ITC and HUL in health care

ITC to expand its Savlon brand across markets, while HUL is aggressively pushing its Lifebuoy handwash programme

Hindustan Unilever (HUL) and ITC, two of the biggest consumer goods companies in India, are set to square off in health care, a category that is rapidly gaining traction. Kolkata-based ITC, which acquired antiseptic liquid brand Savlon from Johnson & Johnson last year, is now launching what is possibly its biggest offensive against its Mumbai-based rival HUL.

Savlon Double Strength soap, launched in select geographies recently, will slowly but steadily be extended across markets, say officials in the know. Additionally, ITC will use its cigarette distribution network to push both Savlon soap and antiseptic liquid into rural areas. It will also launch what company executives describe as a "modernised" handwash range - basically a refurbished set of handwashing products under the Savlon brand, targeting mainly the urban markets.

The idea, say executives, is to present a strong counter to Lifebuoy. Savlon will also compete with British consumer goods major RB's antiseptic Dettol, but ITC's focus will be on Lifebuoy, which has in the past few years strengthened its position in rural areas with its handwashing programme at schools and local communities.

ITC would specifically tap local doctors and chemists to push Savlon into rural households, adding heft to its distribution network which was earlier restricted to wholesalers and retailers, company executives said.

Sandeep Kaul, ITC's chief executive for its personal care product business, says, "Substantial investments are being made in development of insight into health care. We are excited with the prospects of Savlon and will continue to bring alive the brand in an engaging and relevant manner.

Industry sources say ITC's push into the doctor and chemist channels is linked with this group's familiarity with the Savlon antiseptic liquid. While rival Dettol has traditionally enjoyed the lion's share (80-85 per cent according to industry estimates) of the Rs 200-crore antiseptic liquid market, Savlon is not an altogether unfamiliar name to doctors and chemists. At 8-10 per cent market share, Savlon has held its own as number two, drawing ITC into buying it last year, say experts.

The Kolkata-based FMCG major is expected to leverage this latent equity of Savlon while tapping doctor and chemists in rural or even urban areas. In the soap segment, where HUL is the market leader, the game is expected to be tougher for ITC. At Rs 10,000 crore, the Indian branded soap market is one of the most saturated. It is growing at a rate of five-six per cent a year, according to market experts.

HUL controls an estimated 45 per of this market. It is followed by Godrej Consumer, at around 10-11 per cent, while RB (maker of Dettol) and Wipro (Santoor brand of soaps) trade positions at third and fourth positions, each with a share of eight-nine per cent. For ITC, its Vivel brand of soaps in the beauty segment has struggled to go beyond two-three per cent in terms of market share, say experts, thanks to intense competition.

But the prospect of its soap doing well is higher in health care, given the potential of the market, say company executives. At 30-35 per cent of the market, the health & hygiene segment of the branded soap market is growing at double-digit rates, ahead of the overall market.

The category has also got a boost with Prime Minister Narendra Modi's Swachh Bharat Mission, launched last year. Every soap maker in the country has gained from the initiative and made inroads into the category to capitalise on growth. ITC is now making that big leap, say experts.

Kaul hints at this when he says, "We will consider all categories that can expand the brand's consumer reach and build it further."

Competitors in the health and hygiene soap segment include Lifebuoy, Dettol and Santoor. While Lifebuoy's market share is estimated to be in around 15 per cent, Dettol and Santoor have an estimated share of eight-nine per cent each, according to market experts.

Analysts, however, warn of an impending trouble for ITC while taking on the established players, notably Lifebuoy. "It is hard to challenge a product like Lifebuoy in the rural markets, but ITC has the ability to do it with the right pricing strategy," says Amnish Aggarwal, senior vice-president (research) at Mumbai-based brokerage Prabhudas Lilladher.

H.I.V. Education That Aims to Empower

Thanks to medical advances, a diagnosis of H.I.V., while still very serious, is no longer the death sentence it once was. For organizations trying to communicate information about testing and prevention, though, the devastation the virus has caused over the decades remains ever-present.

Traditional public service announcements tend to rely on shock and shame, with mixed success. But when Arizona public health officials began contemplating a new campaign, they wanted to change that.

“We needed a coordinated media strategy and it needed really to focus less on fear-based messaging and more on empowering people,” said John Sapero, office chief for H.I.V. prevention for the Arizona Department of Health Services.

About a year ago, the health department turned to one of its regular media partners, the marketing agency Moses Inc., to create a P.S.A. aimed at encouraging people to visit a website, HIVAZ.org, where they could get information about testing and other resources.

The ads, displayed on billboards, bus shelters and other outdoor areas in the Phoenix and Tucson areas, each depict a person going about an everyday activity — jogging, shopping, talking on the phone — and encountering an unnoticed hazard: a street signpost, a glass door, an open manhole cover.

“It’s only dangerous if you don’t know it’s there,” the ads say. The HIVAZ.org web address and the phrase “Awareness is the answer” are at the bottom. The campaign also has a digital component intended to direct people to the site.

“Slipping or bumping into a door — all of us do it, and it’s dangerous if you don’t know it’s there,” said Louie Moses, president and creative director of Moses Inc. The ultimate goal is to get people to visit the website, he said, where they can receive information about getting an H.I.V. test. The site also offers support resources for patients and information about how people can reduce their risk of contracting the virus.

The initiative had its challenges. The ads had to address a serious topic on a shoestring budget, not to mention the agency had to figure out how to make a pair of headphones look as if they were flying off a jogger’s ears.

To create the eye-catching images, Moses Inc. tapped the advertising photographer Blair Bunting, known for his work capturing athletes in motion, to stage the moments of “impact.”

“The images best represented what we felt like H.I.V. could be for someone who contracted it,” Mr. Bunting said.

He added, “You have to have this image that makes it look like control has been lost.”

The entire campaign had a budget of $300,000, money that the Centers for Disease Control and Prevention distributed to the Arizona Department of Health Services.

With those constraints, Mr. Bunting and his crew had to make the most of their studio time to create the trio of images, using equipment like wind machines and a riser to create the appearance of a person plunging headlong into an unpleasant situation.

Mr. Moses said if the project had been a conventional ad campaign, underwritten by a corporate advertising budget, the cost would have been $5 million to $10 million.

The agency donated “literally hundreds of hours,” he said, while Mr. Bunting said he worked with about 20 percent of his usual budget for the shoot. In addition, Aunt Rita’s Foundation, a nonprofit that works with Arizona’s health department on H.I.V. awareness and prevention, was able through its partners to secure donations of space to display some of the ads.

The efforts have paid off, Mr. Sapero said. Last fall, the HIVAZ.org site had about 9,000 new visitors over a period of about two months. This year, after the campaign began, that figure jumped to 39,000 over the same time period, while the number of repeat visitors to the site rose from 15 percent of overall visitors to more than 40 percent.

“Clearly, people are coming to the site, seeing what it’s about,” he said. “They’re bookmarking it and they’re coming back again.”

The campaign clicked with viewers because it eschewed shaming and judgment, said Nidhi Agrawal, professor of marketing at the University of Washington, who has studied the effect of P.S.A.s for drinking and driving. “You’re taking the stigma away, and when we create distance from the stigma, people can think about it more objectively.”

Mr. Moses said advertisers and nonprofits have learned a great deal about how to communicate messages about H.I.V. since the disease first came onto the national radar in the 1980s.

“We did some pretty shocking ads back then,” he said. “At the time we didn’t know any better, and we wanted to get awareness; we wanted people to know the name AIDS.” Current campaigns tend to focus on H.I.V., the virus that causes AIDS, because health officials and advocates want to connect with patients before the disease progresses to AIDS.

“We kind of learned from the past we didn’t want to shock and scare and judge the group of people we were talking to,” Mr. Moses said. “Since then, the research says that shocking and embarrassing and shaking your finger at the potential consumer does the exact opposite. It just makes them hide.”

Ms. Agrawal agreed that eliciting negative emotions backfires, because people then focus on their feelings instead of absorbing the message. “People are too busy managing the shame and the fear to respond to the P.S.A. or respond to the problem,” she said. (A recently unveiled campaign in cities like New York and San Francisco that is focused on H.I.V. prevention strikes a similar tone to Arizona’s.)

Mr. Bunting said they wanted the Arizona P.S.A. to circumvent those feelings.

“It wasn’t very heavy-handed,” he said. “It made it comfortable for people to talk about something that’s usually a very uncomfortable situation.”

HIV rates still high despite innovations in treatment

Scientific advances for HIV/AIDS have exploded in recent years, and doctors have new ways both to treat people who already have the disease and to prevent others from acquiring it.

But despite new research that allows scientists to track, treat and prevent HIV better than ever before, the disease continues to spread, including in Louisiana.

Baton Rouge is ranked first in the nation for estimated HIV and AIDS case rates per 100,000 people, while New Orleans is ranked third for HIV and fourth for AIDS, according to newly released 2014 Centers for Disease Control and Prevention figures.

How to link people infected with the disease to health care and why they continue to go untreated are questions that physicians nationwide — and in Louisiana — are trying to answer.

A recent New England Journal of Medicine article titled “Applying Public Health Principles to the HIV Epidemic — How Are We Doing?” offered a somewhat pessimistic view of the status quo. In the essay, Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention, and his co-authors called for doctors, as well as local and state health agencies, to adopt a more aggressive approach to combating the spread of the disease, pointing to alarming trends.

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“Most people living with HIV infection in the United States are not receiving antiretroviral treatment; notification of partners of infected people remains the exception rather than the norm; and several high-risk behaviors have become more common,” they wrote.

DeAnn Gruber, the HIV program director for Louisiana’s Department of Health and Hospitals, said she read the article as highlighting that the nation is at a crossroads in terms of HIV care.

“We’re at a real turning point in the epidemic of HIV,” Gruber said. “What they’re raising too is that even though there have been some advances, there’s still a lot of work to be done.”

At-risk communities

The work is particularly needed within smaller, often stigmatized communities.

In line with national trends, gay men contract half of all of the new HIV infections in Baton Rouge, said Timothy Young, the head of the HIV/AIDS Alliance in the Baton Rouge area.

Last year, around 24 percent of the more than 5,000 people living with HIV/AIDS in Baton Rouge were not receiving care related to the disease, according to DHH and CDC estimates.

As for preventing the spread of HIV, Young said that just telling people to have safe sex is not enough.

“There is a disconnect between that knowledge and behavior. We know that trying to teach increased and effective condom use has not been effective,” Young said.

Gruber said smaller subsets of gay and bisexual men, particularly black gay men, have higher risks of being exposed to the disease. Young said the reason involves more than race and sexual orientation, and even geography can come into play.

“People tend to have sex within their own race and ethnic groups within a relatively small geographic area,” Young said.

HIV tends to spread in some communities because of risky behaviors, such as anal sex without condoms. But other risky behaviors are on the rise as well.

Increases in opiate use nationwide have led to more HIV infections from needle-sharing, according to the CDC essay.

Baton Rouge has certainly felt the strain of opiate-usage increases, as the city recorded a record number of heroin deaths this year.

Health experts know that needle sharing and unprotected sex are problems, and they know which communities they most affect. But transforming that knowledge into action is difficult, they say.

Young, DHH and many public health experts are strong advocates of “pre-exposure prophylaxis,” a daily pill called Truvada that people with risky lifestyles can take to prevent getting HIV.

A CDC report from November said the daily pill could reduce the risk of HIV acquired from sex by 90 percent and of HIV from drug injections by 70 percent. But the CDC also estimated that one in three primary care doctors and nurses do not know about the treatment, meaning it is not as widespread as it could be.

Possible solutions

Young said the key to combating HIV is identifying every member of the community who is infected with the disease, linking them to treatment and spreading messages about prevention.

The CDC essay heralded an effort in San Francisco, where a combination of increased testing, partner notification and treatment led to a 40 percent decrease in new HIV infections between 2006 and 2014.

Gruber said New Orleans recently received two grants, totaling $5 million over the next few years, that could help build a San Francisco-like model in that city. She said the money will be directed toward building networks that address behavioral health, housing, employment and transportation for people with HIV.

Gruber said it’s likely that DHH will pluck the most successful aspects of what they do in New Orleans and implement them in Baton Rouge.

One of the state’s most successful initiatives, called “LA Links,” focuses on identifying people who are HIV-positive and connecting them to medical care and support services. The program exists in Baton Rouge, New Orleans and Shreveport, and is set to expand.

Within its two-year existence, Gruber said, around 500 people have enrolled in “LA Links.” About 87 percent of them have started receiving medical treatment.

The New England Journal of Medicine article also emphasizes the importance of newly diagnosed people reporting their partners so that they can get tested. The doctors who authored the study argue that reporting partners is a critical way to trace and stop the spread of the disease.

“Despite the importance of these services, interviews to elicit names and contact information of partners were documented to have been conducted with only about half the people who received a diagnosis of HIV infection in 2014, and patients who named partners named relatively few,” they wrote.

Louisiana state law does not require people to report their sexual partners, but Gruber said the state’s partner services office works hard to have people disclose their partners and then to inform those people of their potential exposure to HIV.

Young said asking people to name partners does not always yield results, for some people will not be honest, some do not remember and others simply do not know. He said the rise of hookup apps, like Grindr — a social networking app that lets users share their location — has led to many fleeting relationships that could make it more difficult for people to report their sexual partners.

“That’s not necessarily a positive sign when we’re trying to control the high rate of STDS that we have here in Louisiana,” Young said.

Barriers to treatment

Stigma is still the biggest barrier to getting people into testing and treatment, Young said.

He said the fear of being associated with HIV is so pronounced that more than 25 percent of those who are newly diagnosed with the disease in Louisiana have already progressed to AIDS.

“We have people who don’t want to test, don’t want to be seen accessing care or going to known providers of HIV care, and are living with the situations that may have allowed them to become HIV-positive in the first place,” Young said.

The good news for people who worry about the stigma of having HIV is that treatment is better than ever, Young and Gruber said.

HIV is no longer a death sentence with a ticking clock; people with the disease who are in treatment can live normal life spans and healthy lives.

It’s unclear how much of a game changer Medicaid expansion might be for treating people with HIV/AIDS in Louisiana. While Gov. Bobby Jindal has declined to expand Medicaid, the federal health insurance program for the poor, Gov.-elect John Bel Edwards has said he wants that to be among his first moves once he takes office.

J.T. Lane, DHH’s assistant secretary for public health, said the state already covers HIV testing and that clinics that are federally qualified health centers can reimburse patients.

DHH spokeswoman Ashley Lewis said that if Medicaid is expanded, it would open up more avenues for recipients to receive overall medical coverage and it could increase specific types of federal funding for people in the state with HIV/AIDS.

Young said the state needs to do more, although he acknowledged that HIV treatments are largely covered for patients right now because of specific federal funding in that area.

“We also know that Louisiana doesn’t have any skin in the game in the sense that there are currently no state dollars dedicated to HIV prevention, which is very sad when we have some of the highest rates,” Young said.

Every year 35 lakh babies are born prematurely in India, Health Minister JP Nadda tells Parliament

Over thirty five lakh babies are born annually in India, making it the country with the highest number of premature births of infants, according to a World Health Organisation report.

Union Minister for Health and Family Welfare JP Nadda told the Parliament on Tuesday while replying to a question in Rajya Sabha, "As per the World Health Organisation (WHO) Publication 'Born too Soon: The Global Action Report on Preterm Birth' out of an estimated annual 2.7 crore live births, in India 35 lakh babies are born preterm and out of these 3.03 lakh babies die due to complications of preterm birth."

He said that Under National Health Mission (NHM), key interventions are being implemented all over the country to bring down infant mortality rates.

"Under NHM, government promotes institutional delivery through Janani Suraksha Yojna cash incentive scheme for pregnant mothers and Janani Shishu Suraksha Karyakaram which entitles all pregnant women and sick infants to absolutely free and no expense treatment at public health facilities," the Minister said.

He said under NHM, strengthening of newborn care services by establishing facilities for the care of sick newborns such as Special New Born Care Units, New Born Stabilisation Units and New Born Care Corners and provision of home-based newborn care through Asha workers is provided.

Health Minister J P Nadda and Priyanka Chopra launch campaign to combat anemia among teenagers

The Health Ministry officially launched a programme on Wednesday to cut down on anaemia levels among the large adolescent population in the country. Anaemia is a medical condition in which a person suffers from lack of red blood cells/haemoglobin in his/her blood levels, resulting in fatigue, impaired physical growth and weariness. The condition occurs due to deficiency of iron.

Government data show that at least 56 per cent of girls and 30 per cent of boys in the age group of 15-19 years in India are anaemic, with a large percentage suffering from moderate to severe anaemia.

Under the programme titled ‘Weekly Iron and Folic Acid Supplementation’ (WIFS), adolescent children, who go to government or aided school as well as those who have dropped out, will be administered a tablet once a week for 13 months. Counselling and a proper information campaign will also be conducted to ensure timely implementation of the programme.

“Through this programme, we can can turn a young India into a healthy India. It is a matter of great happiness for me,” said JP Nadda, the Minister of Health and Family Welfare, at the launch in New Delhi. He added that the programme aims to cover 11.2 crore adolescents across the country.

“It is our responsibility to ensure that the young energy is channelized in the right direction. This can only be achieved if the adolescents are physically and mentally well-prepared for the future of their country,” he said.

The launch was also attended by popular actress Priyanka Chopra, who is the UNICEF’s goodwill ambassador.

“The statistics for anaemia are so scary, particularly among the girl child. WIFS is a way of solving our problem to a great extent,” said Chopra, who has spent almost a decade endorsing the campaigns of the Health Ministry and UNICEF.

Chopra said that her health improved to a great extent after she started taking the iron tablets.

In India, even though malnutrition is widely prevalent among men, women and children, lack of leadership and political action has resulted in millions suffering stunted growth and high incidence of heart diseases. The mortality rate among children below the age of five is also high in India.

“Although examples of state-level leadership are emerging, we believe that national policy commitments and national target-setting are critical to clarifying and emphasising policy priorities,” wrote Lawrence Haddad and Purnima Menon, senior research fellows at the International Food Policy Research Institute.

Renewed focus also needs to be on India’s national health spending, which has gone down from 4.5 per cent of GDP in 2004 -05 to 4 per cent in 2013-14. World bank data showed that in US, the health expenditure is 17% of the GDP in 2013-14 and 9% in the UK.

Through this initiative, launched on Wednesday, at least 11.2 crore adolescents across the country would be given iron and folic acid supplements to reduce nutritional anaemia.

Nadda said that a nationwide campaign is the need of the hour as "accessibility is not the problem, awareness is".

"We have to make India aware about the issue, resources are not a problem. It is a step to make young India healthy India," he said.

The minister also said: "People start comparing countries and say that India is not up to the mark but that is wrong. We should compare India to equivalent countries. India is a country that cannot be compared as it has own strengths and weaknesses."

Priyanka Chopra also lent her voice to a video clip made for taking the message about the benefits of the tablet forward. The actress said that she feels fortunate to be a part of a campaign for the next generation.

The programme will reach adolescents through schools and anganwadi centers on a fixed day of the week. Biannual de-worming for control of worm infestation, information and counselling to improve their dietary intake and screening for moderate and severe anaemia will also undertaken in the programme.

Realising that pills tend to repel children, the health ministry is also mulling various options of providing food supplements in place of tablets.

As the campaign focusses on young India, the event saw a teenager Kajal, who is associated with an NGO working towards the same goal, list out her favourite dishes and she also narrated how she lost her younger sister due to the lack of care at the right time.

Talking about future plans, Nadda said: "We are taking help of digital India as well. Soon, message in regional languages will come on mobile phones asking about the medicines."

UNICEF representative to India Louis Georges Arsenault also attended the programme.

Mother's Health and Poverty Behind Child Malnutrition In India

Short maternal stature, extreme poverty, poor dietary diversity and mother's lack of education are among the top five risk factors for malnutrition in children in India, according to a new Harvard study.

Nearly 40 per cent of all children in India are stunted - of extremely low height for their age - and nearly 30 per cent are underweight, researchers said.

The study from Harvard T H Chan School of Public Health has now pinpointed the five top risk factors responsible for more than two-thirds of the problem.

The study is the first to comprehensively analyses and estimate the relative importance of known risk factors for child under nutrition.

Examining an array of 15 well-known risk factors for chronic under nutrition among children in India, the study found that the five top risk factors were essentially markers of poor socioeconomic conditions as well as poor and insecure nutritional environments in children's households.

Using data on nearly 29,000 children aged 6-59 months from the 3rd India National Family Health Survey, conducted in 2005-06, the researchers found that the five most important predictors of childhood stunting and underweight were short maternal stature, a mother with no education, extreme poverty, poor dietary diversity and maternal underweight.

Meanwhile, factors such as Vitamin A, breastfeeding, use of iodised salt, improved water and sanitation, and even immunisation - all currently high priority interventions in the global discourse on addressing under nutrition - accounted for less than 15 per cent of the cases of under nutrition.

"There is an immediate need to not waste time and resources on short-term and 'doable' interventions," said study senior author S V Subramanian, professor of population health and geography.

"While asking people to change behaviours and offering piecemeal solutions might provide some short-term relief, such strategies cannot be substituted for the urgent need to improve food and livelihood security," Mr Subramanian said.

The study was published in the journal Social Science and Medicine.

Fertility Rates Boosted by Surgery

A fertility specialist at Taipei Veterans General Hospital (TVGH) on Monday said that while about one in every 10 men might have infertility problems, the use of microsurgical testicular sperm extraction (mTESE) can helped increase fertility rates.

The hospital cited a recent case of a 33-year-old man, surnamed Yu , who was diagnosed with azoospermia — the absence of motile (and hence viable) sperm in semen — and was told by doctors at other hospitals that there no hope of impregnating his partner.

However, a team of doctors at TVGH were able to retrieve sperm from Yu’s right testicle via mTESE, and the couple recently gave birth through in vitro fertilization (IVF) treatment.

TVGH Division of Male Reproductive Medicine director William Huang, who performed the surgery, said that about 1 percent to 1.5 percent of males in Taiwan suffer from azoospermia.

Azoospermia can be categorized into obstructive and non-obstructive forms. Obstructive azoospermia means that the individual can produce sperm, but that none are present in the ejaculate, while non-obstructive azoospermia relates to abnormal sperm production within the testes, Huang said

“Non-obstructive azoospermia is one of the most challenging problems to deal with in male infertility and relies on mTESE for treatment,” he said.

Using the mTESE method, doctors can use magnification of up to 24 times to search for areas with increased sperm count to collect sperm for IVF treatment.

“The main feature of mTESE, compared with the traditional method of testicular biopsy, lies in its precision,” Huang said, adding that while a testicular biopsy can be seen as cutting down many trees in a forest and trying to find a few apples within them, mTESE is like precisely locating where the apples are growing, then picking the apples that are needed.

Division statistics showed that the fertility rate of couples with non-obstructive azoospermia after mTESE treatment was 77.52 percent last year, with rates of pregnancy that reached 24 weeks being 39.7 percent, while the 24-week pregnancy rate increased to 50 percent this year, Huang added.

Huang said that the reason for azoospermia is still unknown, but might be related to genetic mutation or environmental influences, such as exposure to high temperaturse, radioactive substances, smoking, drinking alcohol, or consuming unhealthy food.

“I urge men to undergo fertility testing before their partners, because the procedure is not as complicated as it is for women,” he said.

Drinking Green Tea too often may lower Fertility

Are you a green tea lover? Read this carefully as the cup packed with antioxidants and other health benefits may adversely affect your fertility and development in case of frequent use, warn researchers.

In experiments over fruit flies, the team from University of California-Irvine discovered that excessive consumption adversely affected development and reproduction in fruit fly populations. According to them, one should avoid high dose of green tea or any natural product as nutraceuticals such as green tea, while growing in popularity, are largely unregulated.

“While green tea could have health benefits at low doses, our study and others have shown that at high doses, it may have adverse effects,” said Mahtab Jafari, associate professor of pharmaceutical sciences. “Further work is needed to make any definite recommendations but we suggest that green tea should be consumed in moderation,” she added.

Researchers from the University of California-Irvine tested this theory using fruit flies. They found that excessive consumption affected the development and reproduction of the fruit fly population. According to the team, anyone should at least avoid consuming a high dose of green tea or any products with nutraceuticals which are popular are usually unregulated. Mahtab Jafari, associate professor of pharmaceutical sciences said, "While green tea could have health benefits at low doses, our study and others have shown that at high doses, it may have adverse effects. Further work is needed to make any definite recommendations but we suggest that green tea should be consumed in moderation."

For the study, Jafari and colleagues investigated the effects of green tea toxicity on the development and reproduction in fruit fly Drosophila melanogaster. Embryos and larvae were subjected to various doses of green tea polyphenols.

Larvae exposed to 10mg of green tea were slower to develop, were born smaller and exhibited a dramatic decline in the number of emerged offspring. Ten milligrams of green tea made the flies more susceptible to starvation and heat stress but protected them against dehydration.

Female offspring showed decreased reproductive output and a 17 per cent reduction in lifespan while males were unaffected, the study found. Ten milligrams of green tea caused morphological abnormalities in reproductive organs such as testicular and ovarian atrophy. Jafari believes that high doses of green tea may cause “too much” apoptosis or cell death.

Derived from the plant Camellia sinensis, green tea is popular worldwide for its purported brain and heart health and anti-cancer properties. Jafari noted that in other tests with mice and dogs, green tea compounds in large amounts dramatically reduced body weight and, in mice, negatively affected embryo development.

“We are planning to measure total consumption and identify and quantify the metabolites of natural products in flies,” Jafari pointed out, adding that these experiments will enable us to have a better understanding of toxic doses in humans. The paper appeared in the Journal of Functional Foods.

Rise in Temperature Will Affect Male Fertility

Doctors report 20-25 per cent fall in sperm count

The rising temperatures in the city caused by climate change will have a major impact on men as with the increase in temperature, their fertility decreases, claimed medical experts.

“The temperature of Mumbai is comparatively better than other western regional states. But the fluctuation in temperature is a concern. If there is a long span of days when the temperature is above 27 degree Celsius, then it affects the fertility in men as the sperm count drops,” said Dr Suchitra Pandit, gynecologist and obstetrician, Kokilaben Dhirubhai Ambani Hospital. Addressing the concern, Dr Hetal Parekh, consultant fertility physician, from Hiranandani Hospital said, “We have seen that in winter months, men are more fertile than in summer months due to the difference in temperature. So, if winters also become warmer, the fertility in men will be adversely affected thus resulting in low reproduction rate.”

In the past one decade, the western coast of India has been witnessing more incidents of heat waves. And on certain days, the mercury level goes up to 38 degree Celsius. “The rising occurrences of heat waves have become more manifested in the past one-decade,” said Subimal Ghosh, climate change expert from department of civil engineering, IIT-B.

As per the medical experts, excessive exposure to heat results in decrease in sperm count in men. “Rise in temperature, will also affect the sexual behavior of people. It will decrease the production of sperm and increase its mortality,” said Dr Parekh.

In the last 20 years, the doctors said that they have observed a decrease in sperm count by over 20-25 per cent.

Experts across the city have said that they witnessed a rise in the number of cases of infertility among men. And one of the reasons for it is the continuous exposure to heat. This could further aggravate in the long run with more rise in temperature.”

For the effective production of sperms, the scrotum needs to be two degrees cooler than the body’s ideal temperature 98 degree Fahrenheit. But it is a long run process. Shift in temperature for a day does not affect the sperm formation as it takes 10 weeks for a single sperm to reach maturity,” said Dr Sudeshna Ray, coordinator, department of gynaecology and obstetrics at Jaslok Hospital.

Also, according to an article published in the conversation.com, an independent, not-for-profit media outlet, in 2015, “Many developing countries, such as India, already experience hotter climates than the United States. As a result, these developing countries are more likely to feel the effects of climate change, which could include worse fertility outcomes.”

Doctors state Other causes 

Doctors also highlighted other factors that are leading to infertility among men in the city. “Men should avoid wearing tight pants that increases the temperature of the scrotum. Also, people tend to keep their laptops on their lap for hours that also raises the temperature of the scrotum. Also, while driving for long distances, they should take breaks in between to adjust their body temperature,” said Dr Pandit.

United States HIV cases down 20 percent

U.S. HIV cases down 20%, but up 87% for 2 groups

Southern states currently have greatest incidence of HIV infection, CDC says

While the overall number of HIV diagnoses continues to fall in the United States since the first cases were documented 30 years ago, at least two groups of the population are seeing a sharp increase in those numbers.

A report by the Centers for Disease Control and Prevention released this month shows a nearly 87% increase in the number of HIV diagnoses of African-American gay and bisexual males and Latino gay and bisexual males, aged 13-24.

Overall, the number of diagnoses for the entire population dropped by 19% from 2005-2014, the analysis showed.

A risky environment

There is a high prevalence of HIV in the African-American gay and bisexual community, according to Dr. Eugene McCray, director of the CDC's Division of HIV/AIDS Prevention.

"If you are a young black man, and are having sex with other black men, your chance of being exposed is really high," he said.

Part of the problem, he said, is the low rate of condom use in that community.

Adding to the risk is the fact that nearly a third of black gay and bisexual men between the ages of 13-24 who are HIV-positive don't know it, said Dr. Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention.

"A fair proportion haven't been diagnosed. It creates a risky environment," Mermin said.

In all ages of black gay and bisexual men, the number of diagnoses increased 22% over the past decade, but those rates have been leveling off since 2010, the CDC report showed. Latino gay and bisexual men of all ages have also seen their number of HIV diagnoses rise by 24% over the past 10 years.

In the same time period, the number of HIV cases has dropped 35% among heterosexual adults, 63% among intravenous drug users, and 22% among all African-Americans, according to the CDC. Women have also seen a significant decline in HIV infections, down 40%, from 12,499 diagnoses in 2005 to just 7,533 in 2014, with the biggest drop occurring among African-American women, who have seen the number of cases nearly drop in a half, from 8,020 HIV diagnoses in 2005 to 4,623 in 2014.

Southern states have highest incidences of HIV

Across the country, Southern states currently have the greatest incidence of HIV infection, illness and death. In fact, while the South represents about a third of the general population, it is home to 44% of those who are HIV-positive. Those individuals are also three times more likely to die than those with HIV living in other parts of the country.

Mermin said it's very important to target groups that have been disproportionately impacted by HIV with more intervention.

"We have to accelerate access to HIV testing, treatment and prevention, including PrEP (Pre-Exposure Prophylaxis), to those at greatest risk," he explained.

Today, more than 1.2 million people in the United States are HIV-positive. About one in eight of those infected are unaware of their status.

Zimbabwe children still at great risk of HIV/AIDS new data shows

Janet Dube knows the pain of raising a child born with HIV.

Her four-year-old son is one of an estimated 170,000 children living with HIV/AIDS in Zimbabwe, and figures released by the country's statistics agency on Wednesday showed the virus is the leading cause of death among children under five.

A Census Analysis Mortality Report from 1992-2012 revealed that despite progress in fighting the virus, HIV and AIDS had claimed the lives of thousands of Zimbabwean children under five.

"I live in constant fear about my child's health as he sometimes skips medication when we fail to travel to the city (Bulawayo) to get (medication)," Dube, 27, from Filabusi, about 100km (60 miles) from Bulawayo, told the Thomson Reuters Foundation.

Dube, however, is one of the lucky HIV patients who gets free antiretroviral therapy (ART) from a government hospital, though she sometimes goes without medication for herself and her son when she does not have the bus fare to travel to Bulawayo.

When her son goes without medication, it increases her concern about whether he will live long enough to go to school.

About 17 percent of Zimbabwean adults, more than 1.4 million, live with HIV and AIDS, according to UNAIDS figures, making the southern African nation one of five African countries where around 20 percent of adults have HIV or AIDS.

According to the Zimbabwe Network of People Living with HIV's (ZNNP+) executive director, Muchanyara Mukamuri, only 40 percent of children in Zimbabwe who need it are receiving antiretroviral therapy.

Dube said a lack of adequate nutrition adds to her concern about her and her son's health as Zimbabwe's rural areas are facing acute food shortages.

"We just don't have enough to eat," said Dube, a single mother who receives monthly food assistance from a Bulawayo church.

The United Nations Population Fund (UNFPA) Zimbabwe residentrepresentative, Cheikh Tidiane Cisse, said that while the number of children dying before the age of five had fallen in the past three decades, more still needed to be done in the HIV/AIDS sector.

"Access to antiretroviral therapy and antenatal care must be increased," Cisse said.

Zimbabwe's long-running economic crisis has not spared the health sector, and there have been large cuts in public health spending.

Last month, Finance Minister Patrick Chinamasa allocated $301 million to the health and child welfare ministry, but public health campaigners and experts said domestic funding for HIV and AIDS remained inadequate.

In September, the United States approved funding of $95 million under the President's Emergency Plan for Aids Relief (PEPFAR), which is also expected to increase the supply of antiretroviral therapy for children.

As for Dube, she can only hope.

"Each day I blame myself (for her son's condition), I wish one day they get a cure (for HIV)," she said.

Man with HIV charged with exposing woman to disease knowingly

A man accused of knowingly exposin a woman with HIV in 2014 is facing charges in Sumter.

Dexter Durham, 41, was arrested November 12 in North Carolina after authorities say he has been on the lam since August of 2014.

A woman contacted police in 2014 saying that Durham knowingly exposed her to HIV between 2010 and 2012.

He has since been charged with failure to report a contagious/infectious disease. Investigators said Durham learned of his infection in 2005 and may have exposed others to the disease.

The 41-year-old has since been released on bail. If convicted he faces a fine up to $5,000 and a maximum of 10 years in prison.

Authorities are asking if you have any more information on this case to call Sumter Police at 803-436-2700 or CrimeStoppers at 1-888-CRIME-SC.