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Robotic Surgery Breaking New Ground in
Cancer Treatment
To create awareness about how robotic surgery
is bringing about a revolution in treating upon
patients suffering from cancer, the Rajiv Gandhi
Cancer Institute and Research Centre organised a
seminar on “Robotic surgery is no more a science
fiction”.
Dr. Sudhir Rawal said: “With the use of robots
there is enhanced surgical precision, minimal blood
loss, lesser pain, smaller surgical scars, faster recovery
and earlier return to work.” He said using a robot
provides 10 times more magnification and a three-
dimensional view.
Why Endosulfan, All Insecticides are Poison
The pathetic plight of the people of Kasaragod
in Kerala, in the wake of the endosulfan fiasco, brings
into focus an issue which is a ramification of the
green revolution. Whatever the technical grounds for
its acceptance or rejection, the fear engulfing the
minds of people can be removed only if a full-fledged
assurance is given on the complete ban on the
pesticide.
Insecticides which kill the worms that destroy
crops are seldom selective in their action. Most of
them affect other life forms though at a higher dose.
An insecticide is basically a poison. By its very mode
of action, a poison is detrimental to all life forms;
only the dosage to manifest the adverse effects varies.
Several external agents are continuously
destroying the vital molecules in the body of living
forms. But in most cases, especially in higher life
forms, these are restored through a repair mechanism.
When the repair mechanism is weak or not able to
cope with them, different diseases develop. In
Kasaragod, endosulfan was aerially sprayed from a
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helicopter. Though effective in uniform dispersal, this
procedure is the root cause of the present malady.
The droplets of the insecticide would have traversed
several kilometres beyond the boundary of the
plantation. This would naturally adversely affect
other life forms, including humans. Thus, aerial
spraying has to be abandoned and spraying with hand
machines is more desirable even though it is labour
intensive.
The story of DDT was the wake-up call. Traces
of this compound were noticed even among the
penguins living in the South Pole, where no spray of
DDT was ever carried out. In other words, the spray
from the habited land mass has crossed the
continental borders and reached almost the entire
globe. It has also crossed the placental barrier and
new babies are born with DDT contamination. Even
the mother’s milk contains a small dosage of DDT.
This is the fate of a chemical thought to be
marvellous in controlling insects and to have
contributed immensely to the agricultural revolution
of the 1950s and 1960s.
Another mode of transport is by water and this
may find access to the nearby river. This
contamination will have a deleterious effect on
marine life. Further, bio-magnification to a lethal
dose may take place in the higher life forms. The
Minamata disease that occurred in Japan is a standing
example of such maladies. In this case, marine
organisms bio-accumulated mercury that causes
nervous diseases. Thus continuous analysis of soil,
water and air samples has to be carried out around
the area of insecticide spray to understand the
imminent impact and retain it within tolerable limits.
Even after a ban on endosulfan, it is necessary to
resort to other forms of insecticides. Several
constraints and precautions have to be exercised in
the usage.
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1. Spraying is a technically skilled job and
has to be carried out manually by skilled
personnel on the ground. These personnel
have to be certified by the Agricultural
department.
2. They shall wear special protective clothing
and respirators. A mere mask is not
enough.
3. After the spray, the clothing and respirator
have to be cleaned up and stored after
packing on the farm itself. It is even
desirable to bury the cloth in the
plantation itself.
4. The personnel have to be fully
decontaminated (which includes bathing)
before they go home. Children and
pregnant women at home are likely to be
more susceptible to these poisons.
5. Simultaneous scientific investigations on
the flora and fauna around the plantation
should be carried out throughout the year
in addition to the analysis of air, water
and soil samples.
6. Contamination may spread to waterbodies
around the plantation and affect marine
life. Land erosion and leaching in the
sprayed area have to be arrested with
appropriate action.
7. If any adverse effect is noticed, the
insecticide has to be discontinued. It is
not necessary to wait until a human
catastrophe of unmanageable magnitude
surfaces to rouse the conscience of
society.
Not only endosulfan, but most other
insecticides are poison to all forms of life.
Need to Differentiate between Bacterial,
Viral forms of CAP Stressed
Paediatricians need to differentiate between
bacterial and viral forms of community-acquired
pneumonia (CAP) to plan an effective antibiotic
strategy, S. K. Kabra, Professor, Paediatric
Pulmonology Division, AIIMS, New Delhi, said.
It is estimated that bacterial infections account
for 40-60 per cent of pneumonia and viruses for 40-
44 per cent of the cases while atypical pathogens are
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the trigger for 10-20 per cent of the cases, Dr. Kabra
said. CAP is the biggest cause of death in children
worldwide accounting for about 1.5 million children
under five annually. It is particularly rampant in
developing countries where the acute respiratory
infection accounts for 151 of the 156 million global
cases annually. India alone records 43 million cases
a year, Dr. Kabra said.
20 per cent Increase in Consumption of
Iodised Salt
Use of adequately iodised salt has increased
by 20 per cent in the rural households as against the
last country-wide survey conducted under the
National Family Health Survey (2005-06). The
Iodised Salt Coverage Study 2010, released, suggests
that use of iodised salt in rural India has jumped to
47.3 per cent from 27 per cent.
NACP-VI should not be a Cut-and-paste Job
As joint owners of the national response to
HIV/AIDS, civil society groups have called upon the
government to take proactive steps to meaningfully
involve civil society in all aspects of
conceptualisation, design, planning and
implementation of National AIDS Control
Programme-IV. They also want the National AIDS
Control Organisation (NACO) to put in place
transparent mechanisms to inform civil society of the
process in the run-up to the planning and
development of NACP-IV. In a memorandum, the
civil society organisations have called for
collaboration to ensure that the drafting of NACP-
IV is transparent, inclusive and participatory. The
process of NACP-III conceptualisation, design and
planning has been globally recognised for its
inclusivity and transparency and its strategic
integration of human rights in all its aspects, says
the memorandum. India is on the verge of developing
NACP-IV that will define the national response over
the next five years. Early indications are that there
are no evident plans for consultation and involvement
of civil society; the lack of transparency in
constitution of working groups is a case in point.
Moreover, there is no indication of wider
consultation with civil society and community as
was the case in the design of NACP-III. This is a
disturbing trend as it ignores what has been learnt
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in the last five years of programming. “NACP-IV has
to build on the gains of NACP-III and should not
become a cut-and-paste job of the earlier strategy,”
say the civil society groups.
At India’s Insistence, Mental Health
Included as Non-communicable Disease
India achieved a major success on the global
platform by pushing for inclusion of mental health
in the list of non-communicable diseases. India
fought alone to get mental disorders included in the
non-communicable diseases (NCDs) list at the just-
concluded first Ministerial Conference on Healthy
Lifestyles and Non-communicable Disease Control
in Moscow. The principal non-communicable
diseases are cardiovascular diseases, diabetes,
cancers and chronic respiratory diseases, which are
the leading causes of preventable morbidity and
disability, and currently cause over 60 per cent of
global deaths, 80 per cent of which occur in
developing countries. By 2030, the NCDs are
estimated to contribute to 75 per cent of global
deaths. Pleading for its case, India argued that “like
all non-communicable diseases, mental disorders
required long term treatment and affected the quality
of life.”
Global Agenda
Mental disorders will now form part of the
global agenda and get attention. It will also be
brought up at the World Health Assembly in Geneva
later this month, and at the United Nations Summit
on Non-Communicable Diseases. India is also
working towards framing a mental health policy
based on internationally-accepted guidelines.
Superbug NDM-I, a Result of Misuse of
Antibiotics
A recent survey in the Sassoon Hospital showed
that 20 out of 3,172 patients were carrying the
superbug, NDM-1 gene. Sixty-six per cent of the
patients also showed multidrug resistance. While it
is not a cause for immediate worry, experts say, the
high level of resistance to drugs could mean that soon
there will be no antibiotics which can fight diseases.
Renu Bharadwaj, Dean of the BJ Medical
College which conducted the study on the 3,172
patients over two months, said many such
‘superbugs’ existed and NDM-1 (New Delhi metallo-
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beta lactamase-1), a bacterium with multidrug-
resistant gene, was the newest genetic mechanism.
“The reason for the emergence of this
mechanism is that there has been a large-scale
misuse of antibiotics, resulting in high resistance.
There is need for a more disciplined use. We need
to preserve the antibiotics available to us.
International monitoring is necessary,” she said.
The British medical journal The Lancet, in a
report in August 2010 said NDM-1 was found in
sewage and drinking water samples in Delhi. The
causes of NDM-1 could also be that there was
immunodeficiency among patients, Dr. Bharadwaj
said. “NDM-1 can be treated with the anti-bacterial
drug, Colistin, which is very expensive.”
Mixed Stem Cell Transplant done Successfully,
Claims Institute
A Kolkata-based cancer research institute
claimed that it had carried out the country’s first
successful mixed stem cell transplant on a five-year-
old boy suffering from HbE-Beta Thalassemia. A
mixture of cord blood and bone marrow cells
collected from the boy’s younger sister was
transplanted to his body, it said.
The feat assumes greater significance in the
light of the fact that the transplant could be
successfully done even as the blood groups of the
siblings were dissimilar, according to researchers at
the Netaji Subhash Chandra Bose Cancer Research
Institute and stem-cell bank CordLife.
Draft Policy wants Centre to take over UIP
Warning of the risks involved in totally
depending on external sources for funding the
country’s Universal Immunisation Programme (UIP),
the draft National Vaccine Policy has recommended
that the government take ownership of the
programme for ensuring vaccine security and equity
by creating fiscal and legislative provisions with
appropriate support from external donors. The draft
policy says that as such funding depends heavily upon
donor countries and the UIP has yet to recoup from
the impact of the recent global financial crisis. It is
important that India creates and strengthens its own
mechanisms and systems for long-term sustenance
of programmes for vaccine-preventable diseases. The
UIP targets 2.7 crore infants and 3 crore pregnant
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women annually. It is one of the largest programmes
in the world. The country also has a vaccine industry
that caters to 43 per cent of the Expanded Programme
for Immunisation vaccines as well as some of the
new vaccines purchased by Global alliance for
Vaccines and Immunisation. Thirty-five per cent of
the country’s population buys the vaccines through
the private market. Recommending changes in the
existing immunisation schedule to accommodate
new vaccines and for broader utilisation of some
vaccines or changing the number of doses, the
proposed policy draws attention towards the shortage
of trained manpower to manage the UIP at the Centre
and State levels, disease surveillance and
procurement and effective vaccine management.
A Litchi a Day to Keep the Doctor Away
A new research paper has claimed that litchi
is not just a rich source of vitamins and minerals but
a powerful antioxidant as well and could be a
panacea for various ailments. Scientists from the
National Research Centre for Litchi, Muzaffarpur, in
Bihar, says the fruit contains Vitamin K, Vitamin B6
and more Vitamin C than citrus fruits. “Minerals like
magnesium, iron, calcium, copper, phosphorus and
potassium are abundant in Litchi. It is low in sodium,
saturated fat and cholesterol. They are also purported
to have some anti-inflammatory properties, aid in
gastrointestinal health and have as much fibre as an
apple,” it said. Scientists have also found that other
parts of the fruit like the seed, root, bark and flowers
could also be used for various medicinal purposes. -
PTI
Cell Phone Radiation Possibly Cancerous:
WHO
Confirming the worst fears of mobile phone
users all over the world, the World Health
Organisation (WHO) has warned that radiation from
cell phones is possibly cancerous. It has classified
the radio frequency electro-magnetic fields as
“possibly carcinogenic to humans, based on an
increased risk for glioma – a malignant type of brain
cancer – associated with wireless phone use”. The
number of mobile phone users globally is estimated
to be 5 billion and over the past few years there has
been mounting concern about the possibility of
adverse health effects resulting from exposure to
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radio frequency electro-magnetic fields such as those
emitted by wireless communication devices.
Now a study conducted by WHO and the
International Agency for Research on Cancer (IARC)
has placed cell phones on a par with the carcinogenic
hazards category as lead, engine exhaust and
chloroform. The type of radiation coming out of a
mobile phone is called non-ionizing. It is not like
an X-ray, but more like a very low-powered
microwave oven. Results from the largest
international study on cell phones and cancer was
released in 2010. It showed participants in the study
who used a cell phone for 10 years or more had
doubled the rate of glioma. To date, there have been
no long-term studies on the effects of cell phone use
among children.
No Need to Panic over WHO Report on
Mobiles: ICMR
A day after the World Health Organisation
(WHO) warned of the possibility of mobile phone
handsets causing cancer, the Indian Council of
Medical Research (ICMR) said that there was “no
reason to panic” as a study conducted in the Western
countries could not be extrapolated on the Indian
population.
“The people are genetically different, the
technology in India is different, so are the
environmental conditions,” R.S. Sharma, a senior
scientist of the ICMR and chief coordinator of the
ICMR’s study on health impacts of radiation from
mobile phone towers and cellular phones, said
India now follows the WHO-approved
International Commission on Non-ionising
Radiation Protection (ICNIRP) guidelines. But
Canada, Australia, New Zealand, Switzerland and
Russia have adopted stricter guidelines. Though the
Department of Telecommunications has fixed Rs. 5
lakh in penalty for each mobile phone tower emitting
radiation above the prescribed norms, it has failed
to implement these guidelines.
New Molecule may
Lead to Better Drug for TB
Scientists at the Tuberculosis Research Centre
(TRC) have hit upon a new molecule with anti-
bacterial and anti-viral properties that could
potentially lead to a better drug for the treatment of
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TB and common HIV sub-types. The team at TRC
extracted the molecule, Transitmycin, from the
marine microorganism Streptomyces sp. isolated
from a soil sample off the Rameswaram coral reef.
The brominated and pigmented (yellow)
antibiotic was found effective during in vitro tests
against dormant and active forms of Mycobacterium
tuberculosis — the pathogen that triggers one of the
leading infectious diseases worldwide. The
Transitmycin molecule also exhibited promising
inhibiting capability against certain common HIV
sub types such as clade B and C (HIV clade C is the
most common HIV strain in India) and pathogens
such as E. Coli and Staphylococcus aureus.
Now, Contraceptives on the Doorstep
To encourage the use of spacing methods by
young women, the Centre proposes to provide
contraceptives on their doorstep. Accredited Social
Health Activists (ASHAs) will be given monetary
incentives for motivation, follow-up and retention
of Intra-Uterine Devices (IUDs) and for supplying
oral and emergency contraceptive pills to prevent
unwanted pregnancies. If the client retains the IUD
at the end of 12 months from the date of insertion,
the AHSA will be given Rs.100 in a lump sum.
Statistics show there has been no increase in
the acceptance of IUDs in the country over the years.
Lack of follow-up care after insertion, lack of
screening facility to prevent reproductive tract
infections and technical incompetence in IUD
insertion are held responsible for the unpopularity
of IUDs. Often, complaints of spotting and lower-
back pain after insertion have forced women to get
the IUD removed rather than suffer the side-effects.
The scheme, expected to cost Rs.6 crore
annually, will be rolled out across the country. The
acceptance of the IUDs, irrespective of their Total
Fertility Rates (TFR), is poor in all States.
Orissa’s Koraput District has Highest Child
Vulnerability Index
Nearly 100 districts across the country have
been listed as child-vulnerable areas wherein children
are at a high risk of losing parental care and getting
exposed to difficult circumstances, according to a
new survey conducted by SOS Children’s Villages
of India, a non-government organisation that helps
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orphaned children. Koraput district in Orissa has the
highest child vulnerability index followed by
Balaghat district in Madhya Pradesh and Godda,
Giridih and Pakur in Jharkhand. Vulnerable children
are defined as ones most likely to lose parental care
and support due to reasons like poverty, social unrest,
HIV/AIDS and disability. The child vulnerability
index was arrived at after an analysis based on the
most common causes of child vulnerability. Five
hundred and ninety-three districts in the country were
ranked on the basis of key variables like HIV/AIDS,
social unrest and poverty. The sum index value
determined the degree of child vulnerability for each
district. The estimate was arrived at on the basis of
the Census and population projection data.
Report Sought on Genitoplasty Cases
Taking cognisance of a newspaper report about
several hospitals and clinics in Indore performing
surgeries on baby girls to change their sex, the
National Commission for Protection of Child Rights
(NCPCR) has asked the State government to
undertake an investigation with a team of doctors,
known for high professional competence and ethical
standards.
The Commission has sought a detailed report
within 15 days, giving facts, figures and
circumstances of the cases, list of doctors/hospitals
practising genitoplasty and action taken or
contemplated against them.
India has to Play a Critical Role in HIV
Prevention, says UNAIDS Official
The world can achieve the vision of ‘zero new
HIV (human immunodeficiency virus) infections,
zero instance of stigma and discrimination, and zero
AIDS-related deaths’ if India plays a critical role in
bringing about this transformation, domestically and
on the world stage, Michel Sidibe, Executive Director
of UNAIDS (a joint United Nations programme on
HIV/AIDS) has said. The world’s 86 per cent of HIV-
infected population in low and middle-income
countries are now being treated for HIV with generic
drugs manufactured in India. Reminding of the
International AIDS Conference in Vancouver in
1996, where India was branded the future AIDS
capital of the world, with infection levels projected
to reach 20 million people living with HIV by 2010,
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Mr. Sidibe said India had reduced the rate of new
infection by 50 per cent. He also asked India to reduce
its dependence on external funding which often made
good programmes vulnerable.
PM for Multi-sectoral Approach to Tackle
HIV
Calling for a multi-sectoral approach to
respond to the HIV/AIDS epidemic, Prime Minister
Manmohan Singh said there should be greater
integration of resources in dealing with the problem.
“Linkages should be made between the HIV/AIDS
programme and the Mahatma Gandhi National Rural
Employment Guarantee Programme to facilitate
employment of HIV-positive persons. Nutritional
needs of HIV-positive people, especially women and
children should be tackled by linking them with the
Integrated Child Development Scheme and other
developmental programmes,” he said.
The larger health system should also contribute
to providing a wider platform for greater reach of the
HIV/AIDS programme. All healthcare providers,
including ASHAs, should be involved in this gigantic
task. Primary and community health centres should
be made fully capable of providing treatment for
opportunistic infection, the Prime Minister said.
WHO Releases New Guidelines on
Drinking Water Quality
The World Health Organisation (WHO)
launched an updated edition of drinking water
guidelines on July 4 to push water suppliers to
systematically manage the potential risk of
contaminants entering water, from the catchment to
the consumer. Launched at the Singapore
International Water Week. “Countries have an
opportunity to make substantial public health
progress by setting and applying effective and
appropriate standards for ensuring safe water,” said
Maria Neira, WHO Director of Public Environment
and Health. The guidelines, which have been the
most authoritative framework on drinking-water
quality and often form the basis for national laws
and regulations, require “a paradigm shift in drinking-
water management for many countries,” the WHO
said. They contain comprehensive good practice
recommendations for the first time at different levels,
from household rainwater harvesting and safe storage
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through to policy advice on bulk water supply and
the implications of climate change. The last edition
was released in 2004.
The new edition is based on the latest scientific
evidence and includes hundreds of risk assessments
on specific waterborne hazards. It is estimated that
two million people die from waterborne diseases and
billions more suffer illness around the world, and
most of them are children under five. Much of this
is preventable, the WHO said.
Impressive Drop in Maternal, Infant
Mortality Rates
India has impressively brought down its
maternal and infant mortality rates, an indication that
it is close to achieving the Millennium Development
Goals (MDGs) set by the United Nations though the
total fertility rate (TFR) has remained static after
showing a decline during the past few years.
The maternal mortality ratio (MMR) — number
of women dying due to maternal causes per 1,00,000
livebirths — came down to 212 (2007-09) from 254
in 2004-06. The MDG target for India is to bring
down maternal deaths to 109 by 2015. Similarly, the
infant mortality rate (IMR) — the number of infant
deaths per 1,000 livebirths — has registered a 3 point
decline at 50 from 53 in 2008, though every sixth
death in the country is of an infant. The mortality
rate of girls is higher than boys, indicating a
“worrisome trend” for the government.
The under 5 mortality rate (U5MR), denoting
the number of children aged 0-4 years declined by 5
points over 2008 to touch 64 in 2009 as against 69
in 2008. However, the average number of children
born to a woman during her entire reproductive
period or the total fertility rate (TFR) remained
unchanged at 2.6 during 2008-2009.
The maximum infant mortality rate has been
reported from Madhya Pradesh (67) as against the
national average of 50, while Kerala, again, is among
the earliest to achieve the MDG target of 28, well
ahead of the set date. Kerala’s IMR is 12, with Tamil
Nadu just at 28. While Delhi is at 33, Maharashtra
at 31 and West Bengal at 33 are within the reaching
distance. The TFR for the country remained constant
at 2.6 during 2008-09 with Bihar reporting the
highest rate at 3.9, while Kerala and Tamil Nadu
continued their outstanding performance with the
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lowest rate at 1.7. A TFR level of 2.1 has been
attained by nine States and Union Territories, with
Andhra Pradesh at 1.9, Karnataka (2.0), Kerala (1.7),
Maharashtra (1.9), Punjab (1.9), Tamil Nadu (1.7)
and West Bengal (1.9). At present, on average, a rural
woman, (having a TFR of 2.9) at the national level,
would have about one child more than an urban
woman (having a TFR of 2.0). A uniform decline of
about 5 points is seen in the male and female under
5 mortality rate, with the maximum reported from
Madhya Pradesh (89) and the minimum in Kerala
(14). As of now Kerala, Tamil Nadu (33), Maharashtra
(36), Delhi (37) and West Bengal (40) have achieved
the MDG target of 42 set for 2015.
$1 b. World Bank Credit for Rural
Livelihood Mission
The World Bank has approved $1 billion as
credit for the recently reframed National Rural
Livelihood Mission (NRLM), a Centrally-launched
programme that seeks to improve livelihood
prospects in the country’s rural economy.
The World Bank intends to support specific
additional investments in 12 States, which have a
high number of poor people. Bihar, Chhattisgarh,
Gujarat, Jharkhand, Karnataka, Madhya Pradesh,
Maharashtra, Orissa, Rajasthan, Tamil Nadu, Uttar
Pradesh and West Bengal have the highest number
of absolute poor and account for almost 85 per cent
of India’s rural poor, according to the World Bank.
The organisation stressed that its project would
help the NRLM scale up the successes of past
initiatives to other lagging regions of the country. The
World Bank has supported other such projects in
Andhra Pradesh, Bihar, Madhya Pradesh, Rajasthan
and Tamil Nadu, and has mobilised some 35 million
rural poor since 2000. The World Bank claimed that
its projects had so far resulted in household savings
in excess of $1 billion and that self-help groups had
leveraged credit worth nearly $7.5 billion from
commercial banks, and had achieved an annual
turnover of $500 million through the collective
marketing of farm and non-farm produce.
HbA1c Test Highly Predictive of Future
Diabetes in Asian Indian Subjects: Expert
Even as the world debates over whether the
three-month average of blood sugar (HbA1c) could
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be a tool to identify people at high risk of diabetes,
a study from Chennai has shown that the test was
highly predictive of future diabetes in Asian Indian
subjects with impaired glucose tolerance (IGT).
The study by A.Ramachandran et al, published
in Diabetic Medicine, concluded that HbA1c could
show who among the pre-diabetics would go on to
develop diabetes later. A.Ramachandran, founder,
India Diabetes Research Foundation, and
A.Ramachandran’s Diabetes Hospital, explains that
about 55 per cent of pre-diabetics (or IGT) in the
Indian population go on to develop diabetes in the
next three years. “The HbA1c will tell you which of
the 55 per cent will go on from pre-diabetes to
diabetes,” he says.
While the oral glucose tolerance test continues
to be the gold standard for detecting diabetes, the
American Diabetes Association had recently
recommended HbA1c testing for the diagnosis and
monitoring of diabetes, along with the existing
diagnostic criteria including fasting plasma glucose,
and the oral glucose tolerance test.
Among medical practitioners in the U.S., the
HbA1c is seen as having advantages over the oral
glucose tolerance test, which is painful (since it
involves consuming a glucose solution) and time-
consuming for patients, he says. Besides, the time
spent at a hospital for the GTT is seen as having an
impact on indirect costs for the patients. The HbA1c
on the other hand requires only blood from the vein,
and takes lesser time. However, laboratory tests can
be expensive and the measurement of HbA1c is not
standardised, like many other values, in Indian labs,
Dr. Ramachandran points out.
Newborn Deaths Account for 41% of Child
Mortality
Increased global focus on maternal and child
health too often overlooks newborn deaths, which
account for 41 per cent of child deaths, according
to a new study published in the medical journal PLoS
Medicine . India has the greatest number of newborn
deaths — more than 9 lakh a year. Just five countries
now account for more than half of the world’s 3.3
million newborn deaths — India, Nigeria, Pakistan,
China and Democratic Republic of Congo.
Each year 3.3 million babies still die in the first
four weeks of life — despite the existence of proven,
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cost-effective interventions that could save these
newborns, said the study’s co-author, Dr. Joy Lawn
of Save the Children’s ‘Saving Newborn Lives’
programme. While the United Nations reports
annually on deaths of children under ages 5 and 1
years, estimates for newborn deaths are released only
occasionally.
Free Services for Pregnant Women
To increase institutional deliveries in both rural
and urban areas of the State, the Government has
issued an order to provide free and cashless medical
services to pregnant women at government health
institutions. The services include normal deliveries,
Caesarean sections and treatment for babies up to
30 days after they are born.
The facilities will be provided for pregnant
women from both above and below the poverty line,
at government-run hospitals across the State and
government hospitals attached to medical colleges.
The healthcare would be provided under the Janani-
Shishu Suraksha Karyakram (JSSK) scheme.
National Rural Health Mission “A Minor
Success”
An official review of the Union Government’s
ambitious National Rural Health Mission has
described it as a “minor success”, adding that the
results have been heartening compared to past
experience in public health programmes. If this
promising programme is not to splutter to a stop, a
renewed commitment for at least another period of
seven years is essential, it says.
A report on “The National Rural Health
Mission: Performance and Prognosis” by former
Union Health Secretary Javid A. Chowdhury says the
Mission’s programmed outcomes have not been
achieved, but in the past no other State programme
in the health sector has achieved such radical and
significant outcomes, even though the achievement
is short of what was envisaged. The report has been
brought out by the National Institute of Health and
Family Welfare.
Funding Health Care
Rising India’s lack of progress towards
provision of universal, equitable health care for its
people is distressing. The sidelining of the Bhore
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Committee recommendations of 1946 — which
relate to ways and means of building a public-funded
allopathic health system for the entire population —
indicates the low priority given to public health in
policy. The consequence of this disastrous neglect
is that Indians have among the highest out-of-pocket
expenditures on health anywhere. The Planning
Commission is now considering a universal health
insurance scheme. The goal is laudable but the
premise is wrong. As the workshop of the Kolkata
Group chaired by Amartya Sen pointed out in
February 2011, influential policymakers seem to
think that private health care with proper subsidies
or private health insurance subsidised by the state
can meet the challenge. This is unlikely to happen
because of the asymmetry of information between
providers and users, and the absence of patient
empowerment. Moreover, costs and quality of care
are poorly regulated. If the central government is
sincere about building a strong health care system
during the 12 {+t} {+h} Five Year Plan (2012-17),
it must accept the primacy of public-funded
provision, invest heavily in both preventive and
curative spheres, and introduce strong regulation.
The High Level Expert Group on Universal
Health Coverage headed by K. Srinath Reddy has the
important task of prioritising the initiatives to be
taken up during the 12 {+t} {+h} Plan. Universal
health insurance is one stated goal. Here it is relevant
to point out that some classes of citizens, such as
children, the elderly, and women, can be
comprehensively insured first. By focussing on these
vulnerable groups, the National Rural Health
Mission can take on an expanded role while new
urban schemes can be launched to cut out-of-pocket
expenditure substantially. There is also a felt need
for oversight in the case of private health care
providers. In the absence of benchmarking and
scrutiny, hospital costs have hit patients hard. It is
worth pointing out that the Affordable Care Act
enacted last year in the United States emphasises
patient rights through special provisions and
mandates the spending of 85 per cent of large insurer
premiums on actual care to prevent diversion to
administrative overheads, salaries, and executive
bonuses. Additionally in India, non-profit initiatives
in health care can be invited to play a bigger role.
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Raising public expenditure on health to 2.5 per cent
of GDP by the end of the 12 {+t} {+h} Plan will
be a start; it needs to rise progressively. A cess to
fund health care can scale up the effort rapidly.
Three immune pioneers share Medicine
Nobel
For centuries, physicians believed that diseases
were caused by an imbalance in the “four humours”
— blood, phlegm, yellow bile and black bile. These
notions were swept away in the 19th century by the
advent of modern medicine. Bit by bit, it laid bare a
realm of microscopic warfare where the body’s
complex — but also sometimes flawed — defence
fought in close-quarter combat against germs and
viruses. The 2011 Nobel Prize for Medicine was
awarded to three scientists who have done more than
anyone to lay bare the two-tier structure of the
immune system.
They are Bruce Beutler of the U.S., Jules
Hoffmann, born in Luxembourg but a naturalised
French citizen, and Ralph Steinman of Canada.
Working separately, they discovered key secrets in
“innate’ immunity, our first-line response to
pathogens, and its dovetailing with the second-line
defence known as “adaptive”, or acquired, immunity.
Their achievements are central to vaccine
development, which depends on priming the
immune system to target pathogens, and to new
treatments against cancer, a process in which
tumorous cells proliferate unchecked. “[It’s] very
important work, which has opened not only our
understanding of the immune system but also led to
some practical new ways to target immune responses,
including more potent vaccines,” said Seth Berkley,
head of the GAVI Alliance, which promotes
immunisation in poor countries.
In a case with few parallels in medical history,
Mr. Steinman harnessed this knowledge to design an
experimental drug to treat his own pancreatic cancer,
said Rockefeller University in New York. Mr.
Steinman died on Friday at 68, just three days before
the announcement. But the drug extended his life
by four years after diagnosis, beating the odds for a
disease where patients often die within months. The
immune system can be described as an intricate and
dynamic network of millions upon millions of cells,
each with their speciality. Mr. Beutler and Mr.
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Health
Hoffmann identified receptor proteins that trigger the
molecular cascade which is the innate immune
system. This defence is a generalised call to arms,
mustering platoons of immune cells to initiate
inflammation, a chemical process that seeks to
establish a physical barrier against penetration beyond
the microbe’s entry point. The next line of defence,
the innate system, is slower to respond but more
adaptive. It teaches immune cells through a process
called antigen presentation to recognise and
remember the specific intruder for future alerts.
India leads in rotavirus infection deaths:
Lancet
Close to one lakh children below the age of
five years died of diarrhoea attributable to rotavirus
infection in 2008, accounting for 22 per cent of the
total deaths reported globally, reports the latest
edition of the Lancet Infection Diseases magazine.
Diarrhoea related with the rotavirus infection
resulted in 453,000 deaths worldwide in 2008 among
children younger than five years—37 per cent of
deaths attributable to diarrhoea with five countries
accounting for more than half of all deaths
attributable to such infection: Democratic Republic
of the Congo, Ethiopia, India, Nigeria and Pakistan.
Introduction of effective and available rotavirus
vaccines in other countries, mostly middle-income
or poorer, could substantially reduce worldwide
deaths attributable to diarrhoea, the paper has
suggested.
New found Bacteria get Indian
Nomenclatures
Named in honour of the country, the imposing
Himalayas, Aryabhatta and the icy continent of
Antarctica, these are among the 70 bacteria
discovered from diverse habitats ranging from the
cold regions of Antarctica, Arctic, stratosphere and
ancient Lonar lake (in Maharashtra) that was formed
when a meteorite hit the earth millions of years ago
and the deep sea. Led by Dr. S. Shivaji, Director-grade
scientist from the Centre for Cellular and Molecular
Biology (CCMB), the researchers have discovered
these bacteria over the past decade, including five
this year. The majority of the microbes, however,
were from the cold habitats and are considered
unique because of their ability to survive at
temperatures below the freezing point of water.
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Current Affairs
Excellent Model Systems
With their ability to survive, grow and divide
in freezing climes, these psychrophilic or cold-loving
bacteria serve as excellent model systems to
understand molecular basis for cold adaptation.
They could be used to generate as enzymes or
bio-molecules with application in biotech industry,
medicine and agriculture. For instance, in the pharma
industry such enzymes could help in cost-cutting,
and in agriculture, the low-temperature growing
bacteria, when added to soil, have shown improved
yields of plants growing in cold regions.
Anaemia is per se not a
Disease at All
There is a general notion that anaemia is due
to iron deficiency and this could be remedied by
taking iron-rich medicines and good quantity of
greens. But it should not lead to a situation in which
the anaemic patients would resort to self-medication.
Caution ought to be taken that if the iron level
exceeds the permitted limit it might result in poor
health conditions.
hesaid that anaemia was a manifestation of a
disease and not a disease per se. Anaemia was
defined as a low level of haemoglobin in red blood
cell. Three major causes of anaemia were iron
deficiency, malaria and helminthes infections.
Multi-pronged Approach to Contain
Encephalitis
Concerned over the high mortality and
morbidity because of Japanese encephalitis (JE) and
acute encephalitis syndrome (AES), the Group of
Ministers (GoM) held its first meeting here to discuss
short, medium and long-term measures needed to
deal with the disease. Already 861 lives have been
lost to the disease – with over 470 in eastern Uttar
Pradesh alone. The disease has been reported from
the national capital for the first time with the Ministry
of Health and Family Welfare confirming five cases
of JE/AES.
The GoM, constituted, agreed to involve the
Ministries of Human Resource Development and
Housing and Urban Poverty Alleviation (HUPA) to
tackle the disease, which has become an annual affair
in Poorvanchal since 2005.
The disease affects mostly children below the
age of 15 years, of which 25 per cent die, and among
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the survivors about 30-40 per cent suffer from physical
and mental impairment. Between 70 and 75 per cent
of the cases are from Uttar Pradesh. The GoM was
in agreement on the issue that a “multi-pronged
strategy encompassing prevention, case management
and rehabilitation measures are needed to deal with
it.’’ This could be implemented only through the
active engagement of various Ministries.
BioAsia-2012 to focus on Vaccines, IPR,
CROs and Investments
The ninth edition of the annual global event,
‘BioAsia-2012’ held in Hyderabad. It is set to focus
on vaccines, Intellectual Property Rights, Contract
Research Organisation and Investments.
K.V. Raghavan, vice-president, Federation of
Asian Biotech Association (FABA), told reporters here
on Monday that already representatives of top 16
MNCs in bio-pharma have confirmed their
participation. More business support elements like
workshops, company presentations, luncheons and
BioBazaar would be part of ‘BioAsia 2012’. For the
first time, Sri Lanka would participate as a ‘partner
country’.
In another new initiative, the organisers have
decided to sponsor the visit of top regulator in the
life-science field from SAARC countries like Nepal,
Maldives and Bangladesh.
Strong Reactions against Halting of Global
Fund Flow
Health activists have reacted strongly to the
decision of the Global Fund to Fight AIDS,
Tuberculosis and Malaria to cancel new grants to the
three pandemics until 2014. The decision was taken
at the 25 {+t} {+h} Board of the Global Fund as a
consequence of donor governments’ failure to fulfil
their financial pledges to the Global Fund. This will
impact funding of AIDS, TB and Malaria programs
in over 140 countries immediately. The Global Fund
cancelled applications for the 11 {+t} {+t} {+h}
round of funding that would have provided money
for 2011-2013. The Board also announced it did not
have the cash on hand to fund some previously
approved grants. This financing shortfall has created
an emergency in the international fight against HIV/
AIDS, Tuberculosis and Malaria—the world’s three
leading infectious disease killers.
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Largest International Financier
The Global Fund is the world’s largest
international financier of programs to treat TB and
Malaria, and the second largest for HIV/AIDS. January
2012 is the 10 {+t} {+h} anniversary of the Fund’s
existence. So far India has been allocated just over a
billion dollars in grants. A total of US $658,768,825
has already been disbursed between 2004 and 2010
to Indian grantees. “This step takes place even as the
recently released UNAIDS World AIDS Report 2011
outlined steadily declining rates of HIV infections.
In India new HIV infections fell by 56 per cent
between 1996 and 2010,’’ said John Mathai,
Country Director, Global Health Advocates India (an
NGO that works towards the formulation and
implementation of effective public policies to fight
disease and ill-health in India).
He said this funding gap would affect TB
programs in Odisha, Uttarakhand and Chhattisgarh
where large successful programs have been run using
this mechanism, and will cause the National TB
Control effort to suffer, along with the HIV/AIDS and
Malaria programs.
Half of HIV Patients in
Asia live in India
India houses half of Asia’s HIV patients and
is way ahead of China in disease burden. It also finds
a place in the list of 22 countries prioritised for
preventing mother to child transmission infection,
according to the latest UNAIDS report, drafted jointly
with the United Nations Children’s Fund (UNICEF)
and the World Health Organisation (WHO).
About 48 lakh people were living with HIV
in Asia in 2010 and nearly half of them – 49 per
cent to be precise – are in India, says the report
released on the eve of World AIDS Day. The
percentage of pregnant women who tested positive
for HIV infection in India also rose from 2 per cent
in 2005 t0 23 per cent in 2010. Seven Asian
countries report an estimated 100,000 or more
people living with HIV in 2009, collectively
accounting for more than 90 per cent of people with
HIV in the region. India tops the list followed by
China, Thailand, Indonesia, Malaysia, Myanmar and
Vietnam, though the highest prevalence rate, one per
cent, was observed only in Thailand. In Asia, the rate
of HIV transmission appears to be slowing down.
The estimated 3,60,000 people who were newly
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infected with HIV in Asia in 2010 were considerably
fewer than the 4,50,000 estimated for 2001.
Pentavalent vaccine to be Launched in State
from December 14
Kerala will become the first State in the country
to roll out pentavalent vaccine as part of the
Universal Immunisation Programme on December
14. The Union Health Ministry is rolling out the
pentavalent vaccine, which introduces the vaccine
against Haemophilus Influenzae Type B (Hib)
infection in the national immunisation schedule for
infants for the first time, only in Kerala and Tamil
Nadu in the first phase. Tamil Nadu is expected to
launch the vaccine on December 17. The pentavalent
vaccine is a conjugate vaccine which combines the
antigens against five infections — Diphtheria,
Pertussis and Tetanus (DPT), hepatitis B and Hib —
in a single shot
The National Technical Advisory Group on
Immunisation in 2008 itself had recommended that
Hib vaccine be introduced as pentavalent vaccine in
the UIP because of the high mortality due to
meningitis and pneumonia caused by Hib infection.
It suggested that that as two States with excellent
immunisation coverage and good vaccine delivery
system, the vaccine be introduced in Kerala and
Tamil Nadu first.
New Treatment for Elephantiasis
A team of doctors from the Institute of Applied
Dermatology (IAD) in Kasaragod, Kerala, has come
out with a successful treatment for elephantiasis
(filarial lymphoedema) by integrating allopathy with
ayurveda and yoga. The pilot project, sanctioned by
the Centre in Gulbarga and in Alappuzha district in
Kerala, focussed on providing free treatment for 1,000
poor patients in 18 months. The International
Lymphoedema Congress in London had awarded
Excellence in Lymphoedema Care Award 2009 to
IAD.
India source for U.S. Execution Drug?
When Indian pharmaceutical company Kayem
dispatched stocks of sodium thiopental to the U.S.
early this year, they thought it was a golden chance
to bring in good business and build a reputation.
What came, instead, was, in the company’s words,
“a bouncer.” Little did Kayem know that the drug
they so eagerly parcelled off to the U.S. was being
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Current Affairs
injected into prisoners on death row for their
execution in the prisons of Nebraska and South
Dakota. The truth about the use of sodium thiopental
for non-medicinal purposes was uncovered by Maya
Foa, investigator from a U.K. legal NGO ‘Reprieve’.
“The medicine is being used in large parts of
the world for medicinal purposes, but in the U.S. it
is being diverted for executions,” Ms. Foa told a press
conference recently in the city. This “misuse” of the
drug, its shortage in the U.S. and attempts by the
country to obtain the drug from various European
nations has given rise to a body of controversy that
soon threatens to engulf the Indian pharmaceutical
industry, Ms. Foa pointed out.
It’s a Considered Decision on Pentavalent
Vaccine
The government said non-availability of the
pentavalent vaccine in the public health programme
had equity implications for the poor who could not
afford the vaccine in the private sector.
Seeking to put at rest doubts raised by a section
of society over the utility of the pentavalent vaccine
in the universal immunisation programme —
launched in Kerala — the Ministry of Health and
Family Welfare said pentavalent was available in the
private market for over a decade now with three
Indian manufacturers producing it.
The pentavalent vaccine contains five antigens
— Diphtheria, Pertussis, Tetanus, Hepatitis B and
Hib—with Hib being the new addition to the
immunisation programme. The Hib vaccine is
available in both monovalent and combined
formulations. India becomes the 171st country to
introduce vaccination against Hib with the United
States and Finland starting it in the early 1990s.
The pentavalent formulation has several
programmatic advantages as it halves the number of
injections per child and reduces the requirement of
cold chain storage space, besides the ease of
management of logistics and data. Hib infection
causes pneumonia and meningitis that kill close to
5 lakh children every year in India. Meningitis can
also result in crippling disabilities.
Panel wants Japanese Encephalitis vaccine
in Immunisation Programme
Even as New Delhi grappled with the
increasing incidence of Japanese encephalitis — a
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disease reported for the first time — the National
Commission for Protection of Child Rights has
recommended that Japanese encephalitis vaccination
be included in the national immunisation
programme and an eradication programme launched
nationwide against Japanese encephalitis and acute
encephalitis syndrome.
A team of the child rights panel, headed by
commission member Yogesh Dube, visited
Gorakhpur, Kushinagar and Deoria districts in Uttar
Pradesh, the worst-affected by Japanese encephalitis
and acute encephalitis syndrome.
Health Regulatory Bill Tabled in Rajya
Sabha
A Bill for regulation of standards of health
education, and determination, maintenance,
coordination and promotion of human resources in
the country’s health sector was tabled in the Rajya
Sabha. The National Commission for Human
Resources for Health Bill, 2011 seeks to establish
the National Commission for Human Resources for
Health, which will also regulate professional councils
in various disciplines of health sector.
Introduced by Union Health and Family
Welfare Minister Ghulam Nabi Azad, the Bill
proposes to replace independent regulatory bodies
such as the Medical Council of India (MCI), Dental
Council of India (DCI), Pharmacy Council of India
and Nursing Council of India with new national
councils, including a Paramedical Council.
The Bill seeks to consolidate the law in certain
disciplines of health sector and promote human
resources in that sector and provide for mechanism
for the determination, maintenance, coordination
and regulation of standards of health education
throughout the country. It would also be the task of
the Commission to ensure effective use of linkages
in the entire health system.
Council on Declining Child Sex Ratio
Formed
Alarmed over the declining child sex ratio
across the country, the Union government has set up
a Sectoral Innovation Council to look into the entire
gamut of issues connected with the sharp drop in
the number of girls per thousand boys in the ages of
0-6. The council will identify interventions that have
worked and those which did not and also suggest
innovative strategies, approaches and methods of
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interference to address the problem in a time-bound
and effective manner.
The Census 2011 has shown a sharp decline
in the child sex ratio, compared to the previous
census. It has declined to 914 in 2011 from 927 in
2001 and has been continuing unabated since 1961
despite improvements in other social indicators such
as literacy, gender gap in effective literacy rate, and
the overall sex ratio. The decline in the child sex ratio
has spread to 22 States and 5 Union Territories, with
the highest decline in Jammu and Kashmir.
Infant Mortality Rate on Decline
The infant mortality rate (IMR) has shown a 3
point decline, dropping from 50 deaths per 1,000
live births to 47 and moving a step closer to achieving
the Millennium Development Goals (MDG) target
of 30. However, IMR increased by one point in
Kerala, Mizoram and Dadra and Nagar Haveli.
According to the latest Sample Registration System
(SRS), conducted by the Registrar-General of India,
the two worst performing States — Madhya Pradesh
and Himachal Pradesh — have shown an impressive
5 point decline. In the former, the figure dropped
from 67 in 2009 to 62 in 2010 and in the latter, it
was from 45 to 40 .
While the IMR national average is 47, it stands
at 51 in the rural areas and 31 in the urban regions.
However, neo-natal deaths continue to be a challenge
where 34 babies are still dying for every 1,000 born.
The Janani Shishu Suraksha Karyakram,
providing for free transport, food and drugs and
diagnostics to all pregnant women and sick
newborns, would further promote institutional
delivery and eliminate out-of-pocket expenses, which
act as a barrier to seeking institutional care.
Importantly, the government intended to set up
facilities such as Special New Born Care Units, New
Born Stabilisation Units and New Born Baby Corners
at different levels with at least one at the district
level. The mother and child tracking system had
evoked a huge response, with 1.32 crore women and
82.6 lakh children already registered.
Challenges of Stopping Oral Polio Vaccines
With oral vaccines, India appears to have
achieved what was once thought a Herculean task
— decisively breaking the circulation of wild polio
viruses that paralysed countless children. But the use
of oral vaccines, which contain live but weakened
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strains of the virus, can be a bit like riding a tiger.
Discontinuing them, without risking a resurgence of
polio that would undo all that has been achieved, is
going to be a tricky exercise. The endgame for
complete polio eradication could well involve
incorporating the inactivated polio vaccine (IPV),
which must be administered as an injection, into the
immunisation programme.
Massive Coverage
With the oral vaccine, two drops help raise the
immunity of children who receive it. The ease of
administration meant that gigantic mass
immunisation campaigns could be carried out. In
India, each round of national immunisation had,
according to the Union Health Ministry, 24 lakh
vaccinators under 1.5 lakh supervisors visiting over
20 crore households to ensure that the nearly 17.2
crore children under 5 received the vaccine. Other
teams immunised children at railway stations, bus
stands, construction sites and in market areas.
Apart from blocking the polio virus from
invading nerve cells and causing paralysis, the oral
vaccine, by duplicating a natural infection, is said
to raise immunity in the mucosal lining of the gut.
That makes it more difficult for the virus to replicate
there and spread through faeces to others.
But the oral vaccine has its drawbacks also. In
rare cases, the live but attenuated viral strains in the
vaccine can themselves cause polio. Moreover, these
viruses can revert to virulence, resulting in what are
known as vaccine-derived polioviruses (VDPV). A
high proportion of those immunised with OPV
excretes revertant viruses, noted Neal Nathanson of
the University of Pennsylvania and Paul Fine of the
London School of Hygiene and Tropical Medicine
in a commentary published in the journal Science in
2002. Significantly, their commentary was titled
‘Poliomyelitis Eradication — A Dangerous Endgame.’
While no child in India has been crippled by
a wild polio virus during the past year, the country
saw seven cases of paralysis caused by VDPV during
2011. Such VDPV can readily circulate and spread.
At present, the intention is to stop immunisation
with the oral vaccine globally once the wild polio
viruses have been eradicated.
Make Silicosis Notifiable Disease: NHRC
Taking a serious note of the increasing silicosis-
related deaths in the country, the National Human
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Current Affairs
Rights Commission (NHRC) has recommended that
silicosis be made a notifiable disease. Once notified,
all government and private health facilities will have
to report confirmed as well as suspected silicosis
cases to the government.
Silicosis is an incurable lung disease caused
by inhaling of dust containing free crystalline silica.
The potential victims of silicosis are poor migrant
workers employed in quarries, mines, gem cutting
and other hazardous occupations such as construction
sites, a majority of whom are likely to die for lack
of specialised treatment.
WHO Meet Adopts Mental Health
Resolution
The World Health Organisation (WHO) has
adopted a resolution that focuses on the global
burden of mental disorders and the need for a
comprehensive, coordinated response from health
and social sectors at the country level. United States
of America and Switzerland supported the resolution
moved by India at the just-concluded
130{+t}{+h}executive board meeting of the WHO.
This marks the first time in over a decade that the
WHO has, at its highest levels, taken note of this
very major public health concern. Mental disorders
account for 13 per cent of the global burden of the
diseases and, in keeping with the latest thinking, the
resolution recognises the importance of early
identification, care and recovery, the problems of
stigma, poverty and homelessness and the need for
community-based intervention including
deinstitutionalised care.
India had played a key role in getting mental
disorders included in the non-communicable
diseases (NCDs) list at the first Ministerial
Conference on Healthy Lifestyles and Non-
communicable Disease Control in Moscow last year.
Pleading for its case, India had argued that “like all
non-communicable diseases, mental disorders
required long term treatment and affected the quality
of life.” India is already working towards framing a
mental health policy based on internationally
accepted guidelines. A 12-member group entrusted
with framing the National Mental Health Care Policy
and Plan will prepare a situational analysis of the
need for mental health care, taking into account the
issues of human resources, essential drug
procurement and distribution, advocacy, prevention,
and rehabilitation of patients.
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International Canine Congress in Bikaner
from February 9
An international congress on modern concepts
in canine health and diseases was held in Bikaner in
Rajasthan. The three-day event, also to coincide with
the IXth annual convention of Indian Society for
Advancement of Canine Practice, is being hosted by
the Rajasthan University of Veterinary & Animal
Sciences, Bikaner.
Pranab Unveils National Policy on
Narcotic Drugs
The Union government unveiled a
comprehensive policy on narcotic drugs and
psychotropic substances, as announced by Finance
Minister Pranab Mukherjee during the budget
presentation last year. The need for such a policy
assumes significance in the light of the fact that
trafficking in narcotic drugs also contributes to
generation of black money in the country.
Unveiling the policy, Mr. Mukherjee said the
deleterious effect of black economy, generated in the
world through drug trafficking, could well be
imagined and the money could finance several other
forms of criminal activity, including terror financing
and other forms of transnational organised crime. The
policy recommends the production of Concentrate
of Poppy Straw (CPS) in India by a company or body
corporate that would enable the country to retain its
status of a traditional supplier of Opiate Raw
Material (ORM) to the rest of world, while remaining
competitive.
While the consumption of poppy straw by
addicts is to be gradually reduced and finally stopped
in a time frame decided by the States, the policy
emphasises use of satellite imagery for detection of
illicit poppy and cannabis crop and its subsequent
eradication and development of alternate means of
livelihood in respect of cultivators in pockets of
traditional illicit cultivation.
Alongside, while the private sector may be
allowed production of alkaloids from opium — at
present alkaloids from opium are produced only in
Government Opium and Alkaloid Factories (GOAFs)
— non-intrusive methods of regulating the
manufacture, trade and use of such psychotropic
substances will be introduced.
The policy attempts to curb the menace of drug
abuse and contains provisions for treatment,
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rehabilitation and social re-integration of victims of
drug abuse. Implementation of the provisions of the
policy will lead to reduction of crime, improvement
in public health and uplifting of the social milieu.
IIL to Develop vaccine for Chikungunya,
JEV
Indian Immunologicals Limited (IIL), a leading
vaccine manufacturer, has joined the league of a very
few companies in the world to develop a vaccine
for Chikungunya, which is currently undergoing pre-
clinical toxicology studies. The IIL is developing the
vaccine for this disease using a virus strain isolated
by a laboratory in the USA. The company is also
developing a live vaccine for Japanese Encephalitis
Virus (JEV) for the first time in the country.
Every year, several outbreaks of these diseases
occur in India, resulting in thousands of cases of
hospitalisation and innumerable deaths. In 2006,
there was a large outbreak of Chikungunya affecting
many States and over 74,000 cases were reported in
Tamil Nadu and Orissa. In 2011, Uttar Pradesh
reported over 4,000 cases of JEV with 376 deaths.
India Committed to Controlling Foot and
Mouth Disease
India reinforced its commitment to controlling
the contagious “foot and mouth disease’’ (FMD) in
cattle as a crucial measure to enhance productivity
of the livestock. FMD causes viral fever and it is
accompanied by blisters in the mouth and foot of
the affected animal. If untreated, it may probe to be
fatal. The direct economic loss from the disease is
estimated at Rs. 20,000 crore a year. It also affects
the export potential of the livestock industry. The
indirect loss due to decline in the work capacity of
the animal, higher incidence of abortions, reduced
production of milk from infertility and sterility have
not even been quantified.
“Controlling the disease will help improve the
livelihood of small, marginal and resource poor
farmers. It will also help lift the trade barrier with
countries that are free from the disease,’’ Minister
of State for Agriculture and Animal Husbandry Harish
Rawat said at an international conference on
‘Scientific Developments and Technical Challenges
in the Progressive Control of FMD,’ organised jointly
by the Indian Council of Agriculture Research and
the United Nations’ Food and Agriculture
Organisation (FAO).
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Health
India has succeeded in eradicating Rinderpest
and the Contagious Bovine Pleuro-Pneumonia but
has fallen behind in controlling FMD due to shortage
of relevant vaccine.
AYUSH to be Included in National Health
Schemes
The Centre is planning to launch a special
scheme for delivery of healthcare services in 100 out
of 264 focus districts across the country where the
health indicators are very low, by integrating
allopathic and other Indian systems of medicine
soon. Under the scheme, joint teams of doctors of
allopathy, Ayurveda, yoga and naturopathy, Unani,
Siddha and homoeopathy systems of medicine will
visit villages frequently to bring about an
improvement in the general health condition of
people. Modalities were being worked out to include
AYUSH systems of medicine in all national health
programmes within two years, he noted.
India no more a Polio-endemic Country:
WHO
The World Health Organisation (WHO) has
removed India from the list of polio-endemic
countries, suggesting that the wild polio virus had
been totally eliminated from the environment. The
disease paralysed thousands of children every year
for several decades. However, India will have to
remain polio free for two more years before it is
declared polio-free by the WHO.
There were only four countries in the WHO
endemic list, including Pakistan, Nigeria and
Afghanistan. India reported its last polio case on
January 13, 2011 in West Bengal. In 2009, it reported
741 polio cases, more than anywhere else in the
world. In 2010 only 42 cases were reported against
1.5 lakh in 1985. Recounting how India reached the
first step for becoming a polio-free country, Mr. Azad
said 27 per cent of the global expenditure on polio
eradication came from the country’s domestic
resources. More than 99 per cent coverage of children
in the two remaining endemic States of Bihar and
Uttar Pradesh was unprecedented, not witnessed
anywhere else in the world on such a large scale.
Measles and Neonatal Tetanus, Next Target
after Polio
Emboldened by the remarkable success
achieved in its drive against polio, the government
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Current Affairs News for UPSC, IAS, Govt Exams:
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Current Affairs
will now focus on elimination of measles and
neonatal tetanus in the country. Thousands of
children die of these two diseases in India every year.
India has been removed from the list of polio-
endemic countries by the World Health
Organisation (WHO) after it did not report any polio
case for a year.
NRHM to soon become National Health
Mission
The government proposes to convert the
National Rural Health Mission (NRHM) into a
National Health Mission to provide health care to
the urban poor also, in the course of the 12th Plan.
Universal access to free generic essential medicines
in public health institutions in a phased and time-
bound manner will be ensured.
Announcing major initiatives to provide
universal healthcare, President Pratibha Patil said the
government would endeavour to increase both Plan
and Non-Plan public expenditure in the Centre and
the States taken together to 2.5 per cent of the gross
domestic product by the end of the 12th Plan.
The Infant Mortality Rate declined from 58 per
thousand live births in 2005 to 47 in 2010 and
Maternal Mortality Ratio from 254 per one lakh
deliveries in 2004-2006 to 212 in 2007-2009. The
Janani Suraksha Yojana registered impressive gains
with 1.13 crore women benefiting during 2010-11.
Polio has been almost eradicated from the country.
The World Health Organisation has decided to take
India off the list of countries with active endemic
wild poliovirus transmission.
Pointing out that in spite of increased
investment in the health sector over the last 7 years,
public expenditure on healthcare continues to be
low, the President said the government would
strengthen district hospitals to provide advanced level
secondary care under the National Programme for
Prevention and Control of Cancer, Diabetes,
Cardiovascular Diseases & Stroke and The National
Programme for Health Care of the Elderly.
India has Highest Number of MDR-TB
Cases in South East Asia, says WHO
India had an estimated 63,000 cases of
notified multi-drug resistant Tuberculosis (MDR-TB)
in 2010, the highest in the South East Asia region,
the World Health Organisation (WHO) has said.
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The MDR-TB prevalence is estimated to be 2.3
per cent among new cases and 12-17 per cent among
re-treatment cases. However, due to the size of
population and number of TB cases reported
annually, India ranks second among the 27 MDR-
TB high-burden countries worldwide after China.
Extensively drug-resistant TB (XDR-TB) cases
have also been reported from India, Bangladesh,
Indonesia, Nepal and Thailand from the region.
Considerable efforts are required to expand capacity
for quality-assured drugs susceptibility testing in the
region in order to more accurately estimate the extent
of drug-resistant TB. Given the widespread
availability and use of second-line drugs, and as
laboratory capacity to conduct second-line drugs
susceptibility testing increases, additional number
of patients with XDR-TB are likely to be identified,
the report warns.
The estimated percentage of the MDR in new
TB cases in India is 2.1 (1.7- 2.5) per cent, while
the percentage of MDR among previously treated
cases was 15 (13 -17) per cent. By the end of 2009,
treatment services for the MDR-TB patients were
available in sites of ten States. Enforcement of
regulations for prescribing and sale of anti-TB drugs,
promoting rational use of first-and second-line anti-
TB drugs outside the programme to prevent the MDR
and the XDR-TB are some of the major challenges
for India, it says.
The Revised National Tuberculosis Control
Programme has developed a plan to scale-up
considerably MDR-TB services in order to treat
annually at least 30 000 MDR-TB patients in the
country, supported by the Global Fund Round 9 and
the UNITAID to enable a rapid expansion of the
MDR-TB services in the next few years. As on
September 2011, 34 States are providing MDR-TB
diagnostic and treatment services and a cumulative
total of 5810 MDR-TB cases have been started on
treatment, according to the report.
With a population of about 1.2 billion, India
is the largest country in region and the largest TB
burden country in the world in terms of absolute
numbers of incident cases that emerge each year and
it contributed one-fourth of the estimated global TB
cases in 2010.
Clinical Establishments Brought under Act
Almost two years after it was passed by
Parliament, the Clinical Establishments (Registration
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Current Affairs News for UPSC, IAS, Govt Exams:
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and Regulation) Act, 2010, has now been notified
by the Union Government. Notified on February 28,
it has come into force in Arunachal Pradesh,
Himachal Pradesh, Mizoram, Sikkim and all Union
Territories from March 1.
The Act makes it mandatory for all clinical
establishments to provide medical care and treatment
necessary to stabilise any individual who comes or
is brought to the clinical establishment in an
emergency medical condition, particularly women
who come for deliveries and accident cases. It
provides for mandatory registration of all clinical
establishments, including diagnostic centres and
single-doctor clinics across all recognised systems of
medicine both in the public and private sector except
those run by the Defence forces. The registering
authority can impose fines for non-compliance and
if a clinical establishment fails to pay the same, it
would be recovered as an arrear of land revenue. It
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Health
will facilitate policy formulation, resource allocation
and determine standards of treatment, in addition
to helping create an accurate database of such
facilities available in the country. The Act will lay
down Standard Treatment Guidelines for common
disease conditions, for which a core committee of
experts has been formed.
A National Council for Clinical
Establishments, a multi-member body under the
chairmanship of the Director-General of Health
Services, with representatives of various stakeholder
institutions, is being notified shortly while work on
the categorisation of clinical establishments and
development of minimum standards has been
initiated in association with the Quality Council of
India and the Indian Medical Association. A
committee has also been formed for the development
of Standards for Electronic Records Maintenance
systems to be adopted in the hospitals.
CSAT
PAPER–1
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