Several community, education and research related events were held all over India during the activity week beginning 12 Oct wherein globally days have been dedicated to arthritis, osteoporosis, spine disorders and trauma- the target disorders of the global Bone and Joint Decade (BJD) initiative 2000-2010.
The Pune region led the way where a major meeting was held, perhaps for the first time, on 14 Oct, to critically evaluate the 'burden of Rheumatic-Musculoskeletal disorders in India'. Over 150 delegates mostly experts, practitioners and post-graduate students from rheumatology, orthopedics, community medicine, and public health actively participated. Premier medical institutions from Delhi (including ICMR & AIIMS), Calcutta, Bangalore, Chennai, Hyderabad, Mumbai, Coimbatore, Lucknow, and Pune (that included AFMC, BJ medical college, DY Patil Medical college, NIV, University of Pune) were represented. Dr. R K Srivastava, DGHS, Government of India, presided over the meeting. The meeting was organized by Dr. Arvind Chopra, National Secretary, BJD India and a renowned rheumatologist from Center for Rheumatic Diseases, Pune.
Delivering the key note address, Dr. Srivastava described rheumatic musculoskeletal ailments as widely prevalent but neglected disorders that often cripple people and reduce their productivity and quality of life. The Indian data on arthritis, osteoporosis and spine disorders was rather inadequate but some data from the widely published WHO COPCORD (Community oriented program for control of rheumatic diseases) Bhigwan (Pune) study could be used to project the likely overwhelming burden of Rheumatoid arthritis and Osteoarthritis in the Indian population, added Dr Srivastava. Finally applauding BJD India and Center for Rheumatic Diseases Pune, Dr. Arvind Chopra in particular, for their programs on increase awareness, education and research, Dr Srivastava asked them to increase their visibility so as to reach all over India.

Summing up the data of over 35,000 population surveyed in Jammu, Lucknow, Bhigwan, Pune, and Chennai, using the WHO COPCORD model, Dr Arvind Chopra announced that 12-15% of the Indian population seem to suffer from some form of painful rheumatic ailment and at least 55-60% recorded a significant impact on their life, work and finances. RMS was the pre-dominant community ailment in the Indian surveys, much ahead of infections and other non-communicable diseases. About 50-55% patients suffered from some form of soft tissue rheumatism (commonly back, knee, neck and shoulder pains) followed by degenerative disorders (osteoarthritis and spondylitis of knees and spines) in one third. Inflammatory arthritis, including rheumatoid arthritis (often a progressive crippling and deforming disease), affects less than 10% of the community RMS patients but being a major treatment challenge attracts maximum attention. In fact, the maiden Indian Bhigwan WHO COPCORD study had published the highest reported prevalence (0.55% as per the criteria of the American College Rheumatology) of rheumatoid arthritis from a rural population. Dr Chopra also showed WHO published data (TRS 919, 2003) from different countries to demonstrate the alarming high proportion of young women suffering from rheumatoid arthritis in the Bhigwan (India) study as compared to any other population study (e.g. in the women age group 30-44 years, the proportion per 100,000 population was 1639 for Bhigwan-India as compared to 300 in USA and 237 in China). Dr Chopra is also currently the international co-ordinator for the WHO COPCORD that has been initiated in over 19 countries World wide.
Further, Dr Chopra and Dr Vaijayanti Lagu- Joshi, rheumatologists from CRD, based on the Bhigwan and Pune data of over 15,000 population, revealed that smoking-tobacco use and illiteracy had emerged as the leading risk factors for rheumatic pains in multiple variable regression models and that this was altogether a new finding requiring urgent recognition and attention of the medical faculty and public health. "The association of tobacco use with inflammatory arthritis and osteoporosis has been recently proven in the West but we are not aware of any study that has shown its association with rheumatic pains and ailments as a broad based entity", Dr Chopra added.
Dr Mahendranath, Chairman BJD India NAN, outlined the BJD India sponsored urban population multiregional RMS survey road map to collect data in Jammu, Chennai, Pune, Delhi and Kolkatta using the WHO COPCORD Bhigwan model. He said that this was probably the biggest program of its kind in the Asia Pacific region and will be critical to provide information for a national control program. Later in the meeting, Dr Bela Shah, Senior Deputy Director ICMR, announced that Indian Council of Medical Research (ICMR) will launch several rheumatic-musculoskeletal studies to cover at least 30,000 population in 3 different Indian regions. Several essential components of the COPCORD Bhigwan model had been incorporated in the ICMR project that had been earlier envisaged by the DGHS and now prioritized for action.
Prof CS Pandav Head of Department of Community Medicine in AIIMS, New Delhi, in his highly applauded guest lecture strongly supported the notion that 'arthritis is an important public health issue' and even suggested that the Parliament be made aware. As the majority of sufferers are women, Prof Pandav advised Dr Chopra to explore the national women health and empowerment programs. Rheumatic ailments should also find priority in rural and geriatric health care programs. In a bold reference to the historical 'Dandi March', Prof Pandav declared that Gandhi ji must have walked at least 10 miles a day which is not only a symbol of 'freedom movement' but in itself is also an expression of physical fitness and 'freedom of movement' both of which are central to Bone and Joint health. Dr Rajamani, a BJD India Liaison officer and a rheumatologist from Coimbatore, lamented that the IT-Computer wave had unleashed a yet unmeasured enormous burden of rheumatic aches and pains due to computer related occupational overuse, misuse and abuse.
The annual 'Late Amrut Modi-Unichem BJD India research fellowship awards 2006' were given to 6 young medical graduates by Dr Srivastava, DGHS, GOI- Dr S Kalkotwar & Dr A Bang (Mumbai & Gadrichirolli), Dr P Metange (Pune), Dr S Kanjilal (Delhi), Dr T Zaman & Dr S Agarwal (Delhi), Dr P Raj (Mumbai) and Dr Meenaz & Dr Harbeer (Pune). Dr Meenaz and Dr. Harbeer, research medical officers from CRD Pune, made a brief presentation of their award winning project on "Rheumatic musculoskeletal aches and pains in Chikungunya virus infection- a rural population based study". Dr Ramesh Prabhoo, a senior physician social worker and former Mayor of Mumbai and Ex-MLA, co-chaired the award presentation meeting and applauded the dedicated community health and research commitments of BJD India and CRD Pune, and Dr Arvind Chopra in particular. On a move proposed by Dr Mahendranath, a standing ovation was given to Dr Arvind Chopra for his unparalleled efforts to identify the burden of rheumatic ailments in India and provide a national forum for action. Dr Arvind Chopra, a well known rheumatologist from Pune, has been the chief investigator of the BJD India and Bhigwan COPCORD population survey programs.
The program was organized by BJD India and CRD, Pune, and sponsored by Arthritis Research & Care Foundation, IPCA pharmaceutics, Unichem pharmaceutics and El Lily. Ms V Anuradha from CRD Pune expertly co-ordinated and conducted the program.