies show tenofovir is cost-effective; treatment cost to reduce further health complications is higher for other drugs (See table: How cost-effective). It has additional advantage, says Menghaney. One needs to take just a pill of tenofovir a day, which improves compliance with the treatment regime.

Down to Earth, 15 January, 2012, http://www.downtoearth.org.in/content/aids-agency-orders-cheap-drug

Tagged with: medicines Health

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