
Hospital Bombing Deepens Bleak Situation For War-Weary South Sudanese
6 May 2025
'Every time this happens, people lose access to health services – and sometimes, to hope,' said Dr Humphrey Karamagi, the UN World Health Organization (WHO)'s Representative in South Sudan. ' Health is the last safety net. If it fails, everything else will also fall.'
The apparent airstrike on the hospital run by Médecins Sans Frontières (MSF) in Old Fangak in eastern Jonglei state, killed seven civilians and injured another 20, according to the UN humanitarian affairs coordination office (OCHA).
Healthcare not a target
The attack is the eighth time healthcare has been targeted since January 'with health workers killed, facilities and essential supplies looted or destroyed', the WHO official told journalists in Geneva.
'More attacks may lead to closing half the health facilities along the Nile,' he added.
Dr. Karamagi explained that humanitarian convoys and essential cold chain infrastructure had come under fire, at a time of escalating violence that has impacted civilians since South Sudan gained independence in 2011, descending shortly afterwards into civil war.
Since March, tensions have escalated in Upper Nile state, with deadly clashes between Government forces and armed groups. This has uprooted an estimated 80,000 people in three of the most affected counties, the WHO official said.
He added that clashes have also been reported in parts of Western Equatoria, Central Equatoria and Unity states, forcing communities – 'mostly women and children' – to flee into neighbouring countries, including 23,000 arrivals in Ethiopia.
Diseases spreading
Back in South Sudan, outbreaks of cholera, malaria, measles and mpox are spreading rapidly, prompting the UN health agency to deploy rapid response teams and coordinate with local partners where possible, amid access restrictions linked to the escalating violence.
'The alternative, if we do nothing, would be bleak,' the WHO official warned, pointing to cholera cases that may double in just six weeks and measles deaths that could increase by 40 per cent.
Cholera alone has infected more than 55,000 people since September, killing over 1,000, the UN health agency said.
'War crime' condemnation
In a related development, the UN Commission on Human Rights (OHCHR) in South Sudan condemned the bombing as a potential war crime.
'This was not a tragic accident,' said Yasmin Sooka, Chair of the Commission. 'It was a calculated, unlawful attack on a protected medical facility.'
MSF confirmed the hospital's complete destruction, including its pharmacy and emergency care units. Further aerial bombardments were also reported in New Fangak, raising fears that such attacks are part of a broader military campaign.
The airstrike followed public threats by South Sudanese military forces who demanded the return of seized boats and labelled multiple Nuer-majority counties, including Fangak, as 'hostile'.
'Designating entire communities as hostile is deeply irresponsible and may amount to collective punishment,' said Commissioner Barney Afako.
Plea for action
The UN Commission has urged immediate investigations into the bombing and warned that repeated violations threaten to derail South Sudan's fragile peace.
With high-level delegations from the African Union and IGAD now in the capital Juba, calls for renewed dialogue are growing louder. 'The path South Sudan is currently on is perilous,' Ms. Sooka warned. 'If attacks like these continue with impunity, the Peace Agreement risks becoming meaningless.'
In his final appeal, Dr Karamagi emphasised the cost of inaction: 'Help us make sure this doesn't become the moment health – and hope – finally give way.'

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Include Males Too In Addressing Human Papilloma Virus And Related Cancers
Press Release – CNS Human Papilloma Virus (HPV) is a common sexually transmitted infection. Since an effective HPV vaccine exists and HPV screening and treatment of pre-cancer lesions can save lives, no one should be suffering from any of the HPV related cancer or … Human Papilloma Virus (HPV) is a common sexually transmitted infection. Since an effective HPV vaccine exists and HPV screening and treatment of pre-cancer lesions can save lives, no one should be suffering from any of the HPV related cancer or had to die of it. According to the World Health Organization (WHO), HPV do not cause health concerns in most infected people (of all genders), but persistent HPV infection with some high-risk genotypes is common and can cause genital warts or cancer. For example, almost all cervical cancer, which is the 4th top cancers among women worldwide, is caused by HPV. HPV also causes cancers of vulva, vagina, mouth/throat (oropharyngeal), penis and anus. Despite cervical cancer being preventable and curable (if detected early and managed effectively), more than 660,000 women developed cervical cancer in 2022. Over 350,000 women died of cervical cancer in 2022. In 2019, HPV caused over 70,000 cancer cases in men too. HPV screening must be done with DNA test, not pap smear or VIA 'We have a large burden of cervical cancer in India – one woman dies every 8 minutes due to this preventable cancer. All women above the age of 30 years, must undergo cervical cancer screening with an HPV DNA molecular test (and not by pap smear or visual inspection with acetic acid – VIA),' said Dr Smita Joshi, a noted scientist who has made a significant contribution to advancing HPV vaccine and screening research and science-backed interventions in the past two decades. National Family Health Survey (NFHS) of India 2019-2021 shows that among women age 15-49, only 1.2% ever got a screening for cervical cancer in India. WHO Cervical Cancer Elimination Initiative (adopted in 2021) sets the goal of at least 70% of the eligible women to get screened. 'There is a large gap in HPV screening of eligible women in India,' points out Dr Joshi. Dr Joshi leads the Department of Preventive Oncology, Prayas (a non-profit). Dr Joshi has been a principal investigator for HPV vaccine and cervical cancer related research studies of WHO's IARC (International Agency for Research on Cancer) since 2009. She also serves as Programme Director at Jahangir Clinical Development Centre (JCDC) in Pune, India. Connect the dots: HPV, HIV and all genders Women living with HIV are at 6 times higher risk of HPV-related cervical cancer compared to those without HIV. HPV also infects men. For example, studies show that rates of HPV have shown to be alarmingly high among men who have sex with men. Mumbai-based microbiologist and researcher Dr Prapti Gilada-Toshinwal presented an important study at 10th Asia Pacific AIDS and Co-Infections Conference (APACC 2025) in Japan. This study was done to determine the prevalence of HPV anal infection among 105 men who have sex with men who were seeking care at Unison Medicare and Research Centre (a comprehensive infectious diseases centre) between August 2022 and December 2024. It is important to note that Unison Medicare and Research Centre has been serving around 10,000 people living with HIV since last 35 years. Around 80% study participants came from Mumbai and rest of them were from other cities of India except 3 who came from other countries. '70% of study participants were living with HIV,' said Dr Prapti Gilada. 'Overall, anal HPV infection rate was 62%.' She serves as CEO and consultant microbiologist at UniLabs Diagnostics. 'Some of them also had other sexually transmitted infections such as syphilis, chlamydia, or gonorrhoea.' 'In the study we offered DNA test for HPV to all eligible study participants (105 men who have sex with men) who were receiving medical care at our centre. Most common HPV high risk genotype was 16. Other common high-risk HPV genotypes found among study participants were 18 and 45,' said Dr Prapti Gilada. 'HPV positivity rates were higher in those study participants who were also living with HIV (68.5%) compared to those without HIV (48%),' said Dr Prapti Gilada, who is also an independent Director of Thyrocare. Global data shows that among men who have sex with men, HPV is higher among those who are living with HIV than those without it. She was speaking with CNS before 2nd Asia Pacific Conference on Point-of-Care Diagnostics for Infectious Diseases (POC 2025) and 13th International AIDS Society Conference on HIV Science (IAS 2025) open. Dr Prapti Gilada calls for raising awareness, health and treatment literacy among the masses so that eligible boys and men and girls and women can access HPV vaccination, HPV screening and management of pre-cancerous lesions and other health issues. She also hopes governments will make HPV vaccination available to all those eligible of all genders, as well as screening and appropriate management. Dr Prapti Gilada cites a study published in The Lancet in 2023 which showed that almost 1 in 3 men over the age of 15 were infected with at least one genital HPV genotype, and 1 in 5 men were infected with one or more of high risk (or oncogenic) HPV genotypes. It is high time all eligible boys and men too are included in HPV responses globally Agrees Vijay Nair who is the Chairperson of Udaan Trust and a prominent community rights activist from India: 'With no HPV vaccination and screening facilities for males, there are people who have even probably died with undiagnosed HPV-related anal cancers or other health issues. Some may be getting services for piles or anal fissures or fistula as there is hardly any HPV screening facilities for anal HPV. We need to screen high-risk men for HPV and HPV related health conditions including pre-cancerous lesions or anal cancers. Also, we need to include males too for vaccination against HPV.' Vijay was speaking at the India's National Dialogue and Stakeholder Consultation held last month in preventing cancers and addressing ageing among people living with HIV. It was organised by National Coalition of People Living with HIV in India (NCPI Plus). Colposcopy and anoscopy: Do we have enough facilities? Those with persistent HPV infection may need a specialised follow up medical examination with colposcopy (medical experts examine with an equipment for any HPV-related changes or abnormalities in vulva, vagina or cervix of women) or anoscopy (medical experts examine with an equipment for any HPV-related changes or abnormalities in anus or rectum). If any changes or abnormalities, further appropriate medical treatment is required. 'We need more medical centres for anoscopy,' said Dr Prapti Gilada whose study participants may require further follow up. Her centre is continuing to follow up with all the study participants, one of whom has become HPV negative during the study. Dr Smita Joshi is a widely recognised colposcopy trainer too. 'We have screened over 40,000 women for HPV and cervical cancer and managed them appropriately as per the WHO latest guidelines.' Her centre at Prayas is a recognised colposcopy centre too which has trained several medical professionals including gynaecologists from within India and other countries too. She appeals for financial resources to scale up trainings of medical professionals in India and other countries which would go a long way in strengthening capacities and competencies towards addressing HPV and related cancers. Addressing HPV lacks ambition Governments have promised to eliminate cervical cancer by end of this century. In order to be on track towards cervical cancer elimination, all countries must reach and maintain an incidence rate of below 4 per 100,000 women. Achieving that goal rests on 3 key pillars and their corresponding targets to be achieved by 2030 so that countries are on track towards eliminating cervical cancer by end of the century. – vaccination: 90% of all eligible young people must be fully vaccinated with the HPV vaccine by the age of 15 – screening: 70% of women should be screened using a high-performance test by the age of 35, and again by the age of 45 – treatment: 90% of women with pre-cancer treated and 90% of women with invasive cancer managed. Cervical cancer is preventable as vaccines exist since almost two decades now. HPV screening and DNA tests exist. Medical management of pre-cancerous lesions can save lives and avert cancers. Is not a goal to eliminate cervical cancer by turn of this century, lacking ambition? India's first indigenously validated Truenat HPV-HR Plus test in April 2025 Indian government announced in April 2025, India's first indigenously developed and point-of-care HPV DNA molecular test is Truenat HPV-HR Plus test that screens people for 8 high-risk genotypes (16, 18, 31, 33, 35, 45, 52 and 58). These 8 high-risk HPV genotypes cause over 96% of cervical cancers globally. Truenat HPV-HR Plus is developed by Indian company (Molbio Diagnostics). Its independent multi-centric validation was done by Government of India's Department of Biotechnology, Biotechnology Industry Research Assistance Council (BIRAC) and Grand Challenges India. This independent validation of Truenat HPV-HR Plus was conducted under the study 'Validating Indigenous Human Papilloma Virus (HPV) Tests for Cervical Cancer Screening in India.' The study involved leading Indian government's research institutes, including All India Institute of Medical Sciences (AIIMS) Delhi, ICMR National Institute for Cancer Prevention and Research (NICPR) Noida, and ICMR National Institute for Research in Reproductive and Child Health (NIRRCH) Mumbai, in collaboration with WHO's International Agency for Research on Cancer (IARC). However, Truenat HPV-HR DNA molecular test has been around for over 2 years now to screen people for 4 high-risk genotypes. Follow the science: Vaccinate and screen all eligible people for HPV and related cancers Dr Smita Joshi led several researchers in her distinguished career over two decades. She was part of a multi-centric study of WHO's IARC on HPV vaccine which was initiated in 2009 onwards. This study was to evaluate efficacy of HPV vaccine (2 doses vs 3 doses at 0, 2 and 6 months). However, due to government's order to stop HPV vaccination in studies (owing to adverse outcomes in a PATH study), Dr Joshi's study also had to stop vaccination abruptly in April 2009. 'Because of that suspension of HPV vaccinatio, instead of two versus three doses, this study resulted in a cohort of girls that had received only a single dose, two doses (at 0 and 2 months), two doses (at 0 and 6 months) and three doses (at 0, 2 and 6 months). So, the long-term follow-up of these vaccinated girls is still being carried out since then,' said Dr Joshi. 'We have now completed 15 years of the study and of immunogenicity data.' Dr Joshi's study majorly impacted and contributed to informing vaccine dosage in many countries as well as to WHO's recommendation of single dose HP vaccination in the young girls. She was also part of the HPV vaccine study (for India's indigenously developed HPV vaccine Ceravac). She wonders when HPV vaccine would become a part of Indian government's public vaccination programme. Some Indian states (like Sikkim, Delhi, Punjab) had introduced HPV vaccination using a foreign-made vaccine) but latest information on status of these programmes is not with us. Dr Prapti Gilada and Udaan's Vijay Nair too call for including HPV vaccination for those eligible from all genders in the government's programme at the earliest – as well as HPV screening and management of all related health conditions especially pre-cancerous lesions and cancers. Dr Smita Joshi adds that when government of India includes indigenously developed HPV vaccine in its programme, then 'one good thing about Ceravac of Serum Institute of India is that it is also approved for boys. Appeal to world leaders who will meet at UNHLM on NCDs Next High Level Meeting on Non-Communicable Diseases (UNHLM on NCDs) will happen in September 2025 at the United Nations General Assembly. Although HPV is an infection, yet it causes one of the top cancers worldwide. We appeal to world leaders to commit to scale up HPV vaccination for all those eligible (regardless of genders), and screen all eligible people (regardless of gender) for HPV and related pre-cancerous and cancerous conditions. Developing vaccine or point-of-care diagnostics is not enough but deploying them at point-of-need in the Global South is critical pathway towards increasing access to lifesaving services and improving HPV-related responses on the ground. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here


Scoop
21 hours ago
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Include Males Too In Addressing Human Papilloma Virus And Related Cancers
Human Papilloma Virus (HPV) is a common sexually transmitted infection. Since an effective HPV vaccine exists and HPV screening and treatment of pre-cancer lesions can save lives, no one should be suffering from any of the HPV related cancer or had to die of it. According to the World Health Organization (WHO), HPV do not cause health concerns in most infected people (of all genders), but persistent HPV infection with some high-risk genotypes is common and can cause genital warts or cancer. For example, almost all cervical cancer, which is the 4th top cancers among women worldwide, is caused by HPV. HPV also causes cancers of vulva, vagina, mouth/throat (oropharyngeal), penis and anus. Despite cervical cancer being preventable and curable (if detected early and managed effectively), more than 660,000 women developed cervical cancer in 2022. Over 350,000 women died of cervical cancer in 2022. In 2019, HPV caused over 70,000 cancer cases in men too. HPV screening must be done with DNA test, not pap smear or VIA 'We have a large burden of cervical cancer in India - one woman dies every 8 minutes due to this preventable cancer. All women above the age of 30 years, must undergo cervical cancer screening with an HPV DNA molecular test (and not by pap smear or visual inspection with acetic acid – VIA),' said Dr Smita Joshi, a noted scientist who has made a significant contribution to advancing HPV vaccine and screening research and science-backed interventions in the past two decades. National Family Health Survey (NFHS) of India 2019-2021 shows that among women age 15-49, only 1.2% ever got a screening for cervical cancer in India. WHO Cervical Cancer Elimination Initiative (adopted in 2021) sets the goal of at least 70% of the eligible women to get screened. 'There is a large gap in HPV screening of eligible women in India,' points out Dr Joshi. Dr Joshi leads the Department of Preventive Oncology, Prayas (a non-profit). Dr Joshi has been a principal investigator for HPV vaccine and cervical cancer related research studies of WHO's IARC (International Agency for Research on Cancer) since 2009. She also serves as Programme Director at Jahangir Clinical Development Centre (JCDC) in Pune, India. Connect the dots: HPV, HIV and all genders Women living with HIV are at 6 times higher risk of HPV-related cervical cancer compared to those without HIV. HPV also infects men. For example, studies show that rates of HPV have shown to be alarmingly high among men who have sex with men. Mumbai-based microbiologist and researcher Dr Prapti Gilada-Toshinwal presented an important study at 10th Asia Pacific AIDS and Co-Infections Conference (APACC 2025) in Japan. This study was done to determine the prevalence of HPV anal infection among 105 men who have sex with men who were seeking care at Unison Medicare and Research Centre (a comprehensive infectious diseases centre) between August 2022 and December 2024. It is important to note that Unison Medicare and Research Centre has been serving around 10,000 people living with HIV since last 35 years. Around 80% study participants came from Mumbai and rest of them were from other cities of India except 3 who came from other countries. '70% of study participants were living with HIV,' said Dr Prapti Gilada. 'Overall, anal HPV infection rate was 62%.' She serves as CEO and consultant microbiologist at UniLabs Diagnostics. 'Some of them also had other sexually transmitted infections such as syphilis, chlamydia, or gonorrhoea.' 'In the study we offered DNA test for HPV to all eligible study participants (105 men who have sex with men) who were receiving medical care at our centre. Most common HPV high risk genotype was 16. Other common high-risk HPV genotypes found among study participants were 18 and 45,' said Dr Prapti Gilada. 'HPV positivity rates were higher in those study participants who were also living with HIV (68.5%) compared to those without HIV (48%),' said Dr Prapti Gilada, who is also an independent Director of Thyrocare. Global data shows that among men who have sex with men, HPV is higher among those who are living with HIV than those without it. She was speaking with CNS before 2nd Asia Pacific Conference on Point-of-Care Diagnostics for Infectious Diseases (POC 2025) and 13th International AIDS Society Conference on HIV Science (IAS 2025) open. Dr Prapti Gilada calls for raising awareness, health and treatment literacy among the masses so that eligible boys and men and girls and women can access HPV vaccination, HPV screening and management of pre-cancerous lesions and other health issues. She also hopes governments will make HPV vaccination available to all those eligible of all genders, as well as screening and appropriate management. Dr Prapti Gilada cites a study published in The Lancet in 2023 which showed that almost 1 in 3 men over the age of 15 were infected with at least one genital HPV genotype, and 1 in 5 men were infected with one or more of high risk (or oncogenic) HPV genotypes. It is high time all eligible boys and men too are included in HPV responses globally Agrees Vijay Nair who is the Chairperson of Udaan Trust and a prominent community rights activist from India: 'With no HPV vaccination and screening facilities for males, there are people who have even probably died with undiagnosed HPV-related anal cancers or other health issues. Some may be getting services for piles or anal fissures or fistula as there is hardly any HPV screening facilities for anal HPV. We need to screen high-risk men for HPV and HPV related health conditions including pre-cancerous lesions or anal cancers. Also, we need to include males too for vaccination against HPV." Vijay was speaking at the India's National Dialogue and Stakeholder Consultation held last month in preventing cancers and addressing ageing among people living with HIV. It was organised by National Coalition of People Living with HIV in India (NCPI Plus). Colposcopy and anoscopy: Do we have enough facilities? Those with persistent HPV infection may need a specialised follow up medical examination with colposcopy (medical experts examine with an equipment for any HPV-related changes or abnormalities in vulva, vagina or cervix of women) or anoscopy (medical experts examine with an equipment for any HPV-related changes or abnormalities in anus or rectum). If any changes or abnormalities, further appropriate medical treatment is required. 'We need more medical centres for anoscopy,' said Dr Prapti Gilada whose study participants may require further follow up. Her centre is continuing to follow up with all the study participants, one of whom has become HPV negative during the study. Dr Smita Joshi is a widely recognised colposcopy trainer too. 'We have screened over 40,000 women for HPV and cervical cancer and managed them appropriately as per the WHO latest guidelines.' Her centre at Prayas is a recognised colposcopy centre too which has trained several medical professionals including gynaecologists from within India and other countries too. She appeals for financial resources to scale up trainings of medical professionals in India and other countries which would go a long way in strengthening capacities and competencies towards addressing HPV and related cancers. Addressing HPV lacks ambition Governments have promised to eliminate cervical cancer by end of this century. In order to be on track towards cervical cancer elimination, all countries must reach and maintain an incidence rate of below 4 per 100,000 women. Achieving that goal rests on 3 key pillars and their corresponding targets to be achieved by 2030 so that countries are on track towards eliminating cervical cancer by end of the century. - vaccination: 90% of all eligible young people must be fully vaccinated with the HPV vaccine by the age of 15 - screening: 70% of women should be screened using a high-performance test by the age of 35, and again by the age of 45 - treatment: 90% of women with pre-cancer treated and 90% of women with invasive cancer managed. Cervical cancer is preventable as vaccines exist since almost two decades now. HPV screening and DNA tests exist. Medical management of pre-cancerous lesions can save lives and avert cancers. Is not a goal to eliminate cervical cancer by turn of this century, lacking ambition? India's first indigenously validated Truenat HPV-HR Plus test in April 2025 Indian government announced in April 2025, India's first indigenously developed and point-of-care HPV DNA molecular test is Truenat HPV-HR Plus test that screens people for 8 high-risk genotypes (16, 18, 31, 33, 35, 45, 52 and 58). These 8 high-risk HPV genotypes cause over 96% of cervical cancers globally. Truenat HPV-HR Plus is developed by Indian company (Molbio Diagnostics). Its independent multi-centric validation was done by Government of India's Department of Biotechnology, Biotechnology Industry Research Assistance Council (BIRAC) and Grand Challenges India. This independent validation of Truenat HPV-HR Plus was conducted under the study 'Validating Indigenous Human Papilloma Virus (HPV) Tests for Cervical Cancer Screening in India.' The study involved leading Indian government's research institutes, including All India Institute of Medical Sciences (AIIMS) Delhi, ICMR National Institute for Cancer Prevention and Research (NICPR) Noida, and ICMR National Institute for Research in Reproductive and Child Health (NIRRCH) Mumbai, in collaboration with WHO's International Agency for Research on Cancer (IARC). However, Truenat HPV-HR DNA molecular test has been around for over 2 years now to screen people for 4 high-risk genotypes. Follow the science: Vaccinate and screen all eligible people for HPV and related cancers Dr Smita Joshi led several researchers in her distinguished career over two decades. She was part of a multi-centric study of WHO's IARC on HPV vaccine which was initiated in 2009 onwards. This study was to evaluate efficacy of HPV vaccine (2 doses vs 3 doses at 0, 2 and 6 months). However, due to government's order to stop HPV vaccination in studies (owing to adverse outcomes in a PATH study), Dr Joshi's study also had to stop vaccination abruptly in April 2009. "Because of that suspension of HPV vaccinatio, instead of two versus three doses, this study resulted in a cohort of girls that had received only a single dose, two doses (at 0 and 2 months), two doses (at 0 and 6 months) and three doses (at 0, 2 and 6 months). So, the long-term follow-up of these vaccinated girls is still being carried out since then," said Dr Joshi. "We have now completed 15 years of the study and of immunogenicity data." Dr Joshi's study majorly impacted and contributed to informing vaccine dosage in many countries as well as to WHO's recommendation of single dose HP vaccination in the young girls. She was also part of the HPV vaccine study (for India's indigenously developed HPV vaccine Ceravac). She wonders when HPV vaccine would become a part of Indian government's public vaccination programme. Some Indian states (like Sikkim, Delhi, Punjab) had introduced HPV vaccination using a foreign-made vaccine) but latest information on status of these programmes is not with us. Dr Prapti Gilada and Udaan's Vijay Nair too call for including HPV vaccination for those eligible from all genders in the government's programme at the earliest - as well as HPV screening and management of all related health conditions especially pre-cancerous lesions and cancers. Dr Smita Joshi adds that when government of India includes indigenously developed HPV vaccine in its programme, then "one good thing about Ceravac of Serum Institute of India is that it is also approved for boys. Appeal to world leaders who will meet at UNHLM on NCDs Next High Level Meeting on Non-Communicable Diseases (UNHLM on NCDs) will happen in September 2025 at the United Nations General Assembly. Although HPV is an infection, yet it causes one of the top cancers worldwide. We appeal to world leaders to commit to scale up HPV vaccination for all those eligible (regardless of genders), and screen all eligible people (regardless of gender) for HPV and related pre-cancerous and cancerous conditions. Developing vaccine or point-of-care diagnostics is not enough but deploying them at point-of-need in the Global South is critical pathway towards increasing access to lifesaving services and improving HPV-related responses on the ground. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here


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6 days ago
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We Can Do Better So That All People With HIV Live Healthy Normal Lifespans
Article – CNS People living with HIV must take care of ones mental health and wellbeing, adhere to HIV treatment to stay undetectable and take care of life-style related diseases and ageing-related issues. Love oneself. Stay healthy. And have a health-seeking behaviour to ensure all of us get to age with rights and remain disease-free. People living with HIV must take care of one's mental health and wellbeing, adhere to HIV treatment to stay undetectable (because when undetectable equals untransmittable, then they remain healthy and live normal and disease-free lifespans as well as ensure there is zero risk of any further HIV transmission), and take care of life-style related diseases and ageing-related issues, said Daxa Patel, co-founder of National Coalition of People living with HIV in India (NCPI Plus) who has played a key role in founding of Gujarat State Network of People living with HIV too. Everyone has a right to age with rights and human dignity. Never-ever missed a dose since 2007 onwards Daxa was diagnosed with HIV in 1998. Indian government's free rollout of lifesaving antiretroviral therapy began in 2004. But her lifesaving HIV treatment began 9 years later (in 2007 onwards), as per then-eligibility criteria of the WHO and Indian government. Recognising the importance of treatment and health literacy and treatment adherence, she has never-ever missed her dose since then. Daxa advises simple ways like setting up daily mobile reminders to take every dose correctly and at the right time. Last month, Daxa had recently led the organising of a national dialogue and stakeholder consultation in India's national capital Delhi along with her colleagues like Pooja Mishra (Secretary NCPI Plus) and Manoj Pardeshi (co-founder NCPI Plus and leader of a successful social enterprise Taal+ Pharmacy) and other members of NCPI Plus. Alongside this meeting, almost 30 eligible women with HIV were also screened for breast cancer onsite (using a point-of-care thermal screening tool of Niramai Health Analytix). NCPI Plus members from across India learnt a lot from experts on human papilloma virus or HPV (a virus which causes around 95% of cervical cancers along with other health issues in all genders), India's first indigenously developed and validated molecular diagnostics for HPV (Truenat HPV-HR Plus developed by Molbio Diagnostics – announced by the Indian government in April 2025), and on ensuring how people with HIV age healthily and with rights. Daxa was speaking at a special event to mark HIV Long-Term Survivors' Awareness Day 2025 and ahead of 10th Asia Pacific AIDS and Co-Infections Conference (APACC 2025), 2nd Asia Pacific Conference on Point-of-Care Diagnostics for Infectious Diseases (POC 2025) and 13th International AIDS Society Conference on HIV Science (IAS 2025). Eliminate delays in rolling out scientifically approved and validated health tools According to WHO: 'People living with HIV who have an undetectable viral load using any WHO-approved test and continue taking medication as prescribed, have zero risk of transmitting HIV to their sexual partner(s).' Agrees Dr Gilada: 'Science has proven that if people with HIV are on lifesaving antiretroviral therapy and remain virally suppressed, then there is zero risk of any further transmission of HIV from them to anyone else. This is referred to as #UequalsU or undetectable equals untransmittable.' But, in 2023, over 1.3 million people were newly diagnosed with HIV worldwide – despite the science-backed tools to prevent HIV transmission. We can do better to save lives, says Dr Gilada. We need to bridge the deadly divide between 'what we know works' and 'what we do.' Dr Ishwar Gilada is part of the International AIDS Society (IAS) Governing Council, serves as President-Emeritus of AIDS Society of India (ASI – India's network of medical doctors and scientists of HIV and co-infections and co-morbidities), and CEO of Unison Medicare and Research Centre (UMRC), India. He is the longest serving HIV medical expert in India who had established India's first HIV clinic in government-run JJ Hospital when first HIV case got confirmed in the country. Government of India's National AIDS Control Programme began in 1992, seven years after a civil society group (People's Health Organisation – PHO) was consistently raising HIV awareness. There was a 9-years delay in rolling out government-run programme to prevent HIV transmission from mother to the child in 2001 despite PHO-Wadia safe motherhood model had demonstrated evidence and impact since 1992. Medicines like zidovudine was first used in rich nations over 30 years ago to reduce HIV risk of the unborn child of HIV positive parent(s) – and PHO-Wadia model had rolled these out back then in India too (though government's rollout took another 9 years to do so). Today we have far more effective treatment regimens available to ensure children are born free of HIV – and both mother and the child live healthy and normal lives. Likewise for the rollout of lifesaving antiretroviral therapy: In private sector it began 9 years before the government's programme in India (from 7 April 2004 onwards). Rollout of Dolutegravir – one of the most promising antiretroviral medicines – began 3-4 years later in government-run programme (2020) than private sector in the country (2017). Dr Gilada says we have a long journey ahead to pay adequate attention to quality of life too while we test and treat, care and support for people with HIV. He also points out that new HIV prevention methods that are validated and approved years back have not been rolled out in the country. For example, Pre-Exposure Prophylaxis (PrEP) is a HIV medicine that is for people who are HIV negative to reduce their risk of getting infected with the virus. PrEP is not part of India's HIV programme but available on online shopping websites. Likewise, HIV self-test is not yet rolled out as part of government's programme. HIV stigma has reduced but still lurks HIV stigma has reduced considerably over the last 4 decades but still lurks, says Daxa. 'Over the decades, life expectancy of people with HIV has increased due to improved efficacy of the treatment. CDC estimates that around half of all people with HIV are older than 50 years now. By 2030, 70% of all those with HIV would be over 50. With ageing comes new challenges (HIV-associated and non-HIV associated too),' said Dr Gilada. 'Sometimes I believe that people with HIV live better than non-HIV because they are always constantly under health supervision, monitoring and proactively seeking healthcare services which people who do not have HIV may not be getting.' Dr Gilada's Unison Medicare and Research Centre in Mumbai has several people living with HIV under care for over three decades. 'So, in a way we have provided paediatric to geriatric care for those with HIV.' Dr Gilada says that HIV stigma still exists but when he looks at socio-economic background of his patients under care, he often finds that those who are more educated and privileged are more likely to stigmatise and discriminate. 'We need to have a non-judgmental approach in all healthcare settings,' said Dr Gilada. Daxa shared that almost 23 years back, she was asked a whooping INR 16,000 to for pregnancy and child-birth related healthcare services. Dr Gilada calls upon all healthcare professionals including medical community to not charge extra for providing medical care to those with HIV. 'When #UequalsU and person, then where is the risk of HIV transmission?' Dr Gilada asks medical fraternity to follow the science and evidence and stop discriminating against those with HIV. Dr Gilada asks medical fraternity to think that those people who are not aware of their HIV status and seeking surgery, could be in the 'window period' or have had indulged in high HIV risk behaviours couple of days before too – so, best is to follow infection prevention and control measures universally. Dr Gilada appeals to surgeons, obstetricians and gynaecologists and other medical professionals, to not attend to people with HIV at the very last. 'Why discriminate?' He calls upon HIV community to leverage upon HIV/AIDS Act, 2017 and help end all forms of HIV related stigma and discrimination. 'But there is not a single case which has been filed under this law since 2017,' said Dr Gilada who had earlier mobilised several associations in the last 30 years to demand such a law. Dr Gilada cites a Mumbai High Court ruling according to which people living with HIV do not even have to disclose their identity (to maintain confidentiality) while seeking legal recourses for justice. We can do better! Managing HIV co-infections and co-morbidities is vital Dr Gilada reminds that along with lifesaving and effective antiretroviral therapy, healthcare workers need to regularly screen people with HIV for a range of co-infections and co-morbidities. Before beginning treatment for any other illness, drug to drug interaction needs to be considered for example. People with HIV are at a higher risk of some non-communicable diseases, such as, cardiovascular diseases, cancers, diabetes and related complications, chronic respiratory diseases, mental health issues, and others. For example, Dr Gilada shared that risk of impaired glucose and insulin metabolism is double among those with HIV compared to those without the virus. TB, despite being preventable and curable, continues to be the biggest cause of deaths for people with HIV. 'No one needs to die from TB or HIV because we have science-based tools and approaches to avert these untimely deaths,' said Dr Gilada. Dr Gilada and Daxa both advocate for people with HIV to go for adult vaccinations to reduce the risk of or protect themselves from vaccine-preventable diseases. Dr Gilada points to several other concerns that must be considered while caring for people with HIV – and make all efforts to effectively address them in evidence-based and people-centred manner. For example, substance use (tobacco, alcohol, etc), genetics, menopause for women, hypertension, obesity, physical inactivity, poor engagement in healthcare, poverty, among others. Find your inner light: Purposeful and peaceful living is key Daxa Patel shares that we all need to care for our mental wellbeing and try to remain stress-free. Engaging with purposeful and spirited work to help others with HIV since 2002 onwards has helped her remain busy and meaningfully involved. 'It saved my life,' she said. We need to keep ourselves healthy and ensure that we do not let outside stigma and discrimination effect our sensibilities and wellbeing in any way. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here