Social Justice

Module- II, III & IV

Issues relating to development and management of social
sector/services relating to health, education, human
resources -II
Preventive Measures
 Nutrition and Hunger
● Malnutrition is a severe deficiency of vitamins, nutrients and energy intake.
● According to the WHO, malnutrition is responsible for half of the total cases of infant
deaths so far.
● According to the FAO, currently more than 1 billion people or one in six people
in the world are affected by starvation.
● The International Food and Safety Organization (FAO) defines food insecurity as a
condition in which people do not have access to adequate amounts of safe and
nutritious food for normal growth and development and to lead active and healthy
lives.
● Hunger can manifest in different ways – undernourishment, malnutrition, and
malnourishment.
 Hygiene
Important components of cleanliness:

• Clean Toilets : Nirmal Bharat, Swachh Bharat Abhiyan - Construction of Toilets (Building
Infrastructure) - Open Defecation Free India (ODF)

• Clean Drinking Water : Jal Jeevan Mission - Har Ghar Jal - Providing functional
household tap connections, reliable drinking water source development / augmentation of
existing sources, water transfer and water quality

• Clean Neighborhoods and Roads: Swachh Bharat Abhiyan - Keeping streets, roads and
neighborhood infrastructure clean

• Clean Drainage Mechanism: Scientific Waste Management - Solid and Liquid Waste
Management
 Water Sanitation and Hygiene Scheme -WASH
● Objective: The World Health Organization's WASH

strategy aims to improve health through the safe

management of water, sanitation and hygiene services

at all levels.

● In fact, all the three areas of water, sanitation and

hygiene are related to each other. The WASH strategy of

the World Health Organization has been developed in

the light of Sustainable Development Goal-3 (good

health and wellness) and Sustainable Development

Goal-6 (clean water and sanitation) Agenda 2030.

Water Sanitation and Hygiene Scheme -WASH

● The WASH strategy includes providing universal health coverage (UHC) to one
billion people, including the health of three billion people.

● It also emphasizes the progressiveness of human rights such as safe drinking

water and sanitation, adopted by the United Nations General Assembly in July
2010.

● According to the WHO report, 8,27,000 people die annually in low and middle
income countries due to inadequate water, sanitation and lack of hygiene.

● By providing better WASH facilities, 2,97,000 deaths of children under the age of
five could be prevented each year.
 Water Sanitation and Hygiene Scheme -WASH
The following are some of the major missions of the

Government of India, which aim to improve WASH and

health services in India:

 Swajal Scheme

 National Rural Health Mission (NRHM)

 National Urban Health Mission (NUHM)

 National Rural Drinking Water Program

 Jalmani
Water Sanitation and Hygiene Scheme -WASH

● Swachh Bharat Abhiyan (SBA)

● Swachh Bharat Mission (SBM)

● PURA (Provision of Urban Amenities to Rural Area)

● River Clean Projects

● Namami Gange Scheme

● NRuM (National Rurban Mission)

 WASH: Key Strategic Component

AMR (Antimicrobial
resistance), Climate
change and Pollution
GLobal
Antimicrobial Healthcare Facility
resistance
Surveillance Joint Monitoring
System-GLASS WASH Programme for Water
Supply and Sanitation-
JMP)

water quality and Sanitation and Waste

safety Management
 Swachh Bharat Mission
The Swachh Bharat Mission was launched
on 2 October 2014 to accelerate the efforts
to achieve universal sanitation and to focus
on cleanliness.
Aims of Swachh Bharat Mission-

● Open Defecation Free India, Behavior

Change through Information and Education
Dissemination

● Scientific solid waste management

● Capacity Building of Local Bodies

 Swachh Bharat Mission
● Private sector participation

● Empowering by eliminating the role of scavengers

● Community competition

● Use of technology
 Open Defecation Free (ODF) - Plus
● The original ODF protocol issued in 2016 stated that “If at any time of the day, no
person defecates in the open, then that city/ward shall be notified as an ODF
city/ward. “

● ODF+ and ODF++ were launched in August 2018 to take forward and continue
the work done by cities after achieving ODF status in the first phase of Swachh
Bharat Mission-Urban: SBM-U.

● The cities which have been notified ODF at least once based on the ODF protocol
can be declared as SBM-ODF+ and ODF++.
Basis of Determination of ODF+ and ODF++
 Challenges
• Lack of space for construction of toilets
• Lack of toilet maintenance

• Lack of water supply

• Garbage sorting problem

• Challenges of practical change

• Lack of capital allocation

 Cleanliness Survey
● It was launched as part of the Swachh
Bharat Abhiyan, which aimed to make India
clean and free from open defecation.
● Swachh Survekshan 2021: The year
2021 is the sixth edition of Swachh
Survekshan. The main objective of
Swachh Survekshan 2021 is to make
India free from diseases caused by
wet, dry and hazardous waste spread
in the country.
 Cleanliness Survey
Categories of Cleanliness Survey 2021:
● Less than one lakh Population:
❏ The cities of Vita, Lonavala and Saswad in Maharashtra were the first,
second and third cleanest cities respectively.
• More than One Lakh Population:
❏ Indore (Madhya Pradesh) was awarded the cleanest city in India under
the Swachh Survekshan for the 5th consecutive year, while Surat and
Vijayawada secured the second and third positions respectively.
 Education and Awareness
● According to the World Health Organization's report 'Education for All', maternal

mortality can be reduced by two-thirds if all women get secondary education and

infant mortality can be reduced by 61% if they get only primary education.

● Educated women are able to make basic interventions through simple yet effective

use of a commodity, such as access to clean drinking water, nutritional

information, use of mosquito nets, a better understanding of family planning

(better use of contraception), etc.

 Education and Awareness
● The main reason for India's low rank in the Global Human Capital Index

(ranked 116th out of 174 countries in 2020) is the lack of advanced health

and medical facilities and women's access to quality education, which

ultimately affects human resource development as well.

● According to a recent study, women who get 12 years of education or more,

their fertility rate is up to 1.7, while those women who do not get any

education or even primary education, their fertility rate is up to 3.7.

 Pollution
● According to the WHO, exposure to air pollution is estimated to cause
seven million premature deaths and affect the health of millions of
people every year.
● Air pollution has been recognized as the biggest environmental threat
to human health.
● The WHO stated that both PM-10 and PM 2.5 are capable of penetrating
deep into the lungs, but research suggests that PM 2.5 can also enter the
bloodstream, primarily resulting in cardiovascular and respiratory
problems. but it affects other organs as well.
● Rotavirus, cholera, and typhoid, hepatitis A and E, diarrheal diseases, and
wastewater pollution are major health concerns that caused 1.6 million
deaths in 2017.
Stress-free environment and mental health
● According to a report by the World Health Organization (WHO), 7.5 percent
(more than 100 million) of India's 135 crore population are affected by
mental diseases.
● According to the National Mental Health Survey (NMHS) 2015-16, in most
states of India, less than 1% of the total health budget is spent on mental
health.
● According to WHO, suicide is the leading cause of death for people in the
age group of 15-29 years in India.
● In the era of the global pandemic COVID-19, the country has seen a steady
increase in mental health related problems.
 Mental Health Challenges
● Women are more vulnerable than men in terms of mental health -
domestic violence, child marriage, rape and other causes of motherhood
● Social Myths - Suicide Crime, Negligible Behavior as of 2017
● Lack of awareness - social isolation
● Socio-cultural challenges – relationship breakdown, loneliness,
childhood experiences, natural or social accidents
● Reduction in budgetary allocation
● Insufficient investment in mental health - acute shortage of psychiatrists
and paramedical staff - 0.3 psychiatrists per lakh
 Mental Health Act 2017: Major Provisions
● Attempt to suicide (Section 309 of the Indian Penal Code) has been removed
from the category of offence.
● Provides affordable care, equality in treatment, free legal services, freedom to
make decisions regarding treatment and the ability to report any matter related to
treatment, ability to nominate a representative for care, etc. to the mentally
challenged person.
● The right of a mentally ill person to maintain confidentiality in relation to his
mental health, treatment and physical health care.
● Photograph or any other information relating to a mentally ill person may not be
made public without his consent.
 Drug and Alcohol abuse
● More than 190 million people in the world use
drugs, especially among adults under the age of 30,
drug addiction is increasing very rapidly. In India too,
the use of drugs, alcohol and other intoxicants has
increased tremendously, especially among the youth.
● India's geographical position is between two of the
world's largest opium producing regions - the
Golden Triangle and the Golden Crescent, due to
which the menace of drugs is increasing
continuously.
 Drug and Alcohol Abuse
Effects of Drugs on Health:
 Increase in diseases like AIDS, Hepatitis B and C, Tuberculosis
 Bad effect on brain, liver, heart, kidneys - also the risk of heart attack
 Women under the influence of drugs are at risk of molestation, rape, violence,
motor vehicle accidents, homicide, unprotected sex, child abuse, domestic violence
and death
 Low self-esteem, hopelessness, suicidal tendencies
 Addiction causes irritability, loss of appetite, anger, pain and heaviness in
extremities, body tremors, uncontrolled blood pressure, vomiting and nausea
 Relationships with family and friends affected - loneliness and depression
 Major Initiatives taken by the Government to Prevent Drug Abuse

● According to Article 47 of the Constitution, the state should prohibit the consumption of
intoxicating drinks and narcotic drugs injurious to health except for medical purposes.
● Narcotics Drugs and Psychotropic Substances Act 1985 (NDPS) Act - Stringent provisions
for control of illicit drug trafficking and prevention and treatment of addiction
● Mental Health Care Act 2017
● National Action Plan for Drug Demand Reduction (NAPDDR: 2018 2025)
● Drug Free India Campaign - Started in 2020
● United Nations Convention: India is a signatory to the following international treaties and
conventions to combat drug menace - UN Convention on Narcotic Drugs (1961), UN
Convention on Psychotropic Substances (1971), United Against Illegal Traffic of
Narcotic Drugs and Psychotropic Substances Nations Convention (1988).
 Vaccination in India
● More than half of the world's children are deprived of the necessary vaccines for a risk-
free and healthy life. If they get necessary vaccination, than death of more than 15 lakh
children can be avoided.
● According to UNICEF, “About one million children in India die before celebrating their
fifth birthday. Of these, one in four deaths are due to pneumonia and diarrhea, the two
leading infectious diseases of infant mortality worldwide. Most of these children can be
saved through breastfeeding, vaccination and treatment.”
● In the last two decades, India has made significant progress in improving health
indicators, especially those related to child health.
● India has got the certificate of polio free in the year 2014 and eradication of maternal
and neonatal tetanus in the year 2015.
 Vaccination for children and Pregnant Women
● To accelerate complete immunization and reach the underprivileged, the Government of India has
launched an ambitious programme, Mission Indradhanush (since 2015).

● It is the world's largest immunization program in terms of number of beneficiaries, geographic

reach and volume of vaccines, targeting approximately 27 million newborns annually.
Intensive Mission Indradhanush (IMI):
 This program was launched in the year 2017 to ensure more than 90% complete
immunization to the missed children and pregnant women under Mission Indradhanush, by
December 2018 instead of the year 2020 (earlier target) in select districts and cities.
 The focus was on improving coverage.
 Vaccination for children and Pregnant Women

• 2.0. was launched in December 2019 and continued up to March 2020, to further extend
the reach and coverage of the mission, including tribal and hard-to-reach areas.The
diseases covered under the mission are polio, diphtheria, measles, whooping cough,
hepatitis B, tetanus, meningitis, rubella, Japanese encephalitis and pneumonia.

• The Central Government launched the Intensified Mission Indradhanush 3.0 in February
2021 with a view to extending the routine immunisation program to all pregnant women
and children who had missed it due to the COVID-19 pandemic.
 Vaccination for children and Pregnant Women
● Thereafter, Intensified Mission Indradhanush (IMI) 3.0 and Intensified Mission Indradhanush

(IMI) 4.0 (recently launched by the Ministry of Health) targeted the beneficiaries of migrant

areas and inaccessible areas, as they had missed a dose of vaccine during Covid-19.

● Under the National Immunization Program in our country, children up to 15 years of age and

pregnant women are given vaccines against fatal diseases.

● These vaccines include tuberculosis (TB), diphtheria, pertussis (whooping cough), tetanus, measles

(measles) and polio (poliomitis) etc.

● It is mandatory for pregnant women to be given tetanus vaccine. If a woman is not vaccinated with

tetanus (2 vaccines for tetanus toxoid (TT)), the tetanus bacteria or virus can enter her body and

endanger her life.

 Vaccination in Adults
Following are the major vaccines given to adults:

• Hepatitis B - cirrhosis can become the leading cause of liver cancer.

• Hepatitis B is 50 to 100% more contagious than HIV, and once infected, there is no specific effective

treatment available for the disease.

• Typhoid and pneumonia vaccination

• chicken pox vaccination

• cervical cancer vaccination

• Yellow Fever Vaccination : It is necessary for everyone who is traveling to countries in the continent of Africa
where Yellow Fever (a serious disease spread by mosquitoes and caused by virus) is required.

• Hepatitis A vaccination

• H1N1 Vaccination
 Covid-19 Vaccination
● India's COVID-19 vaccination campaign is a historic campaign. The COVID-19 vaccine is effective
in preventing COVID-19 infection, especially its severe symptoms and death.
● Vaccination for COVID-19 is voluntary. Nevertheless, it is advisable to take the full dose of the
COVID 19 vaccine.
● Recently India has achieved the target of 75 percent of the adult population of Covid
vaccination.
● India has recently crossed the figure of applying 190 crore Covid vaccine doses.
The major vaccines commonly used in India are:
• Covishield (Estrogenca vaccine manufactured by Serum Institute of India)
• Covaxin (Manufactured by Bharat Biotech Ltd.)
• Apart from this, Russia's Sputnik V and Moderna vaccines are also being used in India.
 Maternal Child Health
● According to the World Vision report - "The Killer gap: A global index of
Healthcare inequality for children", India has been ranked 135th out of 176
countries.
● This index has 4 parameters:
 Survival
 Health expenses
 Fertility rate in adolescence
 Access to health facilities
 Maternal Child Health
● According to NFHS-4, about 29% of girls in India
become victims of child marriage, which is a major
factor responsible for high maternal mortality
rate and infant mortality rate.
● Every Child Alive - According to UNICEF report,
6.4 lakh newborns die in India.
● There has been a rapid decline in the child
mortality rate in India and for the first time its
figure is less than 1 million, although the girl child
mortality rate is 11% higher than the child mortality
rate.
 Parameters of NNMR, CMR and IMR
● Neonatal Mortality Rate (NNMR) refers to the number of deaths of babies
per 1,000 live births during the first 28-day period.
● Infant Mortality Rate (IMR) refers to the number of deaths of children under
one year of age per 1000 live births.
● Child Mortality Rate (CMR) refers to the number of deaths per 1000 live
births (age group 1-5).
● According to NFHS-5, the average infant mortality rate in the country is 32
per 1,000 live births, of which the average infant mortality rate is 36 in rural
areas and 23 in urban areas.
 The India Newborn Action Plan-INAP
● UNICEF has launched The India
Newborn Action Plan (INAP)
under the Every Newborn Action
Plan (ENAP), a strategy designed
to prevent neonatal deaths and
reduce stillbirths by 2030 in the
country.
● Under this, the target of single
digit NMR and single digit SBR
will be achieved by 2030.
 RMNCH+A
● The RMNCH+A (Reproductive, Maternal, Newborn, Child and Adolescent Health
plus A - RMNCH+A) framework covers six key dimensions in the context of the
National Health Mission:
 pre-pregnancy and antenatal care
 Pre and post pregnancy care
 Care during labor and childbirth
 care of small and sick newborn baby,
 Maintenance provided during childbirth
 Adequate care for newborn survival
 Based on the above dimensions, the target is to reduce the infant mortality rate to 30
children per thousand by 2020.
Maternal Child Health: Some Important Facts
UNDP-SDG
2030 MMR target: 70 per lakh
2030 NNMR target: to do at least 12
2030 CMR target: to do at least 25
According to WHO, India has a high maternal mortality rate and infant
mortality rate due to the following reasons:
 Poverty
 Pregnancy during adolescence
 Shortening of the gap between two children
 Lack of proper medical facilities
 Drug abuse: multidrug resistance
● It is a condition where disease-causing microbes such as bacteria, viruses,
etc., become resistant to drugs.

● In such a situation, medicines and antibiotics are no longer able to kill them.

● A Lancet report states that multidrug resistance or antimicrobial resistance

has now overtaken HIV and malaria in the world's deaths.

● Resistant diseases kill at least 700,000 people globally each year, including
about 230,000 who die from multidrug-resistant tuberculosis. It is also one
of the fastest emerging challenges in India.
 Drug abuse: multidrug resistance
Causes of multidrug resistance:
• Widespread misuse of bio-resistant drugs
• Not completing the entire duration of the
drug.
• Unethical practice of drugs by physicians
• Mutate bacteria
• Medicines sometimes produced by recycling
• Easy availability of medicines from
pharmacies without doctor's advice
 Drug abuse: multidrug resistance
● This problem not only reduces immunity but also affects fertility.
● The Government of India is trying to control it through the Drugs and Cosmetics
Act.
● The following changes are targeted for control:
 Packing of such medicines will be done differently by putting a red bandage.
 The chemists will also have to keep a copy of the patient's medical consultation.
 3 years record of sale of medicines will have to be maintained.
 In this, 46 drugs of third and fourth generation will be included.
 Drug abuse: multidrug resistance
➢ Such pharmaceutical companies will be controlled and monitored, which
are doing research and development on such drugs.
➢ Constitution of State Level Infection and Control Committee through a
National Task Force.
➢ Establishment of antimicrobial resistance survival network.
➢ Establishment of high level Microbiology Testing Centre.
➢ To inform people through medical journals and initiate new research.
 AYUSH
● AYUSH includes traditional and non-traditional systems of health care and
treatment. In this, medical disciplines like Ayurveda, Yoga, Naturopathy,
Unani, Siddha and Homeopathy have been included.
● AYUSH systems of medicine are also used for the protection or prevention of
various diseases, such as increasing immunity, reducing stress, weight, blood
pressure, sugar level and increased cholesterol etc. can be reduced.
● Yoga has also proved to be very helpful in preventing and controlling type 2
diabetes and its associated complications.
 AYUSH
● AYUSH methods have been used extensively by the public to increase
immunity and avoid infection in the difficult circumstances of Covid-19.
● For example, the Ministry of AYUSH has suggested consumption of
Ayush Kwath for Ayurveda, Ayush Kudineer for Siddha and Ayush
Joshanda for Unani to increase immunity during the time of COVID-19.
● It is practiced in various forms around the world today and continues to
grow in popularity (International Yoga Day – 21 June).
Curative Measures
 Clinical Trial
Clinical trials or clinical trials are experiments conducted on human volunteers with the aim
of finding out whether a medical system or drug (treatment) is safe and effective for humans.
India is considered a preferred destination for clinical trials due to the following
reasons:
 Lack of education

 Poverty

 Relatively easy to violate the law

 Racial diversity

 Tropical country - Rapid growth of bacteria or viruses etc. - Simple to check the quality

and effectiveness of the drug or vaccine

 Clinical Trial
Regulatory mechanism for conducting clinical trials in India:

The Central Drugs Standard Control Organization (CDSCO) is the National Regulatory Authority (NRA) of
the Ministry of Health and Family Welfare. It is responsible for conducting clinical trials, framing
standards of drugs, quality control of imported drugs in the country and approval of licenses of various
drugs and vaccines etc. in India.

Major problems related to clinical trials:

 Regulatory failure

 Low cost of testing

 Collusion of pharmaceutical companies and doctors - unethical drug testing

 Allowing drugs or vaccines to be used on patients without a clinical trial

 Exploiting people's financial needs and ignorance by clinical research institutions

 Clinical Trial
● In view of the irregularities and problems, today there is an urgent need to develop a better
regulatory framework regarding clinical trials.
The recommendations of the Ranjit Roy Chowdhury Committee can prove to be very important in this
direction.
• Clinics should be identified before clinical trials. (by ethics committee)
• There should be only 3 patients in a doctor's trial.
• Compensation (decided on the basis of doctor and ethics/ethics committee report) should be ensured
for those affected by the test.
• Audio-visual evidence for the consent of the trial participant.
Due to these irregularities, the Supreme Court has recently said that India should be kept as the first,
not the second and third but not the fourth destination for clinical trials, as well as the efficacy and risk
of the drug or vaccine being trialed. It should be recognized only after thorough scrutiny.
 Organ Donation
● Such a process, in which healthy organs and tissues from a living or dead person
are transplanted into the body of another needy person, is called organ
donation.

● Organ donation made by one person can help about 50 needy people.

● Organs to be transplanted include both kidneys, liver, heart, lungs, intestines,

and pancreas. Whereas the cornea, skin, heart valve cartilage, bones and
vessels are transplanted in the form of tissues. Organs like eyes, digestive
glands, intestines, bone tissue, heart holes, nerves etc. can also be donated.
 Organ Donation
Types of Organ Donation:
There are two types of organ donation, first living organ donation
and second organ donation after death. In living organ donation, a
person can donate a kidney/ kidney and part of the pancreas to help
the needy. In organ donation after death, all those organs of the
deceased person can be donated, which work properly.
Who can donate organ?

● The minimum age for a living person to donate an organ is 18 years.

 Status of Organ Donation in India
India's share in organ donation globally is very low. In India, only 0.16 people donate organs
per million people. Whereas in Spain 36 people per million people, in America this number is
27 per million people.
Cause of lesser Organ Donation:
● Lack of education and awareness
● Religious reasons
● Lack of facilities in remote areas
● There is no provision of organ transplant equipment in hospitals
● Lack of social accountability
● In India, the families of people who have become 'brain dead' or 'mentally dead' avoid organ
donation.
 Challenges
● Big gap between demand and supply of organ donation: a huge imbalance
between organ donors and those awaiting transplants. For example, about 2.1
lakh Indians need kidney transplant every year, but only 3000 to 4000 kidney
transplants take place.
● Inadequate infrastructure: slow pace of organ transplantation due to lack of
adequate infrastructure for transplantation.
● There is no mechanism in place to identify and certify brain death in
hospitals.
● Organ trade and trafficking - trade in organs is a means of exploitation of
people in poverty
● High cost of transplant
Government efforts to encourage Organ Donation
● Organ Transplantation Act (THOA) 1994: The Human Organ Transplantation
Act was passed in 1994 by the Government of India to regulate the sale of organs
and encourage organ donation after brain death.

● In order to make the organ donation process simple and effective, it was
amended in the year 2011 by the Human Transplantation (Amendment) Act
2011.

● To promote organ donation, the Government of India has established the

National Organ and Tissue Transplant Organization (NOTTO) and its
regional organizations in all the states and union territories in the country.

● National Organ Donation Day is celebrated on 27 November.

 Organ Trafficking
According to the Organization for Health (WHO), approximately 1/5th of the total 70,000
kidney transplants that are performed each year are obtained illegally from the black market.
This has been made possible by the extensive network of organ trafficking, which has now
become a global trade and unfortunately India is no exception.
Major reasons for growing organ trafficking:
• Poverty
• High demand and low supply
• Technical availability
• Transplant tourism
• Collusion of medical institutions
• Coercive (kidnapping, especially young children) or misguiding victims by traffickers
 Offence ( THOA
Imprisonment Fine
Amendment act 2011)

Extraction of organ without authority 10 year Rs 20 Lakh

Fine for RMP-Extraction of organ without

For first offence- cancellation Second offence- Permanent
authority
of registration for three years cancellation of licence

commercial trading of organs, falsification of

5-10 Years Rs 20Lakh to 1 crore
documents

Any violation of THOA 5 years Rs 20 lakh

 Non-communicable diseases
● Diseases that are non-communicable, that is, not transmitted from person to person, are
called non-communicable diseases.
● Generally, the symptoms of these diseases appear gradually, due to which they require
long-term and continuous care and treatment.
● The World Health Organization (WHO) has included four main non-communicable
diseases in the plan created under the Global Action for the Prevention and Control of
Non-Communicable Diseases:
 Cardiovascular diseases - heart attack and stroke
 Diabetes
 Chronic respiratory diseases
 Cancer
 Risk Factors and Consequences
According to the World Health Organization, non-communicable diseases such as cardiovascular
disorders, cancer and diabetes account for about 61% of deaths in India.

Factor of Changing
Risk: Consequence:
 High Blood
• Unhealthy Food  Cardiological Disease
Pressure
• Lack of Physical Activities  High Blood  Diabetes
• Tobacco Intake Sugar  Cancer
• Consumption of Alcohol  High Blood Fat  Respiratory Disease
• Environmental Factor  Excessive (Asthma and Shortness of
Irreversible Risk Factors Weight Breath)
• Age  Dental Disease
• Sex
• Family History
 Communicable Disease
● Such diseases, which spread from one diseased person to another healthy person due to
contaminated food, water, contact or due to insecticides and animals etc., are called
communicable diseases. They are spread by various factors (pathogens - virus, bacteria,
protozoa, worm etc.). For example, Malaria, AIDS, Tuberculosis, Leprosy, Rabies, Dengue
etc.
● The Integrated Disease Surveillance Program (IDSP) is one of the major national health
programs under the National Health Mission, aimed at increasing the trend of
communicable diseases. To strengthen the decentralized monitoring system to monitor
● It responds by detecting outbreaks at an early stage through trained rapid response
teams, using information communication technology and strengthening public health
laboratories for the collection, compilation, analysis and dissemination of data.
 Tuberculosis / Tuberculosis Control
● Tuberculosis or Tuberculosis (TB) is caused by a bacterium called Mycobacterium
tuberculosis.
● This occurs through exhalation (air released during the breath) inhaled by the person
suffering from this disease. Only one patient can infect more than 10 people during the
whole year.
● The NHP 2017 has acknowledged the co-infection of HIV and TB and the increase in the
incidence of drug-resistant tuberculosis as major challenges. Anyone can become infected
with tuberculosis, but a person with HIV is at high risk of contracting tuberculosis.
● Similarly, in recent years, tuberculosis has become a major problem due to the emergence
of 'drug-resistant tuberculosis' (MDR), which does not respond to antibiotics given in
common tuberculosis.
 Tuberculosis / Tuberculosis Control
● MDR Tuberculosis can be prevented by regular and full-term use of medicines. These
types of tuberculosis drugs are very expensive, which are not effective due to
irregularities, which can stretch the treatment period for more than two years.
● The Government of India has set a target to make India TB free by 2025.
Control Suggestions (As per NHP):
• By increasing the participation of the private sector
● Improvement in workplace and living conditions
● By adopting preventive and promotional measures
● Free medicine delivery
● By reducing the number of patients who drop out in the middle
● By controlling infection of drug resistant (MDR) tuberculosis cases
 Leprosy Control
● Leprosy is caused by a germ. Leprosy can be spread by coming in contact
with infected leprosy patients who have not been treated for many days.
● It is caused by a bacterium called 'Mycobacterium leprae'
● Any stage of leprosy can be cured completely with the help of multidrug
therapy (Multi drug therapy MDT) and if it is taken regularly.
● Multi-drug therapy (MDT) is available free of cost in the leprosy units of all
hospitals, community health centers and public health centers in each
district. But it is mandatory to take MDT regularly for the time period
prescribed by the medical doctor.
 HIV / AIDS Disease Control
● Around 35 million people have died of HIV worldwide so far. The number of HIV AIDS patients in

India is about 0.26 percent (2.1 million) of the total population.

● HIV (Human Immunodeficiency Virus) is a type of retrovirus that, if not treated properly, can lead to

Acquired Immunodeficiency Syndrome or AIDS. AIDS is the most severe stage of HIV infection.

● Currently, there is no complete cure for HIV AIDS, but the treatment used to control this virus is

called Antiretroviral Therapy or ART.

● The HIV and AIDS (Prevention and Control) Act, 2017 seeks to prevent and control the spread of HIV

and AIDS in the country and to end discrimination against infected persons.
 Vector Borne Disease Control
● Common vector-borne diseases in humans include dengue
fever, Japanese encephalitis, malaria, Zika, etc.

● National Vector Borne Control Program is being conducted

for the prevention and control of malaria and other vector
borne diseases.

● The National Vector Borne Control Program was launched in

the year 2003-04 by merging the National Malaria Control
Programme, National Filariasis Control Program and Kala-
azar Control Programme.

● Japanese Encephalitis and Dengue have also been included

under this programme.
 Stem Cell Bank
● Stem cells are a group of special types of cells found in living
organisms and humans, which have the ability to develop into any
organ or cell in the body.
● These cells are capable of repairing or replacing any type of cell in
the human body.
● Stem Cell Banking is a commendable effort towards providing
health protection to the baby.
● These include leukemia, histiocytic and immune system, platelets,
RBCs, plasma cells, back and back pain, visual impairments due to
old age, cancer, Parkinson's, diabetes, spinal cord damage and
many types of genetic diseases and Tumors can be cured forever.
 Stem Cell Bank
● Parents are now opting to deposit the umbilical cord into a stem cell bank so
that these life-giving stem cells and tissues can be used for future diseases.
● Heart valves, lungs, arteries, cartilage, bladder and artificial sperm have also
been made from stem cells.
● It is speculated that healthy and active heart muscle from stem cells could be
transplanted directly into patients with severe heart disease, or that beta cells
of the insulin-producing pancreas could be transplanted into patients with
diabetes.
 Stem Cell Bank
● Stem cell therapy is not fully approved in India. It is a type of stem cell
therapy approved only for bone marrow transplantation for hematological
disorders and cancers. Stem cell therapy is not yet recognized as proven,
safe and effective for other disease conditions/diseases.
● Challenges in understanding stem cell treatment in India:
 Treatment level of research right now
➢ Very high cost
➢ No law to regulate and control
➢ Clinical Trial Disruptions
 AYUSH
● Recognizing the importance of ancient
medical systems, the Government of
India has implemented National
AYUSH Mission (NAM) through
States/UTs to promote their systematic
development.
 AYUSH

● The mission is expected to yield the following results:

 Better access to AYUSH health services through better availability of AYUSH services and

medicines and better health facilities by providing trained manpower

 Improving AYUSH education through a number of AYUSH educational institutions

equipped with better facilities

 Focus on reducing communicable/non-communicable diseases through targeted public

health programs using AYUSH healthcare systems

 Availability of Drugs and Health Interventions
Highest Pricing of Medicines:
• Identifying life-saving drugs, the Government of India has fixed the price of those
medicines under a new policy.
• This work has been made possible through the efforts of an NGO called All India Drug
Action Network and Public Interest Litigation.
• Under this, 348 medicines have been kept in the list of essential medicines. Due to this,
20 to 25% drop in the price of these medicines and in some cases up to 80% has been
registered.
• Along with popularizing these medicines through Jan Aushadhi dispensaries,
continuous work is also being done on their quality.
Pradhan Mantri Jan Aushadhi Kendra Scheme
● Under this scheme quality generic
medicines will be made available to
the citizens at affordable prices.
● Generic drugs are non-branded
drugs, which are equally safe and
at par with branded drugs in terms
of quality and efficacy.
Pradhan Mantri Jan Aushadhi Kendra Scheme

● Prices of Jan Aushadhi drugs are cheaper by at least 50% and in some cases
by 80% to 90% of the market price of branded drugs.

● This scheme has ensured the availability of menstrual health services (Jan
Aushadhi 'Suvidha' sanitary napkins) to all women at affordable rates across
India.

● All the districts of the country have been covered under the Pradhan Mantri
Bhartiya Jan Aushadhi Pariyojana.

● The government has set a target to increase the number of Pradhan Mantri
Bhartiya Janaushadhi Kendras to 10,000 by the year 2024.
Pradhan Mantri Jan Aushadhi Kendra Scheme

● The scheme is implemented by the 'Pharmaceuticals and Medical Devices

Bureau of India' (PMBI).
● Under this scheme, medicines are procured from World Health
Organization – Good Manufacturing Practices (WHO-GMP) certified
suppliers to ensure the quality of the products.
 Compulsory Licencing
● It is a government-issued authorization to an applicant to manufacture,
use, sell, or use a patented process, a patented product, without the
consent of the patenter.

● According to this agreement, a patent may be granted by the government

to a domestic company to produce a generic version of the drug only in
cases of "national emergency" or "extreme necessity" or "non-commercial
public use".
 Compulsory Licencing
● The drug so manufactured cannot be exported. Through this, essential medicines are made

available to the common man at cheap rates in India.

● For example, Nexavar drug, which is prescribed to kidney and liver cancer patients, costs

₹2.8 lakh per patient per month (manufactured by Beer AG Pharma), while the drug

manufactured by the Government of India (by Natco Pharma Company). But the

expenditure comes to only ₹ 8500 per patient per month.

● Recently, there was a demand by healthcare professionals to issue a mandatory license to

manufacture the generic version of Remdesivir, which is being used to treat COVID-19

patients.
 Parallel Import
● Parallel import involves importing drugs from

other countries that are available at cheaper

rates in other countries without the consent of

the patenter. Parallel imports are also often

referred to as gray market products.

● It is based on the concept of termination of

intellectual property rights.

● Example Glivec ₹15 in India ₹100 Parallel Import

in Botswana
 ECHO - Extension for Community Healthcare Outcomes

● Under this, a doctor sitting in a first aid center will be able to examine the
patients by proper consultation by establishing contact with the eminent
experts of the country through tele-conferencing at the weekly or fortnightly
level.
● In this, patients will avoid traveling and local level access to the best medical
consultation will be ensured.
● For example, a doctor from Maulana Azad Medical College, Delhi at the first
aid center sitting in the village of Ballia can consult for the
diagnosis/treatment of an AIDS patient.
 AMRIT (Affordable medicines and reliable Implant for
treatment)

● AMRUT program has been started for the needy and financially weak
people with the objective of reducing the expenditure related to medical
and treatment.
● Cancer and heart disease medicines and implant machines are available
in this store at affordable rates ranging from 80 to 90% of the market
price.
● Under this, 202 cancer-related drugs, 186 disease-related drugs and 148
types of implant machines have been produced.
Thank You