DECCAN HERALD 11

Wednesday, November 5, 2014

Panorama

Copper may help prevent

Ebola spread. P12

Benefits of sanitation immense, but task ahead is tough

By Naresh Kapoor

rime Minister Narendra Modis

Swachh Bharat campaign is a wellthought out move. It needs to be implemented seriously. Human excreta are
the potential source of transmitting many
infectious diseases such as cholera, typhoid, infectious hepatitis, polio, cryptosporidiosis, and ascariasis. Ensuring that
people have access to safe drinking water
is another critical dimension of sanitation.
Unsafe water, poor sanitation and hygiene leads to under nutrition, pneumonia,
worminfestations,reducedphysicalgrowth,
weakenedphysicalfitnessandimpairedcognitivefunction,particularlyforchildrenunder the age of five. Heavy metals, toxic organic and inorganic substances also can
pose serious threats to human health and
environment, particularly when industrial
wastes are added to the waste stream.
Therefore, benefits of sanitation are immense, but the task ahead is not so easy!
ThePMhasgiventhecountrymenatask
to be achieved in a holistic manner. Sanitation is not only about maintaining clean-

liness around human habitats. If looked at

in totality, sanitation is all about ensuring
a healthy environment to all living creatures, which can come by self-realisation
and awareness on good health. A survey
conducted by the National Sample Survey
Office (NSSO), Union Ministry of Statistics
and Programme Implementation between
July 2012 and December 2012 had made
some startling observations, which were
based on the findings covering 4,475 villages in rural areas and 3,522 urban blocks
spread over all states and Union Territories. About 88.5 per cent households in rural India had improved source of drinking
water while the corresponding figure was
95.3 per cent in urban India. Among rural
households, 85.8 per cent had sufficient
drinking water and for urban India the corresponding figure was 89.6 per cent.
This means that making available safe
drinking water to Indian masses is not a
difficult task. It just needs one major push,
which will bring the whole populace within
the ambit of pure and safe drinking water
supplychain.Itwillalsotremendouslyhelp
animal husbandry as well. By providing

safe drinking water, we will only save our

people suffering from water borne diseases. To have pure source of water, overall
sanitation needs to be improved upon.
What about latrines? The survey shows
that 59.4 per cent and 8.8 per cent householdsinruralandurbanIndia,respectively,
had no latrine facilities. It needs to be addressed on a priority basis. A healthy India
needs toilet facilities for all. About 38.8 and
89.6 per cent households in rural and urban India, respectively, had access to im-

proved type of latrine.

Providingairyaccommodationisanotherimportantdimensionofsanitationgoals.
If we force a large populace to live in compressed accommodation, then most of
themwillenduppickingupmanyailments.
We will never have healthy children from
these areas. It is a major problem in urban
India, where a chunk of people are constrained to live in slums against all odds
and health hazards. If one goes by the survey,thenonly26.3and47.1percenthouseholds in rural India and urban India, respectively, had dwelling units with good
ventilation.As much as 31.7 per cent of rural households and 82.5 per cent of urban
householdshadimproveddrainagefacility
in the environment of their dwelling units.
It is not that people do not want to move
out of slums or squatter settlements, but
they need to be provided with opportunities to do so. At all India level, 70.8 per
cent of households had cited better accommodation as the main reason for
which they thought to move out of slum
or squatter settlement whereas 11.7 per
cent households had identified proximity

to place of work as the main reason.

Best practice models
There is a need to spread awareness on
sanitation related issues and opting for the
best practice models. We must understandthatsanitationisacross-cuttingissue
and has implications for a variety of development areas. To attain the target of total
sanitation, we need to work as well-knit
unit. Total sanitation has to go beyond just
toilets. Urban women use sanitary napkins
but in rural areas, women use a piece cloth
and have no private space to dry the piece
of cloth in sun. It is used while still wet.
This has health and hygiene implications.
Sanitation has also a strong connection
with human dignity and well-being, public
health, nutrition and even education.
Which is why Mahatma Gandhi once said:
Sanitation is more important than independence.Sanitation issues should be given priority in our development policy approaches. Its implications need deep study
and greater understanding. The role of
community leadership in changing old
habits and ways of thinking will be crucial

Risk and cost in

travelling to stars
Twoback-to-backexplosionsareastarkreminderthatthepathtospaceisarduousforprivatecompanies
By Jad Mouawad

pace travel has long been the preserve of

governments and sci-fi fans, but in recent
yearsacropofnewcommercialventures,
often backed by billionaire entrepreneurs, has
sought to get into the race.
The list of so-called thrillonaires has only
grown, along with their ambitions: Jeff Bezos,
the Amazon founder who set up Blue Origin to
lower the cost of space technology; Elon Musk,
who founded SpaceX with the aim of going to
Marsoneday;andRichardBranson,whostarted the space tourism company Virgin Galactic.
But two recent accidents involving commercial rockets have underscored the high risks
and soaring costs involved in any spaceflight.
Last Friday, a Virgin Galactic space plane
exploded during a test flight over the Mojave
Desert, killing one pilot and injuring another.
Daysearlier,anOrbitalSciencesrocketcarrying
a supply vessel to the International Space Station blew up seconds after it was launched.
Both accidents are under investigation. Although they were unrelated, their occurrence
just days apart was a stark reminder that the
pathtospaceisjustasarduousforprivatecompanies as it is for government-funded programmes.
The engineering and physics of space tend
to be unforgiving, no matter who is doing this,
said Scott Pace, director of the Space Policy Institute at George Washington University and a
former assistant administrator at the National
Aeronautics and Space Administration.
The common thread between these new
space initiatives is that they all are looking for
waystosharplycutthecostofspaceflight.Without that, analysts say, there is no realistic
prospect of making spaceflights both routine
and affordable in the future.
What you are seeing playing out are different experiments, by different groups, trying
different approaches, Pace said. To me, this
does not call into question the basic logic of relying more on the private sector. The push to
privatisespaceflightisinpartborneofnecessity.
Afterpioneeringspaceexplorationandlanding
on the moon with programmes like Mercury,
Gemini and Apollo, NASA has had to adapt to
tighterbudgetsandredefineitsmission.Today,
one of its main goals is to encourage and fund
the development of commercial space entities.
Lori B. Garver, a former deputy administrator at NASA and one of the most prominent
advocates for commercial space during her
tenure, said that public funds should focus on
activities that advance technology and provide
public benefits to all, like planetary science. At
thesametime,shesaid,thegovernmentshould
encourage private companies to move ahead
and find innovative ways of reducing costs.
In my view, the private sector has the same
incentive, or even more, to get things right as
the government does,Garver said. If we only
trusted risky things to the government, we
would only fly in government-owned and operated airplanes.

UNFORTUNATE OCCURENCES: The wreckage of the Virgin Galactics SpaceShipTwo, which crashed into the Mojave Desert, killing one pilot
and injuring another on Friday. (INSET) An unmanned Orbital Sciences rocket exploded after liftoff in Virginia last Tuesday. AFP/AP

Many of the current commercial operations

havesomeformofgovernmentsupport.Orbital
Sciences is operating under a $1.9 billion contract from NASA to deliver cargo to the space
station.ItsAntaresrocketexplodedonthethird
of eight resupply missions.
The same is true of SpaceX, which was recently awarded $2.4 billion by NASA to build a
transportationsystemforastronautswithinthe
next three years. SpaceX was also the recipient
ofanearlier$1.4billioncontracttodelivercargo
to the space station. Boeing also won a NASA
contractfor$4.6billiontobuildaspacecraftcapable of flying astronauts to the space station.
SpaceX and Orbital Sciences have sought to
reducecostsindifferentways.Orbitalsrockets
use a pair of refurbished engines built in the
Soviet Union in the 1960s and 1970s. The engineswereintendedforSovietrocketsdestined
for the moon, but were never used and lay in
storage for decades. The engines were refurbished by an American company and incorporated into the Antares rocket by Orbital.
SpaceX, by contrast, builds its engines for its
Falcon 9 rocket and aims to reduce costs, in
the long term, by reusing the rocket. The companyhassucceededinfiringatestrocketcalled
Grasshopper, having it hover at around 2,400
feet and then returning it to its point of launch.
But its efforts to land Falcon 9 rockets have
so far been unsuccessful, though the company
says it is getting closer. In August, a bigger test
rockettryingahigh-altitudetestwasdestroyed

shortly after takeoff. No one was injured.

NASA is looking for cheaper access to
space, said Marco A. Caceres, a space analyst
attheTealGroup,aconsultingfirminVirginia.
Thetroubleisthatreliabilityandpriceareoften
tiedtogether.Itmaybeunreasonabletoexpect
to pay under a certain amount to get a reliable
vehicle,Caceres said. That comes at a cost.
To the edge of space
Virgin Galactic is an exception to the model of
government-funded launchers. The company
has been working on an experimental vessel to
take paying passengers to the edge of space
and back.
The craft, called SpaceShipTwo, was designedtobelaunchedfromaplane,thenrocket
up to its apogee at about 62 miles, an altitude
considered the boundary of outer space. At the
top of its ascent, two tail booms would rotate
upward into a so-called feathered position intended to create more drag and stability, and
allow the plane to descend gently back into the
atmosphere.
Federal accident investigators said that the
plane had shifted early into this high-drag configuration shortly before its accident on Friday
for reasons that are still unclear. The investigators said it was far too soon to draw any conclusions about the crash.
Investigators have located almost all of the
importantpiecesofthespaceplane,whichhad
fallen along a debris field five miles long. That

included the fuel tanks and the engine, which

were intact, showed no signs of burn through,
no signs of being breached, said Christopher
A.Hart,actingchairmanoftheNationalTransportation Safety Board. There is much more
wedontknow,andourinvestigationisfarfrom
over,Hart said during a news conference Sunday night at the Mojave Air and Space Port in
California.
In a statement Sunday, Virgin Galactic responded to criticism that the design of SpaceShipTwo was flawed and that the test flights
were reckless. At Virgin Galactic, we are dedicatedtoopeningthespacefrontier,whilekeeping safety as our North Star, the company
said. This has guided every decision we have
madeoverthepastdecade,andanysuggestion
to the contrary is categorically untrue.
Caceres said the new space entrepreneurs
were good at creating excitement about their
ventures. Before Fridays accident, about 700
people had reserved seats on Virgin Galactic,
with tickets costing $250,000 each.
You are talking about a brand new era of
space, Caceres said. You have personalities
like Richard Branson and Elon Musk and Jeff
Bezos, who are not engineers. These are different kinds of people and they can generate a
lot of excitement and capital investors who are
willing to give you a lot of money.However, he
added, the downside is that if you have problems,youhaveallthisattentionfocusedonyou.
International New York Times

as our own experience has shown. Similarly, sanitation has to be located in an integrated framework of public health policy
to ensure that sanitation activities are indeed adequately funded. For example,
hand washing with soap can reduce the incidence of acute respiratory infections
(ARIs) by around 23 per cent according
to the World Health Organisation.
Thereisalsoaneedtodevelopsanitation
technologies for diverse eco-systems. New
technologieshavetobeaffordableandsustainable. Traditional water systems had
beenengineeredinourvillagestooptimise
scarceresourcesincludingtheuseofwater.
WemustusescientificingenuitytotakeIndiatothenextgenerationofsanitationtechnologies. Human waste should be treated
as a resource to be recycled. With more urbanisation and industrialisation, this challenge will gain importance. We have to
strive for sanitation for dignity and health.
Good sanitation should be a birthright of
every citizen of India. Total health will only
come through total sanitation.
(The writer is Director, BLK Super Speciality Hospital, New Delhi)

Cordbloodbanking:
Ambiguouspolicy
By Shashank S Tiwari

n the interim Union Budget

2014, then finance minister
P Chidambaram had announced exemption of service
taxoncordbloodbankingservices. In his budget speech, he
had said that (the) Ministry of
Health and Family Welfare has
requested that services provided by cord blood banks are also
healthcare services and should
be exempt from service tax. I
propose to accept the request.
The request from the ministry is a clear indication of conflict between biomedical agenciesinIndiaatthelevelofpolicy
formulation. Given that, in the
revised 2013 stem cell research
guidelines, the Indian Council
of Medical Research (ICMR)
has raised concerns over the
commercialisation of private
cord blood banking in India. It
is worth mentioning here that
the newly elected BJP-led government also did not indicate
rolling back of that decision.
Cord blood banking is a
processofcollectingandstoring
a new born cord blood for harvesting stem cell. Cord blood is
one of the richest sources of
stem cell which is widely seen
as a potential to treat many incurable diseases such as spinal
injury, muscular dystrophy,
Parkinsonsdisease,Alzheimers
disease, multiple sclerosis, diabetes, retinal pigmentosa etc.
There are two types of cord
blood banking as per their nature: a) public, and b) private
cord blood banking. In the former,expectantparentspayafee
to preserve their childs cord
blood while in the latter, the natureisaltruism.Therearemore
than15privatecordbloodbanks
in India. The private cord blood
bankingisseenasacommercial
venture which is largely based
on hope and hype and raises
many ethical, social and governance concerns.
The ICMR, jointly with the
Department of Biotechnology,
updated the 2007 stem cell
guidelines in December 2013.
InSection12.1ofstemcellguidelines, it is stated that procurementandbankingofvariousbiological tissues such as
umbilical cord blood, placenta,
extracted tooth, adipose tissue
and other sources of stem cells,
with the specific objective of
theirisolationand/orexvivoexpansion, is increasingly becoming a commercial activity.
Further, Section 12.2.2 emphasises that there are ethical
concernsaboutthepromotional
advertisementsbyprivatebanks
offering storage of cord blood
forpossiblefutureuse.Suchadvertisementsareoftenmisleading for the public and lack comprehensive and accurate
information. It may be men-

tioned that there is no scientific

basis for preservation of cord
bloodforfutureself-useandthis
practice is not recommended.
However, despite these concerns, one of the departments
oftheMinistryandFamilyWelfare requested the government
for service tax exemption on
cord blood banking services.
Self use of cord blood
The legitimate question arises
whethertheICMRhasacknowledged that there is not enough
scientific evidence in favour of
future self-use of the preserved
cordblood.Itisworthhighlighting that for biomedical governance, there are two key agencies in India working under the
Ministry of Health and Family
Welfare ICMR and Central
DrugsStandardControlOrganisation (CDSCO).
The ICMR works as an advisorybodywhileCDSCOisaregulatory body that primarily
oversees manufacturing, sale
and distribution of drugs. The
CDSCO also approves new
drugs and monitors clinical trials. It is the licensing authority
for cord blood banks in the
country. Given the ICMR position in 2013 stem cell research
guidelines, it appears that CDSCOhasrequestedgovernment
for the service tax exemption
oncordbloodbankingservices.
WiththecontradictorystatementoftheformerFM andthe
2013 stem cell research guidelines,onecaninferaseriouspolicyconflictbetweenbiomedical
agencies in India. This needs to
be addressed soon as the proliferation of private cord blood
banking leads to possible economicexploitationofexpectant
parents in the name of biological insurance.
However, the chances that a
particular child will develop a
condition requiring cord blood
transplantationareveryslim.It
hasbeenobservedthat0.04per
cent (1/2,500) of cord blood
unitsstoredwouldeverbeused
forautologoustransplantation.
The reason is that the occurrence of diseases currently
treatedwithcordbloodissmall,
and many patients would not
be eligible for autologous cord
blood, including those with genetic disorders and leukaemia.
In addition, no one knows,
whether CDSCO ensures storage conditions and quality control especially while shipping
thestoredcordbloodfromhospitals to banking firms. Since
Union health minister Harsh
Vardhan is a clinician by profession,onecanexpectarobust
policy regime and an effective
monitoring mechanism for
cord blood banking in India.
(The writer, a scholar of Science
andTechnologyStudies,isbased
in the USA)

WHATS THE BUZZ

Third hand smoke to

have lingering effect
Third hand smoke continues to harm health
even hours after smoking ends, scientists at
the US Department of
Energys Lawrence
Berkeley National Laboratory have found.
They looked at the levels of more than 50
volatile organic compounds and airborne particles for 18 hours after smoking had taken place.
Hugo Destaillats said that in the US, the home
is where nonsmokers are most exposed to second
and third hand smoke and the goal of their study
is to provide information supporting effective

protective measures in the home.

Destaillats added that many smokers know secondhand smoke is harmful, so they dont smoke
when their kids are present, but if, for example,
they stop smoking at 2 pm and the kids come
home at 4 pm, up to 60 per cent of the harm from
inhaling thirdhand smoke remains.
The study found that the total integrated harm
rises sharply in the first five hours after a cigarette has been smoked, continues to rise for another five hours, and doesnt start to level off until
after 10 hours.

Switch to healthy diet doesnt

nullify impact of earlier habits
A new research has revealed that earlier poor
eating habits may impact health even after diet is

improved. The scientists used mice to show that

even after successful treatment of atherosclerosis, lowering of blood cholesterol and a change in
dietary habits, the effects of an unhealthy lifestyle
still affect the way the immune system functions.
This change in function occurs largely because
poor eating habits alter the way genes express
themselves, including genes related to immunity
and this change in gene expression (epigenetics)
ultimately keeps the risk of cardiovascular disorders higher than it would be had there been no
exposure to unhealthy foods in the first place.
Researcher Erik van Kampen said that this
demonstrates the importance of diet-induced
changes in the epigenome and encourages further research into the interaction between dietary patterns, DNA methylation and disease.
John Wherry, Deputy Editor of the Journal of
Leukocyte Biology said that the ability of nutri-

tional history to have durable affects on immune

cells demonstrated in this new report could have
profound implications for treatment of diseases
with immune underpinnings.

Mindfulness meditation good

for breast cancer survivors
Practicing mindfulness meditation or being involved in a support group has a
positive physical impact at the cellular level in breast cancer survivors, a study conducted
by Alberta Health Services Tom Baker Cancer
Centre and the University of Calgary Department
of Oncology has demonstrated.

The study points out that telomeres protein

complexes at the end of chromosomes maintain
their length in breast cancer survivors who practise meditation or are involved in support groups,
while they shorten in a comparison group without any intervention.
Linda E. Carlson, lead research, said that they
already knew that psychosocial interventions like
mindfulness meditation would help one feel better mentally, but now for the first time they had
evidence that they could also influence key aspects of their biology.
A total of 88 breast cancer survivors of around
55 years of age were involved in the study. Most
participants had ended treatment two years prior
and to be eligible they also had to be experiencing
significant levels of emotional distress. All participants had their blood analysed and telomere
length measured before and after interventions.