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Unite against AIDS

On the occasion of World Aids Day, we speak to Dr Ram Shukla who points out the need for people to come together to combat this deadly disease

A specialist in infectious diseases, Dr Ram Shukla who has served in India and Yemen before coming to the UAE emphasises the need for people who are infected with the HIV virus to seek treatment — like for any other disease — because this would not only prolong their life but also help them remain a productive member of society.

“My mantra for Aids or any sexual disease is, if you have a problem, the first step to solve the problem is to accept that the problem exists. Once a person starts hiding HIV out of shame or fear of social rejection, he would fail to seek help or treatment. This decision to suffer in silence leads to a social stigma”.

Dr Shukla advises people to put more energy and focus on prevention of the spread of the virus on the vulnerable section of society, i.e. 14–30 years as they are the most sexually active.

The WHO estimates that in most of the African and Asian countries, more than 50 per cent infected people are under the age of 30.

It is important to target this segment and create awareness by periodic visual campaigns and educating students at schools.

Dr Shukla has a personal commitment to educate high school children in India and certain schools in the UAE.

“The students are eager and enthusiastic to learn and the response from them is amazing. However, not all teachers and parents are open and ready to expose their children to this kind of knowledge due to fear of eroding their cultural and moral values,” he said.

“One must be persevering and dedicated to the cause and I therefore ensure I hold these camps at least once every six months in my country,” the specialist said.

Stressing on the need for treatment, it is imperative that proper counseling, infrastructure and availability of medication is ensured by the authorities in respective countries.

All infected patients need to be treated because it not only helps them become a productive member of society, it makes them responsible for their actions and they don’t transmit the virus to others.

Dr Shukla says that current anti viral medication helps in prolonging the lives of patients between 20 to 25 years.

Without treatment the life expectancy of an average Aids patient is shorter. It also depends on the country, he says.

Treatment for Aids

Speaking about the current treatment for Aids patients, Dr Shukla said there they are of two types.

The first is the ART (anti retroviral therapy) which is available in most of the poor countries and effective in the shorter term.

The other, more sophisticated medication is the HAART (highly active anti retroviral therapy) which is a combination of strong medications. There may be side effects from this medication so it is important to monitor the patients.

Through these drugs, the virus mutates so rapidly that it becomes resistant to any antiviral drug it comes into contact with and specialised care of the patient is paramount.

The specialist said that there are three important issues in the treatment of Aids which helps the patient — specialist doctors, availability of HAART (also known as second line drug) and a facility to monitor the resistance of the virus.

The patient has to be really motivated and supervised as, if he becomes resistant and the resistant virus is transmitted to the other partner, then ordinary ART will not function on that patient, according to Dr Shukla.

Overall, it is important to motivate the patient and support him in leading a normal life. Countries need to stand by these unfortunate people and not judge them for their past actions.

UNAIDS, which functions under the World Health Organisation, has given preference to HIV infected applicants to serve in various positions.

This helps them become responsible citizens and the chances that they would spread the disease are very low. Their confidence is restored, and they can probably not just heal themselves but help create awareness among the others.

Dr Ram Shukla, who organised a series of lectures on Aids in Dubai last year called HIV AIDS — Nobody Should Die of Ignorance — is passionate about helping and supporting people in community to both avoid the disease as well as to ensure proper treatment is given to those infected with the virus.

“At the moment, the world is not optimistic”, he mused.

Having attended Aids conferences globally, Dr Shukla said that in the Aids conference held in Sydney two months ago, Pedro Cahn, President of the International Aids Society said in his inaugural address: “Science has given us the tool to prevent and treat HIV effectively to prolong life. The fact that we have not yet translated this science into practice is a shameful failure on the part of the global community”

“We need to be optimistic, though,” he states. “As doctors we have a huge responsibility to educate the masses around the world and do whatever possible to curb this epidemic. Also, it is important that each individual takes responsibility for his or her own life and that of their family and friends — and beyond!

'We, as citizens of this world, need to be united against AIDS,' Dr Shukla says, grimly.

In the UAE

The UAE held a conference in Abu Dhabi in December 2006 on behalf of AIDS Day, where Humaid Al Qatami, Minister of Health, declared, for the first time, that there are 657 HIV detected cases out of which 466 were being treated.

He further said that part of the community is part of our family. He promised changes to employment laws to help HIV positive patients to secure employment. The conference was attended by media and medical professionals from all over the globe.

Dr Shukla concluded by saying that we must treat people infected with HIV and AIDS like people with any other disease and give them the opportunity to be treated and remain productive members of society.

How the virus spreads

According to Dr Shukla there are various modes of contracting the HIV Virus

Transmitted through blood and blood products in blood transfusion. To avoid being infected through blood transfusion, several countries around the world have a protocol test where all the plasma is screened before pooling. Blood recipients, including hemophiliacs are ensured of a safe supply of blood.

Intravenous drug administration. This is especially common in third world countries where needles are expensive and they are shared even in private clinics and hospitals.

Vertical transmission (or mother to child transmission). This happens when an infected mother transmits the virus to the unborn or newly born child. Responsibility lies on the shoulders of the doctors who need to prevent the virus being transmitted to the child.