Interview with Dr. N.M. Samuel
“We cannot let people die as they wait for ARVs”
Interview with Dr. .N.M Samuel, department of experimental medicine and AIDS research, MGR Medical University, Chennai, India.
He likes to be called `no money` Samuel. Considering his longstanding services to the poor and needy, perhaps this is the best description of Dr N.M. Samuel, from the Department of Experimental Medicine and AIDS Research, in MGR University, Chennai, India.
Dr Samuel, who was recently a guest of honour at the international conference on community care and support for people living with HIV/AIDS in Mumbai, India (7-9 December 2004), is an advocate of scaling up comprehensive care approaches, such as nutritional support, for people living with HIV.
He is also a strong proponent of women being given life-saving antiretroviral (ARV) drugs before men, because families need to be saved, not just individuals. Dr Samuel told AIDS-Care-Watch that India must change its HIV care policy to include additional non- ARV options if more lives are to be saved.
***
ACW: Do you think that India should accept the World Health Organisation (WHO) view that numbers treated are not that important, but that health services must be scaled up before making targeted HIV/AIDS interventions?
A: There cannot be a perfect solution. We have to get on with interventions with or without scaling [up of] health services as we are looking at loss of lives. My own experience has shown that we cannot wait. Three years have passed since I had asked for antiretroviral (ARV) drugs for the affected in the village in which I was working. During this waiting period we have lost lives. Our objective is to save lives so we should not wait for the community to be mobilised or high technology equipment before making interventions. ARVs are vital but it is not in our hands. If we can ensure what is in our hands like basic amenities, a good laboratory where basic tests can be conducted, good doctors and counsellors and, most importantly, good nutrition, then lives can be saved.
ACW: Is there a need for India to change its HIV care strategy?
A: One basic change that India needs to incorporate is to change their current policy to first distribute ARV drugs [only] to the ‘high HIV prevalence states’. It is wrong to differentiate. It is against the human rights of all those living in other states where HIV/AIDS may appear to be less and termed by government as low or medium prevalence states. This is leading to migration from these states to states where antiretroviral therapy is available.
ACW: Currently, access to ARVs is limited, how can it be more equitably distributed?
A:First, the government must not overlook low prevalence states. It wouldn’t want these low prevalence states to become high prevalence states because of sheer negligence. In the absence of ARVs, prevention, care, treatment and awareness programmes must be prioritised. In fact, they can chalk out such a programme for a group of 5,000 persons in these states. Once it becomes sustainable, this can be used as a model for high prevalence states.
ACW: Do you support the underlying objective to prioritise non-ARV care options to protect people’s right to life and health?
A: Certainly, I support it. We cannot let people die as they wait for ARVs. We need to look at alternatives because ARV drugs will not reach everyone. Non-ARV care and support has to be scaled up. I believe that prevention efforts can be improved by increasing care services. Food is another important intervention. It is like medicine. Even giving them the information about the kind of food that can improve their health goes a long way. For example, drumsticks, the vegetable that is eaten by nearly all Indians, is not only readily available and cheap, but more importantly, it is nutritious. In addition, traditional and community-oriented interventions like grain and rice banks should be boosted.Personally, I don’t believe in alternative medicines, as they have not scientifically proven to have any influence on HIV/AIDS. However, I do believe that practices like Reiki, pranik healing and faith-based healing do play a role in improving the quality of life.
ACW: The number of affected and infected Indian women appears to be rising alarmingly. How can the gender aspect of the HIV epidemic be addressed more effectively considering women often cannot negotiate safe sex?
A: There has to be a change in policy. Our HIV/AIDS programmes have to be focussed on women. Women and children must be given ARVs first because families have to be saved not just individuals. Just like the government is prioritising high prevalence states, women and adolescent girls must also be given equal priority as they fall in the same high risk category. Women have to be empowered so they can access prevention and treatment services. A study that we did in Nammakal village in the south Indian state of Karnataka, showed that women knew that they were at risk since most of the men were truck drivers. They wanted some means of protection but could not ask their men to use condoms. In addition, there were also discordant couples where the wife was positive and his husband negative. So, empowerment cannot be the only way. There must be a lady doctor at the health clinics so those women can talk about their problems and seek treatment and care. All strategies must have a human face. Only then can we give our people the dignity they deserve.
AIDS-Care-Watch
info@aidscarewatch.org
This interview was conducted by ACW at the international conference on community care and support for people living with HIV/AIDS in Mumbai, India, December 2004.
Interview with Dr. .N.M Samuel, department of experimental medicine and AIDS research, MGR Medical University, Chennai, India.
He likes to be called `no money` Samuel. Considering his longstanding services to the poor and needy, perhaps this is the best description of Dr N.M. Samuel, from the Department of Experimental Medicine and AIDS Research, in MGR University, Chennai, India.
Dr Samuel, who was recently a guest of honour at the international conference on community care and support for people living with HIV/AIDS in Mumbai, India (7-9 December 2004), is an advocate of scaling up comprehensive care approaches, such as nutritional support, for people living with HIV.
He is also a strong proponent of women being given life-saving antiretroviral (ARV) drugs before men, because families need to be saved, not just individuals. Dr Samuel told AIDS-Care-Watch that India must change its HIV care policy to include additional non- ARV options if more lives are to be saved.
***
ACW: Do you think that India should accept the World Health Organisation (WHO) view that numbers treated are not that important, but that health services must be scaled up before making targeted HIV/AIDS interventions?
A: There cannot be a perfect solution. We have to get on with interventions with or without scaling [up of] health services as we are looking at loss of lives. My own experience has shown that we cannot wait. Three years have passed since I had asked for antiretroviral (ARV) drugs for the affected in the village in which I was working. During this waiting period we have lost lives. Our objective is to save lives so we should not wait for the community to be mobilised or high technology equipment before making interventions. ARVs are vital but it is not in our hands. If we can ensure what is in our hands like basic amenities, a good laboratory where basic tests can be conducted, good doctors and counsellors and, most importantly, good nutrition, then lives can be saved.
ACW: Is there a need for India to change its HIV care strategy?
A: One basic change that India needs to incorporate is to change their current policy to first distribute ARV drugs [only] to the ‘high HIV prevalence states’. It is wrong to differentiate. It is against the human rights of all those living in other states where HIV/AIDS may appear to be less and termed by government as low or medium prevalence states. This is leading to migration from these states to states where antiretroviral therapy is available.
ACW: Currently, access to ARVs is limited, how can it be more equitably distributed?
A:First, the government must not overlook low prevalence states. It wouldn’t want these low prevalence states to become high prevalence states because of sheer negligence. In the absence of ARVs, prevention, care, treatment and awareness programmes must be prioritised. In fact, they can chalk out such a programme for a group of 5,000 persons in these states. Once it becomes sustainable, this can be used as a model for high prevalence states.
ACW: Do you support the underlying objective to prioritise non-ARV care options to protect people’s right to life and health?
A: Certainly, I support it. We cannot let people die as they wait for ARVs. We need to look at alternatives because ARV drugs will not reach everyone. Non-ARV care and support has to be scaled up. I believe that prevention efforts can be improved by increasing care services. Food is another important intervention. It is like medicine. Even giving them the information about the kind of food that can improve their health goes a long way. For example, drumsticks, the vegetable that is eaten by nearly all Indians, is not only readily available and cheap, but more importantly, it is nutritious. In addition, traditional and community-oriented interventions like grain and rice banks should be boosted.Personally, I don’t believe in alternative medicines, as they have not scientifically proven to have any influence on HIV/AIDS. However, I do believe that practices like Reiki, pranik healing and faith-based healing do play a role in improving the quality of life.
ACW: The number of affected and infected Indian women appears to be rising alarmingly. How can the gender aspect of the HIV epidemic be addressed more effectively considering women often cannot negotiate safe sex?
A: There has to be a change in policy. Our HIV/AIDS programmes have to be focussed on women. Women and children must be given ARVs first because families have to be saved not just individuals. Just like the government is prioritising high prevalence states, women and adolescent girls must also be given equal priority as they fall in the same high risk category. Women have to be empowered so they can access prevention and treatment services. A study that we did in Nammakal village in the south Indian state of Karnataka, showed that women knew that they were at risk since most of the men were truck drivers. They wanted some means of protection but could not ask their men to use condoms. In addition, there were also discordant couples where the wife was positive and his husband negative. So, empowerment cannot be the only way. There must be a lady doctor at the health clinics so those women can talk about their problems and seek treatment and care. All strategies must have a human face. Only then can we give our people the dignity they deserve.
AIDS-Care-Watch
info@aidscarewatch.org
This interview was conducted by ACW at the international conference on community care and support for people living with HIV/AIDS in Mumbai, India, December 2004.
posted by AIDS-Care-Watch at 10:38 am
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