This study was a collaborative effort of the National AIDS Control Organization (NACO), United Nations Development Program (UNDP), Indian Council of Medical Research (ICMR), National Council of Applied Economic Research (NCAER), and the Institute of Health Systems (IHS)^[1]. The study aimed to assess the burden of disease and socioeconomic impact of HIV/AIDS in 6 high prevalence states of the country; viz Maharashtra , Karnataka, Andhra Pradesh, Tamil Nadu, Manipur and Nagaland. The Institute was responsible for developing the study design for estimation of burden of disease due to HIV/AIDS. The IHS organized a study workshop on 2nd and 3rd of December, 2003, towards developing reliable estimates of burden of disease and socioeconomic impact of HIV/AIDS within the country. In addition to representatives from partner organizations, other professionals with expertise relevant to the study participated in the workshop. Based on the workshop findings a study design for a HIV prevalence survey was developed and submitted to the NACO Steering Committee.

^[1] MOU dated 06/09/2003 between NACO, UNDP, NCEAR, ICMR, IHSUNDP India Allotment No. IND/PRO/300 (Health)

           This study has been designed to understand the cause of death pattern in Hyderabad city and identify deaths due to causes attributable to air pollution. The study also aims to strengthen the medical certification of cause of deaths and reporting of cause of death statistics in the city of Hyderabad . Data on air pollution has been collected from the Andhra Pradesh Pollution Control Board. Cause of Death data is being collected from the vital statistics division of the municipal corporation of Hyderabad. The quality of the medical certification of deaths will be assessed and where required reassessment of cause of death will be done using verbal autopsy tools. The study has been commissioned by the Ministry of Environment and Forests^[1], Government of India and began in May 2005.

^[1] GoI Ministry of Env. F. No. Q11011/21/2003 EHC dt: 17th March 2005

           Collaborative effort between Naandi Foundation, Effective Interventions and London School of Tropical Medicine and Hygiene. The Field Trial is being implemented in Nagarkurnool Division of Mahabubnagar District of AP. The trial covers over 400 villages with equal number of study and control villages. The field team includes over 400 surveyors and about 20 supervisors. IHS has been selected as a technical consultant for the study.The Institute has been providing technical support for developing of forms and training manuals, training of surveyors and supervisors and quality control over the length of the trial. Institute has developed survey forms, verbal autopsy tools and training manuals. Training of surveyors is currently underway. The project has been commissioned by the Naandi Foundation^[1]

^[1] Nandi Foundation Letter & Contract dated 15th Feb 2007.

           The Andhra Pradesh Rural Health Initiative is a collaborative effort of the Byrraju Foundation, The George Institute for International Health Sydney, the Centre for Chronic Disease Control in New Delhi and the CARE Foundation, Hyderabad to develop cost effective solutions for providing health care to rural communities. As a part of this Initiative, it is required to carry out mortality/morbidity surveillance in about 45 villages of East & West Godavari. Trained personnel conduct verbal autopsy using specially structured Verbal Autopsy Forms, which are sent to the IHS. At the Institute the cause of death (COD) is assigned to each form as per the ICD-10 codes. The project which began in June 2004 is for a minimum of three years and is sponsored by the Byrraju Foundation^[1].Till date we have coded about 4000 VA Forms.

^[1] Byrraju Foundation Agreement & Letter dt: 23rd June 2004.

           Adverse health effects attributable to air pollution are an important public health problem. Air pollutants such as particulate matter have damaging effects on human health. Estimates of the health damages associated with air pollution are required to assess the size of the problem and to evaluate the impact of specific pollution control measures. The IES programme was designed to integrate solutions for multiple benefits. The health effects analysis study aimed to identify and analyze the air quality, public health and GHG mitigation “co-benefits “ in transportation and industrial sectors, to develop an initial estimation of the health impacts of PM10 (Particulate matter of 10 microns diameter) in Hyderabad and their social costs. The analysis was conducted for Business as Usual (BAU) and four identified alternative mitigation scenarios. The magnitude of health impacts in relation to PM10 exposure was calculated using both a health risk assessment approach and percentage increases of mortality or morbidity per unit increase of air pollutant concentration. The analysis was based on Concentration Response (CR) functions derived from available epidemiological studies. Health benefits were computed using Human Capital Approach (HCA) for mortality valuation, and the Cost of Illness (COI) approach for valuing morbidity. Transportation sector is the largest contributor to air emissions (approx. 70% of the total load) in Hyderabad . The effective bus transit mitigation scenario resulted in, 1/3rd reduction of PM10 concentrations compared to BAU levels, and the most significant decreases in mortality and occurrence of CVD and other respiratory diseases. The transportation sector was recognized as an area, where significant air quality and public health benefits could be realized through the IES, India Analysis. The project started in November, 2002 and was funded by the USAID#FF3333; font-size:12px">[1].Till date we have coded about 4000 VA Forms^[1].

^[1] Third tier sub contract No. IES India/EPTRI/02 dated 6 Nov. 2002.

           During the working group^[1] discussion of the socioeconomic panel of the WHO-NIHLBI “Global Strategy for Asthma Management Project”, it became evident that very few studies on social, economic and cultural aspects of asthma have been done in the industrialized and developed economies. In the developing world such studies were not available at all. Without any such studies the panel was handicapped in making recommendations about socioeconomic impact of asthma all over the world. At the same time, the time table of the full project could not be held up because of this. Hence it was decided to go for a few quick exploratory studies. This study^[2] was a result of the decision. The social impact of asthma advances far beyond the bar numbers of affected individuals. It creates a burden not only for the individual but also for society, with reduced productivity, quality of life, and economic costs. Social institutions, family practices and behavioral responses can all contribute towards coping with the morbidity. These social and cultural opportunities should not miss the attention of medical and public health professionals. The study^[3] sought to develop tools to assess socioeconomic aspects of asthma and to describe them. It revealed that the illness ‘asthma’ is an easily identified problem both in rural and urban areas. In the rural area, the poor preferred to avail services from the government health facility. Majority (75%) of those suffering from the disease had to either avoid (40%) or restrict (35%) work on account of asthma. The children among them lost on an average 2.66 days of school per month and the adults lost about 1.65 days work per month. In addition to the direct burden of asthma due to loss of school or work for the affected person, families with an asthmatic experience loss of work by other members of the family to attend on the affected person and quite significant expenditure for treatment of the disease. For example the top two causes cited by asthmatics who perceived their condition as a burden were; (a) overall cost of the treatment takes away a big chunk of the family income, (b) the need for assistance by at least one family member during attacks. Major part of the financial burden was on account of medicine purchase. Thus lowering of prices of asthma medication is likely to increase utilization of the drugs and reduction of morbidity. The report is also brought out as a working paper by IHS^[4].

^[1] Dr. Prasanta Mahapatra, President and Director, IHS was a member of WHO scientific group on Asthma.
^[2] The survey and writing of this paper was made possible by a grant from the NIH-WHO Global Strategy for Asthma Management Project and the Division of Lung Diseases. NHLBI . NIH . Bethesda . MD 20892. U.S.A.
^[3] Global Strategy for Asthma Management and Prevention - NHLBI/WHO Workshop Report, Global Initiative for Asthma, Ch 8; pg 120-137; NIH, NHLBI, USA, 1995.
^[4] Social, economic and cultural aspects of Asthma: An exploratory study in Andhra Pradesh , India . IHS, WP03, 1993.