Chennai, India (Written Jan. 7)

I am in India for the week. My primary mission is to discuss import safety with the leaders of the Indian Government. While I’m here, I will also review our investments in HIV/AIDS, tuberculosis and pandemic preparedness.

Today I’m in Chennai, a city of seven million in India’s south region. This is my first visit to India. The complexity of the place was captured well by the Ambassador to the United States from India, whom I consulted with before I left. He jokingly said, “If you have heard anything about India, it is likely true—someplace.” He referred to the many different cultures. For example, there are 18 official languages spoken. Like China, there are stark differences between urban and rural parts of the country.

The most evident characteristic of India is the density of population. India is about one-third the size of the United States and has four times the population. Put another way, 15 percent of the world’s population lives in India on 2.4 percent of the land mass. Almost a third of the population is under 15 years old, and 70 percent live in one of 550,000 villages. This is one crowded place.

I spent the morning at Tambaram Sanatorium, attached to the Government Hospital of Thoracic Medicine in Chennai. Both CDC and NIH within my department have long-term relationships here. It is a major treatment center for HIV/AIDS. The hospital sees 1,500 patients a day, 33,000 a month and more than 400,000 a year. Being in a HIV/AIDS treatment center is always a moving experience for me.

Generally their patients have been tested some other place, and then come to this hospital to get counseling and a treatment regimen, along with the appropriate drugs. Patients then return about once a month to be checked and get their medicine. The process is similar to what I observed in Africa.

As I walked through the pediatric section, I was surrounded by children and their mothers. I was distributing toys I had brought to cheer them up. Through the crowd, I noticed a woman sitting on a cot. She was thin, dangerously thin, but strikingly beautiful. She must have felt my gaze, because she looked up and engaged me with her eyes. She slowly and deliberately mouthed the words “thank you.” Still surrounded by a press of people, I simply nodded and accepted her expression. We used no words, but communicated deeply. It was not me she addressed, but my country. Her expression sent gratitude to every American. Our compassion had given her hope.

Throughout the day I was with my friend Anbumani Ramadoss, the Indian Minister of Health and Family Welfare. We have known each other for two years now. He is young, charismatic and competent. He is a medical doctor by training, and the son of a prominent regional political party leader. Chennai is his hometown, and he is a popular figure here.

The United States and India have an active agenda of things we already work together on. Vaccines, infectious disease, HIV/AIDS, maternal and child health, vision and medical technology are just a few. Much of our conversation centered on food and drug safety and the Minister’s plans to create an equivalent of the FDA in India. I have offered technical assistance. Dr. Andy Von Eschenbach, Commissioner of the FDA within my department, is with me. Each of us will be putting a team together to work on this, much the same as we did in China. I still need to speak with other Ministers of the Indian Government on this matter.

Our collective teams sat down to review an agenda of items, and then had a formal lunch with about 400 people from the medical community throughout Tamil Nadu state. I directed my remarks mostly to import safety. Actually, I printed off the blog post I wrote on the five lessons I had learned dealing with import safety, and used it as an outline for my speech--an unanticipated side benefit of writing this blog.

The rest of the afternoon was spent visiting Loyola College of Chennai, to observe an HIV/AIDS awareness program called the Red Ribbon Club. They have just launched a curriculum for communicating prevention messages among peer groups of young people. It’s an impressive piece of work. We’re losing the battle when we just treat HIV/AIDS among the infected. We have to be in front of this, and prevent it if we are ever to be hopeful of stopping the epidemic. A lesson from Africa reinforced in India.

I was grateful for a two-and-a-half hour break before dinner with a group of community leaders. The jet lag and a cold I picked up over the holiday were beginning to combine against me. A short nap helped.

I always meet interesting people on these trips. Another I’ll mention today is Dr. Pratap Reddy, M.D. He is a trained cardiologist who worked at the Missouri State Chest Hospital for about 10 years. He returned to India to set up private hospitals. His company, Apollo Hospitals Group, now has 46 hospitals. I want to write more about this later, because one of their hospitals’ trademark characteristics is they make their results public, and post their prices. They have results that rival the best U.S. hospitals, and their costs are a fraction of U.S. prices. Many of their patients are from other countries, part of India’s medical tourism initiative; more on this later.

Comments

I find it interesting that 1/3 of the population is under the age of 15. I had no idea just how quickly the India population is growing.

Posted by: Anne Marie | January 09, 2008 at 02:25 PM

India has made a good progress in terms of reduction in HIV cases. Although the figure looks big, but it is comparatively lower then earlier.
I wish to have more organizations like Apollo in India to make it hub for medical tourism.
Thanks for sharing your thought.

Posted by: Robins Tomar | January 10, 2008 at 04:46 AM

life expectancy is low, I knew that...
with global knowledge sharing and web2.0 and web3.0 this will change I guess

Posted by: Mark Domein | January 10, 2008 at 08:14 AM

apollo hospitals in chennai ripoff chennai locals and poor people.
they always insist on surgeries,operations,extra stay just to make money. often wrong diagnosis on victims is left untold due to their political power in chennai

Posted by: hie | July 16, 2008 at 10:33 AM